|
Culture typing added method
|
$97.37 |
$97.37 |
$97.37 |
$34.45
|
|
Culture typing immunologic
|
$65.17 |
$65.17 |
$65.17 |
$42.12
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,149.56 |
$1,149.56 |
$1,149.56 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$441.45 |
$441.45 |
$441.45 |
$124.02
|
|
Culture urine each isolate
|
$57.00 |
$57.00 |
$101.78 |
$46.20
|
|
Cv line/pic reposition
|
$3,867.73 |
$3,867.73 |
$3,867.73 |
$1,801.20
|
|
Cyanocobalamin unsat binding capacity
|
$162.69 |
$162.69 |
$162.69 |
$58.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$110.34 |
$110.34 |
$182.00 |
$28.08
|
|
Cyclic citrullinated peptide antibody
|
$42.83 |
$42.83 |
$42.83 |
$81.60
|
|
Cyclosporine 2 hour
|
$62.27 |
$62.27 |
$62.27 |
$120.20
|
|
Cyclosporine oral 100 mg
|
$71.31 |
$71.31 |
$71.31 |
$43.04
|
|
Cyp2c19 gene com variants
|
$3,212.24 |
$3,212.24 |
$3,212.24 |
$553.00
|
|
Cystatin c
|
$78.62 |
$78.62 |
$78.62 |
$81.00
|
|
Cystine urine quantitative
|
$13.48 |
$13.48 |
$95.27 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,944.60 |
$1,944.60 |
$3,432.00 |
$527.50
|
|
Cystoscopy and treatment
|
$20,515.76 |
$20,515.76 |
$20,515.76 |
$3,070.20
|
|
Cystoscopy (Bladder Scope)
|
$7,541.63 |
$7,541.63 |
$7,541.63 |
$1,610.20
|
|
Cystourethroscop/calib/dilat stric 52281
|
$20,515.76 |
$20,515.76 |
$20,515.76 |
$2,849.55
|
|
Cytarabine 20 mg/ml injection solution
|
$86.50 |
$86.50 |
$264.00 |
$80.18
|
|
Cytogenetics 25-99
|
$421.00 |
$421.00 |
$421.00 |
$177.45
|
|
Cytogenomic neo microra alys
|
$3,480.00 |
$3,480.00 |
$3,480.00 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$158.66 |
$158.66 |
$158.66 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$44.00 |
$44.00 |
$185.78 |
$96.80
|
|
Cytomegalovirus dfa
|
$409.00 |
$409.00 |
$409.00 |
$51.20
|
|
Cyto/molecular report
|
$172.77 |
$172.77 |
$172.77 |
$144.75
|
|
Cytopath fl nongyn filter
|
$78.00 |
$78.00 |
$78.00 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$61.00 |
$61.00 |
$667.72 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$223.37 |
$223.37 |
$223.37 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$456.83 |
$456.83 |
$834.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$270.00 |
$270.00 |
$456.83 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$18.00 |
$18.00 |
$148.51 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$418.00 |
$418.00 |
$455.16 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$470.00 |
$470.00 |
$667.72 |
$205.00
|
|
Cytopath smear other source
|
$332.34 |
$332.34 |
$348.00 |
$85.80
|
|
Cytopath smear other source
|
$207.00 |
$207.00 |
$207.00 |
$135.01
|
|
Cytopath smear oth prep screen & interp
|
$332.34 |
$332.34 |
$348.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$175.52 |
$175.52 |
$175.52 |
$57.94
|
|
Cytp urine 3-5 probes cmptr
|
$680.68 |
$680.68 |
$680.68 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$175.00 |
$175.00 |
$175.00 |
$76.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$36,768.81 |
$36,768.81 |
$36,768.81 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$23,095.96 |
$23,095.96 |
$23,095.96 |
$5,546.48
|
|
Dch validity tests
|
$44.13 |
$44.13 |
$70.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$72.64 |
$72.64 |
$72.64 |
$44.00
|
|
Debridement (>20 cm) charge pt
|
$302.40 |
$302.40 |
$302.40 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$6,057.04 |
$6,057.04 |
$6,057.04 |
$2,510.89
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,473.87 |
$1,473.87 |
$1,473.87 |
$688.80
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$3,904.99 |
$3,904.99 |
$3,904.99 |
$810.50
|
|
Debride nail6 or more 11721
|
$291.41 |
$291.41 |
$291.41 |
$199.32
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,473.87 |
$1,473.87 |
$1,473.87 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$4,829.64 |
$4,829.64 |
$4,829.64 |
$1,176.57
|
|
Decalcification
|
$115.53 |
$115.53 |
$183.00 |
$74.73
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$613.01 |
$613.01 |
$613.01 |
$534.48
|
|
Deferoxamine 500 mg solution for injection
|
$1,452.23 |
$1,452.23 |
$1,452.23 |
$112.87
|
|
Delivery of placenta 59414
|
$9,318.90 |
$9,318.90 |
$9,318.90 |
$3,185.60
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$478.00 |
$478.00 |
$542.12 |
$193.05
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$36,522.66 |
$36,522.66 |
$36,522.66 |
$7,756.62
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,570.16 |
$1,570.16 |
$1,570.16 |
$460.50
|
|
Design mlc device for imrt
|
$1,562.91 |
$1,562.91 |
$1,562.91 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$566.00 |
$566.00 |
$2,572.46 |
$112.85
|
|
Desoxycorticosterone
|
$62.62 |
$62.62 |
$62.62 |
$109.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$2,671.28 |
$2,671.28 |
$2,671.28 |
$217.16
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$725.68 |
$725.68 |
$725.68 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$66.16 |
$66.16 |
$66.16 |
$25.68
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$6.02 |
$6.02 |
$386.35 |
$57.38
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$54.50 |
$54.50 |
$386.35 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$103.50 |
$103.50 |
$103.50 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$254.86 |
$254.86 |
$386.35 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$75.76 |
$75.76 |
$75.76 |
$105.57
|
|
Diabetes (HbA1c) Test
|
$184.23 |
$184.23 |
$184.23 |
$78.03
|
|
Diab manage trn ind/group
|
$92.37 |
$92.37 |
$171.00 |
$49.40
|
|
Diagnostic digital breast tomosynthesis bil
|
$330.44 |
$330.44 |
$330.44 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$191.13 |
$191.13 |
$191.13 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$2,219.47 |
$2,219.47 |
$2,219.47 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$651.43 |
$651.43 |
$2,672.00 |
$421.26
|
|
Diagnostic Mammogram (one breast)
|
$530.45 |
$530.45 |
$530.45 |
$297.05
|
|
Dialysis one evaluation
|
$1,440.60 |
$1,440.60 |
$1,440.60 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$510.98 |
$510.98 |
$510.98 |
$102.20
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$142.86 |
$142.86 |
$142.86 |
$72.34
|
|
Dicyclomine injection
|
$236.00 |
$236.00 |
$584.84 |
$211.68
|
|
Diffusing capacity
|
$782.00 |
$782.00 |
$954.75 |
$360.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$64.31 |
$64.31 |
$484.00 |
$67.25
|
|
Digoxin immune fab 40 mg intravenous solution
|
$20,477.00 |
$20,477.00 |
$20,477.00 |
$10,731.50
|
|
Digoxin total therapeutic drug level
|
$182.64 |
$182.64 |
$643.00 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$5,163.00 |
$5,163.00 |
$5,163.00 |
$315.57
|
|
Dilate urethra stricture
|
$646.14 |
$646.14 |
$646.14 |
$514.79
|
|
Dilate urethra stricture
|
$359.47 |
$359.47 |
$359.47 |
$185.58
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$54.00 |
$54.00 |
$54.00 |
$2.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$48.91 |
$48.91 |
$205.00 |
$25.12
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$83.00 |
$83.00 |
$83.00 |
$110.48
|
|
Disaccharidases
|
$61.61 |
$61.61 |
$251.87 |
$224.31
|
|
Dna antibody native/double stranded
|
$45.44 |
$45.44 |
$70.00 |
$102.60
|
|
Dna gardnerella
|
$99.00 |
$99.00 |
$99.00 |
$66.05
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,278.51 |
$1,278.51 |
$1,278.51 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$665.64 |
$665.64 |
$665.64 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$495.24 |
$495.24 |
$495.24 |
$78.39
|
|
Doppler echo complete
|
$898.54 |
$898.54 |
$4,193.00 |
$616.87
|
|
Doppler intravascular pressure flow initial vessel
|
$3,106.20 |
$3,106.20 |
$3,106.20 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,142.51 |
$2,142.51 |
$2,142.51 |
$697.23
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$2,238.37 |
$2,238.37 |
$2,238.37 |
$495.00
|
|
Dornase alfa non-comp unit
|
$716.00 |
$716.00 |
$716.00 |
$496.30
|