|
Culture bacteria anaerobic
|
$217.20 |
$217.20 |
$217.20 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$88.20 |
$88.20 |
$88.20 |
$51.45
|
|
Culture body fluid
|
$213.60 |
$213.60 |
$213.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$117.60 |
$117.60 |
$117.60 |
$77.28
|
|
Culture fungi definitive id yeast
|
$117.00 |
$117.00 |
$117.00 |
$79.10
|
|
Culture fungi other (except blood)
|
$186.60 |
$186.60 |
$186.60 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$183.60 |
$183.60 |
$183.60 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$268.20 |
$268.20 |
$268.20 |
$89.70
|
|
Culture quantitative aerobic other source
|
$217.20 |
$217.20 |
$217.20 |
$90.35
|
|
Culture screening strep group a
|
$115.80 |
$115.80 |
$115.80 |
$81.00
|
|
Culture type pulse field gel
|
$355.20 |
$355.20 |
$355.20 |
$38.58
|
|
Culture typing immunologic
|
$66.60 |
$66.60 |
$66.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$625.20 |
$625.20 |
$625.20 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$471.00 |
$471.00 |
$471.00 |
$133.90
|
|
Culture urine each isolate
|
$124.80 |
$124.80 |
$124.80 |
$57.00
|
|
Cyclic citrullinated peptide antibody
|
$143.40 |
$143.40 |
$143.40 |
$70.72
|
|
Cyclosporine 2 hour
|
$361.20 |
$361.20 |
$361.20 |
$129.48
|
|
Cyp2c19 gene com variants
|
$1,609.80 |
$1,609.80 |
$1,609.80 |
$504.00
|
|
Cyp2d6 gene com variants
|
$2,238.60 |
$2,238.60 |
$2,238.60 |
$554.00
|
|
Cystatin c
|
$102.60 |
$102.60 |
$102.60 |
$77.50
|
|
Cystic fibrosis cftr
|
$3,138.00 |
$3,138.00 |
$3,138.00 |
$1,100.00
|
|
Cystine urine quantitative
|
$813.60 |
$813.60 |
$813.60 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,233.00 |
$1,233.00 |
$1,233.00 |
$542.10
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,596.20 |
$2,596.20 |
$2,596.20 |
$3,065.15
|
|
Cytogenetics 25-99
|
$561.60 |
$561.60 |
$561.60 |
$190.00
|
|
Cytogenetics 3-5
|
$221.40 |
$221.40 |
$221.40 |
$170.27
|
|
Cytogenomic neo microra alys
|
$5,468.40 |
$5,468.40 |
$5,468.40 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$5,010.60 |
$5,010.60 |
$5,010.60 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$186.60 |
$186.60 |
$186.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$195.60 |
$195.60 |
$195.60 |
$97.50
|
|
Cyto/molecular report
|
$165.00 |
$165.00 |
$165.00 |
$133.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$207.00 |
$207.00 |
$207.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$166.80 |
$166.80 |
$166.80 |
$91.84
|
|
Cytopathology concentration technique smears & interpretation
|
$194.40 |
$194.40 |
$194.40 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$181.80 |
$181.80 |
$181.80 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$112.80 |
$112.80 |
$112.80 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$219.00 |
$219.00 |
$219.00 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$604.20 |
$604.20 |
$604.20 |
$209.23
|
|
Cytopath smear other source
|
$130.20 |
$130.20 |
$130.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$163.80 |
$163.80 |
$163.80 |
$96.20
|
|
Cytopath tbs c/v manual
|
$79.80 |
$79.80 |
$79.80 |
$59.28
|
|
Cytotoxic antibody screening
|
$782.40 |
$782.40 |
$782.40 |
$133.25
|
|
Dch validity tests
|
$37.20 |
$37.20 |
$37.20 |
$24.50
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$382.20 |
$382.20 |
$382.20 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$537.00 |
$537.00 |
$537.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,589.60 |
$2,589.60 |
$2,589.60 |
$2,316.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$835.20 |
$835.20 |
$835.20 |
$810.50
|
|
Debride nail1-5 11720
|
$79.80 |
$79.80 |
$79.80 |
$148.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$654.60 |
$654.60 |
$654.60 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$1,160.00
|
|
Decalcification
|
$106.20 |
$106.20 |
$106.20 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,033.80 |
$1,033.80 |
$1,033.80 |
$543.00
|
|
Delivery of placenta 59414
|
$3,671.40 |
$3,671.40 |
$3,671.40 |
$3,070.56
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$11,743.80 |
$11,743.80 |
$11,743.80 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$102.00 |
$102.00 |
$102.00 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$586.20 |
$586.20 |
$586.20 |
$408.10
|
|
Design mlc device for imrt
|
$1,544.40 |
$1,544.40 |
$1,544.40 |
$1,677.86
|
|
Desoxycorticosterone
|
$343.80 |
$343.80 |
$343.80 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$3,989.40 |
$3,989.40 |
$3,989.40 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,399.80 |
$1,399.80 |
$1,399.80 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,816.00 |
$3,816.00 |
$3,816.00 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,431.40 |
$6,431.40 |
$6,431.40 |
$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)
|
$426.60 |
$426.60 |
$426.60 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$295.80 |
$295.80 |
$295.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$69.60 |
$69.60 |
$69.60 |
$79.20
|
|
Diab manage trn ind/group
|
$106.80 |
$106.80 |
$106.80 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$117.00 |
$117.00 |
$117.00 |
$190.68
|
|
Diagnostic Mammogram (both breasts)
|
$625.80 |
$625.80 |
$625.80 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$513.60 |
$513.60 |
$513.60 |
$301.55
|
|
Dialysis one evaluation
|
$1,207.20 |
$1,207.20 |
$1,207.20 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$4.80 |
$4.80 |
$4.80 |
$115.15
|
|
Diffusing capacity
|
$253.80 |
$253.80 |
$253.80 |
$332.00
|
|
Digoxin total therapeutic drug level
|
$163.20 |
$163.20 |
$163.20 |
$102.00
|
|
Dilat xst trc ndurlgc px
|
$3,900.60 |
$3,900.60 |
$3,900.60 |
$4,061.71
|
|
Dilat xst trc new access rcs
|
$3,900.60 |
$3,900.60 |
$3,900.60 |
$4,213.20
|
|
Disability dlco
|
$293.40 |
$293.40 |
$293.40 |
$282.40
|
|
Disaccharidases
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$216.00
|
|
Dlyd plmt xtn prosth ea addl
|
$11,743.80 |
$11,743.80 |
$11,743.80 |
$1,582.68
|
|
Dna antibody native/double stranded
|
$331.20 |
$331.20 |
$331.20 |
$97.50
|
|
Dna gardnerella
|
$106.80 |
$106.80 |
$106.80 |
$62.50
|
|
Dna trichomonas
|
$109.80 |
$109.80 |
$109.80 |
$67.80
|
|
Doppler echo complete
|
$826.20 |
$826.20 |
$826.20 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,459.20 |
$1,459.20 |
$1,459.20 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$533.40 |
$533.40 |
$533.40 |
$471.17
|
|
Dpyd gene common variants
|
$1,627.20 |
$1,627.20 |
$1,627.20 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$595.20 |
$595.20 |
$595.20 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$973.20 |
$973.20 |
$973.20 |
$914.34
|
|
Drainage external ear simple 69000
|
$543.60 |
$543.60 |
$543.60 |
$789.60
|
|
Drainage mouth roof lesion
|
$295.80 |
$295.80 |
$295.80 |
$390.39
|
|
Drainage of arm bursa 23931
|
$1,891.20 |
$1,891.20 |
$1,891.20 |
$2,197.48
|
|
Drainage of kidney lesion
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,506.00
|
|
Drainage of mouth lesion
|
$3,900.60 |
$3,900.60 |
$3,900.60 |
$3,900.60
|
|
Drain blood from under nail 11740
|
$302.40 |
$302.40 |
$302.40 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$503.40 |
$503.40 |
$503.40 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$1,184.40 |
$1,184.40 |
$1,184.40 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$445.80 |
$445.80 |
$445.80 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$694.80 |
$694.80 |
$694.80 |
$523.00
|
