|
Culture fungi other (except blood)
|
$300.00 |
$300.00 |
$300.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$288.00 |
$288.00 |
$288.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$150.00 |
$150.00 |
$150.00 |
$84.75
|
|
Culture mycoplasma any source
|
$410.00 |
$410.00 |
$410.00 |
$90.37
|
|
Culture quantitative aerobic other source
|
$339.00 |
$339.00 |
$339.00 |
$87.02
|
|
Culture screening strep group a
|
$300.00 |
$300.00 |
$300.00 |
$81.60
|
|
Culture typing added method
|
$149.00 |
$149.00 |
$149.00 |
$34.45
|
|
Culture typing immunologic
|
$62.00 |
$62.00 |
$62.00 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$621.00 |
$621.00 |
$621.00 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$163.00 |
$163.00 |
$163.00 |
$124.40
|
|
Culture urine each isolate
|
$51.00 |
$51.00 |
$51.00 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$4.20 |
$4.20 |
$4.20 |
$28.00
|
|
Cyclic citrullinated peptide antibody
|
$8.00 |
$8.00 |
$8.00 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$254.49 |
$254.49 |
$254.49 |
$1,348.50
|
|
Cyclophosphamide 25 mg capsule
|
$44.74 |
$44.74 |
$44.74 |
$20.45
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$44.78 |
$44.78 |
$44.78 |
$140.78
|
|
Cyclosporine 2 hour
|
$667.00 |
$667.00 |
$667.00 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$14.39 |
$14.39 |
$14.39 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$57.44 |
$57.44 |
$57.44 |
$34.00
|
|
Cyp2c19 gene com variants
|
$532.00 |
$532.00 |
$532.00 |
$567.75
|
|
Cyp2c9 gene com variants
|
$79.00 |
$79.00 |
$79.00 |
$275.10
|
|
Cystatin c
|
$20.00 |
$20.00 |
$20.00 |
$82.26
|
|
Cystine urine quantitative
|
$87.00 |
$87.00 |
$87.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$539.55
|
|
Cystoscopy and treatment
|
$4,981.78 |
$4,981.78 |
$4,981.78 |
$4,081.37
|
|
Cystoscopy and treatment
|
$5,509.97 |
$5,509.97 |
$5,509.97 |
$4,846.99
|
|
Cystoscopy and treatment
|
$5,751.25 |
$5,751.25 |
$5,751.25 |
$5,949.75
|
|
Cystostomy cystotomy w/drainage 51040
|
$6,491.00 |
$6,491.00 |
$6,491.00 |
$3,774.40
|
|
Cystouretero w/biopsy
|
$5,650.88 |
$5,650.88 |
$5,650.88 |
$4,881.00
|
|
Cysto/uretero w/lithotripsy
|
$5,844.61 |
$5,844.61 |
$5,844.61 |
$5,844.61
|
|
Cystouretero w/lithotripsy
|
$5,048.69 |
$5,048.69 |
$5,048.69 |
$6,015.75
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$4,357.28 |
$4,357.28 |
$4,357.28 |
$3,970.98
|
|
Cytarabine 20 mg/ml injection solution
|
$3.28 |
$3.28 |
$3.28 |
$104.83
|
|
Cytarabine liposome inj
|
$2,074.80 |
$2,074.80 |
$2,074.80 |
$1,106.20
|
|
Cytogenetics 25-99
|
$652.00 |
$652.00 |
$652.00 |
$180.32
|
|
Cytomegalovirus (cmv) antibody igg
|
$217.00 |
$217.00 |
$217.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$303.00 |
$303.00 |
$303.00 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$119.87 |
$119.87 |
$119.87 |
$3,058.32
|
|
Cyto/molecular report
|
$152.00 |
$152.00 |
$152.00 |
$144.75
|
|
Cytopath fl nongyn filter
|
$485.00 |
$485.00 |
$485.00 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$288.00 |
$288.00 |
$288.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$215.00 |
$215.00 |
$215.00 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$183.00 |
$183.00 |
$183.00 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$233.00 |
$233.00 |
$233.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$179.00 |
$179.00 |
$179.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$90.00 |
$90.00 |
$90.00 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$307.00 |
$307.00 |
$307.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$137.00 |
$137.00 |
$137.00 |
$205.00
|
|
Cytopath smear other source
|
$118.00 |
$118.00 |
$118.00 |
$85.80
|
|
Cytopath smear other source
|
$248.00 |
$248.00 |
$248.00 |
$122.19
|
|
Cytotoxic antibody screening
|
$102.00 |
$102.00 |
$102.00 |
$157.60
|
|
Cytp urine 3-5 probes cmptr
|
$926.00 |
$926.00 |
$926.00 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$40.12 |
$40.12 |
$40.12 |
$73.20
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,199.84 |
$1,199.84 |
$1,199.84 |
$3,019.83
|
|
Dalbavancin 500 mg intravenous solution
|
$3,272.50 |
$3,272.50 |
$3,272.50 |
$3,469.30
|
|
Dalteparin sodium
|
$231.74 |
$231.74 |
$231.74 |
$75.17
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$4.53 |
$4.53 |
$4.53 |
$362.16
|
|
Daptomycin (xellia) unrefrig
|
$98.18 |
$98.18 |
$98.18 |
$0.04
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$2,326.92 |
$2,326.92 |
$2,326.92 |
$23,789.22
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$296.89 |
$296.89 |
$296.89 |
$5,500.25
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$36,592.50 |
$36,592.50 |
$36,592.50 |
$22,284.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$57.59 |
$57.59 |
$57.59 |
$300.73
|
|
Dch glucoscan
|
$40.00 |
$40.00 |
$40.00 |
$24.85
|
|
Dch validity tests
|
$75.00 |
$75.00 |
$75.00 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$7.00 |
$7.00 |
$7.00 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,462.00 |
$1,462.00 |
$1,462.00 |
$692.00
|
|
Debridement bone <= 20 sq cm
|
$4,007.00 |
$4,007.00 |
$4,007.00 |
$2,553.60
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,483.00 |
$1,483.00 |
$1,483.00 |
$810.50
|
|
Debride skin bone at fx site
|
$9,057.00 |
$9,057.00 |
$9,057.00 |
$3,278.34
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,483.00 |
$1,483.00 |
$1,483.00 |
$1,193.40
|
|
Decalcification
|
$211.00 |
$211.00 |
$211.00 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$172.06 |
$172.06 |
$172.06 |
$1,350.27
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$42.35 |
$42.35 |
$42.35 |
$96.41
|
|
Degarelix 120 mg subcutaneous solution
|
$1,598.45 |
$1,598.45 |
$1,598.45 |
$1,936.32
|
|
Delayed breast prosthesis 19342
|
$7,507.66 |
$7,507.66 |
$7,507.66 |
$5,910.18
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$9,295.00 |
$9,295.00 |
$9,295.00 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,323.90 |
$6,323.90 |
$6,323.90 |
$6,508.51
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$652.00 |
$652.00 |
$652.00 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$132.72 |
$132.72 |
$132.72 |
$120.72
|
|
Design mlc device for imrt
|
$21,633.00 |
$21,633.00 |
$21,633.00 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$45.82 |
$45.82 |
$45.82 |
$116.22
|
|
Desoxycorticosterone
|
$41.00 |
$41.00 |
$41.00 |
$109.28
|
|
Device intraute mirena
|
$4,048.77 |
$4,048.77 |
$4,048.77 |
$2,211.85
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$962.00 |
$962.00 |
$962.00 |
$220.43
|
|
Dexametha opth insert 0.1 mg
|
$1,613.50 |
$1,613.50 |
$1,613.50 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$5.17 |
$5.17 |
$5.17 |
$5.17
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$9.32 |
$9.32 |
$9.32 |
$27.00
|
|
Dexamethasone intra implant
|
$4,805.50 |
$4,805.50 |
$4,805.50 |
$2,142.45
|
|
Dexmedetomidine film, 1 mcg
|
$349.13 |
$349.13 |
$349.13 |
$0.78
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$888.55 |
$888.55 |
$888.55 |
$641.76
|
|
Dextran 40 infusion
|
$0.24 |
$0.24 |
$0.24 |
$151.20
|
|
Dextran 75 infusion
|
$1.15 |
$1.15 |
$1.15 |
$1.15
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$0.04 |
$0.04 |
$0.04 |
$43.65
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$0.02 |
$0.02 |
$0.02 |
$47.22
|
|
Dhea-s (dehydroepiand sulfate)
|
$5.00 |
$5.00 |
$5.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$327.00 |
$327.00 |
$327.00 |
$78.03
|
|
Diabetes training group per 30 min g0109
|
$91.00 |
$91.00 |
$91.00 |
$35.25
|
|
Diagnostic anoscopy & biopsy
|
$5,249.42 |
$5,249.42 |
$5,249.42 |
$1,395.28
|
|
Diagnostic digital breast tomosynthesis bil
|
$1,902.00 |
$1,902.00 |
$1,902.00 |
$117.94
|
