|
Culture fungi skin/hair/nail
|
$69.15 |
$69.15 |
$69.15 |
$74.75
|
|
Culture screening strep group a
|
$66.10 |
$66.10 |
$66.10 |
$84.60
|
|
Cv line/pic reposition
|
$1,176.80 |
$1,176.80 |
$1,176.80 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$42.04 |
$42.04 |
$42.04 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$141.55 |
$141.55 |
$141.55 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,141.82 |
$2,141.82 |
$2,141.82 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$196.80 |
$196.80 |
$196.80 |
$130.40
|
|
Cystatin c
|
$104.15 |
$104.15 |
$104.15 |
$77.60
|
|
Cystine urine quantitative
|
$434.30 |
$434.30 |
$434.30 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$741.40 |
$741.40 |
$741.40 |
$586.95
|
|
Cystoscopy (Bladder Scope)
|
$1,861.35 |
$1,861.35 |
$1,861.35 |
$1,493.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$6,064.65 |
$6,064.65 |
$6,064.65 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$5,549.90 |
$5,549.90 |
$5,549.90 |
$3,245.90
|
|
Cytarabine 20 mg/ml injection solution
|
$113.31 |
$113.31 |
$113.31 |
$90.00
|
|
Cytogenetics 25-99
|
$310.00 |
$310.00 |
$310.00 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$157.70 |
$157.70 |
$157.70 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$157.70 |
$157.70 |
$157.70 |
$100.00
|
|
Cyto/molecular report
|
$150.30 |
$150.30 |
$150.30 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$200.20 |
$200.20 |
$200.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$189.75 |
$189.75 |
$189.75 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$210.95 |
$210.95 |
$210.95 |
$87.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$168.55 |
$168.55 |
$168.55 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$273.70 |
$273.70 |
$273.70 |
$213.85
|
|
Cytopath smear other source
|
$226.50 |
$226.50 |
$226.50 |
$92.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$329.49 |
$329.49 |
$329.49 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$11,770.22 |
$11,770.22 |
$11,770.22 |
$6,281.29
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$3,229.90 |
$3,229.90 |
$3,229.90 |
$3,774.81
|
|
Dch glucoscan
|
$29.65 |
$29.65 |
$29.65 |
$29.16
|
|
Dch validity tests
|
$20.45 |
$20.45 |
$20.45 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$82.25 |
$82.25 |
$82.25 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$520.30 |
$520.30 |
$520.30 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$4,417.65 |
$4,417.65 |
$4,417.65 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,231.50 |
$1,231.50 |
$1,231.50 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,308.80 |
$2,308.80 |
$2,308.80 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$562.10 |
$562.10 |
$562.10 |
$835.20
|
|
Debride nail1-5 11720
|
$138.85 |
$138.85 |
$138.85 |
$149.60
|
|
Debride nail6 or more 11721
|
$110.50 |
$110.50 |
$110.50 |
$169.80
|
|
Debride skin bone at fx site
|
$1,164.70 |
$1,164.70 |
$1,164.70 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$971.15 |
$971.15 |
$971.15 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,669.25 |
$1,669.25 |
$1,669.25 |
$1,165.50
|
|
Decalcification
|
$92.40 |
$92.40 |
$92.40 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$1,824.84 |
$1,824.84 |
$1,824.84 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$545.90 |
$545.90 |
$545.90 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$82.31 |
$82.31 |
$82.31 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$401.70 |
$401.70 |
$401.70 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$10,492.05 |
$10,492.05 |
$10,492.05 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$629.55 |
$629.55 |
$629.55 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$298.03 |
$298.03 |
$298.03 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$5,515.95 |
$5,515.95 |
$5,515.95 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$545.55 |
$545.55 |
$545.55 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$607.35 |
$607.35 |
$607.35 |
$240.24
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,690.20 |
$1,690.20 |
$1,690.20 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$5,515.95 |
$5,515.95 |
$5,515.95 |
$3,296.80
|
|
Devel tst phys/qhp 1st hr
|
$859.40 |
$859.40 |
$859.40 |
$350.40
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,465.00 |
$1,465.00 |
$1,465.00 |
$4,200.00
|
|
Device intraute mirena
|
$3,694.18 |
$3,694.18 |
$3,694.18 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$291.05 |
$291.05 |
$291.05 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$146.95 |
$146.95 |
$146.95 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$2.30 |
$2.30 |
$2.30 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$8.70 |
$8.70 |
$8.70 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$157.14 |
$157.14 |
$157.14 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$157.14 |
$157.14 |
$157.14 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$212.00 |
$212.00 |
$212.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$103.40 |
$103.40 |
$103.40 |
$79.30
|
|
Diab manage trn ind/group
|
$26.95 |
$26.95 |
$26.95 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$266.90 |
$266.90 |
$266.90 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$377.45 |
$377.45 |
$377.45 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$337.05 |
$337.05 |
$337.05 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$549.45 |
$549.45 |
$549.45 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$521.70 |
$521.70 |
$521.70 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$370.75 |
$370.75 |
$370.75 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$480.24 |
$480.24 |
$480.24 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$170.64 |
$170.64 |
$170.64 |
$79.71
|
|
Diffusing capacity
|
$368.05 |
$368.05 |
$368.05 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$8.37 |
$8.37 |
$8.37 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$15,127.93 |
$15,127.93 |
$15,127.93 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$145.60 |
$145.60 |
$145.60 |
$102.07
|
|
Dilation of cervical canal 57800
|
$8,572.80 |
$8,572.80 |
$8,572.80 |
$4,446.00
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,219.47 |
$2,219.47 |
$2,219.47 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.13 |
$7.13 |
$7.13 |
$18.32
|
|
Disability dlco
|
$464.85 |
$464.85 |
$464.85 |
$293.76
|
|
Disaccharidases
|
$738.60 |
$738.60 |
$738.60 |
$230.40
|
|
Dna antibody native/double stranded
|
$149.60 |
$149.60 |
$149.60 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$117.10 |
$117.10 |
$117.10 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$150.55 |
$150.55 |
$150.55 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$87.83 |
$87.83 |
$87.83 |
$65.40
|
|
Doppler echo complete
|
$934.10 |
$934.10 |
$934.10 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$675.40 |
$675.40 |
$675.40 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$349.10 |
$349.10 |
$349.10 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$96.61 |
$96.61 |
$96.61 |
$89.34
|
|
Dpyd gene common variants
|
$1,076.30 |
$1,076.30 |
$1,076.30 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$2,174.80 |
$2,174.80 |
$2,174.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$2,174.80 |
$2,174.80 |
$2,174.80 |
$964.00
|
|
Drainage external ear complex 69005
|
$6,850.70 |
$6,850.70 |
$6,850.70 |
$2,888.03
|
|
Drainage external ear simple 69000
|
$475.90 |
$475.90 |
$475.90 |
$790.40
|
|
Drainage lymph node lesion 38300
|
$7,742.45 |
$7,742.45 |
$7,742.45 |
$3,088.80
|
|
Drainage mouth roof lesion
|
$704.45 |
$704.45 |
$704.45 |
$405.60
|
|
Drainage of arm bursa 23931
|
$4,684.45 |
$4,684.45 |
$4,684.45 |
$2,271.01
|
|
Drainage of kidney lesion
|
$1,020.40 |
$1,020.40 |
$1,020.40 |
$1,506.00
|