|
Culture mycobacteria definitive id each isolate
|
$89.70 |
$89.70 |
$89.70 |
$79.00
|
|
Culture mycoplasma any source
|
$74.75 |
$74.75 |
$74.75 |
$94.00
|
|
Culture screening strep group a
|
$89.70 |
$89.70 |
$89.70 |
$76.00
|
|
Culture typing immunologic
|
$57.20 |
$57.20 |
$57.20 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$634.40 |
$634.40 |
$634.40 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$37.05 |
$37.05 |
$37.05 |
$100.20
|
|
Culture urine each isolate
|
$37.05 |
$37.05 |
$37.05 |
$44.80
|
|
Cv stress test i&r only 93018
|
$87.10 |
$87.10 |
$87.10 |
$42.00
|
|
Cv stress test/supervision only 93016
|
$91.00 |
$91.00 |
$91.00 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$14.36 |
$14.36 |
$14.36 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$113.75 |
$113.75 |
$113.75 |
$91.20
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$529.11 |
$529.11 |
$529.11 |
$2.42
|
|
Cyclophosphamide 25 mg capsule
|
$35.75 |
$35.75 |
$35.75 |
$22.51
|
|
Cyclosporine 2 hour
|
$243.10 |
$243.10 |
$243.10 |
$126.10
|
|
Cyp2c19 gene com variants
|
$585.65 |
$585.65 |
$585.65 |
$583.20
|
|
Cyp3a4 gene common variants
|
$395.20 |
$395.20 |
$395.20 |
$245.31
|
|
Cystatin c
|
$90.35 |
$90.35 |
$90.35 |
$83.20
|
|
Cystic fibrosis cftr
|
$986.05 |
$986.05 |
$986.05 |
$1,041.95
|
|
Cystogram >= 3 views supervision & interpretation
|
$569.40 |
$569.40 |
$569.40 |
$487.04
|
|
Cytogenetics 25-99
|
$93.60 |
$93.60 |
$93.60 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$87.10 |
$87.10 |
$87.10 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$91.65 |
$91.65 |
$91.65 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$58.50 |
$58.50 |
$58.50 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$89.70 |
$89.70 |
$89.70 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$95.55 |
$95.55 |
$95.55 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$92.30 |
$92.30 |
$92.30 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$94.90 |
$94.90 |
$94.90 |
$129.90
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$118.30 |
$118.30 |
$118.30 |
$205.00
|
|
Cytopath smear other source
|
$68.25 |
$68.25 |
$68.25 |
$88.13
|
|
Cytopath tbs c/v manual
|
$57.20 |
$57.20 |
$57.20 |
$57.94
|
|
Dalbavancin 500 mg intravenous solution
|
$4,047.52 |
$4,047.52 |
$4,047.52 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$126.75 |
$126.75 |
$126.75 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$8,804.25 |
$8,804.25 |
$8,804.25 |
$4,542.99
|
|
Dch validity tests
|
$24.05 |
$24.05 |
$24.05 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$102.70 |
$102.70 |
$102.70 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$263.90 |
$263.90 |
$263.90 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$612.95 |
$612.95 |
$612.95 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$111.15 |
$111.15 |
$111.15 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$182.65 |
$182.65 |
$182.65 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$222.95 |
$222.95 |
$222.95 |
$779.35
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$85.15 |
$85.15 |
$85.15 |
$728.40
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$691.60 |
$691.60 |
$691.60 |
$1,146.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$231.40 |
$231.40 |
$231.40 |
$1,101.10
|
|
Decalcification
|
$5,358.13 |
$5,358.13 |
$5,358.13 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$270.40 |
$270.40 |
$270.40 |
$482.35
|
|
Decompress small bowel
|
$1,803.75 |
$1,803.75 |
$1,803.75 |
$2,394.40
|
|
Deep muscle biopsy 20205
|
$3,628.95 |
$3,628.95 |
$3,628.95 |
$3,111.06
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$136.50 |
$136.50 |
$136.50 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,988.05 |
$3,988.05 |
$3,988.05 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$441.35 |
$441.35 |
$441.35 |
$460.50
|
|
Desoxycorticosterone
|
$142.35 |
$142.35 |
$142.35 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$5,446.67 |
$5,446.67 |
$5,446.67 |
$2,963.07
|
|
Destroy cth facet jnt addl 64634
|
$5,585.68 |
$5,585.68 |
$5,585.68 |
$1,441.44
|
|
Destruction anal lesion(s)
|
$9,237.64 |
$9,237.64 |
$9,237.64 |
$3,035.44
|
|
Destruction benign lesions < 14 lesions
|
$185.90 |
$185.90 |
$185.90 |
$231.52
|
|
Destruction by injection tx of nerve 64630
|
$646.75 |
$646.75 |
$646.75 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$7,255.19 |
$7,255.19 |
$7,255.19 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$7,255.19 |
$7,255.19 |
$7,255.19 |
$3,101.88
|
|
Developmental screen/score/document 96110
|
$341.90 |
$341.90 |
$341.90 |
$126.75
|
|
Devel tst phys/qhp 1st hr
|
$294.45 |
$294.45 |
$294.45 |
$364.48
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$193.05 |
$193.05 |
$193.05 |
$203.19
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$181.35 |
$181.35 |
$181.35 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$6.12 |
$6.12 |
$6.12 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$12.67 |
$12.67 |
$12.67 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$25.35 |
$25.35 |
$25.35 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$23.40 |
$23.40 |
$23.40 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$23.40 |
$23.40 |
$23.40 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$25.35 |
$25.35 |
$25.35 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$169.65 |
$169.65 |
$169.65 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$91.00 |
$91.00 |
$91.00 |
$70.00
|
|
Diag laparo separate proc 49320
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$6,376.26
|
|
Diagnostic anoscopy spx 46600
|
$154.05 |
$154.05 |
$154.05 |
$252.00
|
|
Diagnostic Mammogram (both breasts)
|
$165.10 |
$165.10 |
$165.10 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$108.55 |
$108.55 |
$108.55 |
$276.60
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$14.40 |
$14.40 |
$14.40 |
$42.12
|
|
Dicyclomine injection
|
$51.97 |
$51.97 |
$51.97 |
$153.53
|
|
Diffusing capacity
|
$306.15 |
$306.15 |
$306.15 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$7.15 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$60.45 |
$60.45 |
$60.45 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$177.90 |
$177.90 |
$177.90 |
$297.86
|
|
Diltiazem 5 mg/ml intravenous solution
|
$48.22 |
$48.22 |
$48.22 |
$49.92
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$9.29
|
|
Disability dlco
|
$225.55 |
$225.55 |
$225.55 |
$289.08
|
|
Disaccharidases
|
$22.10 |
$22.10 |
$22.10 |
$224.58
|
|
Dna antibody native/double stranded
|
$126.75 |
$126.75 |
$126.75 |
$101.40
|
|
Dna gardnerella
|
$55.25 |
$55.25 |
$55.25 |
$67.68
|
|
Dna trichomonas
|
$55.25 |
$55.25 |
$55.25 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$95.06 |
$95.06 |
$95.06 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$60.21 |
$60.21 |
$60.21 |
$60.21
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$328.90 |
$328.90 |
$328.90 |
$463.20
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$102.08 |
$102.08 |
$102.08 |
$81.30
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$369.85 |
$369.85 |
$369.85 |
$800.00
|
|
Drainage external ear complex 69005
|
$419.25 |
$419.25 |
$419.25 |
$3,016.11
|
|
Drainage external ear simple 69000
|
$313.30 |
$313.30 |
$313.30 |
$800.00
|
|
Drainage mouth roof lesion
|
$326.30 |
$326.30 |
$326.30 |
$408.80
|
|
Drainage of arm bursa 23931
|
$582.40 |
$582.40 |
$582.40 |
$2,437.50
|
|
Drainage of mouth lesion
|
$734.50 |
$734.50 |
$734.50 |
$3,723.23
|
|
Drainage of nose lesion sept 30020
|
$380.90 |
$380.90 |
$380.90 |
$637.50
|
|
Drain blood from under nail 11740
|
$66.95 |
$66.95 |
$66.95 |
$173.21
|
|
Drain cerebro spinal fluid 62272
|
$440.70 |
$440.70 |
$440.70 |
$1,025.00
|