|
Culture fungi definitive id mold
|
$272.44 |
$272.44 |
$272.44 |
$80.00
|
|
Culture fungi definitive id yeast
|
$272.44 |
$272.44 |
$272.44 |
$79.50
|
|
Culture fungi other (except blood)
|
$418.34 |
$418.34 |
$418.34 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$131.65 |
$131.65 |
$131.65 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$332.57 |
$332.57 |
$332.57 |
$100.00
|
|
Culture mycoplasma any source
|
$194.66 |
$194.66 |
$194.66 |
$81.62
|
|
Culture quantitative aerobic other source
|
$116.53 |
$116.53 |
$116.53 |
$90.35
|
|
Culture screening strep group a
|
$1,726.83 |
$1,726.83 |
$1,726.83 |
$83.16
|
|
Culture typing added method
|
$267.37 |
$267.37 |
$267.37 |
$38.70
|
|
Culture typing immunologic
|
$65.24 |
$65.24 |
$65.24 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$2,654.43 |
$2,654.43 |
$2,654.43 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$2,439.80 |
$2,439.80 |
$2,439.80 |
$138.40
|
|
Culture urine each isolate
|
$100.36 |
$100.36 |
$100.36 |
$54.78
|
|
Cutter lead
|
$26,392.50 |
$26,392.50 |
$26,392.50 |
$6,685.72
|
|
Cv line/pic reposition
|
$4,838.95 |
$4,838.95 |
$4,838.95 |
$1,608.00
|
|
Cyanocobalamin unsat binding capacity
|
$179.43 |
$179.43 |
$179.43 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$82.54 |
$82.54 |
$82.54 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$164.33 |
$164.33 |
$164.33 |
$72.15
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$6,630.54 |
$6,630.54 |
$6,630.54 |
$1,305.02
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$719.65 |
$719.65 |
$719.65 |
$140.78
|
|
Cyclosporine 2 hour
|
$227.21 |
$227.21 |
$227.21 |
$129.48
|
|
Cylinder pump set 20cm titan zero angl
|
$121,370.31 |
$121,370.31 |
$121,370.31 |
$24,372.98
|
|
Cyp2c19 gene com variants
|
$2,374.94 |
$2,374.94 |
$2,374.94 |
$502.45
|
|
Cyp2c9 gene com variants
|
$377.59 |
$377.59 |
$377.59 |
$266.50
|
|
Cyp2d6 gene com variants
|
$3,038.07 |
$3,038.07 |
$3,038.07 |
$573.65
|
|
Cyp3a4 gene common variants
|
$534.89 |
$534.89 |
$534.89 |
$241.24
|
|
Cyp3a5 gene common variants
|
$534.89 |
$534.89 |
$534.89 |
$245.31
|
|
Cystatin c
|
$159.64 |
$159.64 |
$159.64 |
$76.48
|
|
Cystic fibrosis cftr
|
$3,331.69 |
$3,331.69 |
$3,331.69 |
$1,104.40
|
|
Cystine urine quantitative
|
$357.27 |
$357.27 |
$357.27 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,041.04 |
$1,041.04 |
$1,041.04 |
$564.85
|
|
Cytarabine 20 mg/ml injection solution
|
$178.54 |
$178.54 |
$178.54 |
$90.00
|
|
Cytogenetics 25-99
|
$587.35 |
$587.35 |
$587.35 |
$189.80
|
|
Cytogenomic neo microra alys
|
$7,742.83 |
$7,742.83 |
$7,742.83 |
$2,156.05
|
|
Cytogenom microarray copy nmbr var
|
$4,099.64 |
$4,099.64 |
$4,099.64 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$212.10 |
$212.10 |
$212.10 |
$100.00
|
|
Cytomegalovirus dfa
|
$135.17 |
$135.17 |
$135.17 |
$79.34
|
|
Cytopath fl nongyn filter
|
$224.87 |
$224.87 |
$224.87 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$224.87 |
$224.87 |
$224.87 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$283.20 |
$283.20 |
$283.20 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$52.47 |
$52.47 |
$52.47 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$220.29 |
$220.29 |
$220.29 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$219.12 |
$219.12 |
$219.12 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$224.87 |
$224.87 |
$224.87 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$224.87 |
$224.87 |
$224.87 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$858.01 |
$858.01 |
$858.01 |
$209.92
|
|
Cytopath smear other source
|
$99.08 |
$99.08 |
$99.08 |
$91.20
|
|
Cytopath smear other source
|
$312.35 |
$312.35 |
$312.35 |
$140.07
|
|
Cytopath tbs c/v manual
|
$121.22 |
$121.22 |
$121.22 |
$59.28
|
|
Cytotoxic antibody screening
|
$460.27 |
$460.27 |
$460.27 |
$193.80
|
|
Cytp urine 3-5 probes cmptr
|
$502.19 |
$502.19 |
$502.19 |
$664.80
|
|
Dacarbazine 100 mg intravenous solution
|
$207.86 |
$207.86 |
$207.86 |
$62.70
|
|
Dactinomycin 0.5 mg intravenous solution
|
$28,114.64 |
$28,114.64 |
$28,114.64 |
$3,047.85
|
|
Dalbavancin 500 mg intravenous solution
|
$96.48 |
$96.48 |
$96.48 |
$3,480.87
|
|
Dalteparin sodium
|
$721.23 |
$721.23 |
$721.23 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$4,278.74 |
$4,278.74 |
$4,278.74 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$620.76 |
$620.76 |
$620.76 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$15,650.86 |
$15,650.86 |
$15,650.86 |
$6,273.69
|
|
Dark field exam spec collj
|
$206.25 |
$206.25 |
$206.25 |
$31.20
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$1,406.33 |
$1,406.33 |
$1,406.33 |
$259.58
|
|
Dch glucoscan
|
$29.16 |
$29.16 |
$29.16 |
$29.16
|
|
Dch pulmonary stress test
|
$1,014.23 |
$1,014.23 |
$1,014.23 |
$963.30
|
|
Dch validity tests
|
$30.33 |
$30.33 |
$30.33 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$353.33 |
$353.33 |
$353.33 |
$42.75
|
|
Debridement (>20 cm) charge pt
|
$2,150.09 |
$2,150.09 |
$2,150.09 |
$278.50
|
|
Decalcification
|
$122.39 |
$122.39 |
$122.39 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$18,182.03 |
$18,182.03 |
$18,182.03 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$2,045.21 |
$2,045.21 |
$2,045.21 |
$546.84
|
|
Deferoxamine 500 mg solution for injection
|
$283.74 |
$283.74 |
$283.74 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$40.07 |
$40.07 |
$40.07 |
$1,855.50
|
|
Demonstrate use home inr mon
|
$465.65 |
$465.65 |
$465.65 |
$294.75
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$348.99 |
$348.99 |
$348.99 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$309.95 |
$309.95 |
$309.95 |
$6,324.98
|
|
Design mlc device for imrt
|
$19,895.26 |
$19,895.26 |
$19,895.26 |
$1,739.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$8,526.96 |
$8,526.96 |
$8,526.96 |
$93.84
|
|
Desoxycorticosterone
|
$364.71 |
$364.71 |
$364.71 |
$98.80
|
|
Destroy premlg lesns;1st lesn 17000
|
$486.65 |
$486.65 |
$486.65 |
$202.40
|
|
Destruction 2-14 lesions 17003
|
$233.63 |
$233.63 |
$233.63 |
$78.61
|
|
Detect agent nos dna dir
|
$697.87 |
$697.87 |
$697.87 |
$145.80
|
|
Detect agnt mult dna direc
|
$496.46 |
$496.46 |
$496.46 |
$166.77
|
|
Developmental screen/score/document 96110
|
$609.35 |
$609.35 |
$609.35 |
$143.13
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$21,114.00 |
$21,114.00 |
$21,114.00 |
$4,200.00
|
|
Device tiss remov myosure reach
|
$11,004.35 |
$11,004.35 |
$11,004.35 |
$2,466.14
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$1,147.46 |
$1,147.46 |
$1,147.46 |
$227.15
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.12 |
$14.12 |
$14.12 |
$21.20
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$4,426.13 |
$4,426.13 |
$4,426.13 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$35.15 |
$35.15 |
$35.15 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$66.88 |
$66.88 |
$66.88 |
$42.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$97.13 |
$97.13 |
$97.13 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$55.62 |
$55.62 |
$55.62 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$278.51 |
$278.51 |
$278.51 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$164.33 |
$164.33 |
$164.33 |
$79.20
|
|
Diab manage trn ind/group
|
$96.23 |
$96.23 |
$96.23 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$245.97 |
$245.97 |
$245.97 |
$190.68
|
|
Diagnostic laryngoscopy 31505
|
$465.60 |
$465.60 |
$465.60 |
$235.00
|
|
Diagnostic Mammogram (both breasts)
|
$858.92 |
$858.92 |
$858.92 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$754.70 |
$754.70 |
$754.70 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$978.74 |
$978.74 |
$978.74 |
$243.60
|
|
Dialysis one evaluation
|
$2,756.33 |
$2,756.33 |
$2,756.33 |
$936.00
|