|
Cystatin c
|
$67.23 |
$67.23 |
$67.23 |
$76.48
|
|
Cytogenetics 25-99
|
$180.09 |
$180.09 |
$180.09 |
$189.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$134.93 |
$134.93 |
$134.93 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$237.36 |
$237.36 |
$237.36 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$603.34 |
$603.34 |
$603.34 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$951.16 |
$951.16 |
$951.16 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$449.37 |
$449.37 |
$449.37 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$132.69 |
$132.69 |
$132.69 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$787.24 |
$787.24 |
$787.24 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$957.84 |
$957.84 |
$957.84 |
$209.92
|
|
Cytopath smear other source
|
$1,343.67 |
$1,343.67 |
$1,343.67 |
$140.07
|
|
Cytopath smear oth prep screen & interp
|
$1,074.93 |
$1,074.93 |
$1,074.93 |
$96.20
|
|
Cytopath tbs c/v manual
|
$907.74 |
$907.74 |
$907.74 |
$59.28
|
|
Cytopath tbs c/v redo
|
$934.44 |
$934.44 |
$934.44 |
$84.80
|
|
Dacarbazine 100 mg intravenous solution
|
$150.50 |
$150.50 |
$150.50 |
$62.70
|
|
Dalteparin sodium
|
$152.44 |
$152.44 |
$152.44 |
$469.55
|
|
Dch pulmonary stress test
|
$6,637.42 |
$6,637.42 |
$6,637.42 |
$963.30
|
|
Decalcification
|
$316.67 |
$316.67 |
$316.67 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$589.19 |
$589.19 |
$589.19 |
$1,073.52
|
|
Deferoxamine 500 mg solution for injection
|
$157.78 |
$157.78 |
$157.78 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$668.11 |
$668.11 |
$668.11 |
$182.40
|
|
Depo-estradiol cypionate inj
|
$138.00 |
$138.00 |
$138.00 |
$87.27
|
|
Device intraute mirena
|
$3,497.48 |
$3,497.48 |
$3,497.48 |
$2,125.00
|
|
Dextran 40 infusion
|
$135.50 |
$135.50 |
$135.50 |
$151.20
|
|
Dextrose 5 % IV bolus
|
$209.71 |
$209.71 |
$209.71 |
$48.00
|
|
Diagnostic Mammogram (both breasts)
|
$1,685.78 |
$1,685.78 |
$1,685.78 |
$413.50
|
|
Dicyclomine injection
|
$174.00 |
$174.00 |
$174.00 |
$150.91
|
|
Diffusing capacity
|
$2,056.71 |
$2,056.71 |
$2,056.71 |
$335.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$131.28 |
$131.28 |
$131.28 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,796.28 |
$12,796.28 |
$12,796.28 |
$10,079.82
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$165.00 |
$165.00 |
$165.00 |
$297.86
|
|
Diltiazem 5 mg/ml intravenous solution
|
$464.68 |
$464.68 |
$464.68 |
$46.56
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$131.03 |
$131.03 |
$131.03 |
$18.35
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$175.95 |
$175.95 |
$175.95 |
$98.56
|
|
Disability dlco
|
$2,419.19 |
$2,419.19 |
$2,419.19 |
$292.03
|
|
Disaccharidases
|
$511.82 |
$511.82 |
$511.82 |
$224.31
|
|
Discography cerv/thor spine
|
$2,224.17 |
$2,224.17 |
$2,224.17 |
$2,481.50
|
|
Dmd dup/delet analysis
|
$4,508.10 |
$4,508.10 |
$4,508.10 |
$418.50
|
|
Doppler echo complete
|
$2,638.89 |
$2,638.89 |
$2,638.89 |
$558.00
|
|
Doripenem 50 mg/ml inj 10 ml
|
$250.30 |
$250.30 |
$250.30 |
$73.80
|
|
Dorsi & plantar flex ass/res
|
$858.00 |
$858.00 |
$858.00 |
$163.50
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$286.22 |
$286.22 |
$286.22 |
$84.80
|
|
Dpyd gene common variants
|
$979.13 |
$979.13 |
$979.13 |
$423.60
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$288.82 |
$288.82 |
$288.82 |
$5,857.52
|
|
Droperidol 2.5 mg/ml injection solution
|
$121.23 |
$121.23 |
$121.23 |
$31.26
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$18.50 |
$18.50 |
$18.50 |
$58.20
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$27.17 |
$27.17 |
$27.17 |
$135.72
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$50.05 |
$50.05 |
$50.05 |
$8,040.27
|
|
Drug assay caffeine
|
$34.58 |
$34.58 |
$34.58 |
$81.61
|
|
Drug assay voriconazole
|
$320.77 |
$320.77 |
$320.77 |
$96.75
|
|
Drug test def 15-21 classes
|
$2,986.81 |
$2,986.81 |
$2,986.81 |
$316.00
|
|
Drug test def 1-7 classes
|
$1,324.17 |
$1,324.17 |
$1,324.17 |
$263.25
|
|
Drug test def 22+ classes
|
$3,982.44 |
$3,982.44 |
$3,982.44 |
$423.00
|
|
Drug test def 8-14 classes
|
$2,152.49 |
$2,152.49 |
$2,152.49 |
$289.80
|
|
Drug test prsmv instrmnt
|
$927.74 |
$927.74 |
$927.74 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$927.74 |
$927.74 |
$927.74 |
$280.95
|
|
Ecg 12 lead tracing only
|
$2,559.27 |
$2,559.27 |
$2,559.27 |
$226.50
|
|
Ecg external < 48 hours scanning analysis w/report
|
$2,278.67 |
$2,278.67 |
$2,278.67 |
$541.20
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,729.81 |
$1,729.81 |
$1,729.81 |
$711.00
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$4,155.30 |
$4,155.30 |
$4,155.30 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$3,930.02 |
$3,930.02 |
$3,930.02 |
$371.25
|
|
Echo exam of fetal heart
|
$2,087.74 |
$2,087.74 |
$2,087.74 |
$904.80
|
|
Echo exam of fetal heart
|
$1,224.40 |
$1,224.40 |
$1,224.40 |
$538.27
|
|
Echo exam of fetal heart
|
$571.41 |
$571.41 |
$571.41 |
$431.41
|
|
Echo exam of fetal heart
|
$409.70 |
$409.70 |
$409.70 |
$319.00
|
|
Echo guide for amniocentesis
|
$247.78 |
$247.78 |
$247.78 |
$446.60
|
|
Echo guide for artery repair
|
$5,610.28 |
$5,610.28 |
$5,610.28 |
$687.35
|
|
Echo stress
|
$15,364.38 |
$15,364.38 |
$15,364.38 |
$1,606.44
|
|
Echo tee probe placement image acquisition interpretation & report
|
$9,215.74 |
$9,215.74 |
$9,215.74 |
$1,889.20
|
|
Echo transesophageal
|
$3,546.63 |
$3,546.63 |
$3,546.63 |
$1,599.50
|
|
Echo transesophageal intraop
|
$13,104.89 |
$13,104.89 |
$13,104.89 |
$1,578.00
|
|
Echo transthoracic
|
$4,935.27 |
$4,935.27 |
$4,935.27 |
$1,361.75
|
|
Echo transthoracic
|
$1,841.80 |
$1,841.80 |
$1,841.80 |
$1,010.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$4,243.57 |
$4,243.57 |
$4,243.57 |
$1,022.30
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$22,830.50 |
$22,830.50 |
$22,830.50 |
$19,540.29
|
|
Edetate calcium disodium inj
|
$9,424.56 |
$9,424.56 |
$9,424.56 |
$8,672.81
|
|
Eeg 41-60 minutes 95812-26
|
$6,789.63 |
$6,789.63 |
$6,789.63 |
$923.88
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$7,969.69 |
$7,969.69 |
$7,969.69 |
$970.07
|
|
Eeg during surgery
|
$14,006.46 |
$14,006.46 |
$14,006.46 |
$775.45
|
|
Eeg monitor/record/awake/drowsy 95816
|
$6,789.63 |
$6,789.63 |
$6,789.63 |
$831.00
|
|
Eeg over 1 hour 95813 - 26
|
$14,006.46 |
$14,006.46 |
$14,006.46 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$6,789.63 |
$6,789.63 |
$6,789.63 |
$865.00
|
|
Eeg recording awake and asleep
|
$6,789.63 |
$6,789.63 |
$6,789.63 |
$929.00
|
|
Eeg without vid 2-12hr cont mntr
|
$1,068.18 |
$1,068.18 |
$1,068.18 |
$826.15
|
|
Eeg without vid 2-12 hr unmntr
|
$554.69 |
$554.69 |
$554.69 |
$681.02
|
|
Eeg without vid ea 12-26hr cont
|
$1,843.87 |
$1,843.87 |
$1,843.87 |
$1,584.70
|
|
Eeg without vid ea 12-26hr intmt
|
$1,843.87 |
$1,843.87 |
$1,843.87 |
$1,402.50
|
|
Eeg wo vid 2-12hr intmt mntr
|
$1,127.85 |
$1,127.85 |
$1,127.85 |
$704.79
|
|
Eeg wo vid ea 12-26hr unmntr
|
$1,843.87 |
$1,843.87 |
$1,843.87 |
$1,591.10
|
|
Egfr gene com variants
|
$1,238.57 |
$1,238.57 |
$1,238.57 |
$657.00
|
|
Electrode stimulation brain
|
$5,292.73 |
$5,292.73 |
$5,292.73 |
$1,180.80
|
|
Electron microscopy diagnostic
|
$5,220.82 |
$5,220.82 |
$5,220.82 |
$1,006.20
|
|
Electrophysiology evaluation
|
$28,134.62 |
$28,134.62 |
$28,134.62 |
$8,979.45
|
|
Electrophysiology evaluation
|
$36,030.20 |
$36,030.20 |
$36,030.20 |
$10,593.00
|
|
Electrophysiology evaluation
|
$35,746.95 |
$35,746.95 |
$35,746.95 |
$6,760.00
|
|
Electrophysiology evaluation
|
$33,361.30 |
$33,361.30 |
$33,361.30 |
$5,854.80
|
|
Electrophysiology evaluation
|
$12,825.59 |
$12,825.59 |
$12,825.59 |
$2,504.00
|
|
Electrophysiology evaluation
|
$13,417.12 |
$13,417.12 |
$13,417.12 |
$2,902.81
|
|
Electrophys map 3d add-on
|
$22,204.66 |
$22,204.66 |
$22,204.66 |
$5,881.00
|
|
Emg 2 ext w-w/o paraspinal area 95861
|
$1,543.96 |
$1,543.96 |
$1,543.96 |
$377.36
|
