|
Cytopath c/v index add-on
|
$193.00 |
$193.00 |
$193.00 |
$29.60
|
|
Cytopath fl nongyn filter
|
$1,688.00 |
$1,688.00 |
$1,688.00 |
$66.61
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$27.00 |
$27.00 |
$27.00 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$996.00 |
$996.00 |
$996.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$2,039.00 |
$2,039.00 |
$2,039.00 |
$203.08
|
|
Cytopath smear other source
|
$2,454.00 |
$2,454.00 |
$2,454.00 |
$85.80
|
|
Cytopath smear other source
|
$1,137.00 |
$1,137.00 |
$1,137.00 |
$135.27
|
|
Cytopath smear oth prep screen & interp
|
$1,270.00 |
$1,270.00 |
$1,270.00 |
$95.00
|
|
Cytopath tbs c/v manual
|
$2,454.00 |
$2,454.00 |
$2,454.00 |
$57.94
|
|
Dactinomycin 0.5 mg intravenous solution
|
$5,581.00 |
$5,581.00 |
$5,581.00 |
$2,281.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$798.00 |
$798.00 |
$798.00 |
$544.35
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$1,758.00 |
$1,758.00 |
$1,758.00 |
$194.08
|
|
Dch pulmonary stress test
|
$8,078.00 |
$8,078.00 |
$8,078.00 |
$964.41
|
|
Decitabine 50 mg intravenous solution
|
$6,442.00 |
$6,442.00 |
$6,442.00 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$116.00 |
$116.00 |
$116.00 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$4,831.00 |
$4,831.00 |
$4,831.00 |
$1,963.06
|
|
Depo-estradiol cypionate inj
|
$436.00 |
$436.00 |
$436.00 |
$87.27
|
|
Desmopressin 4 mcg/ml injection solution
|
$931.00 |
$931.00 |
$931.00 |
$172.46
|
|
Desoxycorticosterone
|
$426.00 |
$426.00 |
$426.00 |
$109.28
|
|
Detect agent nos dna dir
|
$55.00 |
$55.00 |
$55.00 |
$67.15
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$1,501.00 |
$1,501.00 |
$1,501.00 |
$222.30
|
|
Dextran 40 infusion
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$173.97
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$23.00 |
$23.00 |
$23.00 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$394.00 |
$394.00 |
$394.00 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$109.00 |
$109.00 |
$109.00 |
$107.50
|
|
Diagnostic Mammogram (both breasts)
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$403.32
|
|
Diagnostic radio unlisted proc
|
$2,534.00 |
$2,534.00 |
$2,534.00 |
$236.93
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$252.00 |
$252.00 |
$252.00 |
$67.89
|
|
Dicyclomine injection
|
$804.00 |
$804.00 |
$804.00 |
$210.00
|
|
Diffusing capacity
|
$606.00 |
$606.00 |
$606.00 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$54.00 |
$54.00 |
$54.00 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$35,747.00 |
$35,747.00 |
$35,747.00 |
$9,684.65
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,588.00 |
$1,588.00 |
$1,588.00 |
$308.90
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$3.00 |
$3.00 |
$3.00 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$100.00 |
$100.00 |
$100.00 |
$22.58
|
|
Disability dlco
|
$968.00 |
$968.00 |
$968.00 |
$302.40
|
|
Discography cerv/thor spine
|
$4,106.00 |
$4,106.00 |
$4,106.00 |
$2,360.70
|
|
Doppler echo complete
|
$4,440.00 |
$4,440.00 |
$4,440.00 |
$644.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$3,177.00 |
$3,177.00 |
$3,177.00 |
$681.20
|
|
Dornase alfa non-comp unit
|
$1,068.00 |
$1,068.00 |
$1,068.00 |
$500.29
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$12,117.00 |
$12,117.00 |
$12,117.00 |
$2,469.31
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$69.23 |
$69.23 |
$69.23 |
$89.34
|
|
Dronabinol 2.5mg oral
|
$54.00 |
$54.00 |
$54.00 |
$10.17
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$2,183.16 |
$2,183.16 |
$2,183.16 |
$327.39
|
|
Drug assay caffeine
|
$418.00 |
$418.00 |
$418.00 |
$86.45
|
|
Drug asy hydroxychloroquine
|
$389.00 |
$389.00 |
$389.00 |
$83.85
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
$750.20
|
|
Ecallantide injection
|
$51,466.00 |
$51,466.00 |
$51,466.00 |
$6,132.60
|
|
Ecg 12 lead tracing only
|
$662.00 |
$662.00 |
$662.00 |
$243.61
|
|
Ecg/1-3 leads/tracing only 93041
|
$1,531.00 |
$1,531.00 |
$1,531.00 |
$129.83
|
|
Ecg external < 48 hours recording
|
$6,025.00 |
$6,025.00 |
$6,025.00 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$423.00 |
$423.00 |
$423.00 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$14,441.00 |
$14,441.00 |
$14,441.00 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$3,454.00 |
$3,454.00 |
$3,454.00 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,483.00 |
$4,483.00 |
$4,483.00 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$2,726.00 |
$2,726.00 |
$2,726.00 |
$354.90
|
|
Echo exam uterus 76831-
|
$4,100.00 |
$4,100.00 |
$4,100.00 |
$547.23
|
|
Echo stress
|
$16,259.00 |
$16,259.00 |
$16,259.00 |
$1,607.45
|
|
Echo transesophageal intraop
|
$6,718.00 |
$6,718.00 |
$6,718.00 |
$1,571.70
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$6,556.00 |
$6,556.00 |
$6,556.00 |
$1,020.09
|
|
Edetate calcium disodium inj
|
$647.00 |
$647.00 |
$647.00 |
$6,086.32
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$5,783.00 |
$5,783.00 |
$5,783.00 |
$1,048.30
|
|
Eeg recording awake and asleep
|
$4,709.00 |
$4,709.00 |
$4,709.00 |
$1,030.27
|
|
Electrolyte panel
|
$1,865.00 |
$1,865.00 |
$1,865.00 |
$86.33
|
|
Embolization s&i
|
$7,799.00 |
$7,799.00 |
$7,799.00 |
$2,745.08
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$792.00 |
$792.00 |
$792.00 |
$436.64
|
|
Emg 3 ext w-w/o paraspinal area 95863
|
$792.00 |
$792.00 |
$792.00 |
$512.85
|
|
Emg needle test 1-extremity
|
$792.00 |
$792.00 |
$792.00 |
$340.80
|
|
Emg needle test 4-extremities
|
$792.00 |
$792.00 |
$792.00 |
$547.00
|
|
Encephalitis, california igg/igm
|
$764.00 |
$764.00 |
$764.00 |
$48.57
|
|
Encephalitis, western equine igg/igm
|
$764.00 |
$764.00 |
$764.00 |
$50.35
|
|
Epirubicin 200 mg/100 ml intravenous solution
|
$745.00 |
$745.00 |
$745.00 |
$195.23
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$147.00 |
$147.00 |
$147.00 |
$824.16
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$224.00 |
$224.00 |
$224.00 |
$135.20
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$1,153.00 |
$1,153.00 |
$1,153.00 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$714.00 |
$714.00 |
$714.00 |
$232.84
|
|
Established Patient Office Visit (level 2)
|
$431.00 |
$431.00 |
$431.00 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$937.00 |
$937.00 |
$937.00 |
$186.04
|
|
Established Patient Office Visit (level 4)
|
$1,059.00 |
$1,059.00 |
$1,059.00 |
$231.00
|
|
Established Patient Office Visit (level 5)
|
$1,227.00 |
$1,227.00 |
$1,227.00 |
$280.50
|
|
Estrogens total-sendout
|
$30.80 |
$30.80 |
$30.80 |
$89.25
|
|
Ethanolamine oleate 100 mg
|
$656.00 |
$656.00 |
$656.00 |
$933.59
|
|
Ethylene glycol -sendout
|
$97.00 |
$97.00 |
$97.00 |
$78.00
|
|
Evoked potential visual not glaucoma
|
$792.00 |
$792.00 |
$792.00 |
$844.00
|
|
External chromosome analysis 20-25 cells
|
$2,170.00 |
$2,170.00 |
$2,170.00 |
$389.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$564.00 |
$564.00 |
$564.00 |
$466.15
|
|
F-18 fdg pet diag
|
$1,763.00 |
$1,763.00 |
$1,763.00 |
$609.85
|
|
Factor ix
|
$896.00 |
$896.00 |
$896.00 |
$139.75
|
|
Factor viii
|
$15.00 |
$15.00 |
$15.00 |
$1.60
|
|
Famotidine in ns IV syringe 0.4 mg/ml (neo/ped) - cnr
|
$156.00 |
$156.00 |
$156.00 |
$22.20
|
|
Fat/lipids feces qualitative
|
$133.00 |
$133.00 |
$133.00 |
$37.40
|
|
Fatty acids nonesterified
|
$239.00 |
$239.00 |
$239.00 |
$55.25
|
|
Feeding tube reposition
|
$714.00 |
$714.00 |
$714.00 |
$438.70
|
|
Felbamate (felbatol(r)) - sendout
|
$440.00 |
$440.00 |
$440.00 |
$66.43
|
|
Fibrin degradation products
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$63.90
|
|
Fibrinolytic antiplasmin
|
$155.00 |
$155.00 |
$155.00 |
$56.00
|
|
Fibrinolytic plasminogen xcpt antgnc asa
|
$140.00 |
$140.00 |
$140.00 |
$59.89
|
|
Flecainide (tambocor)-sendout
|
$181.00 |
$181.00 |
$181.00 |
$66.43
|
|
Flow cytometry marker each additional
|
$170.00 |
$170.00 |
$170.00 |
$102.00
|
|
Fludarabine 50 mg intravenous solution
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$592.00
|
