|
Cystourethroscop/calib/dilat stric 52281
|
$896.28 |
$896.28 |
$1,629.60 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$22.00 |
$22.00 |
$40.00 |
$89.94
|
|
Cytogenetics 25-99
|
$37.62 |
$37.62 |
$68.40 |
$190.00
|
|
Cytog genom-wid alys hem mal
|
$834.02 |
$834.02 |
$1,516.40 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$112.86 |
$112.86 |
$205.20 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$16.94 |
$16.94 |
$30.80 |
$97.50
|
|
Cytopath fl nongyn filter
|
$13.42 |
$13.42 |
$24.40 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$27.72 |
$27.72 |
$50.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$12.10 |
$12.10 |
$22.00 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$12.98 |
$12.98 |
$23.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$26.18 |
$26.18 |
$47.60 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$42.68 |
$42.68 |
$77.60 |
$209.23
|
|
Cytp urine 3-5 probes cmptr
|
$227.04 |
$227.04 |
$412.80 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$22.00 |
$22.00 |
$40.00 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,854.35 |
$1,854.35 |
$3,371.54 |
$3,024.59
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,359.96 |
$1,359.96 |
$2,472.66 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$54.94 |
$54.94 |
$99.90 |
$56.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$377.34 |
$377.34 |
$686.06 |
$257.10
|
|
Dch glucoscan
|
$6.16 |
$6.16 |
$11.20 |
$28.10
|
|
Deamidated gliadin antibody iga
|
$8.36 |
$8.36 |
$15.20 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$32.56 |
$32.56 |
$59.20 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$78.54 |
$78.54 |
$142.80 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$288.20 |
$288.20 |
$524.00 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$144.32 |
$144.32 |
$262.40 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$288.20 |
$288.20 |
$524.00 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$343.20 |
$343.20 |
$624.00 |
$810.50
|
|
Debride nail1-5 11720
|
$45.98 |
$45.98 |
$83.60 |
$148.80
|
|
Debride nail6 or more 11721
|
$19.80 |
$19.80 |
$36.00 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$175.12 |
$175.12 |
$318.40 |
$1,012.80
|
|
Debride skn/sq/musc/abd wall 11004
|
$144.54 |
$144.54 |
$262.80 |
$903.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$144.32 |
$144.32 |
$262.40 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$231.22 |
$231.22 |
$420.40 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$597.96 |
$597.96 |
$1,087.20 |
$1,160.00
|
|
Decalcification
|
$8.36 |
$8.36 |
$15.20 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$1,078.12 |
$1,078.12 |
$1,960.21 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$272.80 |
$272.80 |
$496.00 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$125.81 |
$125.81 |
$228.74 |
$95.85
|
|
Delivery of placenta 59414
|
$983.18 |
$983.18 |
$1,787.60 |
$3,070.56
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$4,280.98 |
$4,280.98 |
$7,783.60 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$99.22 |
$99.22 |
$180.40 |
$185.17
|
|
Design mlc device for imrt
|
$197.12 |
$197.12 |
$358.40 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$981.22 |
$981.22 |
$1,784.04 |
$89.78
|
|
Des thora aorta rpr without left sub art 33881
|
$810.70 |
$810.70 |
$1,474.00 |
$5,698.68
|
|
Destroy premlg lesns;1st lesn 17000
|
$132.00 |
$132.00 |
$240.00 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$149.60 |
$149.60 |
$272.00 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$162.80 |
$162.80 |
$296.00 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$338.14 |
$338.14 |
$614.80 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$676.06 |
$676.06 |
$1,229.20 |
$3,202.98
|
|
Devel tst phys/qhp 1st hr
|
$175.12 |
$175.12 |
$318.40 |
$337.50
|
|
Devlopment test interpt&rep
|
$158.40 |
$158.40 |
$288.00 |
$109.46
|
|
Dexamethasone 4 mg tablet
|
$213.67 |
$213.67 |
$388.49 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$103.65 |
$103.65 |
$188.46 |
$21.17
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$239.34 |
$239.34 |
$435.17 |
$858.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$94.60 |
$94.60 |
$172.00 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$104.06 |
$104.06 |
$189.20 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$75.68 |
$75.68 |
$137.60 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$113.52 |
$113.52 |
$206.40 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$23.32 |
$23.32 |
$42.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$8.80 |
$8.80 |
$16.00 |
$79.20
|
|
Diab manage trn ind/group
|
$25.08 |
$25.08 |
$45.60 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$272.80 |
$272.80 |
$496.00 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$53.68 |
$53.68 |
$97.60 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$53.46 |
$53.46 |
$97.20 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$99.44 |
$99.44 |
$180.80 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$91.08 |
$91.08 |
$165.60 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$83.60 |
$83.60 |
$152.00 |
$301.55
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,707.98 |
$2,707.98 |
$4,923.60 |
$5,419.00
|
|
Dialysis one evaluation
|
$403.48 |
$403.48 |
$733.60 |
$919.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$203.33 |
$203.33 |
$369.70 |
$74.76
|
|
Dicyclomine injection
|
$119.06 |
$119.06 |
$216.47 |
$153.29
|
|
Diffusing capacity
|
$46.64 |
$46.64 |
$84.80 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$22.00 |
$22.00 |
$40.00 |
$69.03
|
|
Digoxin total therapeutic drug level
|
$4.84 |
$4.84 |
$8.80 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$400.99 |
$400.99 |
$729.07 |
$297.86
|
|
Dilate urethra stricture
|
$272.80 |
$272.80 |
$496.00 |
$490.00
|
|
Dilation/female urethra/initial 53660
|
$272.80 |
$272.80 |
$496.00 |
$235.61
|
|
Dilat xst trc ndurlgc px
|
$978.34 |
$978.34 |
$1,778.80 |
$4,061.71
|
|
Dimenhydrinate injection
|
$22.00 |
$22.00 |
$40.00 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.44 |
$0.44 |
$0.80 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$35.11 |
$35.11 |
$63.84 |
$17.75
|
|
Dipyridamole injection
|
$57.42 |
$57.42 |
$104.40 |
$47.87
|
|
Disability dlco
|
$55.44 |
$55.44 |
$100.80 |
$282.40
|
|
Disaccharidases
|
$83.38 |
$83.38 |
$151.60 |
$216.00
|
|
Dna antibody native/double stranded
|
$14.74 |
$14.74 |
$26.80 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$117.97 |
$117.97 |
$214.50 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$614.76 |
$614.76 |
$1,117.75 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$69.30 |
$69.30 |
$126.00 |
$65.40
|
|
Doppler echo complete
|
$172.26 |
$172.26 |
$313.20 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$219.78 |
$219.78 |
$399.60 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$163.24 |
$163.24 |
$296.80 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$135.96 |
$135.96 |
$247.20 |
$471.17
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$305.13 |
$305.13 |
$554.78 |
$423.95
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,526.41 |
$1,526.41 |
$2,775.30 |
$1,718.24
|
|
Drainage of arm bursa 23931
|
$802.12 |
$802.12 |
$1,458.40 |
$2,197.48
|
|
Drainage of kidney lesion
|
$545.16 |
$545.16 |
$991.20 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$20.46 |
$20.46 |
$37.20 |
$170.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$807.18 |
$807.18 |
$1,467.60 |
$2,540.00
|
|
Drain cerebro spinal fluid 62272
|
$232.54 |
$232.54 |
$422.80 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$74.14 |
$74.14 |
$134.80 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$78.54 |
$78.54 |
$142.80 |
$392.40
|