|
Culture anaerobic except blood
|
$19.74 |
$19.74 |
$19.74 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$20.16 |
$20.16 |
$20.16 |
$49.40
|
|
Culture body fluid
|
$18.06 |
$18.06 |
$18.06 |
$111.15
|
|
Culture fungi other (except blood)
|
$12.60 |
$12.60 |
$12.60 |
$92.95
|
|
Culture mycoplasma any source
|
$12.35 |
$12.35 |
$12.35 |
$94.00
|
|
Culture screening strep group a
|
$10.25 |
$10.25 |
$10.25 |
$76.00
|
|
Culture urine each isolate
|
$17.64 |
$17.64 |
$17.64 |
$44.80
|
|
Cyanocobalamin unsat binding capacity
|
$7.16 |
$7.16 |
$7.16 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$5.07 |
$5.07 |
$5.07 |
$17.58
|
|
Cyclophosphamide 25 mg capsule
|
$11.93 |
$11.93 |
$11.93 |
$22.51
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$62.67 |
$62.67 |
$62.67 |
$179.92
|
|
Cyclosporine 2 hour
|
$6.33 |
$6.33 |
$6.33 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$2.90 |
$2.90 |
$2.90 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$29.05 |
$29.05 |
$29.05 |
$19.50
|
|
Cystine urine quantitative
|
$66.47 |
$66.47 |
$66.47 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$225.96 |
$225.96 |
$225.96 |
$487.04
|
|
Cytarabine 20 mg/ml injection solution
|
$4.74 |
$4.74 |
$4.74 |
$59.31
|
|
Cytomegalovirus (cmv) antibody igm
|
$31.08 |
$31.08 |
$31.08 |
$95.00
|
|
Cytopath c/v index add-on
|
$13.86 |
$13.86 |
$13.86 |
$29.60
|
|
Cytopath fl nongyn filter
|
$48.72 |
$48.72 |
$48.72 |
$91.20
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$26.04 |
$26.04 |
$26.04 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$41.58 |
$41.58 |
$41.58 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$39.06 |
$39.06 |
$39.06 |
$129.90
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$68.88 |
$68.88 |
$68.88 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$70.14 |
$70.14 |
$70.14 |
$205.00
|
|
Cytopath smear other source
|
$27.72 |
$27.72 |
$27.72 |
$88.13
|
|
Cytopath smear other source
|
$39.06 |
$39.06 |
$39.06 |
$145.31
|
|
Cytopath smear oth prep screen & interp
|
$29.82 |
$29.82 |
$29.82 |
$95.00
|
|
Cytopath tbs c/v manual
|
$25.62 |
$25.62 |
$25.62 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$6.38 |
$6.38 |
$6.38 |
$39.53
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.61 |
$0.61 |
$0.61 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$15.02 |
$15.02 |
$15.02 |
$4,542.99
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$53.80 |
$53.80 |
$53.80 |
$130.13
|
|
Dch validity tests
|
$7.46 |
$7.46 |
$7.46 |
$25.00
|
|
Debridement (>20 cm) charge pt
|
$116.76 |
$116.76 |
$116.76 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$1,432.20 |
$1,432.20 |
$1,432.20 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$783.30 |
$783.30 |
$783.30 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,493.10 |
$1,493.10 |
$1,493.10 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$621.18 |
$621.18 |
$621.18 |
$779.35
|
|
Debride nail1-5 11720
|
$155.40 |
$155.40 |
$155.40 |
$186.88
|
|
Debride nail6 or more 11721
|
$141.12 |
$141.12 |
$141.12 |
$200.21
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$783.30 |
$783.30 |
$783.30 |
$728.40
|
|
Debr inf skin add-on 11001
|
$176.40 |
$176.40 |
$176.40 |
$106.86
|
|
Debr musc/fascia 20sq cm/< 11043
|
$621.18 |
$621.18 |
$621.18 |
$1,101.10
|
|
Decalcification
|
$21.42 |
$21.42 |
$21.42 |
$72.15
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$31.18 |
$31.18 |
$31.18 |
$4,681.80
|
|
Dermagraft
|
$34.44 |
$34.44 |
$34.44 |
$100.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$121.30 |
$121.30 |
$121.30 |
$37.26
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.54 |
$0.54 |
$0.54 |
$8.23
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$2.00 |
$2.00 |
$2.00 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$10.50 |
$10.50 |
$10.50 |
$46.35
|
|
Diabetes (HbA1c) Test
|
$21.42 |
$21.42 |
$21.42 |
$70.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$23.71 |
$23.71 |
$23.71 |
$42.12
|
|
Dicyclomine injection
|
$178.14 |
$178.14 |
$178.14 |
$153.53
|
|
Diffusing capacity
|
$80.64 |
$80.64 |
$80.64 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$177.88 |
$177.88 |
$177.88 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,765.15 |
$3,765.15 |
$3,765.15 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$27.72 |
$27.72 |
$27.72 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$203.46 |
$203.46 |
$203.46 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.21 |
$1.21 |
$1.21 |
$9.29
|
|
Dna antibody native/double stranded
|
$7.70 |
$7.70 |
$7.70 |
$101.40
|
|
Dna probe chlamydia
|
$60.48 |
$60.48 |
$60.48 |
$98.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$9.95 |
$9.95 |
$9.95 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1.95 |
$1.95 |
$1.95 |
$131.40
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$1.45 |
$1.45 |
$1.45 |
$60.21
|
|
Doppler echo complete
|
$432.60 |
$432.60 |
$432.60 |
$517.94
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$144.48 |
$144.48 |
$144.48 |
$463.20
|
|
Dornhoffer fixed part w/window
|
$25,918.20 |
$25,918.20 |
$25,918.20 |
$53,356.20
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$6.88 |
$6.88 |
$6.88 |
$97.83
|
|
Drain blood from under nail 11740
|
$109.62 |
$109.62 |
$109.62 |
$173.21
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$289.80 |
$289.80 |
$289.80 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$275.10 |
$275.10 |
$275.10 |
$353.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$298.62 |
$298.62 |
$298.62 |
$515.00
|
|
Drug test def 1-7 classes
|
$78.54 |
$78.54 |
$78.54 |
$316.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$316.47 |
$316.47 |
$316.47 |
$278.85
|
|
Ecg external < 48 hours recording
|
$183.54 |
$183.54 |
$183.54 |
$461.76
|
|
Echocardiogram (Heart Ultrasound)
|
$1,503.60 |
$1,503.60 |
$1,503.60 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$432.60 |
$432.60 |
$432.60 |
$450.40
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,010.10 |
$1,010.10 |
$1,010.10 |
$720.60
|
|
Echocardiograpy doppler follow up/limited study
|
$150.78 |
$150.78 |
$150.78 |
$348.80
|
|
Echo exam of fetal heart
|
$116.76 |
$116.76 |
$116.76 |
$429.87
|
|
Echo exam of fetal heart
|
$111.72 |
$111.72 |
$111.72 |
$318.34
|
|
Echo guide for amniocentesis
|
$107.52 |
$107.52 |
$107.52 |
$355.17
|
|
Echo stress
|
$1,110.90 |
$1,110.90 |
$1,110.90 |
$1,401.00
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$782.46 |
$782.46 |
$782.46 |
$997.40
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$596.40 |
$596.40 |
$596.40 |
$970.07
|
|
Eeg over 1 hour 95813 - 26
|
$1,922.76 |
$1,922.76 |
$1,922.76 |
$1,072.93
|
|
Eeg recording awake and asleep
|
$280.98 |
$280.98 |
$280.98 |
$937.95
|
|
E equine encephalitis igg
|
$6.27 |
$6.27 |
$6.27 |
$49.92
|
|
Electron microscopy diagnostic
|
$344.82 |
$344.82 |
$344.82 |
$1,107.84
|
|
Electrophysiology evaluation
|
$2,469.18 |
$2,469.18 |
$2,469.18 |
$2,845.10
|
|
Electrophysiology evaluation
|
$2,121.42 |
$2,121.42 |
$2,121.42 |
$2,630.40
|
|
Encephalitis, california igg/igm
|
$6.27 |
$6.27 |
$6.27 |
$49.92
|
|
Encephalitis, st louis igg/igm
|
$6.26 |
$6.26 |
$6.26 |
$55.75
|
|
Encephalitis, western equine igg/igm
|
$6.26 |
$6.26 |
$6.26 |
$55.25
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$2.29 |
$2.29 |
$2.29 |
$43.20
|
|
Enzyme histochemistry
|
$344.82 |
$344.82 |
$344.82 |
$506.35
|
|
Epstein barr early antigen antibody
|
$4.03 |
$4.03 |
$4.03 |
$85.20
|
|
Epstein barr viral capsid antigen antibody igm
|
$38.12 |
$38.12 |
$38.12 |
$112.50
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$58.59 |
$58.59 |
$58.59 |
$62.40
|