|
Culture afb any source
|
$175.20 |
$175.20 |
$175.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$116.16 |
$116.16 |
$116.16 |
$83.30
|
|
Culture anaerobic except blood
|
$118.08 |
$118.08 |
$118.08 |
$120.00
|
|
Culture bacteria anaerobic
|
$184.80 |
$184.80 |
$184.80 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$84.48 |
$84.48 |
$84.48 |
$52.00
|
|
Culture body fluid
|
$126.72 |
$126.72 |
$126.72 |
$128.00
|
|
Culture fungi definitive id mold
|
$90.24 |
$90.24 |
$90.24 |
$79.35
|
|
Culture fungi definitive id yeast
|
$80.64 |
$80.64 |
$80.64 |
$80.00
|
|
Culture fungi other (except blood)
|
$180.96 |
$180.96 |
$180.96 |
$111.09
|
|
Culture fungi skin/hair/nail
|
$68.64 |
$68.64 |
$68.64 |
$74.75
|
|
Culture mycoplasma any source
|
$79.20 |
$79.20 |
$79.20 |
$85.26
|
|
Culture quantitative aerobic other source
|
$43.68 |
$43.68 |
$43.68 |
$92.30
|
|
Culture screening strep group a
|
$68.16 |
$68.16 |
$68.16 |
$83.16
|
|
Culture typing immunologic
|
$112.80 |
$112.80 |
$112.80 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$103.68 |
$103.68 |
$103.68 |
$138.40
|
|
Culture urine each isolate
|
$60.48 |
$60.48 |
$60.48 |
$58.30
|
|
Cutter lead
|
$4,128.48 |
$4,128.48 |
$4,128.48 |
$6,092.06
|
|
Cv stress test i&r only 93018
|
$29.76 |
$29.76 |
$29.76 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$29.76 |
$29.76 |
$29.76 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$47.76 |
$47.76 |
$47.76 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$837.44 |
$837.44 |
$837.44 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$153.17 |
$153.17 |
$153.17 |
$140.78
|
|
Cyclosporine 2 hour
|
$139.20 |
$139.20 |
$139.20 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$236.34 |
$236.34 |
$236.34 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$1,383.46 |
$1,383.46 |
$1,383.46 |
$35.28
|
|
Cylinder pump set 20cm titan zero angl
|
$12,763.30 |
$12,763.30 |
$12,763.30 |
$23,802.06
|
|
Cystatin c
|
$65.28 |
$65.28 |
$65.28 |
$78.75
|
|
Cystine urine quantitative
|
$170.40 |
$170.40 |
$170.40 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$235.20 |
$235.20 |
$235.20 |
$565.61
|
|
Cystoscopy and biopsy
|
$566.88 |
$566.88 |
$566.88 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,102.56 |
$1,102.56 |
$1,102.56 |
$4,081.37
|
|
Cystoscopy and treatment
|
$427.20 |
$427.20 |
$427.20 |
$4,061.71
|
|
Cystoscopy and treatment
|
$566.88 |
$566.88 |
$566.88 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$680.64 |
$680.64 |
$680.64 |
$1,445.41
|
|
Cystoscopy & ureter catheter
|
$1,403.52 |
$1,403.52 |
$1,403.52 |
$3,684.30
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$566.88 |
$566.88 |
$566.88 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$137.16 |
$137.16 |
$137.16 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$132.96 |
$132.96 |
$132.96 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$87.36 |
$87.36 |
$87.36 |
$100.00
|
|
Cytopath fl nongyn filter
|
$97.44 |
$97.44 |
$97.44 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$155.52 |
$155.52 |
$155.52 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$84.96 |
$84.96 |
$84.96 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$73.44 |
$73.44 |
$73.44 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$94.56 |
$94.56 |
$94.56 |
$127.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$83.52 |
$83.52 |
$83.52 |
$128.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$67.68 |
$67.68 |
$67.68 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$69.60 |
$69.60 |
$69.60 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$204.96 |
$204.96 |
$204.96 |
$211.00
|
|
Cytopath smear other source
|
$53.76 |
$53.76 |
$53.76 |
$91.00
|
|
Cytopath smear other source
|
$32.16 |
$32.16 |
$32.16 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$1,212.96 |
$1,212.96 |
$1,212.96 |
$95.00
|
|
Cytopath tbs c/v manual
|
$43.20 |
$43.20 |
$43.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$826.08 |
$826.08 |
$826.08 |
$133.25
|
|
Dacarbazine 100 mg intravenous solution
|
$47.76 |
$47.76 |
$47.76 |
$59.15
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,537.85 |
$1,537.85 |
$1,537.85 |
$3,047.85
|
|
Dalbavancin 500 mg intravenous solution
|
$3,710.00 |
$3,710.00 |
$3,710.00 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$70.30 |
$70.30 |
$70.30 |
$169.00
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$25,245.62 |
$25,245.62 |
$25,245.62 |
$21,050.42
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$8,951.36 |
$8,951.36 |
$8,951.36 |
$6,281.29
|
|
Dark field exam spec collj
|
$117.60 |
$117.60 |
$117.60 |
$31.20
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$198.30 |
$198.30 |
$198.30 |
$259.58
|
|
Dch glucoscan
|
$24.00 |
$24.00 |
$24.00 |
$29.16
|
|
Dch pulmonary stress test
|
$266.40 |
$266.40 |
$266.40 |
$963.30
|
|
Dch validity tests
|
$43.20 |
$43.20 |
$43.20 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$111.36 |
$111.36 |
$111.36 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$376.32 |
$376.32 |
$376.32 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$115.20 |
$115.20 |
$115.20 |
$262.25
|
|
Debridement bone <= 20 sq cm
|
$1,402.08 |
$1,402.08 |
$1,402.08 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$178.56 |
$178.56 |
$178.56 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$552.96 |
$552.96 |
$552.96 |
$1,412.70
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,068.96 |
$1,068.96 |
$1,068.96 |
$810.50
|
|
Debride nail1-5 11720
|
$57.60 |
$57.60 |
$57.60 |
$149.04
|
|
Debride nail6 or more 11721
|
$333.60 |
$333.60 |
$333.60 |
$170.88
|
|
Debride skin bone at fx site
|
$897.60 |
$897.60 |
$897.60 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$178.56 |
$178.56 |
$178.56 |
$639.60
|
|
Debrid mastoidectomy cavity simple 69220
|
$183.36 |
$183.36 |
$183.36 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$608.16 |
$608.16 |
$608.16 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$332.64 |
$332.64 |
$332.64 |
$1,160.00
|
|
Decalcification
|
$60.00 |
$60.00 |
$60.00 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$1,317.03 |
$1,317.03 |
$1,317.03 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$433.44 |
$433.44 |
$433.44 |
$557.00
|
|
Deep muscle biopsy 20205
|
$406.08 |
$406.08 |
$406.08 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$115.56 |
$115.56 |
$115.56 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$3,345.65 |
$3,345.65 |
$3,345.65 |
$1,807.08
|
|
Delivery of placenta 59414
|
$363.36 |
$363.36 |
$363.36 |
$2,859.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$81.60 |
$81.60 |
$81.60 |
$184.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,988.81 |
$7,988.81 |
$7,988.81 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$396.00 |
$396.00 |
$396.00 |
$401.60
|
|
Depo-estradiol cypionate inj
|
$489.68 |
$489.68 |
$489.68 |
$88.06
|
|
Dermagraft
|
$1,814.40 |
$1,814.40 |
$1,814.40 |
$85.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,803.24 |
$1,803.24 |
$1,803.24 |
$91.56
|
|
Destroy premlg lesns;1st lesn 17000
|
$90.72 |
$90.72 |
$90.72 |
$203.04
|
|
Destruct ben lesion 15/> 17111
|
$99.84 |
$99.84 |
$99.84 |
$235.13
|
|
Destruct cut vasl lesions <10cm 17106
|
$459.84 |
$459.84 |
$459.84 |
$666.75
|
|
Destruction 2-14 lesions 17003
|
$41.28 |
$41.28 |
$41.28 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$92.16 |
$92.16 |
$92.16 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$3,205.20
|
