|
Cytomegalovirus dfa
|
$135.17 |
$135.17 |
$799.20 |
|
|
Cytomegalovirus imm IV /vial
|
$2,635.28 |
$5,648.38 |
$5,648.38 |
|
|
Cyto/molecular report
|
$118.80 |
$202.20 |
$225.60 |
|
|
Cytopath c/v index add-on
|
$88.20 |
$88.20 |
$88.20 |
|
|
Cytopath c/v manual
|
$168.00 |
$168.00 |
$168.00 |
|
|
Cytopath fl nongyn filter
|
$145.00 |
$149.50 |
$224.87 |
|
|
Cytopathology cellular enhancement technique non-gyn
|
$94.62 |
$246.00 |
$328.80 |
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$140.40 |
$211.20 |
$283.20 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$52.47 |
$163.80 |
$193.80 |
|
|
Cytopathology concentration technique smears & interpretation
|
$145.00 |
$220.29 |
$435.00 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$113.40 |
$189.00 |
$409.20 |
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$54.50 |
$57.50 |
$247.80 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$198.60 |
$219.60 |
$435.00 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$81.88 |
$315.60 |
$858.01 |
|
|
Cytopath smear other source
|
$99.08 |
$148.20 |
$177.60 |
|
|
Cytopath smear other source
|
$195.00 |
$227.40 |
$312.35 |
|
|
Cytopath smear oth prep screen & interp
|
$126.60 |
$225.60 |
$235.80 |
|
|
Cytopath tbs c/v manual
|
$75.00 |
$85.80 |
$121.22 |
|
|
Cytotoxic antibody screening
|
$48.00 |
$141.60 |
$642.60 |
|
|
Cytotoxic antibody screening
|
$387.00 |
$567.00 |
$718.20 |
|
|
Cytp urine 3-5 probes cmptr
|
$502.19 |
$769.80 |
$830.40 |
|
|
Dacarbazine 100 mg intravenous solution
|
$54.56 |
$180.07 |
$207.86 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,024.52 |
$2,024.52 |
$28,114.64 |
|
|
Dalbavancin 500 mg intravenous solution
|
$96.48 |
$3,070.44 |
$3,959.85 |
|
|
Dalteparin sodium
|
$111.45 |
$111.45 |
$721.23 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.18 |
$171.19 |
$4,278.74 |
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$620.76 |
$15,683.37 |
$22,216.48 |
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$660.03 |
$5,500.25 |
$15,650.86 |
|
|
Dark field exam spec collj
|
$206.25 |
$206.25 |
$206.25 |
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$363.03 |
$26,477.15 |
$26,477.15 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$15.55 |
$127.58 |
$1,406.33 |
|
|
Daunorubicin citrate inj
|
$58.54 |
$58.54 |
$58.54 |
|
|
Dch glucoscan
|
$29.16 |
$54.00 |
$79.80 |
|
|
Dch pulmonary stress test
|
$477.60 |
$1,505.50 |
$2,113.80 |
|
|
Dch validity tests
|
$9.50 |
$15.60 |
$59.40 |
|
|
Deamidated gliadin antibody iga
|
$21.60 |
$68.00 |
$353.33 |
|
|
Debridement (>20 cm) charge pt
|
$81.00 |
$559.20 |
$2,150.09 |
|
|
Debridement bone <= 20 sq cm
|
$2,527.00 |
$4,046.40 |
$5,064.50 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$444.50 |
$1,413.50 |
$1,798.80 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$724.20 |
$2,071.20 |
$2,693.40 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$666.25 |
$944.50 |
$2,699.40 |
|
|
Debride nail1-5 11720
|
$16.80 |
$471.00 |
$595.80 |
|
|
Debride nail6 or more 11721
|
$23.98 |
$346.80 |
$402.00 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$409.12 |
$775.00 |
$1,690.80 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$887.50 |
$2,445.00 |
$3,171.60 |
|
|
Decalcification
|
$60.00 |
$117.00 |
$147.00 |
|
|
Decitabine 50 mg intravenous solution
|
$41.80 |
$410.37 |
$18,182.03 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$199.20 |
$780.00 |
$2,045.21 |
|
|
Deferoxamine 500 mg solution for injection
|
$42.43 |
$73.98 |
$283.74 |
|
|
Degarelix 120 mg subcutaneous solution
|
$40.07 |
$1,807.08 |
$2,303.24 |
|
|
Demonstrate use home inr mon
|
$395.50 |
$407.50 |
$465.65 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$93.50 |
$147.00 |
$348.99 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$309.95 |
$4,681.80 |
$7,951.40 |
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$615.00 |
$615.00 |
$615.00 |
|
|
Depo-estradiol cypionate inj
|
$337.07 |
$883.18 |
$883.18 |
|
|
Dermagraft
|
$2,866.80 |
$2,998.80 |
$3,307.80 |
|
|
Design mlc device for imrt
|
$852.60 |
$967.20 |
$19,895.26 |
|
|
Desmopressin 4 mcg/ml injection solution
|
$20.43 |
$50.62 |
$8,526.96 |
|
|
Desoxycorticosterone
|
$196.80 |
$196.80 |
$364.71 |
|
|
Destroy premlg lesns;1st lesn 17000
|
$153.00 |
$163.80 |
$486.65 |
|
|
Destruct cut vasl lesions <10cm 17106
|
$1,291.80 |
$1,350.60 |
$1,350.60 |
|
|
Destruction 2-14 lesions 17003
|
$119.40 |
$119.40 |
$233.63 |
|
|
Destruction benign lesions < 14 lesions
|
$253.80 |
$295.80 |
$296.40 |
|
|
Destruction by injection tx of nerve 64630
|
$2,012.40 |
$2,012.40 |
$2,012.40 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,622.80 |
$6,622.80 |
$6,622.80 |
|
|
Destruction premal lesions 15/> 17004
|
$285.00 |
$285.00 |
$520.80 |
|
|
Detect agent nos dna dir
|
$150.60 |
$150.60 |
$697.87 |
|
|
Detect agnt mult dna direc
|
$237.60 |
$284.00 |
$496.46 |
|
|
Developmental screen/score/document 96110
|
$7.00 |
$151.80 |
$609.35 |
|
|
Devel tst phys/qhp 1st hr
|
$69.12 |
$69.12 |
$69.12 |
|
|
Device ablt adv novasure
|
$18,900.00 |
$18,900.00 |
$18,900.00 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$8,000.00 |
$8,000.00 |
$21,114.00 |
|
|
Device intraute mirena
|
$1,447.36 |
$1,447.36 |
$1,803.72 |
|
|
Device tiss remov myosure reach
|
$7,845.15 |
$7,845.15 |
$11,004.35 |
|
|
Devlopment test interpt&rep
|
$81.60 |
$135.00 |
$289.80 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$30.80 |
$30.80 |
$30.80 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$143.50 |
$146.00 |
$1,147.46 |
|
|
Dexamethasone 4 mg tablet
|
$47.72 |
$47.72 |
$47.72 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.12 |
$86.54 |
$319.80 |
|
|
Dexamethasone intra implant
|
$2,565.05 |
$2,565.05 |
$2,565.05 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$849.53 |
$1,297.86 |
$4,745.71 |
|
|
Dextran 40 infusion
|
$98.50 |
$98.50 |
$173.97 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$35.15 |
$78.83 |
$78.83 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$7.20 |
$78.65 |
$78.67 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.68 |
$79.76 |
$122.62 |
|
|
Dextrose 5 % IV bolus
|
$55.62 |
$78.86 |
$90.50 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$111.50 |
$315.60 |
$588.00 |
|
|
Diabetes (HbA1c) Test
|
$37.62 |
$135.00 |
$250.80 |
|
|
Diab manage trn ind/group
|
$21.50 |
$51.00 |
$96.23 |
|
|
Diagnostic anoscopy spx 46600
|
$245.97 |
$245.97 |
$245.97 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$35.00 |
$53.40 |
$57.00 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$35.00 |
$53.40 |
$57.00 |
|
|
Diagnostic laryngoscopy 31505
|
$465.60 |
$465.60 |
$465.60 |
|
|
Diagnostic laryngoscopy 31575
|
$245.50 |
$841.80 |
$1,574.40 |
|
|
Diagnostic Mammogram (both breasts)
|
$222.00 |
$324.00 |
$858.92 |
|
|
Diagnostic Mammogram (one breast)
|
$185.50 |
$259.20 |
$754.70 |
|
|
Diagnostic radio unlisted proc
|
$978.74 |
$978.74 |
$1,235.00 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$4,743.50 |
$11,506.80 |
$11,889.00 |
|
|
Dialysis one evaluation
|
$1,051.20 |
$1,568.40 |
$2,756.33 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.22 |
$115.15 |
$298.43 |
|
