|
Culture afb any source
|
$325.20 |
$325.20 |
$325.20 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$131.40 |
$131.40 |
$131.40 |
$73.00
|
|
Culture anaerobic except blood
|
$305.40 |
$305.40 |
$305.40 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$148.20 |
$148.20 |
$148.20 |
$49.40
|
|
Culture body fluid
|
$244.80 |
$244.80 |
$244.80 |
$111.15
|
|
Culture fungi definitive id mold
|
$169.20 |
$169.20 |
$169.20 |
$70.00
|
|
Culture fungi definitive id yeast
|
$129.60 |
$129.60 |
$129.60 |
$68.00
|
|
Culture fungi other (except blood)
|
$243.00 |
$243.00 |
$243.00 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$150.00 |
$150.00 |
$150.00 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$117.00 |
$117.00 |
$117.00 |
$79.00
|
|
Culture mycoplasma any source
|
$332.40 |
$332.40 |
$332.40 |
$94.00
|
|
Culture quantitative aerobic other source
|
$231.00 |
$231.00 |
$231.00 |
$63.45
|
|
Culture screening strep group a
|
$169.80 |
$169.80 |
$169.80 |
$76.00
|
|
Culture typing immunologic
|
$76.80 |
$76.80 |
$76.80 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$392.40 |
$392.40 |
$392.40 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$63.00 |
$63.00 |
$63.00 |
$100.20
|
|
Culture urine each isolate
|
$117.60 |
$117.60 |
$117.60 |
$44.80
|
|
Cv line/pic reposition
|
$1,801.20 |
$1,801.20 |
$1,801.20 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$145.20 |
$145.20 |
$145.20 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$42.47 |
$42.47 |
$42.47 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$220.20 |
$220.20 |
$220.20 |
$91.20
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1.27 |
$1.27 |
$1.27 |
$2.42
|
|
Cyclophosphamide 25 mg capsule
|
$22.51 |
$22.51 |
$22.51 |
$22.51
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$179.92 |
$179.92 |
$179.92 |
$179.92
|
|
Cyclosporine 2 hour
|
$334.80 |
$334.80 |
$334.80 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$9.79 |
$9.79 |
$9.79 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$19.50 |
$1,187.49 |
$1,187.49 |
$19.50
|
|
Cystatin c
|
$135.00 |
$135.00 |
$135.00 |
$83.20
|
|
Cystine urine quantitative
|
$694.20 |
$694.20 |
$694.20 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$315.60 |
$315.60 |
$315.60 |
$487.04
|
|
Cystoscopy (Bladder Scope)
|
$4,519.20 |
$4,519.20 |
$4,519.20 |
$1,633.60
|
|
Cystoscopy removal of clots
|
$3,409.80 |
$3,409.80 |
$3,409.80 |
$3,970.98
|
|
Cytarabine 20 mg/ml injection solution
|
$197.47 |
$197.47 |
$197.47 |
$59.31
|
|
Cytogenetics 25-99
|
$419.40 |
$419.40 |
$419.40 |
$188.40
|
|
Cytogenetics 3-5
|
$277.80 |
$277.80 |
$277.80 |
$127.86
|
|
Cytogenom microarray copy nmbr var
|
$2,056.80 |
$2,056.80 |
$2,056.80 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$263.40 |
$263.40 |
$263.40 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$356.40 |
$356.40 |
$356.40 |
$95.00
|
|
Cytomegalovirus dfa
|
$799.20 |
$799.20 |
$799.20 |
$101.58
|
|
Cytomegalovirus imm IV /vial
|
$2,635.28 |
$2,635.28 |
$2,635.28 |
$2,635.28
|
|
Cyto/molecular report
|
$207.00 |
$207.00 |
$207.00 |
$91.65
|
|
Cytopath fl nongyn filter
|
$202.20 |
$202.20 |
$202.20 |
$91.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$328.80 |
$328.80 |
$328.80 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$211.20 |
$211.20 |
$211.20 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$175.80 |
$175.80 |
$175.80 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$246.60 |
$246.60 |
$246.60 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$235.80 |
$235.80 |
$235.80 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$238.20 |
$238.20 |
$238.20 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$227.40 |
$227.40 |
$227.40 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$367.20 |
$367.20 |
$367.20 |
$205.00
|
|
Cytopath smear other source
|
$148.20 |
$148.20 |
$148.20 |
$88.13
|
|
Cytopath smear other source
|
$227.40 |
$227.40 |
$227.40 |
$145.31
|
|
Cytopath smear oth prep screen & interp
|
$235.80 |
$235.80 |
$235.80 |
$95.00
|
|
Cytotoxic antibody screening
|
$642.60 |
$642.60 |
$642.60 |
$184.63
|
|
Cytotoxic antibody screening
|
$567.00 |
$567.00 |
$567.00 |
$96.46
|
|
Cytp urine 3-5 probes cmptr
|
$769.80 |
$769.80 |
$769.80 |
$779.00
|
|
Dacarbazine 100 mg intravenous solution
|
$182.06 |
$182.06 |
$182.06 |
$39.53
|
|
Dactinomycin 0.5 mg intravenous solution
|
$3,019.83 |
$3,019.83 |
$3,019.83 |
$1,225.86
|
|
Dalbavancin 500 mg intravenous solution
|
$3,070.44 |
$3,070.44 |
$3,070.44 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.18 |
$647.87 |
$647.87 |
$1.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$15,683.37 |
$15,683.37 |
$15,683.37 |
$15,683.37
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,100.05 |
$5,500.25 |
$5,500.25 |
$4,542.99
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$363.03 |
$363.03 |
$363.03 |
$14,514.57
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$194.08 |
$194.08 |
$194.08 |
$130.13
|
|
Dch glucoscan
|
$54.00 |
$54.00 |
$54.00 |
$28.10
|
|
Dch pulmonary stress test
|
$2,113.80 |
$2,113.80 |
$2,113.80 |
$964.41
|
|
Dch validity tests
|
$59.40 |
$59.40 |
$59.40 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$21.60 |
$21.60 |
$21.60 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$323.40 |
$575.40 |
$575.40 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$4,046.40 |
$4,046.40 |
$4,046.40 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$756.00 |
$756.00 |
$756.00 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,349.60 |
$2,349.60 |
$2,349.60 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,681.40 |
$2,681.40 |
$2,681.40 |
$779.35
|
|
Debride nail1-5 11720
|
$468.00 |
$468.00 |
$468.00 |
$186.88
|
|
Debride nail6 or more 11721
|
$344.40 |
$344.40 |
$344.40 |
$200.21
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$756.00 |
$756.00 |
$756.00 |
$728.40
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,814.00 |
$2,814.00 |
$2,814.00 |
$1,101.10
|
|
Decalcification
|
$132.60 |
$132.60 |
$132.60 |
$72.15
|
|
Decitabine 50 mg intravenous solution
|
$41.80 |
$41.80 |
$41.80 |
$225.55
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,277.40 |
$1,277.40 |
$1,277.40 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$192.68 |
$192.68 |
$192.68 |
$47.62
|
|
Degarelix 120 mg subcutaneous solution
|
$2,303.24 |
$2,303.24 |
$2,303.24 |
$2,303.24
|
|
Demonstrate use home inr mon
|
$435.60 |
$435.60 |
$435.60 |
$340.79
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$165.60 |
$165.60 |
$165.60 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,681.80 |
$4,681.80 |
$4,681.80 |
$4,681.80
|
|
Depo-estradiol cypionate inj
|
$337.07 |
$337.07 |
$337.07 |
$337.07
|
|
Dermagraft
|
$2,998.80 |
$2,998.80 |
$2,998.80 |
$100.50
|
|
Design mlc device for imrt
|
$904.20 |
$904.20 |
$904.20 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$20.43 |
$50.62 |
$50.62 |
$37.26
|
|
Destroy premlg lesns;1st lesn 17000
|
$153.00 |
$153.00 |
$153.00 |
$199.50
|
|
Destruct cut vasl lesions <10cm 17106
|
$1,350.60 |
$1,350.60 |
$1,350.60 |
$664.05
|
|
Destruction benign lesions < 14 lesions
|
$296.40 |
$296.40 |
$296.40 |
$231.52
|
|
Destruction by injection tx of nerve 64630
|
$2,012.40 |
$2,012.40 |
$2,012.40 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,622.80 |
$6,622.80 |
$6,622.80 |
$3,101.88
|
|
Developmental screen/score/document 96110
|
$151.80 |
$151.80 |
$151.80 |
$126.75
|
|
Device intraute mirena
|
$1,803.72 |
$1,803.72 |
$1,803.72 |
$3,052.80
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$145.20 |
$145.20 |
$145.20 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$112.07 |
$112.07 |
$319.80 |
$8.23
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$4,745.71 |
$4,745.71 |
$4,745.71 |
$465.34
|
|
Dextran 40 infusion
|
$173.97 |
$173.97 |
$173.97 |
$173.97
|
