|
Culture fungi definitive id mold
|
$60.80 |
$60.80 |
$60.80 |
$80.00
|
|
Culture fungi definitive id yeast
|
$90.40 |
$90.40 |
$90.40 |
$80.00
|
|
Culture fungi other (except blood)
|
$72.80 |
$72.80 |
$72.80 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$83.20 |
$83.20 |
$83.20 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$92.00 |
$92.00 |
$92.00 |
$100.00
|
|
Culture screening strep group a
|
$51.20 |
$51.20 |
$51.20 |
$84.60
|
|
Culture typing immunologic
|
$33.60 |
$33.60 |
$33.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$611.20 |
$611.20 |
$611.20 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$138.40 |
$138.40 |
$138.40 |
$140.80
|
|
Culture urine each isolate
|
$45.60 |
$45.60 |
$45.60 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$24.98 |
$24.98 |
$24.98 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$91.20 |
$91.20 |
$91.20 |
$72.36
|
|
Cystatin c
|
$99.20 |
$99.20 |
$99.20 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$804.00 |
$804.00 |
$804.00 |
$586.95
|
|
Cystoscopy (Bladder Scope)
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$1,493.80
|
|
Cytogenetics 25-99
|
$103.20 |
$103.20 |
$103.20 |
$189.80
|
|
Cytogenetics 3-5
|
$99.20 |
$99.20 |
$99.20 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$66.40 |
$66.40 |
$66.40 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$61.60 |
$61.60 |
$61.60 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$127.20 |
$127.20 |
$127.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$89.60 |
$89.60 |
$89.60 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$72.00 |
$72.00 |
$72.00 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$134.40 |
$134.40 |
$134.40 |
$135.20
|
|
Cytopath tbs c/v manual
|
$71.20 |
$71.20 |
$71.20 |
$59.28
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$56.84 |
$56.84 |
$56.84 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,799.89 |
$1,799.89 |
$1,799.89 |
$6,281.29
|
|
Dch glucoscan
|
$32.80 |
$32.80 |
$32.80 |
$29.16
|
|
Deamidated gliadin antibody iga
|
$54.40 |
$54.40 |
$54.40 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$361.60 |
$361.60 |
$361.60 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$640.00 |
$640.00 |
$640.00 |
$835.20
|
|
Debride nail1-5 11720
|
$136.80 |
$136.80 |
$136.80 |
$149.60
|
|
Debride nail6 or more 11721
|
$159.20 |
$159.20 |
$159.20 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$640.00 |
$640.00 |
$640.00 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,826.40 |
$1,826.40 |
$1,826.40 |
$1,149.50
|
|
Degarelix 120 mg subcutaneous solution
|
$653.68 |
$653.68 |
$653.68 |
$1,856.85
|
|
Delivery of placenta 59414
|
$1,239.20 |
$1,239.20 |
$1,239.20 |
$2,912.46
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,516.08 |
$3,516.08 |
$3,516.08 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$65.48 |
$65.48 |
$65.48 |
$71.51
|
|
Desmopressin 4 mcg/ml injection solution
|
$57.16 |
$57.16 |
$57.16 |
$91.84
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$312.00 |
$312.00 |
$312.00 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$2.86 |
$2.86 |
$2.86 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$24.68 |
$24.68 |
$24.68 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$40.00 |
$40.00 |
$40.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$88.80 |
$88.80 |
$88.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$68.80 |
$68.80 |
$68.80 |
$79.30
|
|
Diagnostic Mammogram (both breasts)
|
$523.20 |
$523.20 |
$523.20 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$409.60 |
$409.60 |
$409.60 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$32.03 |
$32.03 |
$32.03 |
$79.71
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$26.39 |
$26.39 |
$26.39 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$105.60 |
$105.60 |
$105.60 |
$102.07
|
|
Diltiazem 5 mg/ml intravenous solution
|
$25.32 |
$25.32 |
$25.32 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$2.40 |
$2.40 |
$2.40 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$24.52 |
$24.52 |
$24.52 |
$18.32
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$133.60 |
$133.60 |
$133.60 |
$98.15
|
|
Dna antibody native/double stranded
|
$80.00 |
$80.00 |
$80.00 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$122.00 |
$122.00 |
$122.00 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$90.00 |
$90.00 |
$90.00 |
$65.40
|
|
Doppler echo complete
|
$507.20 |
$507.20 |
$507.20 |
$558.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$500.80 |
$500.80 |
$500.80 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$36.27 |
$36.27 |
$36.27 |
$89.34
|
|
Drainage external ear simple 69000
|
$633.60 |
$633.60 |
$633.60 |
$790.40
|
|
Drain blood from under nail 11740
|
$261.60 |
$261.60 |
$261.60 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$485.60 |
$485.60 |
$485.60 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$527.20 |
$527.20 |
$527.20 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$439.20 |
$439.20 |
$439.20 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$660.00 |
$660.00 |
$660.00 |
$541.00
|
|
Drug assay vedolizumab
|
$193.60 |
$193.60 |
$193.60 |
$154.00
|
|
Drug of abuse screen urine
|
$58.40 |
$58.40 |
$58.40 |
$67.89
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$209.60 |
$209.60 |
$209.60 |
$278.85
|
|
Dry needling (97799)
|
$114.40 |
$114.40 |
$114.40 |
$114.27
|
|
Ear irrigation 69209
|
$104.80 |
$104.80 |
$104.80 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$156.80 |
$156.80 |
$156.80 |
$132.08
|
|
Ecg external < 48 hours recording
|
$382.40 |
$382.40 |
$382.40 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$598.40 |
$598.40 |
$598.40 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$194.40 |
$194.40 |
$194.40 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$212.00 |
$212.00 |
$212.00 |
$173.40
|
|
Echocardiogram (Heart Ultrasound)
|
$1,397.60 |
$1,397.60 |
$1,397.60 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$736.80 |
$736.80 |
$736.80 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$503.20 |
$503.20 |
$503.20 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,818.40 |
$2,818.40 |
$2,818.40 |
$1,944.80
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$1,370.40 |
$1,370.40 |
$1,370.40 |
$866.87
|
|
Echocardiograpy doppler follow up/limited study
|
$324.80 |
$324.80 |
$324.80 |
$371.25
|
|
Echo transthoracic
|
$1,522.40 |
$1,522.40 |
$1,522.40 |
$1,361.75
|
|
Egd dilate stricture
|
$2,236.00 |
$2,236.00 |
$2,236.00 |
$2,394.60
|
|
EKG tracing for initial prev
|
$136.00 |
$136.00 |
$136.00 |
$81.76
|
|
EKG (Tracing Only)
|
$224.80 |
$224.80 |
$224.80 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$280.80 |
$280.80 |
$280.80 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$329.60 |
$329.60 |
$329.60 |
$364.20
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$96.00 |
$96.00 |
$96.00 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$91.20 |
$91.20 |
$91.20 |
$81.75
|
|
Electrolyte panel
|
$66.40 |
$66.40 |
$66.40 |
$79.30
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$91.01 |
$91.01 |
$91.01 |
$112.79
|
|
Epinephrine 0.1 mg/ml injection syringe
|
$32.67 |
$32.67 |
$32.67 |
$37.86
|
|
Epinephrine 1 mg/ml im kit - adult
|
$26.08 |
$26.08 |
$26.08 |
$31.76
|
|
Epinephrine hcl (pf) 1 mg/ml (1 ml) injection solution
|
$25.14 |
$25.14 |
$25.14 |
$33.60
|
|
Epoetin alfa, 100 units esrd
|
$248.79 |
$248.79 |
$248.79 |
$6.00
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$292.31 |
$292.31 |
$292.31 |
$865.80
|