|
Culture aerobic additional method definitive id each
|
$43.65 |
$43.65 |
$43.65 |
$62.65
|
|
Culture afb any source
|
$7.15 |
$7.15 |
$7.15 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$43.65 |
$43.65 |
$43.65 |
$75.29
|
|
Culture anaerobic except blood
|
$1,525.60 |
$1,525.60 |
$1,525.60 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$51.00 |
$51.00 |
$51.00 |
$52.50
|
|
Culture fungi definitive id mold
|
$19.10 |
$19.10 |
$19.10 |
$70.00
|
|
Culture fungi definitive id yeast
|
$20.70 |
$20.70 |
$20.70 |
$79.00
|
|
Culture fungi skin/hair/nail
|
$18.00 |
$18.00 |
$18.00 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$20.30 |
$20.30 |
$20.30 |
$88.14
|
|
Culture mycoplasma any source
|
$28.50 |
$28.50 |
$28.50 |
$90.37
|
|
Culture quantitative aerobic other source
|
$53.40 |
$53.40 |
$53.40 |
$85.80
|
|
Culture typing added method
|
$41.80 |
$41.80 |
$41.80 |
$34.45
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$189.50 |
$189.50 |
$189.50 |
$101.45
|
|
Culture urine each isolate
|
$15.00 |
$15.00 |
$15.00 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$117.00 |
$117.00 |
$117.00 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$12.90 |
$12.90 |
$12.90 |
$85.03
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,329.00 |
$1,329.00 |
$1,329.00 |
$779.37
|
|
Cyclosporine 2 hour
|
$18.15 |
$18.15 |
$18.15 |
$119.40
|
|
Cytomegalovirus (cmv) antibody igm
|
$12.95 |
$12.95 |
$12.95 |
$101.94
|
|
Cytopath fl nongyn filter
|
$165.75 |
$165.75 |
$165.75 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$71.10 |
$71.10 |
$71.10 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$18.45 |
$18.45 |
$18.45 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$88.65 |
$88.65 |
$88.65 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$26.95 |
$26.95 |
$26.95 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$19.05 |
$19.05 |
$19.05 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$19.05 |
$19.05 |
$19.05 |
$185.00
|
|
Cytopath smear other source
|
$257.05 |
$257.05 |
$257.05 |
$135.27
|
|
Dacarbazine 100 mg intravenous solution
|
$114.00 |
$114.00 |
$114.00 |
$61.64
|
|
Dactinomycin 0.5 mg intravenous solution
|
$4,688.00 |
$4,688.00 |
$4,688.00 |
$2,281.50
|
|
Dalteparin sodium
|
$274.00 |
$274.00 |
$274.00 |
$124.09
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2,083.00 |
$2,083.00 |
$2,083.00 |
$544.35
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$96.00 |
$96.00 |
$96.00 |
$194.08
|
|
Decalcification
|
$206.40 |
$206.40 |
$206.40 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$7,181.00 |
$7,181.00 |
$7,181.00 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$321.00 |
$321.00 |
$321.00 |
$112.87
|
|
Depo-estradiol cypionate inj
|
$61.00 |
$61.00 |
$61.00 |
$87.27
|
|
Design mlc device for imrt
|
$2,825.45 |
$2,825.45 |
$2,825.45 |
$1,641.90
|
|
Desmopressin 4 mcg/ml injection solution
|
$496.00 |
$496.00 |
$496.00 |
$172.46
|
|
Desoxycorticosterone
|
$62.20 |
$62.20 |
$62.20 |
$109.28
|
|
Detect agent nos dna dir
|
$20.50 |
$20.50 |
$20.50 |
$67.15
|
|
Dextrose 5 % IV bolus
|
$844.45 |
$844.45 |
$844.45 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$5.85 |
$5.85 |
$5.85 |
$107.50
|
|
Diagnostic radio unlisted proc
|
$183.70 |
$183.70 |
$183.70 |
$236.93
|
|
Dicyclomine injection
|
$712.00 |
$712.00 |
$712.00 |
$210.00
|
|
Diffusing capacity
|
$2,816.35 |
$2,816.35 |
$2,816.35 |
$357.50
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,691.00 |
$11,691.00 |
$11,691.00 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$368.45 |
$368.45 |
$368.45 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$429.00 |
$429.00 |
$429.00 |
$308.90
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,272.00 |
$2,272.00 |
$2,272.00 |
$1,001.55
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$10.75 |
$10.75 |
$10.75 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$117.00 |
$117.00 |
$117.00 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$130.00 |
$130.00 |
$130.00 |
$100.80
|
|
Disability dlco
|
$2,263.70 |
$2,263.70 |
$2,263.70 |
$302.40
|
|
Discography cerv/thor spine
|
$7,005.00 |
$7,005.00 |
$7,005.00 |
$2,360.70
|
|
Dna probe chlamydia
|
$10.80 |
$10.80 |
$10.80 |
$82.20
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$115.00 |
$115.00 |
$115.00 |
$712.02
|
|
Doppler echo complete
|
$3,570.90 |
$3,570.90 |
$3,570.90 |
$644.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,066.50 |
$1,066.50 |
$1,066.50 |
$681.20
|
|
Dornase alfa non-comp unit
|
$631.55 |
$631.55 |
$631.55 |
$500.29
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$9,583.00 |
$9,583.00 |
$9,583.00 |
$2,469.31
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$814.10 |
$814.10 |
$814.10 |
$89.34
|
|
Dronabinol 2.5mg oral
|
$68.00 |
$68.00 |
$68.00 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$235.00 |
$235.00 |
$235.00 |
$33.99
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$36.00 |
$36.00 |
$36.00 |
$189.68
|
|
Drug assay caffeine
|
$14.40 |
$14.40 |
$14.40 |
$86.45
|
|
Drug test def 1-7 classes
|
$1.50 |
$1.50 |
$1.50 |
$263.86
|
|
Drug test prsmv instrmnt
|
$812.90 |
$812.90 |
$812.90 |
$78.65
|
|
Drvvt confirm - quest
|
$31.80 |
$31.80 |
$31.80 |
$102.30
|
|
Dup scan/hemodialysis access 93990
|
$553.40 |
$553.40 |
$553.40 |
$499.38
|
|
Durvalumab 50 mg/ml intravenous solution
|
$15,858.50 |
$15,858.50 |
$15,858.50 |
$6,529.68
|
|
Ecg 12 lead tracing only
|
$1,944.55 |
$1,944.55 |
$1,944.55 |
$243.61
|
|
Ecg external < 48 hours recording
|
$5,011.10 |
$5,011.10 |
$5,011.10 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$2,512.10 |
$2,512.10 |
$2,512.10 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$4,349.45 |
$4,349.45 |
$4,349.45 |
$2,049.45
|
|
Echocardiograpy doppler follow up/limited study
|
$1,342.35 |
$1,342.35 |
$1,342.35 |
$354.90
|
|
Echo exam uterus 76831-
|
$1,036.65 |
$1,036.65 |
$1,036.65 |
$547.23
|
|
Echo stress
|
$4,349.45 |
$4,349.45 |
$4,349.45 |
$1,607.45
|
|
Echo transesophageal
|
$11,188.00 |
$11,188.00 |
$11,188.00 |
$577.22
|
|
Echo transthoracic
|
$3,387.90 |
$3,387.90 |
$3,387.90 |
$1,475.25
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$4,349.45 |
$4,349.45 |
$4,349.45 |
$1,020.09
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$24,470.00 |
$24,470.00 |
$24,470.00 |
$17,641.10
|
|
Eeg 41-60 minutes 95812-26
|
$1,561.70 |
$1,561.70 |
$1,561.70 |
$934.05
|
|
Eeg during surgery
|
$2,852.35 |
$2,852.35 |
$2,852.35 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$2,224.80 |
$2,224.80 |
$2,224.80 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$1,587.60 |
$1,587.60 |
$1,587.60 |
$1,100.40
|
|
Eeg recording awake and asleep
|
$2,263.70 |
$2,263.70 |
$2,263.70 |
$1,030.27
|
|
E equine encephalitis igg
|
$65.95 |
$65.95 |
$65.95 |
$48.73
|
|
Egfr gene com variants
|
$1,752.75 |
$1,752.75 |
$1,752.75 |
$646.75
|
|
Ehrlicha chaffeensis amp prb
|
$189.50 |
$189.50 |
$189.50 |
$105.00
|
|
Electroconvulsive therapy 90870
|
$7,611.20 |
$7,611.20 |
$7,611.20 |
$1,130.00
|
|
Electrode stimulation brain
|
$1,325.90 |
$1,325.90 |
$1,325.90 |
$1,180.80
|
|
Electrolyte panel
|
$4.00 |
$4.00 |
$4.00 |
$86.33
|
|
Electrophysiologic study
|
$15,335.75 |
$15,335.75 |
$15,335.75 |
$6,758.40
|
|
Electrophysiology evaluation
|
$14,227.20 |
$14,227.20 |
$14,227.20 |
$8,979.45
|
|
Electrophysiology evaluation
|
$21,888.85 |
$21,888.85 |
$21,888.85 |
$11,542.01
|
|
Electrophysiology evaluation
|
$10,948.10 |
$10,948.10 |
$10,948.10 |
$8,393.40
|
|
Electrophysiology evaluation
|
$10,948.10 |
$10,948.10 |
$10,948.10 |
$6,516.00
|
|
Electrophysiology evaluation
|
$2,743.35 |
$2,743.35 |
$2,743.35 |
$2,845.10
|
|
Electrophysiology evaluation
|
$2,862.05 |
$2,862.05 |
$2,862.05 |
$2,630.40
|
|
Electrophys map 3d add-on
|
$1,585.60 |
$1,585.60 |
$1,585.60 |
$6,534.00
|
