|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$651.56 |
$651.56 |
$651.56 |
$1,085.05
|
|
CT guid parench tis ablat
|
$9,742.97 |
$9,742.97 |
$9,742.97 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$124.98 |
$124.98 |
$124.98 |
$192.00
|
|
CT lower extremity w/contrast (both sides)
|
$2,310.39 |
$2,310.39 |
$2,310.39 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$2,737.43 |
$2,737.43 |
$2,737.43 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$3,915.03 |
$3,915.03 |
$3,915.03 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$2,941.22 |
$2,941.22 |
$2,941.22 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,570.10 |
$1,570.10 |
$1,570.10 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$3,253.04 |
$3,253.04 |
$3,253.04 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,836.34 |
$2,836.34 |
$2,836.34 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$4,169.88 |
$4,169.88 |
$4,169.88 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,734.90 |
$1,734.90 |
$1,734.90 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$1,388.71 |
$1,388.71 |
$1,388.71 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$7,627.63 |
$7,627.63 |
$7,627.63 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$7,152.05 |
$7,152.05 |
$7,152.05 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,041.18 |
$4,041.18 |
$4,041.18 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,281.81 |
$1,281.81 |
$1,281.81 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$999.42 |
$999.42 |
$999.42 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,381.72 |
$1,381.72 |
$1,381.72 |
$400.20
|
|
CT upper extremity w/contrast (both sides)
|
$2,581.74 |
$2,581.74 |
$2,581.74 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,758.02 |
$1,758.02 |
$1,758.02 |
$1,468.83
|
|
Culture aerobic additional method definitive id each
|
$225.49 |
$225.49 |
$225.49 |
$63.75
|
|
Culture afb any source
|
$210.84 |
$210.84 |
$210.84 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$320.02 |
$320.02 |
$320.02 |
$77.31
|
|
Culture anaerobic except blood
|
$148.32 |
$148.32 |
$148.32 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$57.45 |
$57.45 |
$57.45 |
$52.80
|
|
Culture body fluid
|
$120.44 |
$120.44 |
$120.44 |
$130.50
|
|
Culture fungi definitive id mold
|
$473.45 |
$473.45 |
$473.45 |
$70.00
|
|
Culture fungi definitive id yeast
|
$225.23 |
$225.23 |
$225.23 |
$80.60
|
|
Culture fungi other (except blood)
|
$325.79 |
$325.79 |
$325.79 |
$105.60
|
|
Culture screening strep group a
|
$121.05 |
$121.05 |
$121.05 |
$81.60
|
|
Culture typing added method
|
$96.76 |
$96.76 |
$96.76 |
$34.45
|
|
Culture typing immunologic
|
$85.56 |
$85.56 |
$85.56 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,817.22 |
$1,817.22 |
$1,817.22 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$371.02 |
$371.02 |
$371.02 |
$124.40
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$159.70 |
$159.70 |
$159.70 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$204.24 |
$204.24 |
$204.24 |
$80.05
|
|
Cyclosporine 2 hour
|
$392.44 |
$392.44 |
$392.44 |
$121.80
|
|
Cyclosporine oral 100 mg
|
$79.32 |
$79.32 |
$79.32 |
$39.04
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,737.61 |
$1,737.61 |
$1,737.61 |
$539.55
|
|
Cystourethroscop/calib/dilat stric 52281
|
$10,661.78 |
$10,661.78 |
$10,661.78 |
$2,874.36
|
|
Cytarabine 20 mg/ml injection solution
|
$106.31 |
$106.31 |
$106.31 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$179.88 |
$179.88 |
$179.88 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$210.63 |
$210.63 |
$210.63 |
$96.80
|
|
Cyto/molecular report
|
$308.23 |
$308.23 |
$308.23 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$654.98 |
$654.98 |
$654.98 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$455.12 |
$455.12 |
$455.12 |
$90.75
|
|
Cytopathology concentration technique smears & interpretation
|
$391.65 |
$391.65 |
$391.65 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$569.64 |
$569.64 |
$569.64 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$233.74 |
$233.74 |
$233.74 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$303.37 |
$303.37 |
$303.37 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$210.97 |
$210.97 |
$210.97 |
$205.00
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$33,315.88 |
$33,315.88 |
$33,315.88 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$30,299.61 |
$30,299.61 |
$30,299.61 |
$5,546.48
|
|
Deamidated gliadin antibody iga
|
$121.29 |
$121.29 |
$121.29 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$952.66 |
$952.66 |
$952.66 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$3,697.98 |
$3,697.98 |
$3,697.98 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,431.59 |
$1,431.59 |
$1,431.59 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$4,316.96 |
$4,316.96 |
$4,316.96 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,373.19 |
$2,373.19 |
$2,373.19 |
$810.50
|
|
Debride nail6 or more 11721
|
$396.21 |
$396.21 |
$396.21 |
$195.20
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,849.00 |
$1,849.00 |
$1,849.00 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,377.28 |
$2,377.28 |
$2,377.28 |
$1,193.40
|
|
Decalcification
|
$213.60 |
$213.60 |
$213.60 |
$73.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$913.17 |
$913.17 |
$913.17 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$2,142.05 |
$2,142.05 |
$2,142.05 |
$110.82
|
|
Delivery of placenta 59414
|
$9,263.77 |
$9,263.77 |
$9,263.77 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$365.42 |
$365.42 |
$365.42 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$47,916.80 |
$47,916.80 |
$47,916.80 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,015.73 |
$1,015.73 |
$1,015.73 |
$460.50
|
|
Design mlc device for imrt
|
$2,458.27 |
$2,458.27 |
$2,458.27 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$3,370.69 |
$3,370.69 |
$3,370.69 |
$102.32
|
|
Destroy cervthor facet jnt 64633
|
$3,982.40 |
$3,982.40 |
$3,982.40 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$1,807.82 |
$1,807.82 |
$1,807.82 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,769.80 |
$2,769.80 |
$2,769.80 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$4,851.16 |
$4,851.16 |
$4,851.16 |
$3,375.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$950.19 |
$950.19 |
$950.19 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$93.54 |
$93.54 |
$93.54 |
$30.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$441.12 |
$441.12 |
$441.12 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$441.12 |
$441.12 |
$441.12 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$109.94 |
$109.94 |
$109.94 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$441.12 |
$441.12 |
$441.12 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$97.16 |
$97.16 |
$97.16 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$196.87 |
$196.87 |
$196.87 |
$78.03
|
|
Diagnostic digital breast tomosynthesis bil
|
$304.42 |
$304.42 |
$304.42 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$211.42 |
$211.42 |
$211.42 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$772.69 |
$772.69 |
$772.69 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$611.52 |
$611.52 |
$611.52 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$514.69 |
$514.69 |
$514.69 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$520.29 |
$520.29 |
$520.29 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$209.13 |
$209.13 |
$209.13 |
$72.34
|
|
Dicyclomine injection
|
$858.23 |
$858.23 |
$858.23 |
$211.81
|
|
Diffusing capacity
|
$847.72 |
$847.72 |
$847.72 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$90.68 |
$90.68 |
$90.68 |
$69.79
|
|
Digoxin total therapeutic drug level
|
$206.14 |
$206.14 |
$206.14 |
$102.00
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$66.97 |
$66.97 |
$66.97 |
$26.87
|
|
Disaccharidases
|
$325.91 |
$325.91 |
$325.91 |
$223.80
|
|
Dna antibody native/double stranded
|
$163.67 |
$163.67 |
$163.67 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$1,955.55 |
$1,955.55 |
$1,955.55 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$640.12 |
$640.12 |
$640.12 |
$712.02
|