|
Cystine urine quantitative
|
$103.20 |
$103.20 |
$103.20 |
$103.35
|
|
Cystoscopy and treatment
|
$3,820.80 |
$3,820.80 |
$3,820.80 |
$2,867.70
|
|
Cystoscopy and treatment
|
$3,820.80 |
$3,820.80 |
$3,820.80 |
$3,203.50
|
|
Cystoscopy & ureter catheter
|
$3,579.60 |
$3,579.60 |
$3,579.60 |
$3,688.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,820.80 |
$3,820.80 |
$3,820.80 |
$3,015.50
|
|
Cytogenetics 25-99
|
$69.60 |
$69.60 |
$69.60 |
$189.80
|
|
Cytogenomic neo microra alys
|
$3,455.40 |
$3,455.40 |
$3,455.40 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$18.00 |
$18.00 |
$18.00 |
$94.90
|
|
Cytomegalovirus (cmv) antibody igm
|
$64.80 |
$64.80 |
$64.80 |
$95.55
|
|
Cytopath c/v index add-on
|
$34.20 |
$34.20 |
$34.20 |
$34.20
|
|
Cytopath c/v thin layer redo
|
$64.80 |
$64.80 |
$64.80 |
$50.40
|
|
Cytopathology cellular enhancement technique non-gyn
|
$84.00 |
$84.00 |
$84.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$93.60 |
$93.60 |
$93.60 |
$91.50
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$93.60 |
$93.60 |
$93.60 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$147.60 |
$147.60 |
$147.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$147.00 |
$147.00 |
$147.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$105.60 |
$105.60 |
$105.60 |
$67.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$172.20 |
$172.20 |
$172.20 |
$182.65
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$179.40 |
$179.40 |
$179.40 |
$207.50
|
|
Cytopath smear other source
|
$128.40 |
$128.40 |
$128.40 |
$88.13
|
|
Cytopath smear other source
|
$171.00 |
$171.00 |
$171.00 |
$136.85
|
|
Cytopath smear oth prep screen & interp
|
$126.60 |
$126.60 |
$126.60 |
$95.00
|
|
Cytopath tbs c/v manual
|
$43.20 |
$43.20 |
$43.20 |
$57.94
|
|
Cytotoxic antibody screening
|
$252.60 |
$252.60 |
$252.60 |
$184.63
|
|
Cytp urine 3-5 probes cmptr
|
$684.60 |
$684.60 |
$684.60 |
$690.00
|
|
Dalbavancin 500 mg intravenous solution
|
$7,685.88 |
$7,685.88 |
$7,685.88 |
$3,480.35
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$6,687.36 |
$6,687.36 |
$6,687.36 |
$5,546.48
|
|
Dch validity tests
|
$23.40 |
$23.40 |
$23.40 |
$24.36
|
|
Debridement (>20 cm) charge pt
|
$399.60 |
$399.60 |
$399.60 |
$262.25
|
|
Debridement bone <= 20 sq cm
|
$3,218.40 |
$3,218.40 |
$3,218.40 |
$2,280.47
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$648.00 |
$648.00 |
$648.00 |
$798.23
|
|
Debride nail1-5 11720
|
$98.40 |
$98.40 |
$98.40 |
$145.53
|
|
Debride nail6 or more 11721
|
$98.40 |
$98.40 |
$98.40 |
$167.63
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$222.60 |
$222.60 |
$222.60 |
$639.60
|
|
Decalcification
|
$58.20 |
$58.20 |
$58.20 |
$68.90
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$184.20 |
$184.20 |
$184.20 |
$185.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$8,101.86 |
$8,101.86 |
$8,101.86 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$260.40 |
$260.40 |
$260.40 |
$402.36
|
|
Dermapure 1 square cm
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$2,319.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$19.44 |
$19.44 |
$19.44 |
$82.24
|
|
Desoxycorticosterone
|
$82.80 |
$82.80 |
$82.80 |
$109.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$357.60 |
$357.60 |
$357.60 |
$199.50
|
|
Destruction benign lesions < 14 lesions
|
$286.80 |
$286.80 |
$286.80 |
$235.13
|
|
Detect agent nos dna dir
|
$181.80 |
$181.80 |
$181.80 |
$115.20
|
|
Detect agnt mult dna direc
|
$153.60 |
$153.60 |
$153.60 |
$147.75
|
|
Device ablt adv novasure
|
$12,727.47 |
$12,727.47 |
$12,727.47 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,560.55 |
$6,560.55 |
$6,560.55 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,002.11 |
$3,002.11 |
$3,002.11 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,430.68 |
$2,430.68 |
$2,430.68 |
$2,430.68
|
|
Dexamethasone 4 mg tablet
|
$3.06 |
$3.06 |
$3.06 |
$5.82
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$16.92 |
$16.92 |
$16.92 |
$21.64
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$45.80
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.80 |
$37.80 |
$37.80 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$37.80 |
$37.80 |
$37.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$118.80 |
$118.80 |
$118.80 |
$110.38
|
|
Diabetes (HbA1c) Test
|
$103.80 |
$103.80 |
$103.80 |
$79.52
|
|
Diagnostic anoscopy spx 46600
|
$233.40 |
$233.40 |
$233.40 |
$184.80
|
|
Diagnostic laryngoscopy 31505
|
$340.80 |
$340.80 |
$340.80 |
$229.74
|
|
Diagnostic laryngoscopy 31575
|
$340.80 |
$340.80 |
$340.80 |
$327.60
|
|
Diagnostic Mammogram (both breasts)
|
$415.80 |
$415.80 |
$415.80 |
$397.50
|
|
Diagnostic Mammogram (one breast)
|
$359.40 |
$359.40 |
$359.40 |
$296.40
|
|
Dialysis one evaluation
|
$2,935.20 |
$2,935.20 |
$2,935.20 |
$862.40
|
|
Diatrizoate meglumine 18 % urethral solution
|
$82.44 |
$82.44 |
$82.44 |
$116.21
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$27.78 |
$27.78 |
$27.78 |
$74.02
|
|
Dicyclomine injection
|
$88.02 |
$88.02 |
$88.02 |
$160.09
|
|
Diffusing capacity
|
$192.60 |
$192.60 |
$192.60 |
$331.76
|
|
Digital analysis of eeg
|
$622.80 |
$622.80 |
$622.80 |
$605.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.24 |
$6.24 |
$6.24 |
$66.86
|
|
Digoxin immune fab 40 mg intravenous solution
|
$21,487.68 |
$21,487.68 |
$21,487.68 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$114.60 |
$114.60 |
$114.60 |
$99.35
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$408.24
|
|
Diltiazem 5 mg/ml intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$45.60
|
|
Dimethyl sulfoxide 50% 50 ml
|
$3,292.68 |
$3,292.68 |
$3,292.68 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$17.75
|
|
Disability dlco
|
$177.60 |
$177.60 |
$177.60 |
$279.00
|
|
Disaccharidases
|
$174.00 |
$174.00 |
$174.00 |
$223.80
|
|
Dmd dup/delet analysis
|
$496.20 |
$496.20 |
$496.20 |
$385.02
|
|
Dna antibody native/double stranded
|
$66.00 |
$66.00 |
$66.00 |
$100.00
|
|
Dna gardnerella
|
$34.80 |
$34.80 |
$34.80 |
$61.20
|
|
Dna probe chlamydia
|
$260.40 |
$260.40 |
$260.40 |
$82.20
|
|
Dna trichomonas
|
$34.80 |
$34.80 |
$34.80 |
$66.05
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$180.48 |
$180.48 |
$180.48 |
$98.29
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$64.32 |
$64.32 |
$64.32 |
$65.40
|
|
Doppler echo complete
|
$617.40 |
$617.40 |
$617.40 |
$548.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$688.80 |
$688.80 |
$688.80 |
$444.60
|
|
Dornhoffer fixed part w/window
|
$67,573.67 |
$67,573.67 |
$67,573.67 |
$34,278.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$118.86 |
$118.86 |
$118.86 |
$86.65
|
|
Dpyd gene common variants
|
$291.00 |
$291.00 |
$291.00 |
$373.75
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$1,402.80 |
$1,402.80 |
$1,402.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,402.80 |
$1,402.80 |
$1,402.80 |
$863.10
|
|
Drainage external ear simple 69000
|
$1,402.80 |
$1,402.80 |
$1,402.80 |
$779.45
|
|
Drainage mouth roof lesion
|
$462.00 |
$462.00 |
$462.00 |
$381.36
|
|
Drainage of arm bursa 23931
|
$2,634.60 |
$2,634.60 |
$2,634.60 |
$2,175.00
|
|
Drainage of mouth lesion
|
$4,940.40 |
$4,940.40 |
$4,940.40 |
$3,837.72
|
|
Drainage of mouth lesion
|
$802.20 |
$802.20 |
$802.20 |
$962.40
|
|
Drainage of nose lesion sept 30020
|
$843.00 |
$843.00 |
$843.00 |
$755.95
|
|
Drainage of rectal abscess
|
$2,283.60 |
$2,283.60 |
$2,283.60 |
$1,985.40
|
|
Drain blood from under nail 11740
|
$141.60 |
$141.60 |
$141.60 |
$170.50
|
