|
Culture aerobic additional method definitive id each
|
$66.36 |
$66.36 |
$66.36 |
$68.64
|
|
Culture afb any source
|
$306.60 |
$306.60 |
$306.60 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$203.28 |
$203.28 |
$203.28 |
$79.00
|
|
Culture anaerobic except blood
|
$206.64 |
$206.64 |
$206.64 |
$120.00
|
|
Culture bacteria anaerobic
|
$323.40 |
$323.40 |
$323.40 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$147.84 |
$147.84 |
$147.84 |
$51.45
|
|
Culture body fluid
|
$221.76 |
$221.76 |
$221.76 |
$126.75
|
|
Culture fungi definitive id mold
|
$157.92 |
$157.92 |
$157.92 |
$77.28
|
|
Culture fungi definitive id yeast
|
$141.12 |
$141.12 |
$141.12 |
$79.10
|
|
Culture fungi other (except blood)
|
$316.68 |
$316.68 |
$316.68 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$120.12 |
$120.12 |
$120.12 |
$74.88
|
|
Culture mycoplasma any source
|
$138.60 |
$138.60 |
$138.60 |
$85.26
|
|
Culture quantitative aerobic other source
|
$76.44 |
$76.44 |
$76.44 |
$90.35
|
|
Culture screening strep group a
|
$119.28 |
$119.28 |
$119.28 |
$81.00
|
|
Culture typing immunologic
|
$197.40 |
$197.40 |
$197.40 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$181.44 |
$181.44 |
$181.44 |
$133.90
|
|
Culture urine each isolate
|
$105.84 |
$105.84 |
$105.84 |
$57.00
|
|
Cutter lead
|
$7,224.84 |
$7,224.84 |
$7,224.84 |
$6,092.06
|
|
Cv stress test i&r only 93018
|
$52.08 |
$52.08 |
$52.08 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$52.08 |
$52.08 |
$52.08 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$83.58 |
$83.58 |
$83.58 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$126.00 |
$126.00 |
$126.00 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,465.51 |
$1,465.51 |
$1,465.51 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$2,301.60 |
$2,301.60 |
$2,301.60 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$268.05 |
$268.05 |
$268.05 |
$140.78
|
|
Cyclosporine 2 hour
|
$243.60 |
$243.60 |
$243.60 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$413.59 |
$413.59 |
$413.59 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$2,421.05 |
$2,421.05 |
$2,421.05 |
$34.88
|
|
Cylinder pump set 20cm titan zero angl
|
$22,335.77 |
$22,335.77 |
$22,335.77 |
$22,803.38
|
|
Cystatin c
|
$114.24 |
$114.24 |
$114.24 |
$77.50
|
|
Cystine urine quantitative
|
$298.20 |
$298.20 |
$298.20 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$411.60 |
$411.60 |
$411.60 |
$542.10
|
|
Cystoscopy and biopsy
|
$992.04 |
$992.04 |
$992.04 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,929.48 |
$1,929.48 |
$1,929.48 |
$4,081.37
|
|
Cystoscopy and treatment
|
$747.60 |
$747.60 |
$747.60 |
$4,061.71
|
|
Cystoscopy and treatment
|
$992.04 |
$992.04 |
$992.04 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$1,191.12 |
$1,191.12 |
$1,191.12 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$2,456.16 |
$2,456.16 |
$2,456.16 |
$3,786.00
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$992.04 |
$992.04 |
$992.04 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$240.03 |
$240.03 |
$240.03 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$232.68 |
$232.68 |
$232.68 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$152.88 |
$152.88 |
$152.88 |
$97.50
|
|
Cytopath fl nongyn filter
|
$170.52 |
$170.52 |
$170.52 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$272.16 |
$272.16 |
$272.16 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$148.68 |
$148.68 |
$148.68 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$128.52 |
$128.52 |
$128.52 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$165.48 |
$165.48 |
$165.48 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$146.16 |
$146.16 |
$146.16 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$118.44 |
$118.44 |
$118.44 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$121.80 |
$121.80 |
$121.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$358.68 |
$358.68 |
$358.68 |
$209.23
|
|
Cytopath smear other source
|
$94.08 |
$94.08 |
$94.08 |
$88.13
|
|
Cytopath smear other source
|
$56.28 |
$56.28 |
$56.28 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$2,122.68 |
$2,122.68 |
$2,122.68 |
$96.20
|
|
Cytopath tbs c/v manual
|
$75.60 |
$75.60 |
$75.60 |
$59.28
|
|
Cytotoxic antibody screening
|
$1,445.64 |
$1,445.64 |
$1,445.64 |
$133.25
|
|
Dacarbazine 100 mg intravenous solution
|
$83.58 |
$83.58 |
$83.58 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,691.24 |
$2,691.24 |
$2,691.24 |
$3,024.59
|
|
Dalbavancin 500 mg intravenous solution
|
$6,492.49 |
$6,492.49 |
$6,492.49 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$123.02 |
$123.02 |
$123.02 |
$168.53
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$44,179.83 |
$44,179.83 |
$44,179.83 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$15,664.87 |
$15,664.87 |
$15,664.87 |
$6,072.48
|
|
Dark field exam spec collj
|
$205.80 |
$205.80 |
$205.80 |
$31.20
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$347.03 |
$347.03 |
$347.03 |
$257.10
|
|
Dch glucoscan
|
$42.00 |
$42.00 |
$42.00 |
$28.10
|
|
Dch pulmonary stress test
|
$466.20 |
$466.20 |
$466.20 |
$963.30
|
|
Dch validity tests
|
$75.60 |
$75.60 |
$75.60 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$194.88 |
$194.88 |
$194.88 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$658.56 |
$658.56 |
$658.56 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$201.60 |
$201.60 |
$201.60 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,453.64 |
$2,453.64 |
$2,453.64 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$312.48 |
$312.48 |
$312.48 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$967.68 |
$967.68 |
$967.68 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,870.68 |
$1,870.68 |
$1,870.68 |
$810.50
|
|
Debride nail1-5 11720
|
$100.80 |
$100.80 |
$100.80 |
$148.80
|
|
Debride nail6 or more 11721
|
$583.80 |
$583.80 |
$583.80 |
$169.60
|
|
Debride skin bone at fx site
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$312.48 |
$312.48 |
$312.48 |
$639.60
|
|
Debrid mastoidectomy cavity simple 69220
|
$320.88 |
$320.88 |
$320.88 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,064.28 |
$1,064.28 |
$1,064.28 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$582.12 |
$582.12 |
$582.12 |
$1,160.00
|
|
Decalcification
|
$105.00 |
$105.00 |
$105.00 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$2,304.80 |
$2,304.80 |
$2,304.80 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$758.52 |
$758.52 |
$758.52 |
$543.00
|
|
Deep muscle biopsy 20205
|
$710.64 |
$710.64 |
$710.64 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$202.23 |
$202.23 |
$202.23 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$5,854.89 |
$5,854.89 |
$5,854.89 |
$1,807.08
|
|
Delivery of placenta 59414
|
$635.88 |
$635.88 |
$635.88 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$142.80 |
$142.80 |
$142.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$13,980.42 |
$13,980.42 |
$13,980.42 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$693.00 |
$693.00 |
$693.00 |
$408.10
|
|
Depo-estradiol cypionate inj
|
$856.93 |
$856.93 |
$856.93 |
$71.51
|
|
Dermagraft
|
$3,175.20 |
$3,175.20 |
$3,175.20 |
$85.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$3,155.67 |
$3,155.67 |
$3,155.67 |
$89.78
|
|
Destroy premlg lesns;1st lesn 17000
|
$158.76 |
$158.76 |
$158.76 |
$199.50
|
|
Destruct ben lesion 15/> 17111
|
$174.72 |
$174.72 |
$174.72 |
$235.13
|
|
Destruct cut vasl lesions <10cm 17106
|
$804.72 |
$804.72 |
$804.72 |
$660.00
|
|
Destruction 2-14 lesions 17003
|
$72.24 |
$72.24 |
$72.24 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$161.28 |
$161.28 |
$161.28 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,331.00 |
$2,331.00 |
$2,331.00 |
$1,616.72
|
