|
Culture anaerobic additional method definitive id each
|
$192.60 |
$192.60 |
$192.60 |
$79.00
|
|
Culture anaerobic except blood
|
$244.20 |
$244.20 |
$244.20 |
$120.00
|
|
Culture bacteria anaerobic
|
$244.20 |
$244.20 |
$244.20 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$130.20 |
$130.20 |
$130.20 |
$51.45
|
|
Culture body fluid
|
$247.80 |
$247.80 |
$247.80 |
$126.75
|
|
Culture fungi definitive id mold
|
$146.40 |
$146.40 |
$146.40 |
$77.28
|
|
Culture fungi definitive id yeast
|
$118.20 |
$118.20 |
$118.20 |
$79.10
|
|
Culture fungi other (except blood)
|
$181.20 |
$181.20 |
$181.20 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$46.20 |
$46.20 |
$46.20 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$287.40 |
$287.40 |
$287.40 |
$89.70
|
|
Culture quantitative aerobic other source
|
$244.20 |
$244.20 |
$244.20 |
$90.35
|
|
Culture screening strep group a
|
$115.80 |
$115.80 |
$115.80 |
$81.00
|
|
Culture type pulse field gel
|
$435.60 |
$435.60 |
$435.60 |
$38.58
|
|
Culture typing immunologic
|
$96.00 |
$96.00 |
$96.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$631.80 |
$631.80 |
$631.80 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$579.00 |
$579.00 |
$579.00 |
$133.90
|
|
Culture urine each isolate
|
$93.00 |
$93.00 |
$93.00 |
$57.00
|
|
Cv line/pic reposition
|
$1,434.60 |
$1,434.60 |
$1,434.60 |
$1,720.93
|
|
Cyclic citrullinated peptide antibody
|
$46.80 |
$46.80 |
$46.80 |
$70.72
|
|
Cyclosporine 2 hour
|
$308.40 |
$308.40 |
$308.40 |
$129.48
|
|
Cyp2c19 gene com variants
|
$1,770.60 |
$1,770.60 |
$1,770.60 |
$504.00
|
|
Cyp2d6 gene com variants
|
$2,385.60 |
$2,385.60 |
$2,385.60 |
$554.00
|
|
Cystatin c
|
$120.60 |
$120.60 |
$120.60 |
$77.50
|
|
Cystic fibrosis cftr
|
$3,341.40 |
$3,341.40 |
$3,341.40 |
$1,100.00
|
|
Cystine urine quantitative
|
$970.20 |
$970.20 |
$970.20 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$307.80 |
$307.80 |
$307.80 |
$542.10
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,764.80 |
$2,764.80 |
$2,764.80 |
$3,065.15
|
|
Cytogenetics 25-99
|
$597.00 |
$597.00 |
$597.00 |
$190.00
|
|
Cytogenetics 3-5
|
$247.20 |
$247.20 |
$247.20 |
$170.27
|
|
Cytogenomic neo microra alys
|
$5,814.60 |
$5,814.60 |
$5,814.60 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$4,657.80 |
$4,657.80 |
$4,657.80 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$186.60 |
$186.60 |
$186.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$146.40 |
$146.40 |
$146.40 |
$97.50
|
|
Cyto/molecular report
|
$155.40 |
$155.40 |
$155.40 |
$133.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$229.80 |
$229.80 |
$229.80 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$229.20 |
$229.20 |
$229.20 |
$91.84
|
|
Cytopathology concentration technique smears & interpretation
|
$178.80 |
$178.80 |
$178.80 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$192.00 |
$192.00 |
$192.00 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$234.00 |
$234.00 |
$234.00 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$208.80 |
$208.80 |
$208.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$643.20 |
$643.20 |
$643.20 |
$209.23
|
|
Cytopath smear other source
|
$179.40 |
$179.40 |
$179.40 |
$88.13
|
|
Cytopath smear other source
|
$138.60 |
$138.60 |
$138.60 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$91.20 |
$91.20 |
$91.20 |
$96.20
|
|
Cytopath tbs c/v manual
|
$108.60 |
$108.60 |
$108.60 |
$59.28
|
|
Cytotoxic antibody screening
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$133.25
|
|
Dch pulmonary stress test
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$963.30
|
|
Dch validity tests
|
$38.40 |
$38.40 |
$38.40 |
$24.50
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$12,935.40 |
$12,935.40 |
$12,935.40 |
$4,952.36
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$381.60 |
$381.60 |
$381.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$653.40 |
$653.40 |
$653.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,478.60 |
$2,478.60 |
$2,478.60 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,162.80 |
$1,162.80 |
$1,162.80 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,095.20 |
$2,095.20 |
$2,095.20 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$902.40 |
$902.40 |
$902.40 |
$810.50
|
|
Debride nail1-5 11720
|
$285.60 |
$285.60 |
$285.60 |
$148.80
|
|
Debride nail6 or more 11721
|
$285.60 |
$285.60 |
$285.60 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$1,012.80
|
|
Debride skin bone at fx site
|
$1,803.00 |
$1,803.00 |
$1,803.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$843.00 |
$843.00 |
$843.00 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,101.60 |
$1,101.60 |
$1,101.60 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,162.80 |
$1,162.80 |
$1,162.80 |
$1,160.00
|
|
Decalcification
|
$88.80 |
$88.80 |
$88.80 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,273.20 |
$1,273.20 |
$1,273.20 |
$543.00
|
|
Delivery of placenta 59414
|
$3,671.40 |
$3,671.40 |
$3,671.40 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$103.20 |
$103.20 |
$103.20 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$110.40 |
$110.40 |
$110.40 |
$408.10
|
|
Design mlc device for imrt
|
$901.20 |
$901.20 |
$901.20 |
$1,677.86
|
|
Desoxycorticosterone
|
$466.20 |
$466.20 |
$466.20 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$5,775.00 |
$5,775.00 |
$5,775.00 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$3,605.40 |
$3,605.40 |
$3,605.40 |
$1,441.44
|
|
Destruction anal lesion(s) smpl chem 46900
|
$511.80 |
$511.80 |
$511.80 |
$535.46
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,004.80 |
$3,004.80 |
$3,004.80 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$4,812.60 |
$4,812.60 |
$4,812.60 |
$3,202.98
|
|
Developmental screen/score/document 96110
|
$164.40 |
$164.40 |
$164.40 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$331.80 |
$331.80 |
$331.80 |
$337.50
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$186.00 |
$186.00 |
$186.00 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$214.80 |
$214.80 |
$214.80 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$102.60 |
$102.60 |
$102.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$69.60 |
$69.60 |
$69.60 |
$79.20
|
|
Diab manage trn ind/group
|
$102.00 |
$102.00 |
$102.00 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$169.20 |
$169.20 |
$169.20 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$440.40 |
$440.40 |
$440.40 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$831.00 |
$831.00 |
$831.00 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$578.40 |
$578.40 |
$578.40 |
$301.55
|
|
Dialysis one evaluation
|
$1,307.40 |
$1,307.40 |
$1,307.40 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$3.60 |
$3.60 |
$3.60 |
$115.15
|
|
Diffusing capacity
|
$1,076.40 |
$1,076.40 |
$1,076.40 |
$332.00
|
|
Digital analysis of eeg
|
$1,042.80 |
$1,042.80 |
$1,042.80 |
$605.60
|
|
Digoxin total therapeutic drug level
|
$141.00 |
$141.00 |
$141.00 |
$102.00
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$3,033.08
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$1,533.00 |
$1,533.00 |
$1,533.00 |
$5,250.40
|
|
Disability dlco
|
$612.60 |
$612.60 |
$612.60 |
$282.40
|
|
Disaccharidases
|
$1,440.60 |
$1,440.60 |
$1,440.60 |
$216.00
|
|
Discography cerv/thor spine
|
$1,230.00 |
$1,230.00 |
$1,230.00 |
$2,565.00
|
|
Dlyd plmt xtn prosth ea addl
|
$4,306.80 |
$4,306.80 |
$4,306.80 |
$1,582.68
|
|
Dna antibody native/double stranded
|
$123.00 |
$123.00 |
$123.00 |
$97.50
|
|
Dna gardnerella
|
$66.00 |
$66.00 |
$66.00 |
$62.50
|
|
Dna trichomonas
|
$66.00 |
$66.00 |
$66.00 |
$67.80
|
