|
Cystoscopy (Bladder Scope)
|
$1,610.20 |
$1,610.20 |
$1,610.20 |
$1,493.80
|
|
Cystoscopy removal of clots
|
$711.30 |
$711.30 |
$711.30 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$4,100.35 |
$4,100.35 |
$4,100.35 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,623.90 |
$3,623.90 |
$3,623.90 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$4,100.35 |
$4,100.35 |
$4,100.35 |
$3,245.90
|
|
Cytogenetics 25-99
|
$648.60 |
$648.60 |
$648.60 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$166.00 |
$166.00 |
$166.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$26.70 |
$26.70 |
$26.70 |
$100.00
|
|
Cyto/molecular report
|
$258.25 |
$258.25 |
$258.25 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$1,022.30 |
$1,022.30 |
$1,022.30 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$73.85 |
$73.85 |
$73.85 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$119.55 |
$119.55 |
$119.55 |
$87.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$239.15 |
$239.15 |
$239.15 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$445.70 |
$445.70 |
$445.70 |
$213.85
|
|
Cytopath smear other source
|
$75.85 |
$75.85 |
$75.85 |
$92.50
|
|
Dacarbazine 100 mg intravenous solution
|
$139.24 |
$139.24 |
$139.24 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$4,248.21 |
$4,248.21 |
$4,248.21 |
$3,493.11
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$25,243.50 |
$25,243.50 |
$25,243.50 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$9,240.79 |
$9,240.79 |
$9,240.79 |
$6,281.29
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$4,856.25 |
$4,856.25 |
$4,856.25 |
$3,774.81
|
|
Dch glucoscan
|
$45.00 |
$45.00 |
$45.00 |
$29.16
|
|
Dch validity tests
|
$13.35 |
$13.35 |
$13.35 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,430.70 |
$1,430.70 |
$1,430.70 |
$5,121.00
|
|
Deamidated gliadin antibody iga
|
$34.25 |
$34.25 |
$34.25 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,005.45 |
$1,005.45 |
$1,005.45 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$604.60 |
$604.60 |
$604.60 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,438.85 |
$2,438.85 |
$2,438.85 |
$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
|
$967.75 |
$967.75 |
$967.75 |
$835.20
|
|
Debride nail1-5 11720
|
$195.75 |
$195.75 |
$195.75 |
$149.60
|
|
Debride nail6 or more 11721
|
$182.25 |
$182.25 |
$182.25 |
$169.80
|
|
Debride skin bone at fx site
|
$4,968.20 |
$4,968.20 |
$4,968.20 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$424.10 |
$424.10 |
$424.10 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$983.95 |
$983.95 |
$983.95 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,287.15 |
$1,287.15 |
$1,287.15 |
$1,165.50
|
|
Decalcification
|
$127.20 |
$127.20 |
$127.20 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$589.85 |
$589.85 |
$589.85 |
$572.95
|
|
Degarelix 120 mg subcutaneous solution
|
$2,066.58 |
$2,066.58 |
$2,066.58 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$492.30 |
$492.30 |
$492.30 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$8,237.29 |
$8,237.29 |
$8,237.29 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$583.10 |
$583.10 |
$583.10 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$791.91 |
$791.91 |
$791.91 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$5,408.25 |
$5,408.25 |
$5,408.25 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$946.80 |
$946.80 |
$946.80 |
$1,441.44
|
|
Destruct cut vasl lesions <10cm 17106
|
$664.05 |
$664.05 |
$664.05 |
$666.75
|
|
Destruction anal lesion(s) smpl chem 46900
|
$770.75 |
$770.75 |
$770.75 |
$557.90
|
|
Destruction benign lesions < 14 lesions
|
$194.40 |
$194.40 |
$194.40 |
$240.24
|
|
Destruction by injection tx of nerve 64630
|
$2,596.95 |
$2,596.95 |
$2,596.95 |
$1,646.40
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,410.15 |
$2,410.15 |
$2,410.15 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,597.10 |
$6,597.10 |
$6,597.10 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$277.75 |
$277.75 |
$277.75 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$456.70 |
$456.70 |
$456.70 |
$350.40
|
|
Device ablt adv novasure
|
$2,488.00 |
$2,488.00 |
$2,488.00 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$4,200.00
|
|
Device intraute mirena
|
$2,900.29 |
$2,900.29 |
$2,900.29 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$228.35 |
$228.35 |
$228.35 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$133.65 |
$133.65 |
$133.65 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$3.63 |
$3.63 |
$3.63 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$87.02 |
$87.02 |
$87.02 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$2,002.78 |
$2,002.78 |
$2,002.78 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$73.72 |
$73.72 |
$73.72 |
$36.05
|
|
Dhea-s (dehydroepiand sulfate)
|
$21.90 |
$21.90 |
$21.90 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$30.25 |
$30.25 |
$30.25 |
$79.30
|
|
Diab manage trn ind/group
|
$74.20 |
$74.20 |
$74.20 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$290.15 |
$290.15 |
$290.15 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$143.00 |
$143.00 |
$143.00 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$143.00 |
$143.00 |
$143.00 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$781.50 |
$781.50 |
$781.50 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$430.50 |
$430.50 |
$430.50 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$855.70 |
$855.70 |
$855.70 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$692.45 |
$692.45 |
$692.45 |
$314.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$55.20 |
$55.20 |
$55.20 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$328.54 |
$328.54 |
$328.54 |
$79.71
|
|
Diffusing capacity
|
$410.95 |
$410.95 |
$410.95 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$63.82 |
$63.82 |
$63.82 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,876.92 |
$11,876.92 |
$11,876.92 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$237.95 |
$237.95 |
$237.95 |
$102.07
|
|
Dilate urethra stricture
|
$684.25 |
$684.25 |
$684.25 |
$513.00
|
|
Dilation of cervical canal 57800
|
$4,957.90 |
$4,957.90 |
$4,957.90 |
$4,446.00
|
|
Dilator fascial 10fx20cm
|
$74.75 |
$74.75 |
$74.75 |
$402.10
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,742.50 |
$1,742.50 |
$1,742.50 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$14.97 |
$14.97 |
$14.97 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$13.60 |
$13.60 |
$13.60 |
$18.32
|
|
Disability dlco
|
$248.10 |
$248.10 |
$248.10 |
$293.76
|
|
Disaccharidases
|
$590.30 |
$590.30 |
$590.30 |
$230.40
|
|
Dna antibody native/double stranded
|
$71.70 |
$71.70 |
$71.70 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$390.39 |
$390.39 |
$390.39 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,840.70 |
$1,840.70 |
$1,840.70 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$165.34 |
$165.34 |
$165.34 |
$65.40
|
|
Doppler echo complete
|
$924.50 |
$924.50 |
$924.50 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$611.85 |
$611.85 |
$611.85 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$593.25 |
$593.25 |
$593.25 |
$481.65
|
|
Dornase alfa non-comp unit
|
$1,305.62 |
$1,305.62 |
$1,305.62 |
$356.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$325.25 |
$325.25 |
$325.25 |
$450.14
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,903.91 |
$1,903.91 |
$1,903.91 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$256.98 |
$256.98 |
$256.98 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$703.15 |
$703.15 |
$703.15 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$435.95 |
$435.95 |
$435.95 |
$964.00
|
|
Drainage external ear complex 69005
|
$4,417.55 |
$4,417.55 |
$4,417.55 |
$2,888.03
|