|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$234.60 |
$234.60 |
$234.60 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$193.80 |
$193.80 |
$193.80 |
$90.88
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$313.80 |
$313.80 |
$313.80 |
$205.00
|
|
Cytopath smear other source
|
$177.60 |
$177.60 |
$177.60 |
$88.13
|
|
Cytopath tbs c/v manual
|
$109.20 |
$109.20 |
$109.20 |
$57.94
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.18 |
$2.18 |
$2.18 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3,483.00 |
$3,483.00 |
$3,483.00 |
$4,542.99
|
|
Dch glucoscan
|
$49.80 |
$49.80 |
$49.80 |
$28.10
|
|
Dch validity tests
|
$48.00 |
$48.00 |
$48.00 |
$25.00
|
|
Debridement (>20 cm) charge pt
|
$758.40 |
$758.40 |
$758.40 |
$313.30
|
|
Decalcification
|
$122.40 |
$122.40 |
$122.40 |
$72.15
|
|
Deferoxamine 500 mg solution for injection
|
$45.44 |
$45.44 |
$45.44 |
$47.62
|
|
Degarelix 120 mg subcutaneous solution
|
$1,395.76 |
$1,395.76 |
$1,395.76 |
$2,303.24
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,681.80 |
$4,681.80 |
$4,681.80 |
$4,681.80
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$256.80 |
$256.80 |
$256.80 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$41.53 |
$41.53 |
$41.53 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$78.83 |
$78.83 |
$78.83 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$78.65 |
$78.65 |
$78.65 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.75 |
$49.75 |
$49.75 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$78.86 |
$78.86 |
$78.86 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$425.40 |
$425.40 |
$425.40 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$151.20 |
$151.20 |
$151.20 |
$70.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$57.00 |
$57.00 |
$57.00 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$57.00 |
$57.00 |
$57.00 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$379.20 |
$379.20 |
$379.20 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$313.20 |
$313.20 |
$313.20 |
$276.60
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.22 |
$0.22 |
$0.22 |
$58.24
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$80.83 |
$80.83 |
$80.83 |
$42.12
|
|
Dicyclomine injection
|
$193.54 |
$193.54 |
$193.54 |
$153.53
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$41.63 |
$41.63 |
$41.63 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,815.78 |
$6,815.78 |
$6,815.78 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$180.60 |
$180.60 |
$180.60 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$38.75 |
$38.75 |
$38.75 |
$9.29
|
|
Disaccharidases
|
$247.80 |
$247.80 |
$247.80 |
$224.58
|
|
Dna antibody native/double stranded
|
$210.00 |
$210.00 |
$210.00 |
$101.40
|
|
Dna gardnerella
|
$75.60 |
$75.60 |
$75.60 |
$67.68
|
|
Dna probe chlamydia
|
$121.80 |
$121.80 |
$121.80 |
$98.40
|
|
Dna trichomonas
|
$77.40 |
$77.40 |
$77.40 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$99.10 |
$99.10 |
$99.10 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$104.59 |
$104.59 |
$104.59 |
$60.21
|
|
Doppler echo complete
|
$1,081.80 |
$1,081.80 |
$1,081.80 |
$517.94
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$634.80 |
$634.80 |
$634.80 |
$463.20
|
|
Droperidol 2.5 mg/ml injection solution
|
$43.80 |
$43.80 |
$43.80 |
$32.82
|
|
Drug of abuse screen urine
|
$133.20 |
$133.20 |
$133.20 |
$58.50
|
|
Drug test def 1-7 classes
|
$365.40 |
$365.40 |
$365.40 |
$316.80
|
|
Drug test def 8-14 classes
|
$365.40 |
$365.40 |
$365.40 |
$249.10
|
|
Drug test prsmv instrmnt
|
$133.20 |
$133.20 |
$133.20 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$205.20 |
$205.20 |
$205.20 |
$278.85
|
|
Drvvt confirm - quest
|
$210.00 |
$210.00 |
$210.00 |
$108.55
|
|
Ear irrigation 69209
|
$184.80 |
$184.80 |
$184.80 |
$152.50
|
|
Ecg 12 lead tracing only
|
$294.60 |
$294.60 |
$294.60 |
$222.30
|
|
Ecg external < 48 hours recording
|
$1,509.60 |
$1,509.60 |
$1,509.60 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$922.80 |
$922.80 |
$922.80 |
$541.73
|
|
Ecg external > 48 hours up to 7 days recording
|
$707.40 |
$707.40 |
$707.40 |
$180.00
|
|
Ecg external >7 days up to 15 days recording
|
$638.40 |
$638.40 |
$638.40 |
$213.20
|
|
Echocardiogram (Heart Ultrasound)
|
$2,632.80 |
$2,632.80 |
$2,632.80 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$854.40 |
$854.40 |
$854.40 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,230.60 |
$1,230.60 |
$1,230.60 |
$720.60
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$997.40
|
|
Electrical stimulation/unattended 97014
|
$113.40 |
$113.40 |
$113.40 |
$79.20
|
|
Electrolyte panel
|
$150.00 |
$150.00 |
$150.00 |
$68.56
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$43.20 |
$43.20 |
$43.20 |
$43.20
|
|
Entamoeba histolytica ag eia - sendout
|
$118.80 |
$118.80 |
$118.80 |
$68.90
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$1,074.20 |
$1,074.20 |
$1,074.20 |
$336.66
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$182.13 |
$182.13 |
$182.13 |
$178.29
|
|
Epstein barr early antigen antibody
|
$135.00 |
$135.00 |
$135.00 |
$85.20
|
|
Epstein barr nuclear antigen antibody
|
$145.80 |
$145.80 |
$145.80 |
$88.80
|
|
Epstein barr viral capsid antigen antibody igm
|
$180.60 |
$180.60 |
$180.60 |
$112.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$15.59 |
$15.59 |
$15.59 |
$62.40
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$364.08 |
$364.08 |
$364.08 |
$138.28
|
|
ER Visit (level 1, minor)
|
$318.60 |
$318.60 |
$318.60 |
$270.00
|
|
ER Visit (level 2)
|
$503.40 |
$503.40 |
$503.40 |
$469.39
|
|
ER Visit (level 3)
|
$915.60 |
$915.60 |
$915.60 |
$821.52
|
|
ER Visit (level 4)
|
$1,734.60 |
$1,734.60 |
$1,734.60 |
$1,320.00
|
|
ER Visit (level 5, high severity)
|
$2,332.80 |
$2,332.80 |
$2,332.80 |
$1,900.20
|
|
Esmolol 2,500 mg/250 ml (10 mg/ml) IV wrapper osm only
|
$562.34 |
$562.34 |
$562.34 |
$406.83
|
|
Established Patient Office Visit (level 1)
|
$226.80 |
$226.80 |
$226.80 |
$118.20
|
|
Established Patient Office Visit (level 2)
|
$435.60 |
$435.60 |
$435.60 |
$138.60
|
|
Established Patient Office Visit (level 3)
|
$539.40 |
$539.40 |
$539.40 |
$183.60
|
|
Established Patient Office Visit (level 4)
|
$645.60 |
$645.60 |
$645.60 |
$213.21
|
|
Established Patient Office Visit (level 5)
|
$991.20 |
$991.20 |
$991.20 |
$270.09
|
|
Estradiol total
|
$392.40 |
$392.40 |
$392.40 |
$142.20
|
|
Estrogens total-sendout
|
$187.80 |
$187.80 |
$187.80 |
$111.00
|
|
Ethylene glycol -sendout
|
$171.00 |
$171.00 |
$171.00 |
$81.25
|
|
Etoposide 20 mg/ml intravenous solution
|
$1.82 |
$1.82 |
$1.82 |
$20.35
|
|
External tissue culture neoplastic disorders bone marrow/blood cells
|
$849.00 |
$849.00 |
$849.00 |
$569.60
|
|
Extractable nuclear antigen/antibody any method each antibody centromere
|
$181.20 |
$181.20 |
$181.20 |
$102.50
|
|
Facial bones <3
|
$246.60 |
$246.60 |
$246.60 |
$216.45
|
|
Factor ix
|
$314.40 |
$314.40 |
$314.40 |
$139.75
|
|
Factor viii
|
$357.60 |
$357.60 |
$357.60 |
$152.50
|
|
Fat/lipids feces qualitative
|
$75.60 |
$75.60 |
$75.60 |
$43.66
|
|
#fecal-sodium
|
$54.60 |
$54.60 |
$54.60 |
$40.30
|
|
Fentanyl citrate (pf) 50 mcg/ml injection for compounding (wrapper)
|
$45.58 |
$45.58 |
$45.58 |
$48.88
|
|
Ferric carboxymaltose 50 mg iron/ml intravenous solution
|
$2,172.80 |
$2,172.80 |
$2,172.80 |
$2,131.58
|
|
Ferritin
|
$198.00 |
$198.00 |
$198.00 |
$86.45
|
|
Ferumoxytol 510 mg/17 ml (30 mg/ml) intravenous solution
|
$1,392.29 |
$1,392.29 |
$1,392.29 |
$2,289.60
|
|
Fibrin degradation d dimer quantitative
|
$272.40 |
$272.40 |
$272.40 |
$87.60
|
|
Fibrin degradation products
|
$174.00 |
$174.00 |
$174.00 |
$56.16
|