|
Culture fungi other (except blood)
|
$74.73 |
$74.73 |
$74.73 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$24.52 |
$24.52 |
$24.52 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$29.69 |
$29.69 |
$29.69 |
$100.00
|
|
Culture mycoplasma any source
|
$69.96 |
$69.96 |
$69.96 |
$83.21
|
|
Culture screening strep group a
|
$82.80 |
$82.80 |
$82.80 |
$84.60
|
|
Culture typing added method
|
$16.35 |
$16.35 |
$16.35 |
$42.60
|
|
Culture typing immunologic
|
$10.95 |
$10.95 |
$10.95 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$443.08 |
$443.08 |
$443.08 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$90.84 |
$90.84 |
$90.84 |
$140.80
|
|
Culture urine each isolate
|
$45.44 |
$45.44 |
$45.44 |
$55.50
|
|
Cyanocobalamin unsat binding capacity
|
$43.24 |
$43.24 |
$43.24 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$8.83 |
$8.83 |
$8.83 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$339.55 |
$339.55 |
$339.55 |
$72.36
|
|
Cystatin c
|
$44.94 |
$44.94 |
$44.94 |
$77.60
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,356.67 |
$3,356.67 |
$3,356.67 |
$3,245.90
|
|
Cytogenetics 25-99
|
$105.14 |
$105.14 |
$105.14 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$133.34 |
$133.34 |
$133.34 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$189.02 |
$189.02 |
$189.02 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$100.68 |
$100.68 |
$100.68 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$84.24 |
$84.24 |
$84.24 |
$87.45
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$77.60 |
$77.60 |
$77.60 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$82.89 |
$82.89 |
$82.89 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$384.34 |
$384.34 |
$384.34 |
$191.66
|
|
Cytopath smear oth prep screen & interp
|
$96.71 |
$96.71 |
$96.71 |
$96.20
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.06 |
$0.06 |
$0.06 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$11.70 |
$11.70 |
$11.70 |
$6,281.29
|
|
Dch validity tests
|
$43.96 |
$43.96 |
$43.96 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$24.36 |
$24.36 |
$24.36 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$394.61 |
$394.61 |
$394.61 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$915.44 |
$915.44 |
$915.44 |
$835.20
|
|
Debride nail1-5 11720
|
$141.04 |
$141.04 |
$141.04 |
$149.60
|
|
Debride nail6 or more 11721
|
$141.04 |
$141.04 |
$141.04 |
$169.80
|
|
Debride skin bone at fx site
|
$2,358.16 |
$2,358.16 |
$2,358.16 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$728.59 |
$728.59 |
$728.59 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,425.53 |
$1,425.53 |
$1,425.53 |
$1,165.50
|
|
Decalcification
|
$53.50 |
$53.50 |
$53.50 |
$68.34
|
|
Delivery of placenta 59414
|
$2,930.27 |
$2,930.27 |
$2,930.27 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$558.13 |
$558.13 |
$558.13 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$288.10 |
$288.10 |
$288.10 |
$401.60
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$431.61 |
$431.61 |
$431.61 |
$275.88
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$431.61 |
$431.61 |
$431.61 |
$274.80
|
|
Destroy vulva lesion simple 56501
|
$2,166.46 |
$2,166.46 |
$2,166.46 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$131.87 |
$131.87 |
$131.87 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$22.93 |
$22.93 |
$22.93 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$137.16 |
$137.16 |
$137.16 |
$240.24
|
|
Destruction mal lsn t/a/l 3.1-4cm
|
$1,093.55 |
$1,093.55 |
$1,093.55 |
$482.00
|
|
Destruction mal lsn t/a/l >4cm
|
$857.10 |
$857.10 |
$857.10 |
$569.80
|
|
Developmental screen/score/document 96110
|
$142.38 |
$142.38 |
$142.38 |
$142.38
|
|
Device intraute mirena
|
$1,773.21 |
$1,773.21 |
$1,773.21 |
$2,125.00
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$5.19 |
$5.19 |
$5.19 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$183.53 |
$183.53 |
$183.53 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$117.60 |
$117.60 |
$117.60 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$348.09 |
$348.09 |
$348.09 |
$195.50
|
|
Diagnostic digital breast tomosynthesis bil
|
$74.11 |
$74.11 |
$74.11 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$79.23 |
$79.23 |
$79.23 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$243.15 |
$243.15 |
$243.15 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$474.10 |
$474.10 |
$474.10 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$407.64 |
$407.64 |
$407.64 |
$314.00
|
|
Diffusing capacity
|
$238.12 |
$238.12 |
$238.12 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$127.11 |
$127.11 |
$127.11 |
$102.07
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,105.00 |
$1,105.00 |
$1,105.00 |
$1,258.20
|
|
Disability dlco
|
$256.02 |
$256.02 |
$256.02 |
$293.76
|
|
Dis site tele svcs rhc/fqhc
|
$216.27 |
$216.27 |
$216.27 |
$96.75
|
|
Dna antibody native/double stranded
|
$251.64 |
$251.64 |
$251.64 |
$100.00
|
|
Dna gardnerella
|
$42.37 |
$42.37 |
$42.37 |
$61.83
|
|
Dna trichomonas
|
$42.37 |
$42.37 |
$42.37 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$10.08 |
$10.08 |
$10.08 |
$95.06
|
|
Doppler echo complete
|
$325.84 |
$325.84 |
$325.84 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$356.86 |
$356.86 |
$356.86 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$284.91 |
$284.91 |
$284.91 |
$481.65
|
|
Dpyd gene common variants
|
$429.25 |
$429.25 |
$429.25 |
$423.60
|
|
Drainage external ear simple 69000
|
$1,738.83 |
$1,738.83 |
$1,738.83 |
$790.40
|
|
Drainage mouth roof lesion
|
$549.65 |
$549.65 |
$549.65 |
$405.60
|
|
Drainage of arm bursa 23931
|
$4,292.42 |
$4,292.42 |
$4,292.42 |
$2,271.01
|
|
Drainage of mouth lesion
|
$5,357.45 |
$5,357.45 |
$5,357.45 |
$3,837.72
|
|
Drain blood from under nail 11740
|
$150.03 |
$150.03 |
$150.03 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$443.10 |
$443.10 |
$443.10 |
$428.40
|
|
Drain neck/chest lesion 21501
|
$7,435.50 |
$7,435.50 |
$7,435.50 |
$3,339.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$371.16 |
$371.16 |
$371.16 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$443.10 |
$443.10 |
$443.10 |
$349.50
|
|
Drng of eyelid abscess 67700
|
$726.00 |
$726.00 |
$726.00 |
$655.72
|
|
Drng of finger abscess comp 26011
|
$2,967.69 |
$2,967.69 |
$2,967.69 |
$2,079.50
|
|
Drug assay caffeine
|
$94.36 |
$94.36 |
$94.36 |
$80.00
|
|
Drug assay posaconazole
|
$66.58 |
$66.58 |
$66.58 |
$96.75
|
|
Drug assay rufinamide
|
$59.82 |
$59.82 |
$59.82 |
$87.10
|
|
Drug assay vedolizumab
|
$96.06 |
$96.06 |
$96.06 |
$154.00
|
|
Drug assay voriconazole
|
$63.17 |
$63.17 |
$63.17 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$38.62 |
$38.62 |
$38.62 |
$66.43
|
|
Drug of abuse screen urine
|
$24.57 |
$24.57 |
$24.57 |
$67.89
|
|
Drug screening tapentadol
|
$92.85 |
$92.85 |
$92.85 |
$47.03
|
|
Drug/substance nos 4-6
|
$602.26 |
$602.26 |
$602.26 |
$72.14
|
|
Drug test def 15-21 classes
|
$512.42 |
$512.42 |
$512.42 |
$322.50
|
|
Drug test def 1-7 classes
|
$157.66 |
$157.66 |
$157.66 |
$263.25
|
|
Drug test def 8-14 classes
|
$330.90 |
$330.90 |
$330.90 |
$289.80
|
|
Drug test prsmv instrmnt
|
$43.93 |
$43.93 |
$43.93 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$121.17 |
$121.17 |
$121.17 |
$278.85
|
|
Dstr mal ls f/e/e/n/l/m>4.0
|
$1,293.53 |
$1,293.53 |
$1,293.53 |
$886.40
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$908.46 |
$908.46 |
$908.46 |
$904.78
|
|
Durvalumab 50 mg/ml intravenous solution
|
$130.88 |
$130.88 |
$130.88 |
$8,445.90
|
|
Dx aly aud oi snd prcsr 1st
|
$335.65 |
$335.65 |
$335.65 |
$186.40
|