|
Cyclophosphamide 25 mg capsule
|
$10.04 |
$10.04 |
$48.00 |
$25.76
|
|
Cyclosporine 2 hour
|
$145.23 |
$145.23 |
$145.23 |
$121.68
|
|
Cyclosporine modified 25 mg capsule
|
$5.48 |
$5.48 |
$15.00 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$17.00 |
$17.00 |
$95.25 |
$42.33
|
|
Cyp2c19 gene com variants
|
$151.46 |
$151.46 |
$151.46 |
$553.00
|
|
Cystatin c
|
$24.80 |
$24.80 |
$24.80 |
$81.00
|
|
Cystic fibrosis cftr
|
$480.00 |
$480.00 |
$480.00 |
$1,041.95
|
|
Cystine urine quantitative
|
$25.89 |
$25.89 |
$25.89 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$382.40 |
$382.40 |
$382.40 |
$533.61
|
|
Cytogenetics 25-99
|
$82.70 |
$82.70 |
$82.70 |
$177.45
|
|
Cytogenomic neo microra alys
|
$614.00 |
$614.00 |
$614.00 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$141.10 |
$141.10 |
$141.10 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$101.94 |
$101.94 |
$101.94 |
$98.35
|
|
Cyto/molecular report
|
$45.14 |
$45.14 |
$45.14 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$48.00 |
$48.00 |
$48.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$49.60 |
$49.60 |
$49.60 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$18.75 |
$18.75 |
$18.75 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$77.20 |
$77.20 |
$737.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$66.40 |
$66.40 |
$100.30 |
$129.12
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$98.40 |
$98.40 |
$256.30 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$108.80 |
$108.80 |
$135.55 |
$205.00
|
|
Cytopath tbs c/v manual
|
$11.05 |
$11.05 |
$27.60 |
$57.94
|
|
Cytp urine 3-5 probes cmptr
|
$254.40 |
$254.40 |
$254.40 |
$690.00
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.25 |
$0.25 |
$0.25 |
$342.88
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$14.45 |
$14.45 |
$14.45 |
$5,546.48
|
|
Dch pulmonary stress test
|
$3,506.40 |
$3,506.40 |
$3,506.40 |
$973.00
|
|
Dch validity tests
|
$9.68 |
$9.68 |
$9.68 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$22.56 |
$22.56 |
$22.56 |
$44.00
|
|
Decalcification
|
$6.80 |
$6.80 |
$531.00 |
$75.38
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$11,998.00 |
$11,998.00 |
$11,998.00 |
$7,933.81
|
|
Dermagraft
|
$55.20 |
$55.20 |
$55.20 |
$383.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$39.50 |
$39.50 |
$39.50 |
$111.80
|
|
Desoxycorticosterone
|
$98.80 |
$98.80 |
$98.80 |
$109.28
|
|
Dexamethasone 4 mg tablet
|
$1.60 |
$1.60 |
$1.60 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$12.68 |
$12.68 |
$12.68 |
$26.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$8.65 |
$8.65 |
$19.18 |
$57.07
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$905.65 |
$905.65 |
$905.65 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$3.97 |
$3.97 |
$3.97 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$10.20 |
$10.20 |
$19.18 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$156.62 |
$156.62 |
$156.62 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$58.56 |
$58.56 |
$58.56 |
$78.40
|
|
Diagnostic Mammogram (both breasts)
|
$534.80 |
$534.80 |
$938.75 |
$421.26
|
|
Diagnostic Mammogram (one breast)
|
$454.00 |
$454.00 |
$454.00 |
$297.05
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$22.44 |
$22.44 |
$248.00 |
$72.34
|
|
Dicyclomine injection
|
$81.00 |
$81.00 |
$81.74 |
$211.68
|
|
Diffusing capacity
|
$3,874.20 |
$3,874.20 |
$3,874.20 |
$360.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.52 |
$19.52 |
$19.52 |
$66.86
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,006.66 |
$6,006.66 |
$11,027.00 |
$10,731.50
|
|
Digoxin total therapeutic drug level
|
$59.80 |
$59.80 |
$59.80 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$46.98 |
$46.98 |
$376.00 |
$321.30
|
|
Dimenhydrinate injection
|
$22.50 |
$22.50 |
$22.50 |
$24.68
|
|
Dimethyl sulfoxide 50% 50 ml
|
$3,789.00 |
$3,789.00 |
$3,789.00 |
$1,091.69
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.00 |
$4.00 |
$73.76 |
$25.12
|
|
Disability dlco
|
$416.45 |
$416.45 |
$416.45 |
$302.90
|
|
Disaccharidases
|
$34.50 |
$34.50 |
$52.90 |
$224.31
|
|
Discography cerv/thor spine
|
$3,662.80 |
$3,662.80 |
$4,475.85 |
$2,344.44
|
|
Dna antibody native/double stranded
|
$115.04 |
$115.04 |
$115.04 |
$102.60
|
|
Dna probe gc
|
$19.85 |
$19.85 |
$19.85 |
$88.67
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$5.84 |
$5.84 |
$5.84 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$771.27
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$3.99 |
$3.99 |
$3.99 |
$79.61
|
|
Doppler echo complete
|
$4,019.00 |
$4,019.00 |
$4,019.00 |
$608.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$361.60 |
$361.60 |
$361.60 |
$697.66
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$347.20 |
$347.20 |
$347.20 |
$495.00
|
|
Dornase alfa non-comp unit
|
$76.59 |
$76.59 |
$76.59 |
$495.28
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$9.65 |
$9.65 |
$50.00 |
$279.10
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.12 |
$0.12 |
$30.00 |
$100.10
|
|
Drainage of rectal abscess
|
$3,439.20 |
$3,439.20 |
$3,439.20 |
$2,299.90
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$643.80 |
$643.80 |
$643.80 |
$5,568.00
|
|
Droperidol 2.5 mg/ml injection solution
|
$11.64 |
$11.64 |
$31.00 |
$39.60
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$17.00 |
$17.00 |
$26.40 |
$357.80
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$38.00 |
$38.00 |
$38.00 |
$318.13
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$45.17 |
$45.17 |
$45.17 |
$12,735.45
|
|
Drug asy hydroxychloroquine
|
$35.04 |
$35.04 |
$35.04 |
$83.85
|
|
Drug of abuse screen urine
|
$10.08 |
$10.08 |
$10.08 |
$63.75
|
|
Drug screen quant tiagabine
|
$30.35 |
$30.35 |
$30.35 |
$91.65
|
|
Drug test def 1-7 classes
|
$59.20 |
$59.20 |
$59.20 |
$263.86
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$931.73 |
$931.73 |
$931.73 |
$280.11
|
|
Drvvt confirm - quest
|
$33.60 |
$33.60 |
$33.60 |
$101.66
|
|
Dup scan/hemodialysis access 93990
|
$644.00 |
$644.00 |
$644.00 |
$499.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$604.40 |
$604.40 |
$604.40 |
$890.55
|
|
Dxa bone density axl vrt fx
|
$401.20 |
$401.20 |
$3,029.00 |
$377.65
|
|
Dx bronchoscope/brush 31623
|
$1,852.80 |
$1,852.80 |
$1,852.80 |
$2,168.40
|
|
Dx bronchoscope/lavage 31624
|
$1,668.80 |
$1,668.80 |
$1,668.80 |
$2,672.16
|
|
Dx bronchoscope/wash 31622
|
$2,587.60 |
$2,587.60 |
$2,587.60 |
$2,466.80
|
|
Ecg < 30 days transmission & analysis
|
$508.30 |
$508.30 |
$508.30 |
$466.20
|
|
Ecg external < 48 hours recording
|
$1,193.45 |
$1,193.45 |
$1,193.45 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$942.40 |
$942.40 |
$1,193.45 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$2,372.80 |
$2,372.80 |
$5,246.15 |
$2,049.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$2,193.60 |
$2,193.60 |
$4,019.00 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$4,019.00 |
$4,019.00 |
$4,019.00 |
$353.46
|
|
Echo exam of fetal heart
|
$447.30 |
$447.30 |
$447.30 |
$323.40
|
|
Echo guide villus sampling
|
$447.30 |
$447.30 |
$447.30 |
$355.80
|
|
Echo stress
|
$7,830.80 |
$7,830.80 |
$7,830.80 |
$1,586.90
|
|
Echo tee probe placement image acquisition interpretation & report
|
$2,198.40 |
$2,198.40 |
$9,920.35 |
$1,851.45
|
|
Echo transesophageal intraop
|
$1,832.80 |
$1,832.80 |
$1,832.80 |
$1,571.70
|
|
Echo transthoracic
|
$1,337.60 |
$1,337.60 |
$7,472.30 |
$1,473.15
|
|
Echo transthoracic
|
$3,851.60 |
$3,851.60 |
$3,851.60 |
$944.14
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$2,090.80 |
$2,090.80 |
$4,019.00 |
$1,011.36
|
|
Edetate calcium disodium inj
|
$895.00 |
$895.00 |
$895.00 |
$6,086.32
|
