|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$30.80 |
$30.80 |
$30.80 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$33.04 |
$33.04 |
$33.04 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$76.16 |
$76.16 |
$76.16 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$81.76 |
$81.76 |
$81.76 |
$129.90
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$25.20 |
$25.20 |
$25.20 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$61.04 |
$61.04 |
$61.04 |
$205.00
|
|
Cytopath smear other source
|
$30.24 |
$30.24 |
$30.24 |
$88.13
|
|
Cytp urine 3-5 probes cmptr
|
$252.00 |
$252.00 |
$252.00 |
$779.00
|
|
Dch pulmonary stress test
|
$966.00 |
$966.00 |
$966.00 |
$964.41
|
|
Dch validity tests
|
$6.72 |
$6.72 |
$6.72 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$21.28 |
$21.28 |
$21.28 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$502.32 |
$502.32 |
$502.32 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$1,911.84 |
$1,911.84 |
$1,911.84 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$717.92 |
$717.92 |
$717.92 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,723.12 |
$1,723.12 |
$1,723.12 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$458.64 |
$458.64 |
$458.64 |
$779.35
|
|
Debride nail1-5 11720
|
$184.80 |
$184.80 |
$184.80 |
$186.88
|
|
Debride nail6 or more 11721
|
$196.56 |
$196.56 |
$196.56 |
$200.21
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$358.96 |
$358.96 |
$358.96 |
$728.40
|
|
Debr musc/fascia 20sq cm/< 11043
|
$869.68 |
$869.68 |
$869.68 |
$1,101.10
|
|
Decalcification
|
$35.28 |
$35.28 |
$35.28 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$236.88 |
$236.88 |
$236.88 |
$482.35
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$386.96 |
$386.96 |
$386.96 |
$165.60
|
|
Dermagraft
|
$55.44 |
$55.44 |
$55.44 |
$100.50
|
|
Design mlc device for imrt
|
$969.92 |
$969.92 |
$969.92 |
$1,677.86
|
|
Device ablt adv novasure
|
$3,179.68 |
$3,179.68 |
$3,179.68 |
$7,153.60
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,640.80 |
$1,640.80 |
$1,640.80 |
$4,298.87
|
|
Device tiss remov myosure reach
|
$1,067.92 |
$1,067.92 |
$1,067.92 |
$1,070.85
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$313.04 |
$313.04 |
$313.04 |
$220.43
|
|
Dhea-s (dehydroepiand sulfate)
|
$65.52 |
$65.52 |
$65.52 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$29.68 |
$29.68 |
$29.68 |
$70.00
|
|
Diagnostic Mammogram (both breasts)
|
$281.68 |
$281.68 |
$281.68 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$206.08 |
$206.08 |
$206.08 |
$276.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$31,106.88 |
$31,106.88 |
$31,106.88 |
$9,395.77
|
|
Diffusing capacity
|
$103.60 |
$103.60 |
$103.60 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$38.08 |
$38.08 |
$38.08 |
$92.95
|
|
Dilate biliary duct/ampulla
|
$3,437.28 |
$3,437.28 |
$3,437.28 |
$1,866.73
|
|
Dilat xst trc ndurlgc px
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$4,031.47
|
|
Dilat xst trc new access rcs
|
$4,220.72 |
$4,220.72 |
$4,220.72 |
$5,842.20
|
|
Disability dlco
|
$85.68 |
$85.68 |
$85.68 |
$289.08
|
|
Disaccharidases
|
$21.84 |
$21.84 |
$21.84 |
$224.58
|
|
Dna antibody native/double stranded
|
$63.28 |
$63.28 |
$63.28 |
$101.40
|
|
Dna gardnerella
|
$25.20 |
$25.20 |
$25.20 |
$67.68
|
|
Dna probe chlamydia
|
$49.84 |
$49.84 |
$49.84 |
$98.40
|
|
Dna probe gc
|
$49.84 |
$49.84 |
$49.84 |
$88.67
|
|
Dna trichomonas
|
$25.20 |
$25.20 |
$25.20 |
$69.60
|
|
Doppler echo complete
|
$487.76 |
$487.76 |
$487.76 |
$517.94
|
|
Doppler intravascular pressure flow initial vessel
|
$3,092.32 |
$3,092.32 |
$3,092.32 |
$3,026.62
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$801.36 |
$801.36 |
$801.36 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$413.28 |
$413.28 |
$413.28 |
$463.20
|
|
Dornhoffer fixed part w/window
|
$19,600.00 |
$19,600.00 |
$19,600.00 |
$53,356.20
|
|
Drainage of kidney lesion
|
$797.44 |
$797.44 |
$797.44 |
$1,578.89
|
|
Drain blood from under nail 11740
|
$74.48 |
$74.48 |
$74.48 |
$173.21
|
|
Drain cath image guided visceral pq
|
$3,387.44 |
$3,387.44 |
$3,387.44 |
$2,999.34
|
|
Drain cerebro spinal fluid 62272
|
$780.08 |
$780.08 |
$780.08 |
$1,025.00
|
|
Drain lower leg lesion 27603
|
$2,872.24 |
$2,872.24 |
$2,872.24 |
$3,631.18
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$248.08 |
$248.08 |
$248.08 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$166.32 |
$166.32 |
$166.32 |
$353.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$284.48 |
$284.48 |
$284.48 |
$515.00
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$2,099.44 |
$2,099.44 |
$2,099.44 |
$5,715.36
|
|
Drill hole implt ventricular cath/device 61107
|
$1,503.60 |
$1,503.60 |
$1,503.60 |
$1,737.06
|
|
Drng of finger abscess comp 26011
|
$1,436.40 |
$1,436.40 |
$1,436.40 |
$1,908.09
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$15.12 |
$15.12 |
$15.12 |
$57.00
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$21.84 |
$21.84 |
$21.84 |
$983.03
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$1,853.60 |
$1,853.60 |
$1,853.60 |
$12,735.45
|
|
Drug admin & hemodynmic meas
|
$394.80 |
$394.80 |
$394.80 |
$612.15
|
|
Drug test def 1-7 classes
|
$147.28 |
$147.28 |
$147.28 |
$316.80
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$80.08 |
$80.08 |
$80.08 |
$278.85
|
|
Ductogram sgl duct
|
$654.08 |
$654.08 |
$654.08 |
$346.42
|
|
Duplex scan unilateral study 93986
|
$417.20 |
$417.20 |
$417.20 |
$357.60
|
|
Dup scan/hemodialysis access 93990
|
$417.20 |
$417.20 |
$417.20 |
$499.38
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$955.92 |
$955.92 |
$955.92 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,069.04 |
$1,069.04 |
$1,069.04 |
$852.57
|
|
Dxa bone density axl vrt fx
|
$310.24 |
$310.24 |
$310.24 |
$365.14
|
|
Ecg 12 lead tracing only
|
$80.08 |
$80.08 |
$80.08 |
$222.30
|
|
Ecg < 30 days transmission & analysis
|
$280.56 |
$280.56 |
$280.56 |
$404.21
|
|
Ecg external < 48 hours recording
|
$177.52 |
$177.52 |
$177.52 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$554.96 |
$554.96 |
$554.96 |
$541.73
|
|
Echocardiogram (Heart Ultrasound)
|
$2,182.88 |
$2,182.88 |
$2,182.88 |
$2,021.12
|
|
Echocardiography doppler color flow mapping
|
$819.84 |
$819.84 |
$819.84 |
$450.40
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,182.88 |
$2,182.88 |
$2,182.88 |
$1,899.00
|
|
Echocardiography transthoracic 2d followup/limited
|
$506.80 |
$506.80 |
$506.80 |
$720.60
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,050.56 |
$1,050.56 |
$1,050.56 |
$840.00
|
|
Echo exam of fetal heart
|
$539.28 |
$539.28 |
$539.28 |
$855.38
|
|
Echo exam of fetal heart
|
$408.80 |
$408.80 |
$408.80 |
$481.55
|
|
Echo exam of fetal heart
|
$104.72 |
$104.72 |
$104.72 |
$429.87
|
|
Echo exam of fetal heart
|
$81.76 |
$81.76 |
$81.76 |
$318.34
|
|
Echo exam uterus 76831-
|
$228.48 |
$228.48 |
$228.48 |
$497.93
|
|
Echo guidance radiotherapy
|
$474.88 |
$474.88 |
$474.88 |
$655.00
|
|
Echo guide for amniocentesis
|
$221.20 |
$221.20 |
$221.20 |
$355.17
|
|
Echo guide for artery repair
|
$878.64 |
$878.64 |
$878.64 |
$687.35
|
|
Echo guide for transfusion
|
$139.44 |
$139.44 |
$139.44 |
$317.25
|
|
Echo tee guidance
|
$1,285.20 |
$1,285.20 |
$1,285.20 |
$2,007.00
|
|
Echo tee probe placement image acquisition interpretation & report
|
$1,097.60 |
$1,097.60 |
$1,097.60 |
$1,946.10
|
|
Echo transesophageal
|
$1,097.60 |
$1,097.60 |
$1,097.60 |
$637.97
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$877.52 |
$877.52 |
$877.52 |
$997.40
|
|
Ecmo/ecls initiation artery 33947
|
$11,117.68 |
$11,117.68 |
$11,117.68 |
$3,151.20
|
|
Ecmo/ecls initiation venous 33946
|
$1,188.32 |
$1,188.32 |
$1,188.32 |
$4,324.50
|
|
Ecmo/ecls insj prph cannula 6yrs&older perq 33952
|
$1,649.76 |
$1,649.76 |
$1,649.76 |
$3,321.00
|
|
Ecmo/ecls remove prph cannula 6yrs&older perq 33966
|
$915.60 |
$915.60 |
$915.60 |
$1,898.66
|
