|
Culture quantitative aerobic other source
|
$963.00 |
$963.00 |
$963.00 |
$90.35
|
|
Culture screening strep group a
|
$112.20 |
$112.20 |
$117.60 |
$81.00
|
|
Culture type pulse field gel
|
$436.20 |
$436.20 |
$436.20 |
$38.58
|
|
Culture typing immunologic
|
$31.80 |
$31.80 |
$91.20 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$634.20 |
$634.20 |
$634.20 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$54.60 |
$54.60 |
$531.00 |
$133.90
|
|
Culture urine each isolate
|
$120.60 |
$120.60 |
$120.60 |
$57.00
|
|
Cv line/pic reposition
|
$3,941.40 |
$3,941.40 |
$3,941.40 |
$1,720.93
|
|
Cyclic citrullinated peptide antibody
|
$142.20 |
$142.20 |
$142.20 |
$70.72
|
|
Cyclosporine 2 hour
|
$506.40 |
$506.40 |
$506.40 |
$129.48
|
|
Cyp2c19 gene com variants
|
$1,702.80 |
$1,702.80 |
$1,702.80 |
$504.00
|
|
Cyp2d6 gene com variants
|
$2,655.00 |
$2,655.00 |
$2,655.00 |
$554.00
|
|
Cystatin c
|
$355.80 |
$355.80 |
$355.80 |
$77.50
|
|
Cystic fibrosis cftr
|
$3,303.60 |
$3,303.60 |
$3,303.60 |
$1,100.00
|
|
Cystine urine quantitative
|
$207.00 |
$207.00 |
$872.40 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$493.20 |
$493.20 |
$963.60 |
$542.10
|
|
Cystometrogram w/up 51727
|
$1,537.80 |
$1,537.80 |
$1,537.80 |
$908.59
|
|
Cystoscopy and treatment
|
$5,812.80 |
$5,812.80 |
$5,812.80 |
$3,213.14
|
|
Cystoscopy and treatment
|
$5,812.80 |
$5,812.80 |
$5,812.80 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$5,455.80 |
$5,455.80 |
$5,455.80 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$6,156.00 |
$6,156.00 |
$6,156.00 |
$3,065.15
|
|
Cytogenetics 25-99
|
$588.00 |
$588.00 |
$588.00 |
$190.00
|
|
Cytogenetics 3-5
|
$307.20 |
$307.20 |
$307.20 |
$170.27
|
|
Cytogenomic neo microra alys
|
$5,730.60 |
$5,730.60 |
$5,730.60 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$5,940.00 |
$5,940.00 |
$5,940.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$186.60 |
$186.60 |
$186.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$174.00 |
$174.00 |
$174.00 |
$97.50
|
|
Cyto/molecular report
|
$230.40 |
$230.40 |
$230.40 |
$133.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$118.20 |
$118.20 |
$262.80 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$204.00 |
$204.00 |
$204.00 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$73.80 |
$73.80 |
$73.80 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$102.60 |
$102.60 |
$132.00 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$92.40 |
$92.40 |
$192.00 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$154.20 |
$154.20 |
$154.20 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$209.40 |
$209.40 |
$213.00 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$187.80 |
$187.80 |
$635.40 |
$209.23
|
|
Cytopath smear other source
|
$68.40 |
$68.40 |
$160.20 |
$88.13
|
|
Cytopath smear other source
|
$136.20 |
$136.20 |
$136.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$88.80 |
$88.80 |
$187.20 |
$96.20
|
|
Cytopath tbs c/v manual
|
$128.40 |
$128.40 |
$128.40 |
$59.28
|
|
Cytotoxic antibody screening
|
$836.40 |
$836.40 |
$836.40 |
$133.25
|
|
Dch glucoscan
|
$42.60 |
$42.60 |
$42.60 |
$28.10
|
|
Dch pulmonary stress test
|
$1,642.20 |
$1,642.20 |
$1,642.20 |
$963.30
|
|
Dch validity tests
|
$50.40 |
$50.40 |
$50.40 |
$24.50
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$6,072.60 |
$6,072.60 |
$6,072.60 |
$4,952.36
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$369.60 |
$369.60 |
$369.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$581.40 |
$581.40 |
$581.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$3,327.60 |
$3,327.60 |
$3,327.60 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$464.40 |
$464.40 |
$464.40 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$700.20 |
$700.20 |
$700.20 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$862.20 |
$862.20 |
$973.20 |
$810.50
|
|
Debride nail1-5 11720
|
$140.40 |
$140.40 |
$142.80 |
$148.80
|
|
Debride nail6 or more 11721
|
$131.40 |
$131.40 |
$169.80 |
$169.60
|
|
Debride skin bone at fx site
|
$5,126.40 |
$5,126.40 |
$5,126.40 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$281.40 |
$281.40 |
$433.80 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,126.20 |
$1,126.20 |
$1,126.20 |
$1,160.00
|
|
Decalcification
|
$53.40 |
$53.40 |
$93.60 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$2,171.40 |
$2,171.40 |
$2,171.40 |
$543.00
|
|
Decompress fasciotomyhand 26037
|
$319.80 |
$319.80 |
$319.80 |
$3,839.54
|
|
Delivery of placenta 59414
|
$5,436.60 |
$5,436.60 |
$5,436.60 |
$3,070.56
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$10,597.80 |
$10,597.80 |
$10,597.80 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$120.00 |
$120.00 |
$120.00 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$480.60 |
$480.60 |
$480.60 |
$408.10
|
|
Descend thora aorta rpr/lt sub art 33880
|
$5,958.60 |
$5,958.60 |
$5,958.60 |
$6,687.93
|
|
Design mlc device for imrt
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$1,677.86
|
|
Desoxycorticosterone
|
$444.00 |
$444.00 |
$444.00 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$5,958.60 |
$5,958.60 |
$5,958.60 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$2,356.20 |
$2,356.20 |
$2,356.20 |
$2,727.20
|
|
Destroy cervthor facet jnt 64633
|
$5,773.20 |
$5,773.20 |
$5,773.20 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,602.00 |
$1,602.00 |
$1,602.00 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$225.00 |
$225.00 |
$225.00 |
$199.50
|
|
Destroy vulva lesion extensive 56515
|
$393.00 |
$393.00 |
$393.00 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$268.20 |
$268.20 |
$268.20 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$258.60 |
$258.60 |
$258.60 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$64.80 |
$64.80 |
$64.80 |
$72.60
|
|
Destruction anal lesion(s) smpl chem 46900
|
$378.00 |
$378.00 |
$378.00 |
$535.46
|
|
Destruction benign lesions < 14 lesions
|
$265.80 |
$265.80 |
$265.80 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,586.00 |
$2,586.00 |
$2,586.00 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$5,773.20 |
$5,773.20 |
$5,773.20 |
$3,202.98
|
|
Destruction penis lesion(s) chem 54050
|
$280.20 |
$280.20 |
$280.20 |
$332.00
|
|
Destruction premal lesions 15/> 17004
|
$378.00 |
$378.00 |
$378.00 |
$436.64
|
|
Destruction vag lesions simple 57061
|
$255.00 |
$255.00 |
$255.00 |
$3,815.20
|
|
Determine refractive state
|
$43.20 |
$43.20 |
$43.20 |
$19.80
|
|
Developmental screen/score/document 96110
|
$164.40 |
$164.40 |
$164.40 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$503.40 |
$503.40 |
$503.40 |
$337.50
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$213.60 |
$213.60 |
$213.60 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$191.40 |
$191.40 |
$272.40 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$407.40 |
$407.40 |
$407.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$82.20 |
$82.20 |
$82.20 |
$79.20
|
|
Diab manage trn ind/group
|
$139.80 |
$139.80 |
$139.80 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$325.20 |
$325.20 |
$325.20 |
$190.68
|
|
Diagnostic laryngoscopy 31505
|
$136.20 |
$136.20 |
$136.20 |
$236.60
|
|
Diagnostic laryngoscopy 31575
|
$640.80 |
$640.80 |
$640.80 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$681.00 |
$681.00 |
$681.00 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$514.80 |
$514.80 |
$514.80 |
$301.55
|
|
Diagnostic radio unlisted proc
|
$274.80 |
$274.80 |
$274.80 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$21,088.80 |
$21,088.80 |
$21,088.80 |
$5,419.00
|
|
Dialysis one evaluation
|
$2,302.20 |
$2,302.20 |
$3,361.80 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$4.20 |
$4.20 |
$4.20 |
$115.15
|
|
Diffusing capacity
|
$576.60 |
$576.60 |
$576.60 |
$332.00
|
