|
Cystorrhaphy wound comp 51865
|
$4,108.00 |
$4,108.00 |
$4,108.00 |
$1,756.80
|
|
Cystorrhaphy wound simple 51860
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$6,297.20
|
|
Cysto rx balo cath urtl strx
|
$886.60 |
$886.60 |
$886.60 |
$6,853.60
|
|
Cystoscopy and biopsy
|
$785.20 |
$785.20 |
$785.20 |
$4,081.37
|
|
Cystoscopy and treatment
|
$910.00 |
$910.00 |
$910.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$12,890.15 |
$12,890.15 |
$12,890.15 |
$4,638.40
|
|
Cystoscopy and treatment
|
$12,890.15 |
$12,890.15 |
$12,890.15 |
$5,304.00
|
|
Cystoscopy and treatment
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$5,995.60
|
|
Cystoscopy and treatment
|
$2,145.00 |
$2,145.00 |
$2,145.00 |
$6,593.60
|
|
Cystoscopy and treatment
|
$1,016.60 |
$1,016.60 |
$1,016.60 |
$3,320.50
|
|
Cystoscopy and treatment
|
$764.40 |
$764.40 |
$764.40 |
$2,424.12
|
|
Cystoscopy and treatment
|
$1,297.40 |
$1,297.40 |
$1,297.40 |
$4,045.60
|
|
Cystoscopy and treatment
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$4,055.01
|
|
Cystoscopy and treatment
|
$969.80 |
$969.80 |
$969.80 |
$2,424.12
|
|
Cystoscopy and treatment
|
$936.00 |
$936.00 |
$936.00 |
$958.81
|
|
Cystoscopy and treatment
|
$1,190.80 |
$1,190.80 |
$1,190.80 |
$2,874.36
|
|
Cystoscopy and treatment
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,430.00 |
$1,430.00 |
$1,430.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$6,015.75
|
|
Cystoscopy and treatment
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$2,867.70
|
|
Cystoscopy and treatment
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$3,203.50
|
|
Cystoscopy and treatment
|
$1,219.40 |
$1,219.40 |
$1,219.40 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,307.80 |
$1,307.80 |
$1,307.80 |
$3,817.53
|
|
Cystoscopy (Bladder Scope)
|
$2,494.70 |
$2,494.70 |
$2,494.70 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$2,874.36
|
|
Cystoscopy implant stent
|
$1,661.40 |
$1,661.40 |
$1,661.40 |
$4,081.37
|
|
Cystoscopy inject material
|
$1,346.80 |
$1,346.80 |
$1,346.80 |
$5,986.78
|
|
Cystoscopy removal of clots
|
$12,890.15 |
$12,890.15 |
$12,890.15 |
$4,081.37
|
|
Cystoscopy & revise urethra
|
$873.60 |
$873.60 |
$873.60 |
$2,874.36
|
|
Cystoscopy & revise urethra
|
$1,219.40 |
$1,219.40 |
$1,219.40 |
$3,032.64
|
|
Cystoscopy stone removal
|
$1,599.00 |
$1,599.00 |
$1,599.00 |
$5,741.00
|
|
Cystoscopy & ureter catheter
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$4,129.45
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$1,999.40 |
$1,999.40 |
$1,999.40 |
$4,081.37
|
|
Cystotomy excise/incise/repair 51535
|
$3,614.00 |
$3,614.00 |
$3,614.00 |
$4,081.37
|
|
Cystouretero & or pyeloscope
|
$1,644.50 |
$1,644.50 |
$1,644.50 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$1,833.00 |
$1,833.00 |
$1,833.00 |
$5,110.00
|
|
Cystouretero w/biopsy
|
$2,080.00 |
$2,080.00 |
$2,080.00 |
$6,015.75
|
|
Cystouretero w/excise tumor
|
$2,340.00 |
$2,340.00 |
$2,340.00 |
$5,584.80
|
|
Cysto/uretero w/lithotripsy
|
$19,000.15 |
$19,000.15 |
$19,000.15 |
$9,430.00
|
|
Cystouretero w/lithotripsy
|
$1,950.00 |
$1,950.00 |
$1,950.00 |
$7,372.68
|
|
Cystouretero w/renal strict
|
$2,230.80 |
$2,230.80 |
$2,230.80 |
$5,741.00
|
|
Cystouretero w/stone remove
|
$1,755.00 |
$1,755.00 |
$1,755.00 |
$5,741.00
|
|
Cysto/uretero w/up stricture
|
$1,963.00 |
$1,963.00 |
$1,963.00 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$3,245.90
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$7,656.35 |
$7,656.35 |
$7,656.35 |
$4,057.50
|
|
Cystourethro w/addl implant 52442
|
$288.60 |
$288.60 |
$288.60 |
$2,161.60
|
|
Cystourethro w/implant
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$2,777.60
|
|
Cysto w/renal stricture tx
|
$1,703.00 |
$1,703.00 |
$1,703.00 |
$4,045.60
|
|
Cysto w/up stricture tx
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$4,081.37
|
|
Cysto w/ureter stricture tx
|
$12,890.15 |
$12,890.15 |
$12,890.15 |
$4,081.37
|
|
Cytarabine 20 mg/ml injection solution
|
$22.10 |
$22.10 |
$22.10 |
$90.00
|
|
Cytogenetics 25-99
|
$110.50 |
$110.50 |
$110.50 |
$189.80
|
|
Cytogenomic neo microra alys
|
$2,156.05 |
$2,156.05 |
$2,156.05 |
$2,198.00
|
|
Cytogenom microarray copy nmbr var
|
$1,307.80 |
$1,307.80 |
$1,307.80 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$86.45 |
$86.45 |
$86.45 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$29.25 |
$29.25 |
$29.25 |
$100.00
|
|
Cytomegalovirus imm IV /vial
|
$3,248.05 |
$3,248.05 |
$3,248.05 |
$3,072.34
|
|
Cyto/molecular report
|
$221.00 |
$221.00 |
$221.00 |
$144.75
|
|
Cytopath c/v index add-on
|
$28.60 |
$28.60 |
$28.60 |
$34.20
|
|
Cytopath c/v manual
|
$70.85 |
$70.85 |
$70.85 |
$36.80
|
|
Cytopath fl nongyn filter
|
$114.40 |
$114.40 |
$114.40 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$388.05 |
$388.05 |
$388.05 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$140.40 |
$140.40 |
$140.40 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$126.10 |
$126.10 |
$126.10 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$299.65 |
$299.65 |
$299.65 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$156.65 |
$156.65 |
$156.65 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$117.65 |
$117.65 |
$117.65 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$193.05 |
$193.05 |
$193.05 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$388.70 |
$388.70 |
$388.70 |
$213.85
|
|
Cytopath smear other source
|
$140.40 |
$140.40 |
$140.40 |
$92.50
|
|
Cytopath smear other source
|
$212.55 |
$212.55 |
$212.55 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$165.75 |
$165.75 |
$165.75 |
$96.20
|
|
Cytopath tbs c/v manual
|
$18.20 |
$18.20 |
$18.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$135.85 |
$135.85 |
$135.85 |
$193.80
|
|
Cytp urine 3-5 probes cmptr
|
$447.20 |
$447.20 |
$447.20 |
$664.80
|
|
Dacarbazine 100 mg intravenous solution
|
$38.66 |
$38.66 |
$38.66 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,725.75 |
$1,725.75 |
$1,725.75 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$4,162.86 |
$4,162.86 |
$4,162.86 |
$3,493.11
|
|
Dalteparin sodium
|
$1,847.31 |
$1,847.31 |
$1,847.31 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$11.05 |
$11.05 |
$11.05 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$1,649.21 |
$1,649.21 |
$1,649.21 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$9,055.80 |
$9,055.80 |
$9,055.80 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$5.85 |
$5.85 |
$5.85 |
$7.20
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$34,257.60 |
$34,257.60 |
$34,257.60 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$204.75 |
$204.75 |
$204.75 |
$259.58
|
|
Dbrdmt prmlg les w/pdt
|
$288.60 |
$288.60 |
$288.60 |
$468.00
|
|
D&c after delivery 59160
|
$717.60 |
$717.60 |
$717.60 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$11,883.95 |
$11,883.95 |
$11,883.95 |
$3,774.81
|
|
Dch pulmonary stress test
|
$1,532.70 |
$1,532.70 |
$1,532.70 |
$963.30
|
|
Dch validity tests
|
$25.35 |
$25.35 |
$25.35 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$2,347.80 |
$2,347.80 |
$2,347.80 |
$5,121.00
|
|
Dcmprn orbit only transcrnl
|
$6,578.00 |
$6,578.00 |
$6,578.00 |
$5,855.00
|
|
Dcmprn plantar digital nerve
|
$1,110.20 |
$1,110.20 |
$1,110.20 |
$2,685.07
|
|
D&c of cervical stump
|
$447.20 |
$447.20 |
$447.20 |
$3,762.53
|
|
Deamidated gliadin antibody iga
|
$78.00 |
$78.00 |
$78.00 |
$43.35
|
|
Debr g/per/abd wall 11006
|
$3,406.00 |
$3,406.00 |
$3,406.00 |
$1,562.83
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,491.75 |
$1,491.75 |
$1,491.75 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$606.45 |
$606.45 |
$606.45 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$3,949.40 |
$3,949.40 |
$3,949.40 |
$2,320.80
|
