|
CT hrt w/3d image
|
$175.00 |
$175.00 |
$175.00 |
$1,418.60
|
|
CT lower extremity w/contrast (both sides)
|
$700.00 |
$700.00 |
$700.00 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$625.00 |
$625.00 |
$625.00 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$750.00 |
$750.00 |
$750.00 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$700.00 |
$700.00 |
$700.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$625.00 |
$625.00 |
$625.00 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$750.00 |
$750.00 |
$750.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$750.00 |
$750.00 |
$750.00 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$700.00 |
$700.00 |
$700.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$625.00 |
$625.00 |
$625.00 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$130.00 |
$130.00 |
$130.00 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,525.00 |
$1,525.00 |
$1,525.00 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$700.00 |
$700.00 |
$700.00 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$625.00 |
$625.00 |
$625.00 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$127.50 |
$127.50 |
$127.50 |
$400.20
|
|
CT upper extremity w/contrast (both sides)
|
$700.00 |
$700.00 |
$700.00 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$625.00 |
$625.00 |
$625.00 |
$1,468.83
|
|
Culture aerobic additional method definitive id each
|
$28.75 |
$28.75 |
$28.75 |
$63.75
|
|
Culture afb any source
|
$50.00 |
$50.00 |
$50.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$37.50 |
$37.50 |
$37.50 |
$77.31
|
|
Culture anaerobic except blood
|
$78.75 |
$78.75 |
$78.75 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$32.50 |
$32.50 |
$32.50 |
$52.80
|
|
Culture body fluid
|
$66.50 |
$66.50 |
$66.50 |
$130.50
|
|
Culture fungi definitive id mold
|
$40.00 |
$40.00 |
$40.00 |
$70.00
|
|
Culture fungi definitive id yeast
|
$31.25 |
$31.25 |
$31.25 |
$80.60
|
|
Culture fungi other (except blood)
|
$46.25 |
$46.25 |
$46.25 |
$105.60
|
|
Culture mycobacteria definitive id each isolate
|
$35.00 |
$35.00 |
$35.00 |
$84.75
|
|
Culture mycoplasma any source
|
$40.00 |
$40.00 |
$40.00 |
$90.37
|
|
Culture screening strep group a
|
$31.25 |
$31.25 |
$31.25 |
$81.60
|
|
Culture typing added method
|
$20.00 |
$20.00 |
$20.00 |
$34.45
|
|
Culture typing immunologic
|
$22.50 |
$22.50 |
$22.50 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$136.25 |
$136.25 |
$136.25 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$27.50 |
$27.50 |
$27.50 |
$124.40
|
|
Culture urine each isolate
|
$21.00 |
$21.00 |
$21.00 |
$46.20
|
|
Cv line/pic reposition
|
$625.00 |
$625.00 |
$625.00 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$35.40 |
$35.40 |
$35.40 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$35.00 |
$35.00 |
$35.00 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,944.65 |
$2,944.65 |
$2,944.65 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$18.93 |
$18.93 |
$18.93 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$38.24 |
$38.24 |
$38.24 |
$179.10
|
|
Cyclosporine 2 hour
|
$40.00 |
$40.00 |
$40.00 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$2.79 |
$2.79 |
$2.79 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$47.69 |
$47.69 |
$47.69 |
$39.04
|
|
Cystatin c
|
$43.75 |
$43.75 |
$43.75 |
$82.26
|
|
Cystine urine quantitative
|
$50.00 |
$50.00 |
$50.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$231.25 |
$231.25 |
$231.25 |
$539.55
|
|
Cytarabine 20 mg/ml injection solution
|
$64.52 |
$64.52 |
$64.52 |
$89.95
|
|
Cytogenetics 25-99
|
$43.75 |
$43.75 |
$43.75 |
$180.32
|
|
Cytogenomic neo microra alys
|
$725.00 |
$725.00 |
$725.00 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$35.00 |
$35.00 |
$35.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$40.00 |
$40.00 |
$40.00 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$82.34 |
$82.34 |
$82.34 |
$3,113.07
|
|
Cyto/molecular report
|
$75.00 |
$75.00 |
$75.00 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$56.25 |
$56.25 |
$56.25 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$43.75 |
$43.75 |
$43.75 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$37.50 |
$37.50 |
$37.50 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$27.50 |
$27.50 |
$27.50 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$27.50 |
$27.50 |
$27.50 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$50.00 |
$50.00 |
$50.00 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$81.25 |
$81.25 |
$81.25 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$131.25 |
$131.25 |
$131.25 |
$205.00
|
|
Cytopath smear other source
|
$18.75 |
$18.75 |
$18.75 |
$85.80
|
|
Cytopath tbs c/v manual
|
$40.00 |
$40.00 |
$40.00 |
$57.94
|
|
Cytp urine 3-5 probes cmptr
|
$250.00 |
$250.00 |
$250.00 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$48.24 |
$48.24 |
$48.24 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,964.75 |
$2,964.75 |
$2,964.75 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$7,152.11 |
$7,152.11 |
$7,152.11 |
$3,469.30
|
|
Dalteparin sodium
|
$150.35 |
$150.35 |
$150.35 |
$124.09
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$315.32 |
$315.32 |
$315.32 |
$315.32
|
|
Daptomycin (xellia) unrefrig
|
$89.74 |
$89.74 |
$89.74 |
$0.04
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$42,498.90 |
$42,498.90 |
$42,498.90 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,648.39 |
$1,648.39 |
$1,648.39 |
$5,546.48
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$43,285.35 |
$43,285.35 |
$43,285.35 |
$26,349.55
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$95.78 |
$95.78 |
$95.78 |
$260.95
|
|
Dch validity tests
|
$30.00 |
$30.00 |
$30.00 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$35.00 |
$35.00 |
$35.00 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$131.25 |
$131.25 |
$131.25 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$850.00 |
$850.00 |
$850.00 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$300.00 |
$300.00 |
$300.00 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$300.00 |
$300.00 |
$300.00 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$360.00 |
$360.00 |
$360.00 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$300.00 |
$300.00 |
$300.00 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$325.00 |
$325.00 |
$325.00 |
$1,193.40
|
|
Decalcification
|
$33.75 |
$33.75 |
$33.75 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$1,157.57 |
$1,157.57 |
$1,157.57 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$150.00 |
$150.00 |
$150.00 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$74.94 |
$74.94 |
$74.94 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$769.59 |
$769.59 |
$769.59 |
$2,086.82
|
|
Delivery of placenta 59414
|
$425.00 |
$425.00 |
$425.00 |
$3,271.20
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$7,763.47
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$50.00 |
$50.00 |
$50.00 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$13,867.96 |
$13,867.96 |
$13,867.96 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$43.75 |
$43.75 |
$43.75 |
$460.50
|
|
Deodorant ostmy adapt lube 8ml
|
$2.07 |
$2.07 |
$2.07 |
$5.00
|
|
Depo-estradiol cypionate inj
|
$69.99 |
$69.99 |
$69.99 |
$132.72
|
|
Design mlc device for imrt
|
$350.00 |
$350.00 |
$350.00 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$326.18 |
$326.18 |
$326.18 |
$102.32
|
|
Destroy cervthor facet jnt 64633
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$3,164.80
|
