|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,104.83 |
$1,104.83 |
$1,104.83 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,104.83 |
$1,104.83 |
$1,104.83 |
$1,365.36
|
|
Ctrl nosebld postir subsq 30906
|
$551.57 |
$551.57 |
$551.57 |
$481.00
|
|
CT scan for therapy guide
|
$478.59 |
$478.59 |
$478.59 |
$777.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,332.70 |
$2,332.70 |
$2,332.70 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,780.71 |
$1,780.71 |
$1,780.71 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,638.15 |
$1,638.15 |
$1,638.15 |
$2,412.75
|
|
CT thoracic spine w/contrast
|
$1,147.26 |
$1,147.26 |
$1,147.26 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,260.97 |
$1,260.97 |
$1,260.97 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$961.00 |
$961.00 |
$961.00 |
$427.44
|
|
CT t-spine w /wo contrast
|
$1,026.34 |
$1,026.34 |
$1,026.34 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$765.83 |
$765.83 |
$765.83 |
$1,706.10
|
|
CT upper extremity without contrast (both sides)
|
$758.20 |
$758.20 |
$758.20 |
$1,473.75
|
|
CT uppr extremity w/o&w/dye
|
$841.35 |
$841.35 |
$841.35 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$33.52 |
$33.52 |
$33.52 |
$63.60
|
|
Culture afb any source
|
$72.56 |
$72.56 |
$72.56 |
$108.63
|
|
Culture anaerobic additional method definitive id each
|
$20.79 |
$20.79 |
$20.79 |
$77.31
|
|
Culture anaerobic except blood
|
$83.59 |
$83.59 |
$83.59 |
$120.59
|
|
Culture bact stool aero addl path ea
|
$95.04 |
$95.04 |
$95.04 |
$52.65
|
|
Culture body fluid
|
$96.74 |
$96.74 |
$96.74 |
$130.50
|
|
Culture fungi definitive id mold
|
$35.64 |
$35.64 |
$35.64 |
$70.00
|
|
Culture fungi definitive id yeast
|
$27.58 |
$27.58 |
$27.58 |
$79.10
|
|
Culture fungi other (except blood)
|
$84.86 |
$84.86 |
$84.86 |
$98.80
|
|
Culture fungi skin/hair/nail
|
$81.04 |
$81.04 |
$81.04 |
$77.37
|
|
Culture mycoplasma any source
|
$81.04 |
$81.04 |
$81.04 |
$92.91
|
|
Culture quantitative aerobic other source
|
$50.49 |
$50.49 |
$50.49 |
$87.02
|
|
Culture screening strep group a
|
$59.83 |
$59.83 |
$59.83 |
$79.20
|
|
Culture typing immunologic
|
$32.25 |
$32.25 |
$32.25 |
$42.12
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$231.24 |
$231.24 |
$231.24 |
$121.00
|
|
Culture urine each isolate
|
$114.14 |
$114.14 |
$114.14 |
$46.20
|
|
Cutter lead
|
$855.10 |
$855.10 |
$855.10 |
$2,205.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$28.21 |
$28.21 |
$28.21 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$112.02 |
$112.02 |
$112.02 |
$85.58
|
|
Cyclophosphamide 25 mg capsule
|
$292.66 |
$292.66 |
$292.66 |
$22.51
|
|
Cyclosporine 2 hour
|
$285.97 |
$285.97 |
$285.97 |
$119.40
|
|
Cyclosporine modified 25 mg capsule
|
$29.09 |
$29.09 |
$29.09 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$1,072.52 |
$1,072.52 |
$1,072.52 |
$42.97
|
|
Cylinder pump set 20cm titan zero angl
|
$6,446.70 |
$6,446.70 |
$6,446.70 |
$18,784.86
|
|
Cystatin c
|
$34.37 |
$34.37 |
$34.37 |
$82.50
|
|
Cystic fibrosis cftr
|
$437.86 |
$437.86 |
$437.86 |
$1,058.20
|
|
Cystine urine quantitative
|
$46.25 |
$46.25 |
$46.25 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$282.15 |
$282.15 |
$282.15 |
$527.50
|
|
Cystoscopy and treatment
|
$556.24 |
$556.24 |
$556.24 |
$3,097.60
|
|
Cystoscopy and treatment
|
$817.59 |
$817.59 |
$817.59 |
$3,219.80
|
|
Cystoscopy (Bladder Scope)
|
$462.90 |
$462.90 |
$462.90 |
$1,619.67
|
|
Cystoscopy & ureter catheter
|
$626.67 |
$626.67 |
$626.67 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$739.53 |
$739.53 |
$739.53 |
$3,929.90
|
|
Cysto/uretero stricture tx
|
$897.36 |
$897.36 |
$897.36 |
$4,024.52
|
|
Cysto/uretero w/lithotripsy
|
$4,916.15 |
$4,916.15 |
$4,916.15 |
$5,631.74
|
|
Cystourethroscop/calib/dilat stric 52281
|
$556.24 |
$556.24 |
$556.24 |
$2,849.55
|
|
Cytomegalovirus (cmv) antibody igg
|
$28.43 |
$28.43 |
$28.43 |
$102.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$105.23 |
$105.23 |
$105.23 |
$104.65
|
|
Cytopath fl nongyn filter
|
$100.14 |
$100.14 |
$100.14 |
$75.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$74.25 |
$74.25 |
$74.25 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$43.28 |
$43.28 |
$43.28 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$53.04 |
$53.04 |
$53.04 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$24.19 |
$24.19 |
$24.19 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$104.38 |
$104.38 |
$104.38 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$89.95 |
$89.95 |
$89.95 |
$205.00
|
|
Cytopath smear other source
|
$32.25 |
$32.25 |
$32.25 |
$85.80
|
|
Cytopath smear other source
|
$32.25 |
$32.25 |
$32.25 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$32.25 |
$32.25 |
$32.25 |
$96.20
|
|
Cytotoxic antibody screening
|
$200.69 |
$200.69 |
$200.69 |
$158.48
|
|
Cytp urine 3-5 probes cmptr
|
$183.72 |
$183.72 |
$183.72 |
$723.89
|
|
Dacarbazine 100 mg intravenous solution
|
$169.56 |
$169.56 |
$169.56 |
$61.64
|
|
Dalbavancin 500 mg intravenous solution
|
$4,331.59 |
$4,331.59 |
$4,331.59 |
$3,746.85
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,247.53 |
$1,247.53 |
$1,247.53 |
$544.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$24,370.46 |
$24,370.46 |
$24,370.46 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,756.63 |
$4,756.63 |
$4,756.63 |
$5,500.25
|
|
Darbepoetin alfa, esrd use
|
$161.25 |
$161.25 |
$161.25 |
$152.66
|
|
D&c after delivery 59160
|
$299.97 |
$299.97 |
$299.97 |
$3,441.98
|
|
Dch glucoscan
|
$6.37 |
$6.37 |
$6.37 |
$24.20
|
|
Dch validity tests
|
$53.46 |
$53.46 |
$53.46 |
$25.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$128.56 |
$128.56 |
$128.56 |
$668.98
|
|
Debridement (>20 cm) charge pt
|
$272.39 |
$272.39 |
$272.39 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$923.66 |
$923.66 |
$923.66 |
$2,578.95
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$226.57 |
$226.57 |
$226.57 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$544.78 |
$544.78 |
$544.78 |
$810.50
|
|
Debride nail1-5 11720
|
$128.56 |
$128.56 |
$128.56 |
$173.25
|
|
Debride skin bone at fx site
|
$1,235.51 |
$1,235.51 |
$1,235.51 |
$3,127.88
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$372.95 |
$372.95 |
$372.95 |
$1,160.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$603.76 |
$603.76 |
$603.76 |
$1,193.40
|
|
Decalcification
|
$46.25 |
$46.25 |
$46.25 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$1,188.44 |
$1,188.44 |
$1,188.44 |
$1,026.60
|
|
Decompress fasciotomyhand 26037
|
$1,138.78 |
$1,138.78 |
$1,138.78 |
$2,788.80
|
|
Deferoxamine 500 mg solution for injection
|
$57.31 |
$57.31 |
$57.31 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$1,456.70 |
$1,456.70 |
$1,456.70 |
$1,930.00
|
|
Delivery of placenta 59414
|
$1,306.79 |
$1,306.79 |
$1,306.79 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$59.40 |
$59.40 |
$59.40 |
$182.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,347.06 |
$7,347.06 |
$7,347.06 |
$7,599.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$255.85 |
$255.85 |
$255.85 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$53.21 |
$53.21 |
$53.21 |
$87.27
|
|
Derma-fat-fascia graft 15770
|
$1,325.46 |
$1,325.46 |
$1,325.46 |
$3,703.68
|
|
Dermagraft
|
$47.52 |
$47.52 |
$47.52 |
$220.24
|
|
Design mlc device for imrt
|
$1,037.80 |
$1,037.80 |
$1,037.80 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$818.64 |
$818.64 |
$818.64 |
$168.50
|
|
Destroy cervthor facet jnt 64633
|
$1,055.19 |
$1,055.19 |
$1,055.19 |
$3,122.45
|
|
Destroy cth facet jnt addl 64634
|
$252.88 |
$252.88 |
$252.88 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$140.44 |
$140.44 |
$140.44 |
$199.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$252.88 |
$252.88 |
$252.88 |
$1,879.50
|