|
Cytomegalovirus (cmv) antibody igg
|
$15.58 |
$46.23 |
$205.20 |
|
|
Cytomegalovirus (cmv) antibody igm
|
$16.94 |
$47.04 |
$134.25 |
|
|
Cytomegalovirus dfa
|
$7.59 |
$81.27 |
$174.15 |
|
|
Cyto/molecular report
|
$196.80 |
$196.80 |
$196.80 |
|
|
Cytopath c/v thin layer redo
|
$11.76 |
$11.76 |
$11.76 |
|
|
Cytopath fl nongyn filter
|
$12.60 |
$15.25 |
$60.16 |
|
|
Cytopathology cellular enhancement technique non-gyn
|
$27.72 |
$45.84 |
$84.15 |
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$24.20 |
$34.02 |
$58.65 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$11.55 |
$22.40 |
$60.48 |
|
|
Cytopathology concentration technique smears & interpretation
|
$12.60 |
$14.49 |
$55.04 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$12.60 |
$15.33 |
$47.60 |
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$2.00 |
$2.40 |
$7.68 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$21.12 |
$58.32 |
$67.00 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$27.80 |
$34.75 |
$78.78 |
|
|
Cytopath smear other source
|
$29.04 |
$29.04 |
$40.45 |
|
|
Cytopath smear other source
|
$53.12 |
$53.12 |
$53.12 |
|
|
Cytopath smear oth prep screen & interp
|
$12.60 |
$15.12 |
$37.12 |
|
|
Cytopath tbs c/v manual
|
$45.84 |
$45.84 |
$45.84 |
|
|
Cytp urine 3-5 probes cmptr
|
$214.60 |
$257.52 |
$482.85 |
|
|
Dacarbazine 100 mg intravenous solution
|
$6.81 |
$8.17 |
$40.00 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$842.89 |
$1,053.61 |
$3,371.54 |
|
|
Dalbavancin 500 mg intravenous solution
|
$4,440.71 |
$4,440.71 |
$4,440.71 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$97.54 |
$710.89 |
$2,472.66 |
|
|
Daptomycin (xellia) unrefrig
|
$24.97 |
$31.22 |
$99.90 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$171.52 |
$214.39 |
$686.06 |
|
|
D&c after delivery 59160
|
$384.00 |
$384.00 |
$384.00 |
|
|
Dch glucoscan
|
$1.75 |
$11.20 |
$23.55 |
|
|
Dch pulmonary stress test
|
$393.40 |
$452.41 |
$491.75 |
|
|
Dch validity tests
|
$6.14 |
$24.00 |
$48.48 |
|
|
Deamidated gliadin antibody iga
|
$7.60 |
$9.50 |
$19.76 |
|
|
Debr g/per/abd wall 11006
|
$111.09 |
$111.09 |
$505.60 |
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$32.56 |
$187.50 |
$808.96 |
|
|
Debridement (>20 cm) charge pt
|
$78.54 |
$136.77 |
$640.35 |
|
|
Debridement bone <= 20 sq cm
|
$288.20 |
$722.89 |
$2,303.36 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$144.32 |
$233.94 |
$640.35 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$288.20 |
$524.00 |
$1,717.20 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$146.60 |
$343.20 |
$759.68 |
|
|
Debride nail1-5 11720
|
$33.60 |
$79.20 |
$117.97 |
|
|
Debride nail6 or more 11721
|
$19.80 |
$79.20 |
$148.50 |
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$175.12 |
$392.70 |
$531.20 |
|
|
Debride skin bone at fx site
|
$758.60 |
$877.50 |
$3,982.72 |
|
|
Debride skn/sq/musc/abd wall 11004
|
$144.54 |
$237.30 |
$282.50 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$144.32 |
$233.94 |
$640.35 |
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$231.22 |
$385.56 |
$970.24 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$157.40 |
$557.75 |
$1,087.20 |
|
|
Decalcification
|
$6.30 |
$9.12 |
$15.20 |
|
|
Decitabine 50 mg intravenous solution
|
$490.05 |
$588.06 |
$1,960.21 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$228.27 |
$293.50 |
$496.00 |
|
|
Decompression of leg
|
$752.00 |
$752.00 |
$752.00 |
|
|
Deferoxamine 500 mg solution for injection
|
$57.18 |
$65.76 |
$228.74 |
|
|
Delivery of placenta 59414
|
$567.63 |
$1,108.23 |
$1,787.60 |
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$4,280.98 |
$6,908.79 |
$8,224.75 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$99.22 |
$140.25 |
$180.40 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,458.15 |
$4,458.15 |
$4,458.15 |
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$52.00 |
$71.61 |
$178.56 |
|
|
Dermagraft
|
$129.60 |
$129.60 |
$129.60 |
|
|
Design mlc device for imrt
|
$197.12 |
$611.94 |
$762.22 |
|
|
Desmopressin 4 mcg/ml injection solution
|
$225.81 |
$557.51 |
$1,784.04 |
|
|
Desoxycorticosterone
|
$127.44 |
$149.50 |
$343.00 |
|
|
Des thora aorta rpr without left sub art 33881
|
$810.70 |
$1,474.00 |
$4,912.25 |
|
|
Destroy cervthor facet jnt 64633
|
$807.50 |
$1,051.65 |
$1,154.25 |
|
|
Destroy cth facet jnt addl 64634
|
$403.75 |
$403.75 |
$561.60 |
|
|
Destroy premlg lesns;1st lesn 17000
|
$81.92 |
$107.42 |
$240.00 |
|
|
Destruct ben lesion 15/> 17111
|
$159.90 |
$159.90 |
$175.50 |
|
|
Destruct cut vasl lesions <10cm 17106
|
$394.08 |
$394.08 |
$394.08 |
|
|
Destruction 2-14 lesions 17003
|
$84.21 |
$117.90 |
$272.00 |
|
|
Destruction benign lesions < 14 lesions
|
$43.20 |
$107.42 |
$296.00 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$338.14 |
$403.75 |
$614.80 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$676.06 |
$1,051.65 |
$1,786.88 |
|
|
Detect agent nos dna dir
|
$18.00 |
$46.83 |
$75.40 |
|
|
Devel tst phys/qhp 1st hr
|
$175.12 |
$318.40 |
$413.92 |
|
|
Device ablt adv novasure
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
|
|
Dev interrog remote 1/2/mlt
|
$32.13 |
$32.13 |
$32.13 |
|
|
Devlopment test interpt&rep
|
$46.28 |
$158.40 |
$288.00 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$85.26 |
$110.40 |
$121.00 |
|
|
Dexamethasone 4 mg tablet
|
$80.94 |
$97.12 |
$388.49 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$47.11 |
$56.54 |
$188.46 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$108.79 |
$135.99 |
$435.17 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$46.00 |
$55.20 |
$172.00 |
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$50.60 |
$60.72 |
$189.20 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$36.80 |
$44.16 |
$137.60 |
|
|
Dextrose 5 % IV bolus
|
$55.20 |
$66.24 |
$206.40 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$23.32 |
$42.40 |
$211.50 |
|
|
Diabetes (HbA1c) Test
|
$8.80 |
$46.46 |
$92.50 |
|
|
Diab manage trn ind/group
|
$8.40 |
$20.58 |
$45.60 |
|
|
Diag laparo separate proc 49320
|
$240.00 |
$240.00 |
$240.00 |
|
|
Diagnostic anoscopy spx 46600
|
$79.25 |
$178.56 |
$496.00 |
|
|
Diagnostic digital breast tomosynthesis bil
|
$21.00 |
$26.25 |
$97.60 |
|
|
Diagnostic digital breast tomosynthesis unil
|
$21.00 |
$26.25 |
$97.20 |
|
|
Diagnostic laryngoscopy 31505
|
$56.20 |
$56.20 |
$109.41 |
|
|
Diagnostic laryngoscopy 31575
|
$52.80 |
$101.00 |
$180.80 |
|
|
Diagnostic Mammogram (both breasts)
|
$91.08 |
$179.20 |
$279.90 |
|
|
Diagnostic Mammogram (one breast)
|
$83.60 |
$143.80 |
$192.60 |
|
|
Diagnostic radio unlisted proc
|
$56.28 |
$64.32 |
$73.60 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,047.25 |
$2,258.55 |
$4,923.60 |
|
|
Dialysis one evaluation
|
$269.20 |
$403.48 |
$733.60 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$92.42 |
$110.91 |
$369.70 |
|
|
Dicyclomine injection
|
$54.12 |
$64.94 |
$216.47 |
|
|
Diffusing capacity
|
$46.64 |
$79.50 |
$134.20 |
|
|
Digital analysis of eeg
|
$176.00 |
$176.00 |
$202.40 |
|
