|
Cystostomy cystotomy w/drainage 51040
|
$1,130.90 |
$1,130.90 |
$1,130.90 |
$3,986.00
|
|
Cysto/uretero stricture tx
|
$1,654.42 |
$1,654.42 |
$1,654.42 |
$4,024.52
|
|
Cysto/uretero w/lithotripsy
|
$5,585.57 |
$5,585.57 |
$5,585.57 |
$5,631.74
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,188.75 |
$1,188.75 |
$1,188.75 |
$2,861.18
|
|
Cytogenetics 25-99
|
$108.47 |
$108.47 |
$108.47 |
$185.35
|
|
Cytomegalovirus (cmv) antibody igg
|
$95.45 |
$95.45 |
$95.45 |
$102.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$101.24 |
$101.24 |
$101.24 |
$105.23
|
|
Cytopathology cellular enhancement technique non-gyn
|
$90.63 |
$90.63 |
$90.63 |
$163.43
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$60.74 |
$60.74 |
$60.74 |
$124.80
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$105.09 |
$105.09 |
$105.09 |
$205.00
|
|
Cytopath smear other source
|
$54.00 |
$54.00 |
$54.00 |
$85.80
|
|
Cytotoxic antibody screening
|
$228.02 |
$228.02 |
$228.02 |
$158.48
|
|
Dacarbazine 100 mg intravenous solution
|
$192.65 |
$192.65 |
$192.65 |
$61.64
|
|
Dalbavancin 500 mg intravenous solution
|
$4,921.41 |
$4,921.41 |
$4,921.41 |
$3,753.91
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,417.40 |
$1,417.40 |
$1,417.40 |
$544.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$27,688.92 |
$27,688.92 |
$27,688.92 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$5,404.32 |
$5,404.32 |
$5,404.32 |
$5,500.25
|
|
Darbepoetin alfa, esrd use
|
$183.20 |
$183.20 |
$183.20 |
$161.25
|
|
D&c after delivery 59160
|
$1,025.33 |
$1,025.33 |
$1,025.33 |
$3,441.98
|
|
Dch glucoscan
|
$6.27 |
$6.27 |
$6.27 |
$24.20
|
|
Dch validity tests
|
$17.84 |
$17.84 |
$17.84 |
$25.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$356.24 |
$356.24 |
$356.24 |
$668.98
|
|
Debridement (>20 cm) charge pt
|
$88.70 |
$88.70 |
$88.70 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$891.32 |
$891.32 |
$891.32 |
$2,578.95
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$257.42 |
$257.42 |
$257.42 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$383.72 |
$383.72 |
$383.72 |
$810.50
|
|
Debride nail1-5 11720
|
$57.37 |
$57.37 |
$57.37 |
$173.25
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$357.21 |
$357.21 |
$357.21 |
$1,288.00
|
|
Debride skin bone at fx site
|
$859.99 |
$859.99 |
$859.99 |
$3,035.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$171.62 |
$171.62 |
$171.62 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$383.72 |
$383.72 |
$383.72 |
$1,160.00
|
|
Decalcification
|
$54.00 |
$54.00 |
$54.00 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$1,350.27 |
$1,350.27 |
$1,350.27 |
$1,026.60
|
|
Decompress fasciotomyhand 26037
|
$887.95 |
$887.95 |
$887.95 |
$2,788.80
|
|
Deferoxamine 500 mg solution for injection
|
$65.12 |
$65.12 |
$65.12 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$1,655.05 |
$1,655.05 |
$1,655.05 |
$1,963.06
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$17.36 |
$17.36 |
$17.36 |
$180.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$8,347.49 |
$8,347.49 |
$8,347.49 |
$7,737.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$149.92 |
$149.92 |
$149.92 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$60.46 |
$60.46 |
$60.46 |
$87.27
|
|
Derma-fat-fascia graft 15770
|
$1,370.00 |
$1,370.00 |
$1,370.00 |
$3,703.68
|
|
Dermagraft
|
$54.00 |
$54.00 |
$54.00 |
$220.24
|
|
Desmopressin 4 mcg/ml injection solution
|
$930.11 |
$930.11 |
$930.11 |
$172.46
|
|
Desoxycorticosterone
|
$176.44 |
$176.44 |
$176.44 |
$114.02
|
|
Destroy cth facet jnt addl 64634
|
$201.99 |
$201.99 |
$201.99 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$73.76 |
$73.76 |
$73.76 |
$199.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$201.99 |
$201.99 |
$201.99 |
$1,879.50
|
|
Detect agent nos dna dir
|
$79.54 |
$79.54 |
$79.54 |
$67.15
|
|
Device ablt adv novasure
|
$2,147.56 |
$2,147.56 |
$2,147.56 |
$5,201.82
|
|
Device sut capio slim opn
|
$253.08 |
$253.08 |
$253.08 |
$1,350.00
|
|
Device tiss remov myosure reach
|
$479.65 |
$479.65 |
$479.65 |
$1,280.86
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$209.22 |
$209.22 |
$209.22 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$47.41 |
$47.41 |
$47.41 |
$5.17
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$40.65 |
$40.65 |
$40.65 |
$23.27
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$482.14 |
$482.14 |
$482.14 |
$537.74
|
|
Dextran 40 infusion
|
$44.31 |
$44.31 |
$44.31 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$11.98 |
$11.98 |
$11.98 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$11.98 |
$11.98 |
$11.98 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$12.47 |
$12.47 |
$12.47 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$11.98 |
$11.98 |
$11.98 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$130.16 |
$130.16 |
$130.16 |
$108.00
|
|
Diabetes (HbA1c) Test
|
$46.76 |
$46.76 |
$46.76 |
$79.30
|
|
Diab manage trn ind/group
|
$38.09 |
$38.09 |
$38.09 |
$52.07
|
|
Diagnostic anoscopy spx 46600
|
$145.59 |
$145.59 |
$145.59 |
$245.35
|
|
Diagnostic laryngoscopy 31505
|
$302.25 |
$302.25 |
$302.25 |
$239.30
|
|
Diagnostic laryngoscopy 31575
|
$251.16 |
$251.16 |
$251.16 |
$403.24
|
|
Diagnostic radio unlisted proc
|
$546.65 |
$546.65 |
$546.65 |
$259.00
|
|
Dialysis one evaluation
|
$470.01 |
$470.01 |
$470.01 |
$827.97
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$64.99 |
$64.99 |
$64.99 |
$67.89
|
|
Dicyclomine injection
|
$169.00 |
$169.00 |
$169.00 |
$210.00
|
|
Diffusing capacity
|
$64.60 |
$64.60 |
$64.60 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$242.02 |
$242.02 |
$242.02 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,738.82 |
$12,738.82 |
$12,738.82 |
$10,388.97
|
|
Digoxin total therapeutic drug level
|
$32.78 |
$32.78 |
$32.78 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$206.91 |
$206.91 |
$206.91 |
$308.90
|
|
Dilate urethra stricture
|
$122.45 |
$122.45 |
$122.45 |
$514.79
|
|
Dilation/female urethra/initial 53660
|
$163.42 |
$163.42 |
$163.42 |
$207.39
|
|
Dilator fascial 10fx20cm
|
$57.90 |
$57.90 |
$57.90 |
$266.65
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,091.69 |
$1,091.69 |
$1,091.69 |
$1,027.00
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.72 |
$1.72 |
$1.72 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$26.10 |
$26.10 |
$26.10 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$132.59 |
$132.59 |
$132.59 |
$100.80
|
|
Disability dlco
|
$114.73 |
$114.73 |
$114.73 |
$304.99
|
|
Disaccharidases
|
$198.61 |
$198.61 |
$198.61 |
$231.67
|
|
#d/lmeth-l-methamphetamine
|
$144.62 |
$144.62 |
$144.62 |
$72.14
|
|
Dna antibody native/double stranded
|
$92.08 |
$92.08 |
$92.08 |
$103.20
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$85.60 |
$85.60 |
$85.60 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$424.75 |
$424.75 |
$424.75 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$62.57 |
$62.57 |
$62.57 |
$64.77
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$588.11 |
$588.11 |
$588.11 |
$696.80
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$539.42 |
$539.42 |
$539.42 |
$495.30
|
|
Dornhoffer fixed part w/window
|
$5,071.22 |
$5,071.22 |
$5,071.22 |
$32,112.76
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$297.33 |
$297.33 |
$297.33 |
$232.80
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,321.97 |
$1,321.97 |
$1,321.97 |
$2,759.64
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$183.19 |
$183.19 |
$183.19 |
$813.63
|
|
Drainage ext aud canal abscess 69020
|
$787.20 |
$787.20 |
$787.20 |
$865.60
|
|
Drainage external ear complex 69005
|
$1,763.84 |
$1,763.84 |
$1,763.84 |
$3,016.11
|
|
Drainage external ear simple 69000
|
$178.37 |
$178.37 |
$178.37 |
$800.00
|
|
Drainage mouth roof lesion
|
$255.98 |
$255.98 |
$255.98 |
$528.80
|
|
Drainage of arm bursa 23931
|
$791.54 |
$791.54 |
$791.54 |
$2,419.30
|