|
Cymetra injectable
|
$471.91 |
$471.91 |
$522.56 |
|
|
Cyp2c19 gene com variants
|
$103.32 |
$114.41 |
$425.25 |
|
|
Cyp2c9 gene com variants
|
$123.00 |
$136.20 |
$255.15 |
|
|
Cyp2d6 gene com variants
|
$657.56 |
$657.56 |
$657.56 |
|
|
Cyp3a4 gene common variants
|
$255.15 |
$255.15 |
$255.15 |
|
|
Cyp3a5 gene common variants
|
$255.15 |
$255.15 |
$255.15 |
|
|
Cystatin c
|
$26.99 |
$35.47 |
$49.48 |
|
|
Cystic fibrosis cftr
|
$394.63 |
$436.98 |
$550.55 |
|
|
Cystine urine quantitative
|
$11.69 |
$12.94 |
$43.86 |
|
|
Cystogram >= 3 views supervision & interpretation
|
$211.18 |
$520.50 |
$726.16 |
|
|
Cysto, litho, vacuum kidney
|
$6,166.40 |
$6,166.40 |
$6,828.16 |
|
|
Cystoscopy and treatment
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
|
|
Cystoscopy and treatment
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
|
|
Cystoscopy (Bladder Scope)
|
$3,161.51 |
$3,161.51 |
$3,161.51 |
|
|
Cystouretero w/stone remove
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
|
|
Cytarabine 20 mg/ml injection solution
|
$12.92 |
$12.92 |
$22.70 |
|
|
Cytogenetics 25-99
|
$27.65 |
$50.43 |
$70.36 |
|
|
Cytogenomic neo microra alys
|
$688.80 |
$762.72 |
$960.96 |
|
|
Cytomegalovirus (cmv) antibody igg
|
$32.39 |
$34.56 |
$45.19 |
|
|
Cytomegalovirus (cmv) antibody igm
|
$35.14 |
$39.16 |
$54.63 |
|
|
Cytomegalovirus imm IV /vial
|
$1,940.53 |
$1,940.53 |
$2,148.79 |
|
|
Cytopathology cellular enhancement technique non-gyn
|
$19.27 |
$21.34 |
$26.89 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$15.38 |
$17.03 |
$21.45 |
|
|
Cytopathology concentration technique smears & interpretation
|
$18.14 |
$84.05 |
$117.26 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$13.33 |
$14.76 |
$18.59 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$11.48 |
$12.72 |
$16.02 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$20.71 |
$22.93 |
$28.89 |
|
|
Dacarbazine 100 mg intravenous solution
|
$13.33 |
$13.33 |
$14.76 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$15.58 |
$15.58 |
$17.26 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$491.59 |
$544.35 |
$685.83 |
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$855.06 |
$855.06 |
$946.82 |
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$3,359.60 |
$3,359.60 |
$3,359.60 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$148.22 |
$148.22 |
$164.13 |
|
|
Dch validity tests
|
$5.29 |
$7.59 |
$10.59 |
|
|
Deamidated gliadin antibody iga
|
$9.43 |
$10.45 |
$33.98 |
|
|
Debridement (>20 cm) charge pt
|
$37.70 |
$138.17 |
$192.77 |
|
|
Debridement bone <= 20 sq cm
|
$2,329.01 |
$2,329.01 |
$2,578.95 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$545.51 |
$545.51 |
$604.05 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$962.27 |
$962.27 |
$1,065.54 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$612.95 |
$612.95 |
$678.73 |
|
|
Debride nail1-5 11720
|
$33.62 |
$33.62 |
$37.23 |
|
|
Debride nail6 or more 11721
|
$56.79 |
$56.79 |
$62.88 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$263.63 |
$263.63 |
$291.93 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,556.77 |
$1,556.77 |
$1,723.84 |
|
|
Decalcification
|
$8.41 |
$9.31 |
$11.73 |
|
|
Decitabine 50 mg intravenous solution
|
$920.45 |
$920.45 |
$1,019.23 |
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$142.78 |
$592.04 |
$825.97 |
|
|
Deferoxamine 500 mg solution for injection
|
$34.24 |
$34.24 |
$37.91 |
|
|
Delivery of placenta 59414
|
$1,150.44 |
$1,150.44 |
$1,184.59 |
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$61.71 |
$68.33 |
$86.09 |
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$931.93 |
$931.93 |
$1,019.23 |
|
|
Dermagraft
|
$1,356.08 |
$1,356.08 |
$1,501.61 |
|
|
Desmopressin 4 mcg/ml injection solution
|
$74.01 |
$81.95 |
$103.25 |
|
|
Desoxycorticosterone
|
$29.52 |
$32.69 |
$41.19 |
|
|
Destroy cervthor facet jnt 64633
|
$645.96 |
$645.96 |
$1,044.26 |
|
|
Destroy cth facet jnt addl 64634
|
$171.19 |
$171.19 |
$376.18 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$177.00 |
$177.00 |
$376.18 |
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$645.96 |
$645.96 |
$1,033.92 |
|
|
Developmental screen/score/document 96110
|
$78.93 |
$110.11 |
$111.36 |
|
|
Devel tst phys/qhp 1st hr
|
$163.18 |
$163.18 |
$227.66 |
|
|
Device ablt adv novasure
|
$5,040.54 |
$5,040.54 |
$5,581.48 |
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,763.41 |
$1,763.41 |
$1,952.66 |
|
|
Device sut capio slim opn
|
$890.52 |
$986.09 |
$6,658.50 |
|
|
Device tiss remov myosure reach
|
$1,356.08 |
$1,501.61 |
$6,711.28 |
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$56.99 |
$56.99 |
$79.51 |
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$221.90 |
$221.90 |
$221.90 |
|
|
Dexamethasone 4 mg tablet
|
$1.15 |
$5.13 |
$5.68 |
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$5.33 |
$5.91 |
$7.44 |
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$506.56 |
$506.56 |
$560.92 |
|
|
Dextran 40 infusion
|
$36.90 |
$36.90 |
$40.86 |
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.64 |
$11.07 |
$15.45 |
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$11.07 |
$12.26 |
$15.45 |
|
|
Dextrose 5 % IV bolus
|
$11.07 |
$12.26 |
$15.45 |
|
|
Dhea-s (dehydroepiand sulfate)
|
$17.02 |
$18.85 |
$32.29 |
|
|
Diabetes (HbA1c) Test
|
$30.37 |
$106.19 |
$148.15 |
|
|
Diab manage trn ind/group
|
$22.25 |
$22.25 |
$22.25 |
|
|
Diagnostic laryngoscopy 31575
|
$144.38 |
$144.38 |
$144.38 |
|
|
Diagnostic Mammogram (both breasts)
|
$244.53 |
$246.21 |
$343.49 |
|
|
Diagnostic Mammogram (one breast)
|
$123.00 |
$136.20 |
$171.60 |
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,454.87 |
$3,454.87 |
$3,454.87 |
|
|
Dialysis one evaluation
|
$742.31 |
$821.97 |
$1,035.61 |
|
|
Diatrizoate meglumine 18 % urethral solution
|
$60.07 |
$66.52 |
$83.80 |
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$12.30 |
$17.16 |
$41.32 |
|
|
Dicyclomine injection
|
$92.87 |
$102.84 |
$129.56 |
|
|
Diffusing capacity
|
$179.99 |
$181.91 |
$251.11 |
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$145.14 |
$160.72 |
$202.49 |
|
|
Digoxin immune fab 40 mg intravenous solution
|
$947.72 |
$947.72 |
$1,049.43 |
|
|
Digoxin total therapeutic drug level
|
$25.55 |
$198.24 |
$276.57 |
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$86.31 |
$86.31 |
$95.57 |
|
|
Dilate ic vasospasm init
|
$1,973.33 |
$1,973.33 |
$2,185.11 |
|
|
Dilate urethra stricture
|
$220.58 |
$220.58 |
$220.58 |
|
|
Dilator fascial 10fx20cm
|
$213.82 |
$228.52 |
$1,041.83 |
|
|
Dilat xst trc ndurlgc px
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
|
|
Dilat xst trc new access rcs
|
$1,204.99 |
$1,204.99 |
$1,204.99 |
|
|
Dimecaprol injection
|
$91.02 |
$91.02 |
$100.79 |
|
|
Dimenhydrinate injection
|
$6.36 |
$6.36 |
$7.04 |
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$5.33 |
$5.91 |
$7.44 |
|
|
Dipyridamole injection
|
$5.33 |
$5.33 |
$5.91 |
|
|
Disability dlco
|
$120.34 |
$167.89 |
$186.00 |
|
|
Disaccharidases
|
$174.48 |
$204.80 |
$285.72 |
|
