|
Cyclic citrullinated peptide antibody
|
$99.20 |
$99.20 |
$99.20 |
$68.00
|
|
Cyclosporine 2 hour
|
$314.40 |
$314.40 |
$314.40 |
$126.00
|
|
Cyp2c19 gene com variants
|
$2,572.00 |
$2,572.00 |
$2,572.00 |
$419.85
|
|
Cyp2d6 gene com variants
|
$1,585.60 |
$1,585.60 |
$1,585.60 |
$537.50
|
|
Cystatin c
|
$143.20 |
$143.20 |
$143.20 |
$78.75
|
|
Cystic fibrosis cftr
|
$4,188.80 |
$4,188.80 |
$4,188.80 |
$1,060.00
|
|
Cystine urine quantitative
|
$292.80 |
$292.80 |
$292.80 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$920.00 |
$920.00 |
$920.00 |
$542.10
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,946.40 |
$2,946.40 |
$2,946.40 |
$3,015.50
|
|
Cytogenetics 25-99
|
$766.40 |
$766.40 |
$766.40 |
$189.80
|
|
Cytogenomic neo microra alys
|
$7,458.40 |
$7,458.40 |
$7,458.40 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$2,196.80 |
$2,196.80 |
$2,196.80 |
$1,341.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$248.80 |
$248.80 |
$248.80 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$232.00 |
$232.00 |
$232.00 |
$95.00
|
|
Cyto/molecular report
|
$184.00 |
$184.00 |
$184.00 |
$140.25
|
|
Cytopathology cellular enhancement technique non-gyn
|
$272.00 |
$272.00 |
$272.00 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$199.20 |
$199.20 |
$199.20 |
$91.84
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$224.80 |
$224.80 |
$224.80 |
$132.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$258.40 |
$258.40 |
$258.40 |
$185.64
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$805.60 |
$805.60 |
$805.60 |
$207.50
|
|
Cytopath smear other source
|
$280.80 |
$280.80 |
$280.80 |
$88.13
|
|
Cytopath smear other source
|
$177.60 |
$177.60 |
$177.60 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$296.00 |
$296.00 |
$296.00 |
$96.20
|
|
Cytotoxic antibody screening
|
$1,087.20 |
$1,087.20 |
$1,087.20 |
$75.20
|
|
Dch validity tests
|
$39.20 |
$39.20 |
$39.20 |
$24.50
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$504.80 |
$504.80 |
$504.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$569.60 |
$569.60 |
$569.60 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,551.20 |
$2,551.20 |
$2,551.20 |
$2,321.40
|
|
Debridement/bone/20 sq cm or less 11046
|
$570.40 |
$570.40 |
$570.40 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,531.20 |
$1,531.20 |
$1,531.20 |
$1,418.55
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$811.20 |
$811.20 |
$811.20 |
$810.50
|
|
Debride nail1-5 11720
|
$529.60 |
$529.60 |
$529.60 |
$155.40
|
|
Debride nail6 or more 11721
|
$643.20 |
$643.20 |
$643.20 |
$167.63
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$376.80 |
$376.80 |
$376.80 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$4,319.20 |
$4,319.20 |
$4,319.20 |
$1,176.57
|
|
Decalcification
|
$154.40 |
$154.40 |
$154.40 |
$69.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$591.20 |
$591.20 |
$591.20 |
$540.00
|
|
Delivery of placenta 59414
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$2,993.25
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$116.00 |
$116.00 |
$116.00 |
$192.72
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,002.40 |
$1,002.40 |
$1,002.40 |
$414.78
|
|
Desoxycorticosterone
|
$487.20 |
$487.20 |
$487.20 |
$108.75
|
|
Developmental screen/score/document 96110
|
$219.20 |
$219.20 |
$219.20 |
$132.24
|
|
Devel tst phys/qhp 1st hr
|
$442.40 |
$442.40 |
$442.40 |
$307.20
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$248.00 |
$248.00 |
$248.00 |
$196.30
|
|
Dhea-s (dehydroepiand sulfate)
|
$376.00 |
$376.00 |
$376.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$79.20 |
$79.20 |
$79.20 |
$79.52
|
|
Diab manage trn ind/group
|
$48.00 |
$48.00 |
$48.00 |
$57.75
|
|
Diagnostic laryngoscopy 31505
|
$568.00 |
$568.00 |
$568.00 |
$239.30
|
|
Diagnostic Mammogram (both breasts)
|
$709.60 |
$709.60 |
$709.60 |
$399.94
|
|
Diagnostic Mammogram (one breast)
|
$604.00 |
$604.00 |
$604.00 |
$310.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$5.60 |
$5.60 |
$5.60 |
$114.18
|
|
Diffusing capacity
|
$232.00 |
$232.00 |
$232.00 |
$332.01
|
|
Digoxin total therapeutic drug level
|
$340.00 |
$340.00 |
$340.00 |
$99.60
|
|
Disaccharidases
|
$1,866.40 |
$1,866.40 |
$1,866.40 |
$203.08
|
|
Dna antibody native/double stranded
|
$237.60 |
$237.60 |
$237.60 |
$100.00
|
|
Dna gardnerella
|
$184.00 |
$184.00 |
$184.00 |
$62.50
|
|
Dna trichomonas
|
$184.00 |
$184.00 |
$184.00 |
$63.00
|
|
Doppler echo complete
|
$780.80 |
$780.80 |
$780.80 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,524.80 |
$2,524.80 |
$2,524.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,605.60 |
$1,605.60 |
$1,605.60 |
$476.45
|
|
Dpyd gene common variants
|
$2,219.20 |
$2,219.20 |
$2,219.20 |
$362.05
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$2,068.80 |
$2,068.80 |
$2,068.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,328.00 |
$1,328.00 |
$1,328.00 |
$914.34
|
|
Drainage external ear simple 69000
|
$2,181.60 |
$2,181.60 |
$2,181.60 |
$789.60
|
|
Drainage mouth roof lesion
|
$334.40 |
$334.40 |
$334.40 |
$405.60
|
|
Drainage of arm bursa 23931
|
$2,143.20 |
$2,143.20 |
$2,143.20 |
$2,362.62
|
|
Drainage of mouth lesion
|
$4,765.60 |
$4,765.60 |
$4,765.60 |
$3,848.00
|
|
Drain blood from under nail 11740
|
$805.60 |
$805.60 |
$805.60 |
$173.21
|
|
Drain finger abscess;simple 26010
|
$3,712.00 |
$3,712.00 |
$3,712.00 |
$442.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$397.15
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$1,403.20 |
$1,403.20 |
$1,403.20 |
$355.80
|
|
Dress/debrid prtl-thick burn l 16030
|
$3,169.60 |
$3,169.60 |
$3,169.60 |
$526.40
|
|
Drng of eyelid abscess 67700
|
$474.40 |
$474.40 |
$474.40 |
$684.95
|
|
Drng of scrotum abscess 55100
|
$2,124.00 |
$2,124.00 |
$2,124.00 |
$1,956.40
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$77.60 |
$77.60 |
$77.60 |
$94.65
|
|
Drug assay posaconazole
|
$224.00 |
$224.00 |
$224.00 |
$91.00
|
|
Drug assay rufinamide
|
$149.60 |
$149.60 |
$149.60 |
$88.20
|
|
Drug assay vedolizumab
|
$510.40 |
$510.40 |
$510.40 |
$136.08
|
|
Drug assay voriconazole
|
$185.60 |
$185.60 |
$185.60 |
$96.75
|
|
Drug test prsmv instrmnt
|
$464.00 |
$464.00 |
$464.00 |
$81.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$1,365.60 |
$1,365.60 |
$1,365.60 |
$278.85
|
|
Drvvt confirm - quest
|
$297.60 |
$297.60 |
$297.60 |
$101.66
|
|
Ductogram sgl duct
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$452.50
|
|
Duplex scan bilateral study 93985
|
$1,533.60 |
$1,533.60 |
$1,533.60 |
$673.00
|
|
Duplex scan unilateral study 93986
|
$1,023.20 |
$1,023.20 |
$1,023.20 |
$392.15
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$2,569.60 |
$2,569.60 |
$2,569.60 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$2,008.80 |
$2,008.80 |
$2,008.80 |
$903.00
|
|
Dxa bone density axl vrt fx
|
$344.00 |
$344.00 |
$344.00 |
$397.65
|
|
Ear irrigation 69209
|
$414.40 |
$414.40 |
$414.40 |
$150.00
|
|
Ecg 12 lead tracing only
|
$484.00 |
$484.00 |
$484.00 |
$226.50
|
|
Ecg < 30 days transmission & analysis
|
$613.60 |
$613.60 |
$613.60 |
$429.00
|
|
Ecg external < 48 hours recording
|
$613.60 |
$613.60 |
$613.60 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$613.60 |
$613.60 |
$613.60 |
$535.00
|
|
Ecg external > 48 hours up to 7 days recording
|
$216.80 |
$216.80 |
$216.80 |
$153.17
|
|
Ecg external >7 days up to 15 days recording
|
$360.80 |
$360.80 |
$360.80 |
$182.00
|
|
Echocardiogram (Heart Ultrasound)
|
$3,931.20 |
$3,931.20 |
$3,931.20 |
$2,038.40
|
|
Echocardiography doppler color flow mapping
|
$588.00 |
$588.00 |
$588.00 |
$501.81
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$701.25
|
|
Echocardiograpy doppler follow up/limited study
|
$607.20 |
$607.20 |
$607.20 |
$356.40
|
|
Echo stress
|
$3,452.00 |
$3,452.00 |
$3,452.00 |
$1,586.90
|
