|
Cytomegalovirus (cmv) antibody igg
|
$176.98 |
$176.98 |
$176.98 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$132.91 |
$132.91 |
$132.91 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$82.27 |
$82.27 |
$82.27 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$143.95 |
$143.95 |
$143.95 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$211.54 |
$211.54 |
$211.54 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$91.39 |
$91.39 |
$91.39 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$93.94 |
$93.94 |
$93.94 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$413.86 |
$413.86 |
$413.86 |
$213.85
|
|
Cytopath smear other source
|
$82.85 |
$82.85 |
$82.85 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$35.57 |
$35.57 |
$35.57 |
$96.20
|
|
Cytopath tbs c/v manual
|
$223.63 |
$223.63 |
$223.63 |
$59.28
|
|
Dacarbazine 100 mg intravenous solution
|
$129.09 |
$129.09 |
$129.09 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$4,522.58 |
$4,522.58 |
$4,522.58 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$1,524.18 |
$1,524.18 |
$1,524.18 |
$3,493.11
|
|
Dalteparin sodium
|
$1,025.79 |
$1,025.79 |
$1,025.79 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$750.03 |
$750.03 |
$750.03 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$6,188.46 |
$6,188.46 |
$6,188.46 |
$6,281.29
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$14,300.64 |
$14,300.64 |
$14,300.64 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$321.72 |
$321.72 |
$321.72 |
$259.58
|
|
Daunorubicin citrate inj
|
$585.31 |
$585.31 |
$585.31 |
$585.31
|
|
Dch pulmonary stress test
|
$807.26 |
$807.26 |
$807.26 |
$963.30
|
|
Deamidated gliadin antibody iga
|
$78.48 |
$78.48 |
$78.48 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$687.12 |
$687.12 |
$687.12 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$139.44 |
$139.44 |
$139.44 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,809.20 |
$2,809.20 |
$2,809.20 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$921.17 |
$921.17 |
$921.17 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,863.10 |
$2,863.10 |
$2,863.10 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$779.23 |
$779.23 |
$779.23 |
$835.20
|
|
Debride nail1-5 11720
|
$175.58 |
$175.58 |
$175.58 |
$149.60
|
|
Debride nail6 or more 11721
|
$251.76 |
$251.76 |
$251.76 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$741.41 |
$741.41 |
$741.41 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$893.66 |
$893.66 |
$893.66 |
$1,165.50
|
|
Decalcification
|
$36.67 |
$36.67 |
$36.67 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$2,692.99 |
$2,692.99 |
$2,692.99 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$822.00 |
$822.00 |
$822.00 |
$572.95
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$9,976.94 |
$9,976.94 |
$9,976.94 |
$4,914.00
|
|
Deferoxamine 500 mg solution for injection
|
$110.37 |
$110.37 |
$110.37 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$2,392.44 |
$2,392.44 |
$2,392.44 |
$1,856.85
|
|
Delivery of placenta 59414
|
$1,094.54 |
$1,094.54 |
$1,094.54 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$15,705.94 |
$15,705.94 |
$15,705.94 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$137.42 |
$137.42 |
$137.42 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$5,530.46 |
$5,530.46 |
$5,530.46 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$422.89 |
$422.89 |
$422.89 |
$71.51
|
|
Descend thora aorta rpr/lt sub art 33880
|
$1,872.72 |
$1,872.72 |
$1,872.72 |
$6,288.45
|
|
Design mlc device for imrt
|
$4,421.14 |
$4,421.14 |
$4,421.14 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$47.88 |
$47.88 |
$47.88 |
$91.84
|
|
Des thora aorta rpr without left sub art 33881
|
$2,706.77 |
$2,706.77 |
$2,706.77 |
$5,267.20
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,199.86 |
$1,199.86 |
$1,199.86 |
$3,273.55
|
|
Destroy cervthor facet jnt 64633
|
$3,144.14 |
$3,144.14 |
$3,144.14 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,863.17 |
$1,863.17 |
$1,863.17 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,221.26 |
$1,221.26 |
$1,221.26 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,052.51 |
$3,052.51 |
$3,052.51 |
$3,296.80
|
|
Determination venous press
|
$192.91 |
$192.91 |
$192.91 |
$166.56
|
|
Devel tst phys/qhp 1st hr
|
$228.58 |
$228.58 |
$228.58 |
$350.40
|
|
Device ablt adv novasure
|
$24,069.12 |
$24,069.12 |
$24,069.12 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,225.54 |
$1,225.54 |
$1,225.54 |
$4,200.00
|
|
Device intraute mirena
|
$1,983.72 |
$1,983.72 |
$1,983.72 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$1,383.79 |
$1,383.79 |
$1,383.79 |
$2,515.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$114.29 |
$114.29 |
$114.29 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$92.50 |
$92.50 |
$92.50 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$36.80 |
$36.80 |
$36.80 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$77.12 |
$77.12 |
$77.12 |
$20.76
|
|
Dexamethasone intra implant
|
$2,262.34 |
$2,262.34 |
$2,262.34 |
$2,356.90
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$335.98 |
$335.98 |
$335.98 |
$884.80
|
|
Dextran 40 infusion
|
$146.81 |
$146.81 |
$146.81 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$29.38 |
$29.38 |
$29.38 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$27.60 |
$27.60 |
$27.60 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$27.78 |
$27.78 |
$27.78 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$29.38 |
$29.38 |
$29.38 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$36.14 |
$36.14 |
$36.14 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$31.20 |
$31.20 |
$31.20 |
$79.30
|
|
Diab manage trn ind/group
|
$20.78 |
$20.78 |
$20.78 |
$54.99
|
|
Diab shoe for density insert
|
$136.66 |
$136.66 |
$136.66 |
$147.56
|
|
Diagnostic anoscopy spx 46600
|
$98.74 |
$98.74 |
$98.74 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$408.19 |
$408.19 |
$408.19 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$518.06 |
$518.06 |
$518.06 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$466.32 |
$466.32 |
$466.32 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$1,618.08 |
$1,618.08 |
$1,618.08 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$6,576.38 |
$6,576.38 |
$6,576.38 |
$5,741.00
|
|
Dialysis one evaluation
|
$755.14 |
$755.14 |
$755.14 |
$936.00
|
|
Diathermy eg microwave
|
$77.47 |
$77.47 |
$77.47 |
$29.68
|
|
Diatrizoate meglumine 18 % urethral solution
|
$1.44 |
$1.44 |
$1.44 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$71.72 |
$71.72 |
$71.72 |
$79.71
|
|
Dicyclomine injection
|
$37.84 |
$37.84 |
$37.84 |
$154.33
|
|
Diffusing capacity
|
$236.83 |
$236.83 |
$236.83 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$31.69 |
$31.69 |
$31.69 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,720.39 |
$6,720.39 |
$6,720.39 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$38.02 |
$38.02 |
$38.02 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$236.47 |
$236.47 |
$236.47 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,035.60 |
$1,035.60 |
$1,035.60 |
$1,866.73
|
|
Dilate esophagus
|
$2,458.08 |
$2,458.08 |
$2,458.08 |
$2,142.40
|
|
Dilate ic vasospasm init
|
$12,459.41 |
$12,459.41 |
$12,459.41 |
$5,151.95
|
|
Dilate urethra stricture
|
$1,996.42 |
$1,996.42 |
$1,996.42 |
$513.00
|
|
Dilation/female urethra/initial 53660
|
$1,305.79 |
$1,305.79 |
$1,305.79 |
$235.61
|
|
Dilation of cervical canal 57800
|
$3,492.10 |
$3,492.10 |
$3,492.10 |
$4,446.00
|
|
Dilation of salivary duct
|
$1,273.63 |
$1,273.63 |
$1,273.63 |
$790.00
|
|
Dilation of urethra
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$172.00
|
|
Dilator fascial 10fx20cm
|
$161.52 |
$161.52 |
$161.52 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$6,254.40 |
$6,254.40 |
$6,254.40 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$6,254.40 |
$6,254.40 |
$6,254.40 |
$4,258.20
|