|
Culture fungi other (except blood)
|
$137.90 |
$137.90 |
$137.90 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$73.50 |
$73.50 |
$73.50 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$112.70 |
$112.70 |
$112.70 |
$100.00
|
|
Culture mycoplasma any source
|
$214.20 |
$214.20 |
$214.20 |
$81.62
|
|
Culture quantitative aerobic other source
|
$197.40 |
$197.40 |
$197.40 |
$90.35
|
|
Culture screening strep group a
|
$186.20 |
$186.20 |
$186.20 |
$83.16
|
|
Culture typing added method
|
$75.60 |
$75.60 |
$75.60 |
$38.70
|
|
Culture typing immunologic
|
$75.60 |
$75.60 |
$75.60 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$529.20 |
$529.20 |
$529.20 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$135.80 |
$135.80 |
$135.80 |
$138.40
|
|
Culture urine each isolate
|
$113.40 |
$113.40 |
$113.40 |
$54.78
|
|
Cutter lead
|
$10,226.78 |
$10,226.78 |
$10,226.78 |
$6,685.72
|
|
Cv line/pic reposition
|
$6,287.47 |
$6,287.47 |
$6,287.47 |
$1,608.00
|
|
Cyanocobalamin unsat binding capacity
|
$84.70 |
$84.70 |
$84.70 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$234.50 |
$234.50 |
$234.50 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$198.10 |
$198.10 |
$198.10 |
$72.15
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$4,533.55 |
$4,533.55 |
$4,533.55 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$258.82 |
$258.82 |
$258.82 |
$19.49
|
|
Cyclosporine 2 hour
|
$184.80 |
$184.80 |
$184.80 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$37.62 |
$37.62 |
$37.62 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$105.17 |
$105.17 |
$105.17 |
$35.57
|
|
Cylinder pump set 20cm titan zero angl
|
$28,069.09 |
$28,069.09 |
$28,069.09 |
$24,372.98
|
|
Cyp2c19 gene com variants
|
$656.60 |
$656.60 |
$656.60 |
$502.45
|
|
Cyp2c9 gene com variants
|
$403.20 |
$403.20 |
$403.20 |
$266.50
|
|
Cyp2d6 gene com variants
|
$1,041.60 |
$1,041.60 |
$1,041.60 |
$573.65
|
|
Cyp3a5 gene common variants
|
$403.20 |
$403.20 |
$403.20 |
$245.31
|
|
Cystatin c
|
$78.40 |
$78.40 |
$78.40 |
$76.48
|
|
Cystic fibrosis cftr
|
$1,877.40 |
$1,877.40 |
$1,877.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$121.10 |
$121.10 |
$121.10 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$921.20 |
$921.20 |
$921.20 |
$564.85
|
|
Cysto rx balo cath urtl strx
|
$27,912.14 |
$27,912.14 |
$27,912.14 |
$6,853.60
|
|
Cystoscopy and treatment
|
$32,880.81 |
$32,880.81 |
$32,880.81 |
$4,350.00
|
|
Cystoscopy and treatment
|
$19,727.25 |
$19,727.25 |
$19,727.25 |
$5,304.00
|
|
Cystoscopy and treatment
|
$25,605.94 |
$25,605.94 |
$25,605.94 |
$5,995.60
|
|
Cystoscopy and treatment
|
$42,473.51 |
$42,473.51 |
$42,473.51 |
$6,593.60
|
|
Cystoscopy and treatment
|
$18,562.98 |
$18,562.98 |
$18,562.98 |
$4,045.60
|
|
Cystoscopy and treatment
|
$11,574.77 |
$11,574.77 |
$11,574.77 |
$2,850.95
|
|
Cystoscopy and treatment
|
$30,840.91 |
$30,840.91 |
$30,840.91 |
$4,081.37
|
|
Cystoscopy (Bladder Scope)
|
$9,786.06 |
$9,786.06 |
$9,786.06 |
$1,445.41
|
|
Cystoscopy chemodenervation
|
$15,312.79 |
$15,312.79 |
$15,312.79 |
$2,831.92
|
|
Cystoscopy removal of clots
|
$48,568.93 |
$48,568.93 |
$48,568.93 |
$4,051.50
|
|
Cystoscopy & ureter catheter
|
$16,816.92 |
$16,816.92 |
$16,816.92 |
$3,688.80
|
|
Cystouretero & or pyeloscope
|
$18,804.88 |
$18,804.88 |
$18,804.88 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$21,831.23 |
$21,831.23 |
$21,831.23 |
$4,865.91
|
|
Cystouretero w/biopsy
|
$36,972.65 |
$36,972.65 |
$36,972.65 |
$6,015.75
|
|
Cysto/uretero w/lithotripsy
|
$31,587.05 |
$31,587.05 |
$31,587.05 |
$7,573.50
|
|
Cystouretero w/lithotripsy
|
$26,422.83 |
$26,422.83 |
$26,422.83 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$26,541.61 |
$26,541.61 |
$26,541.61 |
$5,339.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$11,475.38 |
$11,475.38 |
$11,475.38 |
$3,131.20
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$41,886.89 |
$41,886.89 |
$41,886.89 |
$4,045.60
|
|
Cystourethro w/addl implant 52442
|
$32,936.13 |
$32,936.13 |
$32,936.13 |
$2,161.60
|
|
Cystourethro w/implant
|
$35,288.51 |
$35,288.51 |
$35,288.51 |
$2,777.60
|
|
Cytarabine 20 mg/ml injection solution
|
$644.87 |
$644.87 |
$644.87 |
$90.00
|
|
Cytogenetics 25-99
|
$230.30 |
$230.30 |
$230.30 |
$189.80
|
|
Cytogenomic neo microra alys
|
$6,578.60 |
$6,578.60 |
$6,578.60 |
$2,156.05
|
|
Cytomegalovirus (cmv) antibody igg
|
$143.50 |
$143.50 |
$143.50 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$143.50 |
$143.50 |
$143.50 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$197.40 |
$197.40 |
$197.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$83.30 |
$83.30 |
$83.30 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$407.40 |
$407.40 |
$407.40 |
$131.36
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$205.80 |
$205.80 |
$205.80 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$247.10 |
$247.10 |
$247.10 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$242.20 |
$242.20 |
$242.20 |
$209.92
|
|
Cytopath smear oth prep screen & interp
|
$67.90 |
$67.90 |
$67.90 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$170.80 |
$170.80 |
$170.80 |
$62.70
|
|
Dactinomycin 0.5 mg intravenous solution
|
$7,918.92 |
$7,918.92 |
$7,918.92 |
$3,047.85
|
|
Dalbavancin 500 mg intravenous solution
|
$4,578.87 |
$4,578.87 |
$4,578.87 |
$3,480.87
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$432.42 |
$432.42 |
$432.42 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$57,501.50 |
$57,501.50 |
$57,501.50 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,055.07 |
$1,055.07 |
$1,055.07 |
$6,273.69
|
|
D&c after delivery 59160
|
$17,108.44 |
$17,108.44 |
$17,108.44 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$16,688.71 |
$16,688.71 |
$16,688.71 |
$3,774.81
|
|
Dch glucoscan
|
$37.80 |
$37.80 |
$37.80 |
$29.16
|
|
Dch validity tests
|
$53.20 |
$53.20 |
$53.20 |
$25.00
|
|
Dcmprn plantar digital nerve
|
$28,796.87 |
$28,796.87 |
$28,796.87 |
$2,375.24
|
|
Deamidated gliadin antibody iga
|
$163.10 |
$163.10 |
$163.10 |
$42.75
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,899.80 |
$1,899.80 |
$1,899.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$475.30 |
$475.30 |
$475.30 |
$278.50
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,843.80 |
$1,843.80 |
$1,843.80 |
$820.15
|
|
Debride nail1-5 11720
|
$160.30 |
$160.30 |
$160.30 |
$149.04
|
|
Debride nail6 or more 11721
|
$123.20 |
$123.20 |
$123.20 |
$167.63
|
|
Debride skin bone at fx site
|
$1,523.20 |
$1,523.20 |
$1,523.20 |
$2,921.60
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$1,899.80 |
$1,899.80 |
$1,899.80 |
$1,899.80
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,985.90 |
$1,985.90 |
$1,985.90 |
$1,129.45
|
|
Decalcification
|
$19,293.26 |
$19,293.26 |
$19,293.26 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$707.52 |
$707.52 |
$707.52 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$20,014.22 |
$20,014.22 |
$20,014.22 |
$546.84
|
|
Decompression of leg
|
$7,102.90 |
$7,102.90 |
$7,102.90 |
$4,094.02
|
|
Decompression of lower leg
|
$7,102.90 |
$7,102.90 |
$7,102.90 |
$3,839.54
|
|
Deferoxamine 500 mg solution for injection
|
$358.22 |
$358.22 |
$358.22 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$3,098.37 |
$3,098.37 |
$3,098.37 |
$1,855.50
|
|
Delivery of placenta 59414
|
$2,444.40 |
$2,444.40 |
$2,444.40 |
$2,822.68
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$146.30 |
$146.30 |
$146.30 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$18,306.40 |
$18,306.40 |
$18,306.40 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$252.70 |
$252.70 |
$252.70 |
$399.93
|
|
Design mlc device for imrt
|
$31,486.70 |
$31,486.70 |
$31,486.70 |
$1,739.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$531.47 |
$531.47 |
$531.47 |
$93.84
|
|
Desoxycorticosterone
|
$65.10 |
$65.10 |
$65.10 |
$98.80
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$425.60 |
$425.60 |
$425.60 |
$364.50
|
|
Destruction anal lesion(s)
|
$4,953.90 |
$4,953.90 |
$4,953.90 |
$3,711.00
|
