|
Culture fungi definitive id yeast
|
$130.96 |
$130.96 |
$130.96 |
$79.10
|
|
Culture fungi other (except blood)
|
$240.94 |
$240.94 |
$240.94 |
$105.60
|
|
Culture mycobacteria definitive id each isolate
|
$225.51 |
$225.51 |
$225.51 |
$84.80
|
|
Culture mycoplasma any source
|
$237.54 |
$237.54 |
$237.54 |
$90.37
|
|
Culture quantitative aerobic other source
|
$152.65 |
$152.65 |
$152.65 |
$87.02
|
|
Culture screening strep group a
|
$192.83 |
$192.83 |
$192.83 |
$79.20
|
|
Culture typing added method
|
$119.47 |
$119.47 |
$119.47 |
$34.45
|
|
Culture typing immunologic
|
$79.96 |
$79.96 |
$79.96 |
$42.12
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$3,365.75 |
$3,365.75 |
$3,365.75 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$541.61 |
$541.61 |
$541.61 |
$124.02
|
|
Culture urine each isolate
|
$124.87 |
$124.87 |
$124.87 |
$46.20
|
|
Cyanocobalamin unsat binding capacity
|
$71.05 |
$71.05 |
$71.05 |
$58.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$173.48 |
$173.48 |
$173.48 |
$28.08
|
|
Cyclic citrullinated peptide antibody
|
$95.32 |
$95.32 |
$95.32 |
$81.60
|
|
Cyclosporine 2 hour
|
$261.42 |
$261.42 |
$261.42 |
$120.20
|
|
Cyclosporine oral 100 mg
|
$89.59 |
$89.59 |
$89.59 |
$43.04
|
|
Cyp2c19 gene com variants
|
$4,497.14 |
$4,497.14 |
$4,497.14 |
$553.00
|
|
Cystatin c
|
$285.85 |
$285.85 |
$285.85 |
$81.00
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,241.87 |
$1,241.87 |
$1,241.87 |
$527.50
|
|
Cystoscopy (Bladder Scope)
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$1,610.20
|
|
Cytarabine 20 mg/ml injection solution
|
$95.38 |
$95.38 |
$95.38 |
$80.18
|
|
Cytomegalovirus (cmv) antibody igg
|
$222.11 |
$222.11 |
$222.11 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$260.09 |
$260.09 |
$260.09 |
$96.80
|
|
Cyto/molecular report
|
$192.76 |
$192.76 |
$192.76 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$612.08 |
$612.08 |
$612.08 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$312.71 |
$312.71 |
$312.71 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$143.48 |
$143.48 |
$143.48 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$143.48 |
$143.48 |
$143.48 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$251.51 |
$251.51 |
$251.51 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$498.15 |
$498.15 |
$498.15 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$194.74 |
$194.74 |
$194.74 |
$205.00
|
|
Cytopath smear other source
|
$209.49 |
$209.49 |
$209.49 |
$85.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$43,571.82 |
$43,571.82 |
$43,571.82 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$38,762.41 |
$38,762.41 |
$38,762.41 |
$5,546.48
|
|
Dch validity tests
|
$61.78 |
$61.78 |
$61.78 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$76.07 |
$76.07 |
$76.07 |
$44.00
|
|
Debridement (>20 cm) charge pt
|
$262.25 |
$262.25 |
$262.25 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$6,406.79 |
$6,406.79 |
$6,406.79 |
$2,510.89
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,109.09 |
$1,109.09 |
$1,109.09 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$5,524.04 |
$5,524.04 |
$5,524.04 |
$1,339.77
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,505.56 |
$2,505.56 |
$2,505.56 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,522.77 |
$1,522.77 |
$1,522.77 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,978.81 |
$1,978.81 |
$1,978.81 |
$1,176.57
|
|
Decalcification
|
$198.67 |
$198.67 |
$198.67 |
$74.73
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,659.36 |
$1,659.36 |
$1,659.36 |
$534.48
|
|
Deferoxamine 500 mg solution for injection
|
$2,250.25 |
$2,250.25 |
$2,250.25 |
$112.87
|
|
Delivery of placenta 59414
|
$9,457.44 |
$9,457.44 |
$9,457.44 |
$3,185.60
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$550.17 |
$550.17 |
$550.17 |
$193.05
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$61,303.13 |
$61,303.13 |
$61,303.13 |
$7,756.62
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$4,307.59 |
$4,307.59 |
$4,307.59 |
$112.85
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$837.72 |
$837.72 |
$837.72 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$100.42 |
$100.42 |
$100.42 |
$25.68
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$160.75 |
$160.75 |
$160.75 |
$57.38
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$160.75 |
$160.75 |
$160.75 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$43.88 |
$43.88 |
$43.88 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$160.75 |
$160.75 |
$160.75 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$110.38 |
$110.38 |
$110.38 |
$105.57
|
|
Diabetes (HbA1c) Test
|
$263.92 |
$263.92 |
$263.92 |
$78.03
|
|
Diagnostic digital breast tomosynthesis bil
|
$281.60 |
$281.60 |
$281.60 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$162.89 |
$162.89 |
$162.89 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$687.12 |
$687.12 |
$687.12 |
$421.26
|
|
Diagnostic Mammogram (one breast)
|
$559.51 |
$559.51 |
$559.51 |
$297.05
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,772.38 |
$3,772.38 |
$3,772.38 |
$7,548.00
|
|
Dialysis one evaluation
|
$1,396.77 |
$1,396.77 |
$1,396.77 |
$827.97
|
|
Diatrizoate meglumine 18 % urethral solution
|
$510.98 |
$510.98 |
$510.98 |
$102.20
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$227.83 |
$227.83 |
$227.83 |
$72.34
|
|
Dicyclomine injection
|
$900.80 |
$900.80 |
$900.80 |
$211.68
|
|
Diffusing capacity
|
$646.29 |
$646.29 |
$646.29 |
$360.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$97.29 |
$97.29 |
$97.29 |
$67.25
|
|
Digoxin total therapeutic drug level
|
$206.97 |
$206.97 |
$206.97 |
$102.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$71.32 |
$71.32 |
$71.32 |
$25.12
|
|
Disability dlco
|
$836.98 |
$836.98 |
$836.98 |
$302.40
|
|
Disaccharidases
|
$342.20 |
$342.20 |
$342.20 |
$224.31
|
|
Dna antibody native/double stranded
|
$72.06 |
$72.06 |
$72.06 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$520.41 |
$520.41 |
$520.41 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$851.10 |
$851.10 |
$851.10 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$203.84 |
$203.84 |
$203.84 |
$78.39
|
|
Doppler echo complete
|
$1,415.99 |
$1,415.99 |
$1,415.99 |
$616.87
|
|
Doppler intravascular pressure flow initial vessel
|
$3,267.35 |
$3,267.35 |
$3,267.35 |
$3,006.25
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,543.04 |
$2,543.04 |
$2,543.04 |
$697.23
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,016.84 |
$1,016.84 |
$1,016.84 |
$495.00
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$47,409.79 |
$47,409.79 |
$47,409.79 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$231.34 |
$231.34 |
$231.34 |
$269.37
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$8,841.02 |
$8,841.02 |
$8,841.02 |
$2,469.31
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$6,198.68 |
$6,198.68 |
$6,198.68 |
$820.50
|
|
Drainage external ear complex 69005
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$2,967.58
|
|
Drainage external ear simple 69000
|
$2,039.50 |
$2,039.50 |
$2,039.50 |
$809.25
|
|
Drainage of kidney lesion
|
$2,469.82 |
$2,469.82 |
$2,469.82 |
$1,619.40
|
|
Drainage of nose lesion int 30000
|
$2,553.81 |
$2,553.81 |
$2,553.81 |
$548.00
|
|
Drain blood from under nail 11740
|
$364.82 |
$364.82 |
$364.82 |
$190.33
|
|
Drain cath image guided visceral pq
|
$7,440.32 |
$7,440.32 |
$7,440.32 |
$3,032.97
|
|
Drain finger abscess;simple 26010
|
$2,130.07 |
$2,130.07 |
$2,130.07 |
$492.81
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$618.20 |
$618.20 |
$618.20 |
$365.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$1,276.11 |
$1,276.11 |
$1,276.11 |
$532.80
|
|
Drng of finger abscess comp 26011
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$1,972.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$117.61 |
$117.61 |
$117.61 |
$39.31
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,016.54 |
$1,016.54 |
$1,016.54 |
$10,375.97
|
|
Drug admin & hemodynmic meas
|
$373.54 |
$373.54 |
$373.54 |
$528.50
|
|
Drug assay voriconazole
|
$418.45 |
$418.45 |
$418.45 |
$96.75
|