|
Culture fungi skin/hair/nail
|
$6.90 |
$6.90 |
$6.90 |
$74.40
|
|
Culture mycoplasma any source
|
$121.44 |
$121.44 |
$121.44 |
$85.26
|
|
Culture quantitative aerobic other source
|
$8.74 |
$8.74 |
$8.74 |
$86.40
|
|
Culture screening strep group a
|
$62.56 |
$62.56 |
$62.56 |
$81.00
|
|
Culture typing immunologic
|
$8.74 |
$8.74 |
$8.74 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$169.05 |
$169.05 |
$169.05 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$25.30 |
$25.30 |
$25.30 |
$124.37
|
|
Culture urine each isolate
|
$6.21 |
$6.21 |
$6.21 |
$51.35
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$170.83 |
$170.83 |
$170.83 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$36.34 |
$36.34 |
$36.34 |
$72.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$740.20 |
$740.20 |
$740.20 |
$1,299.41
|
|
Cyclophosphamide 25 mg capsule
|
$3.66 |
$3.66 |
$3.66 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$62.44 |
$62.44 |
$62.44 |
$140.78
|
|
Cyclosporine 2 hour
|
$172.27 |
$172.27 |
$172.27 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$1.12 |
$1.12 |
$1.12 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$34.51 |
$34.51 |
$34.51 |
$33.53
|
|
Cyp2c19 gene com variants
|
$169.28 |
$169.28 |
$169.28 |
$433.00
|
|
Cyp2c9 gene com variants
|
$936.56 |
$936.56 |
$936.56 |
$266.50
|
|
Cyp2d6 gene com variants
|
$348.68 |
$348.68 |
$348.68 |
$525.95
|
|
Cystatin c
|
$53.59 |
$53.59 |
$53.59 |
$76.05
|
|
Cystic fibrosis cftr
|
$387.32 |
$387.32 |
$387.32 |
$1,060.00
|
|
Cystine urine quantitative
|
$43.01 |
$43.01 |
$43.01 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$224.02 |
$224.02 |
$224.02 |
$533.06
|
|
Cystoscopy and treatment
|
$1,296.51 |
$1,296.51 |
$1,296.51 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$369.61 |
$369.61 |
$369.61 |
$1,493.80
|
|
Cysto/uretero w/up stricture
|
$2,150.27 |
$2,150.27 |
$2,150.27 |
$4,061.71
|
|
Cystourethroscop/calib/dilat stric 52281
|
$653.66 |
$653.66 |
$653.66 |
$3,015.50
|
|
Cytarabine 20 mg/ml injection solution
|
$12.78 |
$12.78 |
$12.78 |
$90.00
|
|
Cytogenetics 25-99
|
$155.71 |
$155.71 |
$155.71 |
$189.80
|
|
Cytogenomic neo microra alys
|
$936.56 |
$936.56 |
$936.56 |
$1,911.78
|
|
Cytogenom microarray copy nmbr var
|
$1,248.21 |
$1,248.21 |
$1,248.21 |
$1,341.36
|
|
Cytog genom-wid alys hem mal
|
$871.93 |
$871.93 |
$871.93 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$46.23 |
$46.23 |
$46.23 |
$94.90
|
|
Cytomegalovirus (cmv) antibody igm
|
$46.23 |
$46.23 |
$46.23 |
$95.55
|
|
Cytomegalovirus dfa
|
$7.59 |
$7.59 |
$7.59 |
$74.88
|
|
Cytopath fl nongyn filter
|
$36.11 |
$36.11 |
$36.11 |
$82.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$31.97 |
$31.97 |
$31.97 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$58.65 |
$58.65 |
$58.65 |
$91.50
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$25.76 |
$25.76 |
$25.76 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$14.49 |
$14.49 |
$14.49 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$14.49 |
$14.49 |
$14.49 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$2.30 |
$2.30 |
$2.30 |
$67.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$61.64 |
$61.64 |
$61.64 |
$182.65
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$31.97 |
$31.97 |
$31.97 |
$207.50
|
|
Cytp urine 3-5 probes cmptr
|
$246.79 |
$246.79 |
$246.79 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$7.83 |
$7.83 |
$7.83 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$969.32 |
$969.32 |
$969.32 |
$3,047.85
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$710.89 |
$710.89 |
$710.89 |
$165.94
|
|
Daptomycin (xellia) unrefrig
|
$28.72 |
$28.72 |
$28.72 |
$47.45
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$197.24 |
$197.24 |
$197.24 |
$259.58
|
|
Dch pulmonary stress test
|
$452.41 |
$452.41 |
$452.41 |
$930.80
|
|
Dch validity tests
|
$9.66 |
$9.66 |
$9.66 |
$24.36
|
|
Deamidated gliadin antibody iga
|
$8.74 |
$8.74 |
$8.74 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$177.79 |
$177.79 |
$177.79 |
$667.80
|
|
Debridement (>20 cm) charge pt
|
$104.88 |
$104.88 |
$104.88 |
$262.25
|
|
Debridement bone <= 20 sq cm
|
$722.89 |
$722.89 |
$722.89 |
$2,280.47
|
|
Debridement/bone/20 sq cm or less 11046
|
$543.72 |
$543.72 |
$543.72 |
$654.75
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$543.72 |
$543.72 |
$543.72 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$372.14 |
$372.14 |
$372.14 |
$798.23
|
|
Debride nail1-5 11720
|
$37.72 |
$37.72 |
$37.72 |
$145.53
|
|
Debride skin bone at fx site
|
$854.91 |
$854.91 |
$854.91 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$543.72 |
$543.72 |
$543.72 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$390.77 |
$390.77 |
$390.77 |
$1,094.40
|
|
Debr musc/fascia 20sq cm/< 11043
|
$557.75 |
$557.75 |
$557.75 |
$1,160.00
|
|
Decalcification
|
$9.20 |
$9.20 |
$9.20 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$563.56 |
$563.56 |
$563.56 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$270.02 |
$270.02 |
$270.02 |
$540.00
|
|
Deferoxamine 500 mg solution for injection
|
$65.76 |
$65.76 |
$65.76 |
$95.85
|
|
Delivery of placenta 59414
|
$1,036.84 |
$1,036.84 |
$1,036.84 |
$2,778.27
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$59.80 |
$59.80 |
$59.80 |
$402.36
|
|
Design mlc device for imrt
|
$762.22 |
$762.22 |
$762.22 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$512.91 |
$512.91 |
$512.91 |
$82.24
|
|
Desoxycorticosterone
|
$149.50 |
$149.50 |
$149.50 |
$109.28
|
|
Destruction benign lesions < 14 lesions
|
$48.76 |
$48.76 |
$48.76 |
$235.13
|
|
Detect agent nos dna dir
|
$34.96 |
$34.96 |
$34.96 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$111.32 |
$111.32 |
$111.32 |
$221.50
|
|
Dexamethasone 4 mg tablet
|
$93.08 |
$93.08 |
$93.08 |
$5.82
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$54.18 |
$54.18 |
$54.18 |
$21.64
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$125.11 |
$125.11 |
$125.11 |
$849.53
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$52.90 |
$52.90 |
$52.90 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$58.19 |
$58.19 |
$58.19 |
$45.80
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$42.32 |
$42.32 |
$42.32 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$63.48 |
$63.48 |
$63.48 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$93.38 |
$93.38 |
$93.38 |
$110.38
|
|
Diabetes (HbA1c) Test
|
$46.46 |
$46.46 |
$46.46 |
$79.52
|
|
Diagnostic digital breast tomosynthesis bil
|
$24.15 |
$24.15 |
$24.15 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$24.15 |
$24.15 |
$24.15 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$122.13 |
$122.13 |
$122.13 |
$327.60
|
|
Diagnostic Mammogram (both breasts)
|
$149.96 |
$149.96 |
$149.96 |
$397.50
|
|
Diagnostic Mammogram (one breast)
|
$99.13 |
$99.13 |
$99.13 |
$296.40
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,423.74 |
$2,423.74 |
$2,423.74 |
$5,366.71
|
|
Dialysis one evaluation
|
$463.68 |
$463.68 |
$463.68 |
$862.40
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$106.29 |
$106.29 |
$106.29 |
$74.02
|
|
Dicyclomine injection
|
$62.23 |
$62.23 |
$62.23 |
$160.09
|
|
Diffusing capacity
|
$70.84 |
$70.84 |
$70.84 |
$331.76
|
|
Digital analysis of eeg
|
$202.40 |
$202.40 |
$202.40 |
$605.60
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$5.01 |
$5.01 |
$5.01 |
$66.86
|
|
Digoxin total therapeutic drug level
|
$55.89 |
$55.89 |
$55.89 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$209.61 |
$209.61 |
$209.61 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$561.20 |
$561.20 |
$561.20 |
$1,866.73
|