|
Culture aerobic additional method definitive id each
|
$40.68 |
$40.68 |
$40.68 |
$63.02
|
|
Culture afb any source
|
$66.02 |
$66.02 |
$66.02 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$11.42 |
$11.42 |
$11.42 |
$76.35
|
|
Culture anaerobic except blood
|
$77.44 |
$77.44 |
$77.44 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$19.99 |
$19.99 |
$19.99 |
$52.50
|
|
Culture body fluid
|
$59.60 |
$59.60 |
$59.60 |
$130.40
|
|
Culture fungi definitive id mold
|
$19.99 |
$19.99 |
$19.99 |
$70.00
|
|
Culture fungi definitive id yeast
|
$24.98 |
$24.98 |
$24.98 |
$79.10
|
|
Culture fungi other (except blood)
|
$71.37 |
$71.37 |
$71.37 |
$95.93
|
|
Culture fungi skin/hair/nail
|
$30.34 |
$30.34 |
$30.34 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$81.72 |
$81.72 |
$81.72 |
$88.14
|
|
Culture quantitative aerobic other source
|
$87.43 |
$87.43 |
$87.43 |
$85.80
|
|
Culture screening strep group a
|
$50.32 |
$50.32 |
$50.32 |
$78.60
|
|
Culture typing immunologic
|
$15.71 |
$15.71 |
$15.71 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$214.11 |
$214.11 |
$214.11 |
$115.05
|
|
Culture urine each isolate
|
$27.84 |
$27.84 |
$27.84 |
$46.20
|
|
Culture virus isolation
|
$191.98 |
$191.98 |
$191.98 |
$39.20
|
|
Cutter lead
|
$719.17 |
$719.17 |
$719.17 |
$2,205.00
|
|
Cyanocobalamin unsat binding capacity
|
$89.21 |
$89.21 |
$89.21 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$23.73 |
$23.73 |
$23.73 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$44.25 |
$44.25 |
$44.25 |
$85.20
|
|
Cyclophosphamide 25 mg capsule
|
$246.14 |
$246.14 |
$246.14 |
$22.51
|
|
Cyclosporine 2 hour
|
$66.73 |
$66.73 |
$66.73 |
$119.40
|
|
Cyclosporine modified 25 mg capsule
|
$24.46 |
$24.46 |
$24.46 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$902.02 |
$902.02 |
$902.02 |
$42.97
|
|
Cylinder pump set 20cm titan zero angl
|
$5,421.90 |
$5,421.90 |
$5,421.90 |
$18,784.86
|
|
Cyp2c19 gene com variants
|
$194.84 |
$194.84 |
$194.84 |
$567.75
|
|
Cyp2c9 gene com variants
|
$966.67 |
$966.67 |
$966.67 |
$275.10
|
|
Cyp2d6 gene com variants
|
$270.84 |
$270.84 |
$270.84 |
$537.50
|
|
Cystatin c
|
$49.61 |
$49.61 |
$49.61 |
$82.50
|
|
Cystine urine quantitative
|
$133.10 |
$133.10 |
$133.10 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$108.84 |
$108.84 |
$108.84 |
$527.50
|
|
Cystoscopy (Bladder Scope)
|
$796.10 |
$796.10 |
$796.10 |
$1,619.67
|
|
Cystoscopy chemodenervation
|
$926.71 |
$926.71 |
$926.71 |
$2,355.42
|
|
Cystostomy cystotomy w/drainage 51040
|
$895.66 |
$895.66 |
$895.66 |
$3,623.90
|
|
Cytomegalovirus (cmv) antibody igg
|
$69.59 |
$69.59 |
$69.59 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$44.25 |
$44.25 |
$44.25 |
$103.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$66.38 |
$66.38 |
$66.38 |
$163.43
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$16.78 |
$16.78 |
$16.78 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$28.19 |
$28.19 |
$28.19 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$70.66 |
$70.66 |
$70.66 |
$203.08
|
|
Cytotoxic antibody screening
|
$165.58 |
$165.58 |
$165.58 |
$157.60
|
|
Dacarbazine 100 mg intravenous solution
|
$142.61 |
$142.61 |
$142.61 |
$61.64
|
|
Dalbavancin 500 mg intravenous solution
|
$3,643.02 |
$3,643.02 |
$3,643.02 |
$3,591.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,049.21 |
$1,049.21 |
$1,049.21 |
$544.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$20,496.42 |
$20,496.42 |
$20,496.42 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,000.49 |
$4,000.49 |
$4,000.49 |
$5,500.25
|
|
Darbepoetin alfa, esrd use
|
$135.62 |
$135.62 |
$135.62 |
$89.04
|
|
Dch glucoscan
|
$6.07 |
$6.07 |
$6.07 |
$23.25
|
|
Dch validity tests
|
$17.13 |
$17.13 |
$17.13 |
$25.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$219.82 |
$219.82 |
$219.82 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$149.88 |
$149.88 |
$149.88 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$879.60 |
$879.60 |
$879.60 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$244.08 |
$244.08 |
$244.08 |
$681.60
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$223.03 |
$223.03 |
$223.03 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$420.71 |
$420.71 |
$420.71 |
$810.50
|
|
Debride nail1-5 11720
|
$55.67 |
$55.67 |
$55.67 |
$173.25
|
|
Debride nail6 or more 11721
|
$83.15 |
$83.15 |
$83.15 |
$200.21
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$109.55 |
$109.55 |
$109.55 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$587.00 |
$587.00 |
$587.00 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$715.46 |
$715.46 |
$715.46 |
$1,193.40
|
|
Decalcification
|
$84.22 |
$84.22 |
$84.22 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$999.52 |
$999.52 |
$999.52 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$48.20 |
$48.20 |
$48.20 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$1,225.13 |
$1,225.13 |
$1,225.13 |
$1,707.16
|
|
Delivery of placenta 59414
|
$1,078.00 |
$1,078.00 |
$1,078.00 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$89.57 |
$89.57 |
$89.57 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,179.14 |
$6,179.14 |
$6,179.14 |
$7,251.58
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$220.89 |
$220.89 |
$220.89 |
$450.40
|
|
Depo-estradiol cypionate inj
|
$44.76 |
$44.76 |
$44.76 |
$87.27
|
|
Dermagraft
|
$39.97 |
$39.97 |
$39.97 |
$220.24
|
|
Design mlc device for imrt
|
$2,093.91 |
$2,093.91 |
$2,093.91 |
$1,641.90
|
|
Desmopressin 4 mcg/ml injection solution
|
$688.51 |
$688.51 |
$688.51 |
$163.62
|
|
Desoxycorticosterone
|
$170.93 |
$170.93 |
$170.93 |
$109.28
|
|
Destroy cth facet jnt addl 64634
|
$146.66 |
$146.66 |
$146.66 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$95.28 |
$95.28 |
$95.28 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$146.66 |
$146.66 |
$146.66 |
$1,879.50
|
|
Device ablt adv novasure
|
$1,589.71 |
$1,589.71 |
$1,589.71 |
$5,201.82
|
|
Device sut capio slim opn
|
$187.34 |
$187.34 |
$187.34 |
$1,350.00
|
|
Device tiss remov myosure reach
|
$355.06 |
$355.06 |
$355.06 |
$1,280.86
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$372.90 |
$372.90 |
$372.90 |
$222.30
|
|
Dexamethasone 4 mg tablet
|
$35.10 |
$35.10 |
$35.10 |
$5.17
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$30.09 |
$30.09 |
$30.09 |
$23.27
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$356.90 |
$356.90 |
$356.90 |
$482.14
|
|
Dextran 40 infusion
|
$32.80 |
$32.80 |
$32.80 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$8.87 |
$8.87 |
$8.87 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$8.87 |
$8.87 |
$8.87 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$9.23 |
$9.23 |
$9.23 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$8.87 |
$8.87 |
$8.87 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$92.78 |
$92.78 |
$92.78 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$67.45 |
$67.45 |
$67.45 |
$78.41
|
|
Diab manage trn ind/group
|
$38.54 |
$38.54 |
$38.54 |
$49.50
|
|
Diagnostic anoscopy spx 46600
|
$105.99 |
$105.99 |
$105.99 |
$245.35
|
|
Diagnostic laryngoscopy 31505
|
$164.15 |
$164.15 |
$164.15 |
$231.71
|
|
Diagnostic laryngoscopy 31575
|
$190.91 |
$190.91 |
$190.91 |
$381.00
|
|
Diagnostic Mammogram (both breasts)
|
$291.90 |
$291.90 |
$291.90 |
$407.04
|
|
Diagnostic Mammogram (one breast)
|
$122.76 |
$122.76 |
$122.76 |
$282.50
|
|
Dialysis one evaluation
|
$341.50 |
$341.50 |
$341.50 |
$827.97
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$48.11 |
$48.11 |
$48.11 |
$67.89
|
|
Dicyclomine injection
|
$125.10 |
$125.10 |
$125.10 |
$210.00
|
