|
CT angio hrt w/3d image
|
$2,303.20 |
$2,303.20 |
$2,303.20 |
$1,428.68
|
|
CT angio pelvis
|
$2,580.00 |
$2,580.00 |
$2,580.00 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,582.40 |
$2,582.40 |
$2,582.40 |
$1,691.30
|
|
CT cerebral perf w cont & prcssng
|
$800.00 |
$800.00 |
$800.00 |
$1,040.00
|
|
CT colonography dx
|
$1,518.40 |
$1,518.40 |
$1,518.40 |
$811.41
|
|
CT colonography dx w/dye
|
$1,632.80 |
$1,632.80 |
$1,632.80 |
$1,069.25
|
|
CT guidance for needle placement
|
$1,471.20 |
$1,471.20 |
$1,471.20 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$4,885.60 |
$4,885.60 |
$4,885.60 |
$2,039.76
|
|
CT guid parench tis ablat
|
$1,950.40 |
$1,950.40 |
$1,950.40 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$258.40 |
$258.40 |
$258.40 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,031.20 |
$2,031.20 |
$2,031.20 |
$1,395.79
|
|
CT hrt w/3d image
|
$2,015.20 |
$2,015.20 |
$2,015.20 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$992.80 |
$992.80 |
$992.80 |
$636.55
|
|
Ctlso a-p-l control with inter
|
$5,407.03 |
$5,407.03 |
$5,407.03 |
$4,186.78
|
|
CT lwr extremity w/o&w/dye
|
$2,492.00 |
$2,492.00 |
$2,492.00 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$496.00 |
$496.00 |
$496.00 |
$422.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,288.80 |
$4,288.80 |
$4,288.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,016.00 |
$4,016.00 |
$4,016.00 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,476.00 |
$3,476.00 |
$3,476.00 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,856.80 |
$2,856.80 |
$2,856.80 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,449.60 |
$2,449.60 |
$2,449.60 |
$1,845.36
|
|
Curette/treat cornea
|
$2,028.80 |
$2,028.80 |
$2,028.80 |
$1,365.60
|
|
Cutter lead
|
$17,483.68 |
$17,483.68 |
$17,483.68 |
$6,581.45
|
|
Cv line/pic reposition
|
$2,237.60 |
$2,237.60 |
$2,237.60 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$46.15 |
$46.15 |
$46.15 |
$25.32
|
|
Cyclophosphamide 25 mg capsule
|
$10.43 |
$10.43 |
$10.43 |
$19.49
|
|
Cyclosporine modified 25 mg capsule
|
$5.85 |
$5.85 |
$5.85 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$185.11 |
$185.11 |
$185.11 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$32,402.40 |
$32,402.40 |
$32,402.40 |
$24,728.89
|
|
Cystogram >= 3 views supervision & interpretation
|
$844.00 |
$844.00 |
$844.00 |
$586.95
|
|
Cystoscopy and treatment
|
$4,893.60 |
$4,893.60 |
$4,893.60 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$3,484.00 |
$3,484.00 |
$3,484.00 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$4,696.00 |
$4,696.00 |
$4,696.00 |
$2,874.36
|
|
Cystoscopy & ureter catheter
|
$5,012.80 |
$5,012.80 |
$5,012.80 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$6,255.20 |
$6,255.20 |
$6,255.20 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$5,693.60 |
$5,693.60 |
$5,693.60 |
$3,245.90
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$5,371.20 |
$5,371.20 |
$5,371.20 |
$4,057.50
|
|
Cystourethro w/addl implant 52442
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
$2,161.60
|
|
Cystourethro w/implant
|
$1,493.60 |
$1,493.60 |
$1,493.60 |
$2,777.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$144.80 |
$144.80 |
$144.80 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$97.60 |
$97.60 |
$97.60 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$70.40 |
$70.40 |
$70.40 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$130.40 |
$130.40 |
$130.40 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$122.40 |
$122.40 |
$122.40 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$339.20 |
$339.20 |
$339.20 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$249.60 |
$249.60 |
$249.60 |
$213.85
|
|
Cytopath smear other source
|
$137.60 |
$137.60 |
$137.60 |
$92.50
|
|
Cytopath tbs c/v manual
|
$49.60 |
$49.60 |
$49.60 |
$59.28
|
|
Dalbavancin 500 mg intravenous solution
|
$1,007.00 |
$1,007.00 |
$1,007.00 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$107.00 |
$107.00 |
$107.00 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$868.00 |
$868.00 |
$868.00 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$2,079.83 |
$2,079.83 |
$2,079.83 |
$7.20
|
|
D&c after delivery 59160
|
$4,656.00 |
$4,656.00 |
$4,656.00 |
$3,827.25
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$6,620.00 |
$6,620.00 |
$6,620.00 |
$5,121.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$362.40 |
$362.40 |
$362.40 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,616.00 |
$2,616.00 |
$2,616.00 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,502.40 |
$1,502.40 |
$1,502.40 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,215.20 |
$1,215.20 |
$1,215.20 |
$835.20
|
|
Debride nail1-5 11720
|
$172.80 |
$172.80 |
$172.80 |
$149.60
|
|
Debride nail6 or more 11721
|
$187.20 |
$187.20 |
$187.20 |
$169.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$2,492.00 |
$2,492.00 |
$2,492.00 |
$1,163.24
|
|
Debride skin bone at fx site
|
$2,921.60 |
$2,921.60 |
$2,921.60 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$808.00 |
$808.00 |
$808.00 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,560.80 |
$1,560.80 |
$1,560.80 |
$1,165.50
|
|
Decalcification
|
$96.80 |
$96.80 |
$96.80 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$685.60 |
$685.60 |
$685.60 |
$572.95
|
|
Decompression unspecified nerve 64722
|
$3,170.40 |
$3,170.40 |
$3,170.40 |
$2,310.83
|
|
Decompress small bowel
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$1,503.60
|
|
Deferoxamine 500 mg solution for injection
|
$53.95 |
$53.95 |
$53.95 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$793.01 |
$793.01 |
$793.01 |
$1,856.85
|
|
Delivery of placenta 59414
|
$2,600.00 |
$2,600.00 |
$2,600.00 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$204.80 |
$204.80 |
$204.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$1,735.76 |
$1,735.76 |
$1,735.76 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$437.60 |
$437.60 |
$437.60 |
$401.60
|
|
Design mlc device for imrt
|
$1,980.80 |
$1,980.80 |
$1,980.80 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$57.92 |
$57.92 |
$57.92 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$3,404.00 |
$3,404.00 |
$3,404.00 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,233.60 |
$1,233.60 |
$1,233.60 |
$1,441.44
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$966.60
|
|
Destruction benign lesions < 14 lesions
|
$297.60 |
$297.60 |
$297.60 |
$240.24
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,734.40 |
$1,734.40 |
$1,734.40 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,480.00 |
$3,480.00 |
$3,480.00 |
$3,296.80
|
|
Device ablt adv novasure
|
$12,420.00 |
$12,420.00 |
$12,420.00 |
$6,237.48
|
|
Device intraute mirena
|
$852.38 |
$852.38 |
$852.38 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,390.76 |
$1,390.76 |
$1,390.76 |
$1,860.95
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$284.00 |
$284.00 |
$284.00 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$27.89 |
$27.89 |
$27.89 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$50.24 |
$50.24 |
$50.24 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$14.00 |
$14.00 |
$14.00 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$13.51 |
$13.51 |
$13.51 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$14.00 |
$14.00 |
$14.00 |
$48.00
|
|
Diab manage trn ind/group
|
$72.00 |
$72.00 |
$72.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$295.20 |
$295.20 |
$295.20 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$190.40 |
$190.40 |
$190.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$166.40 |
$166.40 |
$166.40 |
$75.93
|
|
Diagnostic laryngoscopy 31505
|
$350.40 |
$350.40 |
$350.40 |
$242.14
|
