|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$137.50 |
$137.50 |
$137.50 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$110.00 |
$110.00 |
$110.00 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$177.50 |
$177.50 |
$177.50 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$132.50 |
$132.50 |
$132.50 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$147.50 |
$147.50 |
$147.50 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$295.00 |
$295.00 |
$295.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$205.00 |
$205.00 |
$205.00 |
$213.85
|
|
Cytopath smear other source
|
$97.50 |
$97.50 |
$97.50 |
$92.50
|
|
Cytopath smear other source
|
$140.00 |
$140.00 |
$140.00 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$95.00 |
$95.00 |
$95.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$62.50 |
$62.50 |
$62.50 |
$59.28
|
|
Cytp urine 3-5 probes cmptr
|
$855.00 |
$855.00 |
$855.00 |
$664.80
|
|
Dacarbazine 100 mg intravenous solution
|
$38.15 |
$38.15 |
$38.15 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$40.17 |
$40.17 |
$40.17 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.29 |
$0.29 |
$0.29 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$135.36 |
$135.36 |
$135.36 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$23.09 |
$23.09 |
$23.09 |
$6,281.29
|
|
Dch validity tests
|
$25.00 |
$25.00 |
$25.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$72.50 |
$72.50 |
$72.50 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$230.00 |
$230.00 |
$230.00 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,030.00 |
$2,030.00 |
$2,030.00 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$580.00 |
$580.00 |
$580.00 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,015.00 |
$1,015.00 |
$1,015.00 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$665.00 |
$665.00 |
$665.00 |
$835.20
|
|
Debride nail1-5 11720
|
$107.50 |
$107.50 |
$107.50 |
$149.60
|
|
Debride nail6 or more 11721
|
$117.50 |
$117.50 |
$117.50 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$332.50 |
$332.50 |
$332.50 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$1,165.50
|
|
Decalcification
|
$67.50 |
$67.50 |
$67.50 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$472.50 |
$472.50 |
$472.50 |
$572.95
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$73.67 |
$73.67 |
$73.67 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$150.00 |
$150.00 |
$150.00 |
$401.60
|
|
Description not available
|
$41.22 |
$41.22 |
$41.22 |
$19.50
|
|
Design mlc device for imrt
|
$1,345.00 |
$1,345.00 |
$1,345.00 |
$1,753.00
|
|
Destroy cervthor facet jnt 64633
|
$2,720.00 |
$2,720.00 |
$2,720.00 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$232.50 |
$232.50 |
$232.50 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,840.00 |
$2,840.00 |
$2,840.00 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$105.00 |
$105.00 |
$105.00 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$87.50 |
$87.50 |
$87.50 |
$350.40
|
|
Device ablt adv novasure
|
$5,839.33 |
$5,839.33 |
$5,839.33 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,827.50 |
$2,827.50 |
$2,827.50 |
$4,200.00
|
|
Device intraute mirena
|
$2,910.49 |
$2,910.49 |
$2,910.49 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$2,844.60 |
$2,844.60 |
$2,844.60 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$200.00 |
$200.00 |
$200.00 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$0.62 |
$0.62 |
$0.62 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$15.49 |
$15.49 |
$15.49 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$164.27 |
$164.27 |
$164.27 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$64.10 |
$64.10 |
$64.10 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$67.10 |
$67.10 |
$67.10 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$55.40 |
$55.40 |
$55.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$67.84 |
$67.84 |
$67.84 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$107.50 |
$107.50 |
$107.50 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$70.00 |
$70.00 |
$70.00 |
$79.30
|
|
Diab manage trn ind/group
|
$25.00 |
$25.00 |
$25.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$145.00 |
$145.00 |
$145.00 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$215.00 |
$215.00 |
$215.00 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$215.00 |
$215.00 |
$215.00 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$282.50 |
$282.50 |
$282.50 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$282.50 |
$282.50 |
$282.50 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$310.00 |
$310.00 |
$310.00 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$7,145.00 |
$7,145.00 |
$7,145.00 |
$5,741.00
|
|
Dialysis one evaluation
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$936.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$65.93 |
$65.93 |
$65.93 |
$79.71
|
|
Diffusing capacity
|
$272.50 |
$272.50 |
$272.50 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$69.03 |
$69.03 |
$69.03 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$95.00 |
$95.00 |
$95.00 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,485.00 |
$1,485.00 |
$1,485.00 |
$1,866.73
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$6,735.00 |
$6,735.00 |
$6,735.00 |
$3,169.00
|
|
Dilate ic vasospasm ea add vsl same territory
|
$7,745.00 |
$7,745.00 |
$7,745.00 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$8,985.00 |
$8,985.00 |
$8,985.00 |
$5,151.95
|
|
Dilate urethra stricture
|
$380.00 |
$380.00 |
$380.00 |
$513.00
|
|
Dilation/female urethra/initial 53660
|
$180.00 |
$180.00 |
$180.00 |
$235.61
|
|
Dilation of cervical canal 57800
|
$3,105.00 |
$3,105.00 |
$3,105.00 |
$4,446.00
|
|
Dilation of salivary duct
|
$1,505.00 |
$1,505.00 |
$1,505.00 |
$790.00
|
|
Dilation/urethral strict/male/ini 53620
|
$740.00 |
$740.00 |
$740.00 |
$1,372.80
|
|
Dilat xst trc ndurlgc px
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$4,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$59.64 |
$59.64 |
$59.64 |
$18.32
|
|
Disaccharidases
|
$357.50 |
$357.50 |
$357.50 |
$230.40
|
|
Discography cerv/thor spine
|
$2,565.00 |
$2,565.00 |
$2,565.00 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$1,475.00 |
$1,475.00 |
$1,475.00 |
$1,579.93
|
|
Dna antibody native/double stranded
|
$92.50 |
$92.50 |
$92.50 |
$100.00
|
|
Dna gardnerella
|
$85.00 |
$85.00 |
$85.00 |
$61.83
|
|
Dna trichomonas
|
$87.50 |
$87.50 |
$87.50 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$52.43 |
$52.43 |
$52.43 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$4.29 |
$4.29 |
$4.29 |
$949.39
|
|
Doppler echo complete
|
$297.50 |
$297.50 |
$297.50 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$600.00 |
$600.00 |
$600.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$400.00 |
$400.00 |
$400.00 |
$481.65
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$457.55 |
$457.55 |
$457.55 |
$23,613.78
|
|
Dpyd gene common variants
|
$175.00 |
$175.00 |
$175.00 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$800.00 |
$800.00 |
$800.00 |
$800.00
|
|
Drainage external ear simple 69000
|
$800.00 |
$800.00 |
$800.00 |
$790.40
|
|
Drainage mouth roof lesion
|
$275.00 |
$275.00 |
$275.00 |
$405.60
|
|
Drainage of eye
|
$2,360.00 |
$2,360.00 |
$2,360.00 |
$2,415.65
|
|
Drainage of kidney lesion
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$1,506.00
|
