|
CT guidance for needle placement
|
$1,861.20 |
$1,861.20 |
$1,861.20 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,523.85 |
$2,523.85 |
$2,523.85 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$882.70 |
$882.70 |
$882.70 |
$2,039.76
|
|
CT heart w/evaluation of calcium without contrast
|
$1,297.05 |
$1,297.05 |
$1,297.05 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,214.85 |
$2,214.85 |
$2,214.85 |
$1,395.79
|
|
CT hrt w/3d image
|
$2,214.85 |
$2,214.85 |
$2,214.85 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$1,028.40 |
$1,028.40 |
$1,028.40 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$2,812.75 |
$2,812.75 |
$2,812.75 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$641.10 |
$641.10 |
$641.10 |
$422.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$6,057.45 |
$6,057.45 |
$6,057.45 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,781.90 |
$4,781.90 |
$4,781.90 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,659.00 |
$3,659.00 |
$3,659.00 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,812.75 |
$2,812.75 |
$2,812.75 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,812.75 |
$2,812.75 |
$2,812.75 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$32.85 |
$32.85 |
$32.85 |
$72.00
|
|
Culture afb any source
|
$102.60 |
$102.60 |
$102.60 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$159.95 |
$159.95 |
$159.95 |
$84.76
|
|
Culture anaerobic except blood
|
$226.75 |
$226.75 |
$226.75 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$13.50 |
$13.50 |
$13.50 |
$52.50
|
|
Culture body fluid
|
$181.60 |
$181.60 |
$181.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$17.05 |
$17.05 |
$17.05 |
$80.00
|
|
Culture fungi definitive id yeast
|
$32.40 |
$32.40 |
$32.40 |
$80.00
|
|
Culture fungi other (except blood)
|
$120.05 |
$120.05 |
$120.05 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$99.90 |
$99.90 |
$99.90 |
$74.75
|
|
Culture screening strep group a
|
$75.80 |
$75.80 |
$75.80 |
$84.60
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$112.58 |
$112.58 |
$112.58 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$253.75 |
$253.75 |
$253.75 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$6,379.93 |
$6,379.93 |
$6,379.93 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$203.85 |
$203.85 |
$203.85 |
$130.40
|
|
Cystatin c
|
$107.45 |
$107.45 |
$107.45 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,194.50 |
$1,194.50 |
$1,194.50 |
$586.95
|
|
Cystoscopy (Bladder Scope)
|
$1,610.20 |
$1,610.20 |
$1,610.20 |
$1,493.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$674.85 |
$674.85 |
$674.85 |
$4,129.45
|
|
Cytarabine 20 mg/ml injection solution
|
$205.46 |
$205.46 |
$205.46 |
$90.00
|
|
Cytogenetics 25-99
|
$147.10 |
$147.10 |
$147.10 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$414.35 |
$414.35 |
$414.35 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$334.65 |
$334.65 |
$334.65 |
$100.00
|
|
Cyto/molecular report
|
$152.45 |
$152.45 |
$152.45 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$143.00 |
$143.00 |
$143.00 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$58.50 |
$58.50 |
$58.50 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$71.55 |
$71.55 |
$71.55 |
$87.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$538.45 |
$538.45 |
$538.45 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$206.55 |
$206.55 |
$206.55 |
$213.85
|
|
Cytopath smear other source
|
$143.00 |
$143.00 |
$143.00 |
$92.50
|
|
Dacarbazine 100 mg intravenous solution
|
$147.49 |
$147.49 |
$147.49 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$7,747.94 |
$7,747.94 |
$7,747.94 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2,379.61 |
$2,379.61 |
$2,379.61 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$27,623.23 |
$27,623.23 |
$27,623.23 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$13,482.70 |
$13,482.70 |
$13,482.70 |
$6,281.29
|
|
Dch glucoscan
|
$22.95 |
$22.95 |
$22.95 |
$29.16
|
|
Dch pulmonary stress test
|
$897.50 |
$897.50 |
$897.50 |
$963.30
|
|
Dch validity tests
|
$21.05 |
$21.05 |
$21.05 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$59.10 |
$59.10 |
$59.10 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$117.40 |
$117.40 |
$117.40 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$172.70 |
$172.70 |
$172.70 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$1,063.55 |
$1,063.55 |
$1,063.55 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$163.30 |
$163.30 |
$163.30 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$278.05 |
$278.05 |
$278.05 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$214.60 |
$214.60 |
$214.60 |
$835.20
|
|
Debride nail1-5 11720
|
$68.10 |
$68.10 |
$68.10 |
$149.60
|
|
Debride nail6 or more 11721
|
$98.55 |
$98.55 |
$98.55 |
$169.80
|
|
Debride skin bone at fx site
|
$1,587.20 |
$1,587.20 |
$1,587.20 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$91.75 |
$91.75 |
$91.75 |
$663.30
|
|
Debr inf skin add-on 11001
|
$51.10 |
$51.10 |
$51.10 |
$124.08
|
|
Debr musc/fascia 20sq cm/< 11043
|
$584.45 |
$584.45 |
$584.45 |
$1,165.50
|
|
Decalcification
|
$55.35 |
$55.35 |
$55.35 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$1,379.65 |
$1,379.65 |
$1,379.65 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$202.45 |
$202.45 |
$202.45 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$627.25 |
$627.25 |
$627.25 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$2,836.24 |
$2,836.24 |
$2,836.24 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$72.85 |
$72.85 |
$72.85 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$12,018.56 |
$12,018.56 |
$12,018.56 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$611.40 |
$611.40 |
$611.40 |
$401.60
|
|
Dermagraft
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$85.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$475.42 |
$475.42 |
$475.42 |
$91.84
|
|
Destruction benign lesions < 14 lesions
|
$226.35 |
$226.35 |
$226.35 |
$240.24
|
|
Devel tst phys/qhp 1st hr
|
$616.80 |
$616.80 |
$616.80 |
$350.40
|
|
Device ablt adv novasure
|
$350.00 |
$350.00 |
$350.00 |
$6,237.48
|
|
Device intraute mirena
|
$5,289.60 |
$5,289.60 |
$5,289.60 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$616.80 |
$616.80 |
$616.80 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$188.95 |
$188.95 |
$188.95 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$3.50 |
$3.50 |
$3.50 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$82.13 |
$82.13 |
$82.13 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$34.84 |
$34.84 |
$34.84 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$34.84 |
$34.84 |
$34.84 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$34.95 |
$34.95 |
$34.95 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$77.70 |
$77.70 |
$77.70 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$167.35 |
$167.35 |
$167.35 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$121.45 |
$121.45 |
$121.45 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$121.45 |
$121.45 |
$121.45 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$180.85 |
$180.85 |
$180.85 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$873.25 |
$873.25 |
$873.25 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$503.35 |
$503.35 |
$503.35 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$418.40 |
$418.40 |
$418.40 |
$314.00
|
|
Dialysis one evaluation
|
$278.05 |
$278.05 |
$278.05 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$71.76 |
$71.76 |
$71.76 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$22.29 |
$22.29 |
$22.29 |
$79.71
|
|
Dicyclomine injection
|
$157.69 |
$157.69 |
$157.69 |
$154.33
|
|
Diffusing capacity
|
$368.45 |
$368.45 |
$368.45 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$74.29 |
$74.29 |
$74.29 |
$65.84
|