|
Culture fungi definitive id mold
|
$158.40 |
$158.40 |
$158.40 |
$77.28
|
|
Culture fungi definitive id yeast
|
$130.40 |
$130.40 |
$130.40 |
$79.10
|
|
Culture fungi other (except blood)
|
$364.80 |
$364.80 |
$364.80 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$187.20 |
$187.20 |
$187.20 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$357.60 |
$357.60 |
$357.60 |
$89.70
|
|
Culture quantitative aerobic other source
|
$1,074.40 |
$1,074.40 |
$1,074.40 |
$90.35
|
|
Culture screening strep group a
|
$154.40 |
$154.40 |
$154.40 |
$81.00
|
|
Culture type pulse field gel
|
$460.00 |
$460.00 |
$460.00 |
$38.58
|
|
Culture typing immunologic
|
$103.20 |
$103.20 |
$103.20 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$827.20 |
$827.20 |
$827.20 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$611.20 |
$611.20 |
$611.20 |
$133.90
|
|
Culture urine each isolate
|
$123.20 |
$123.20 |
$123.20 |
$57.00
|
|
Cv line/pic reposition
|
$2,113.60 |
$2,113.60 |
$2,113.60 |
$1,720.93
|
|
Cyclic citrullinated peptide antibody
|
$196.80 |
$196.80 |
$196.80 |
$70.72
|
|
Cyclosporine 2 hour
|
$486.40 |
$486.40 |
$486.40 |
$129.48
|
|
Cyp2c19 gene com variants
|
$2,353.60 |
$2,353.60 |
$2,353.60 |
$504.00
|
|
Cyp2d6 gene com variants
|
$3,593.60 |
$3,593.60 |
$3,593.60 |
$554.00
|
|
Cystatin c
|
$139.20 |
$139.20 |
$139.20 |
$77.50
|
|
Cystic fibrosis cftr
|
$4,112.00 |
$4,112.00 |
$4,112.00 |
$1,100.00
|
|
Cystine urine quantitative
|
$1,213.60 |
$1,213.60 |
$1,213.60 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$964.80 |
$964.80 |
$964.80 |
$542.10
|
|
Cystoscopy (Bladder Scope)
|
$1,005.60 |
$1,005.60 |
$1,005.60 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,402.40 |
$3,402.40 |
$3,402.40 |
$3,065.15
|
|
Cytogenetics 25-99
|
$741.60 |
$741.60 |
$741.60 |
$190.00
|
|
Cytogenetics 3-5
|
$288.80 |
$288.80 |
$288.80 |
$170.27
|
|
Cytogenomic neo microra alys
|
$7,221.60 |
$7,221.60 |
$7,221.60 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$8,039.20 |
$8,039.20 |
$8,039.20 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$248.80 |
$248.80 |
$248.80 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$242.40 |
$242.40 |
$242.40 |
$97.50
|
|
Cyto/molecular report
|
$212.80 |
$212.80 |
$212.80 |
$133.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$322.40 |
$322.40 |
$322.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$252.00 |
$252.00 |
$252.00 |
$91.84
|
|
Cytopathology concentration technique smears & interpretation
|
$304.00 |
$304.00 |
$304.00 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$284.80 |
$284.80 |
$284.80 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$193.60 |
$193.60 |
$193.60 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$187.20 |
$187.20 |
$187.20 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$790.40 |
$790.40 |
$790.40 |
$209.23
|
|
Cytopath smear other source
|
$172.00 |
$172.00 |
$172.00 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$120.80 |
$120.80 |
$120.80 |
$96.20
|
|
Cytopath tbs c/v manual
|
$130.40 |
$130.40 |
$130.40 |
$59.28
|
|
Cytotoxic antibody screening
|
$1,440.80 |
$1,440.80 |
$1,440.80 |
$133.25
|
|
Dch pulmonary stress test
|
$1,484.80 |
$1,484.80 |
$1,484.80 |
$963.30
|
|
Dch validity tests
|
$51.20 |
$51.20 |
$51.20 |
$24.50
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$17,878.40 |
$17,878.40 |
$17,878.40 |
$4,952.36
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$514.40 |
$514.40 |
$514.40 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$924.00 |
$924.00 |
$924.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,335.20 |
$2,335.20 |
$2,335.20 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,415.20 |
$1,415.20 |
$1,415.20 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,272.80 |
$1,272.80 |
$1,272.80 |
$810.50
|
|
Debride nail1-5 11720
|
$396.00 |
$396.00 |
$396.00 |
$148.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,416.80 |
$1,416.80 |
$1,416.80 |
$1,012.80
|
|
Debride skin bone at fx site
|
$2,404.00 |
$2,404.00 |
$2,404.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,319.20 |
$1,319.20 |
$1,319.20 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,352.80 |
$1,352.80 |
$1,352.80 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$1,160.00
|
|
Decalcification
|
$161.60 |
$161.60 |
$161.60 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$2,113.60 |
$2,113.60 |
$2,113.60 |
$543.00
|
|
Delivery of placenta 59414
|
$4,895.20 |
$4,895.20 |
$4,895.20 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$292.80 |
$292.80 |
$292.80 |
$408.10
|
|
Desoxycorticosterone
|
$610.40 |
$610.40 |
$610.40 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$6,712.80 |
$6,712.80 |
$6,712.80 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$4,188.80 |
$4,188.80 |
$4,188.80 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$4,188.80 |
$4,188.80 |
$4,188.80 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,712.80 |
$6,712.80 |
$6,712.80 |
$3,202.98
|
|
Developmental screen/score/document 96110
|
$219.20 |
$219.20 |
$219.20 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$442.40 |
$442.40 |
$442.40 |
$337.50
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$248.00 |
$248.00 |
$248.00 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$445.60 |
$445.60 |
$445.60 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$524.80 |
$524.80 |
$524.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$92.80 |
$92.80 |
$92.80 |
$79.20
|
|
Diab manage trn ind/group
|
$110.40 |
$110.40 |
$110.40 |
$56.55
|
|
Diagnostic laryngoscopy 31575
|
$206.40 |
$206.40 |
$206.40 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$750.40 |
$750.40 |
$750.40 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$567.20 |
$567.20 |
$567.20 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$4.80 |
$4.80 |
$4.80 |
$115.15
|
|
Diffusing capacity
|
$141.60 |
$141.60 |
$141.60 |
$332.00
|
|
Digoxin total therapeutic drug level
|
$220.00 |
$220.00 |
$220.00 |
$102.00
|
|
Disability dlco
|
$810.40 |
$810.40 |
$810.40 |
$282.40
|
|
Disaccharidases
|
$1,794.40 |
$1,794.40 |
$1,794.40 |
$216.00
|
|
Discography cerv/thor spine
|
$4,468.00 |
$4,468.00 |
$4,468.00 |
$2,565.00
|
|
Dna antibody native/double stranded
|
$445.60 |
$445.60 |
$445.60 |
$97.50
|
|
Dna gardnerella
|
$70.40 |
$70.40 |
$70.40 |
$62.50
|
|
Dna trichomonas
|
$70.40 |
$70.40 |
$70.40 |
$67.80
|
|
Doppler echo complete
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,184.80 |
$1,184.80 |
$1,184.80 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$509.60 |
$509.60 |
$509.60 |
$471.17
|
|
Dpyd gene common variants
|
$2,148.80 |
$2,148.80 |
$2,148.80 |
$380.50
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$660.80 |
$660.80 |
$660.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
$914.34
|
|
Drainage external ear simple 69000
|
$680.80 |
$680.80 |
$680.80 |
$789.60
|
|
Drainage mouth roof lesion
|
$387.20 |
$387.20 |
$387.20 |
$390.39
|
|
Drainage of arm bursa 23931
|
$7,245.60 |
$7,245.60 |
$7,245.60 |
$2,197.48
|
|
Drainage of mouth lesion
|
$5,328.00 |
$5,328.00 |
$5,328.00 |
$3,900.60
|
|
Drain blood from under nail 11740
|
$152.00 |
$152.00 |
$152.00 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$766.40 |
$766.40 |
$766.40 |
$419.00
|
|
Drain penis lesion
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$2,112.60
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$564.00 |
$564.00 |
$564.00 |
$392.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$557.60 |
$557.60 |
$557.60 |
$344.00
|
|
Dress/debrid prtl-thick burn l 16030
|
$488.00 |
$488.00 |
$488.00 |
$523.00
|
