|
CT angio pelvis
|
$799.20 |
$799.20 |
$799.20 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$798.60 |
$798.60 |
$798.60 |
$1,691.30
|
|
CT guidance for needle placement
|
$490.20 |
$490.20 |
$490.20 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$299.40 |
$299.40 |
$299.40 |
$1,215.06
|
|
CT lwr extremity w/o&w/dye
|
$795.00 |
$795.00 |
$795.00 |
$1,818.96
|
|
CT scan for therapy guide
|
$252.00 |
$252.00 |
$252.00 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$627.60 |
$627.60 |
$627.60 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$474.60 |
$474.60 |
$474.60 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$249.60 |
$249.60 |
$249.60 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$794.40 |
$794.40 |
$794.40 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$795.00 |
$795.00 |
$795.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$19.80 |
$19.80 |
$19.80 |
$72.00
|
|
Culture afb any source
|
$26.40 |
$26.40 |
$26.40 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$19.80 |
$19.80 |
$19.80 |
$84.76
|
|
Culture anaerobic except blood
|
$22.80 |
$22.80 |
$22.80 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$22.80 |
$22.80 |
$22.80 |
$52.50
|
|
Culture body fluid
|
$21.00 |
$21.00 |
$21.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$25.20 |
$25.20 |
$25.20 |
$80.00
|
|
Culture fungi definitive id yeast
|
$25.20 |
$25.20 |
$25.20 |
$80.00
|
|
Culture fungi other (except blood)
|
$20.40 |
$20.40 |
$20.40 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$18.60 |
$18.60 |
$18.60 |
$74.75
|
|
Culture mycoplasma any source
|
$51.00 |
$51.00 |
$51.00 |
$83.21
|
|
Culture screening strep group a
|
$16.20 |
$16.20 |
$16.20 |
$84.60
|
|
Culture typing immunologic
|
$33.00 |
$33.00 |
$33.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$490.80 |
$490.80 |
$490.80 |
$140.80
|
|
Cutter lead
|
$706.80 |
$706.80 |
$706.80 |
$6,581.45
|
|
Cv line/pic reposition
|
$666.60 |
$666.60 |
$666.60 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$36.60 |
$36.60 |
$36.60 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$3.40 |
$3.40 |
$3.40 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$31.80 |
$31.80 |
$31.80 |
$72.36
|
|
Cyclophosphamide 25 mg capsule
|
$7.20 |
$7.20 |
$7.20 |
$19.49
|
|
Cyclosporine 2 hour
|
$175.20 |
$175.20 |
$175.20 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$8.40 |
$8.40 |
$8.40 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$73.20 |
$73.20 |
$73.20 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$10,723.20 |
$10,723.20 |
$10,723.20 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$524.00
|
|
Cyp2c9 gene com variants
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$275.10
|
|
Cyp2d6 gene com variants
|
$254.40 |
$254.40 |
$254.40 |
$570.70
|
|
Cystatin c
|
$130.20 |
$130.20 |
$130.20 |
$77.60
|
|
Cystine urine quantitative
|
$94.20 |
$94.20 |
$94.20 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$228.60 |
$228.60 |
$228.60 |
$586.95
|
|
Cystoscopy and treatment
|
$3,780.60 |
$3,780.60 |
$3,780.60 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$2,992.80 |
$2,992.80 |
$2,992.80 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$3,480.00 |
$3,480.00 |
$3,480.00 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$4,825.20 |
$4,825.20 |
$4,825.20 |
$4,129.45
|
|
Cystouretero w/stone remove
|
$6,237.60 |
$6,237.60 |
$6,237.60 |
$5,741.00
|
|
Cytarabine 20 mg/ml injection solution
|
$10.80 |
$10.80 |
$10.80 |
$90.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$35.40 |
$35.40 |
$35.40 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$41.40 |
$41.40 |
$41.40 |
$100.00
|
|
Cyto/molecular report
|
$54.60 |
$54.60 |
$54.60 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$96.00 |
$96.00 |
$96.00 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$102.00 |
$102.00 |
$102.00 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$105.00 |
$105.00 |
$105.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$88.20 |
$88.20 |
$88.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$35.40 |
$35.40 |
$35.40 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$149.40 |
$149.40 |
$149.40 |
$213.85
|
|
Dacarbazine 100 mg intravenous solution
|
$21.40 |
$21.40 |
$21.40 |
$62.41
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$797.40 |
$797.40 |
$797.40 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$103.20 |
$103.20 |
$103.20 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,383.80 |
$2,383.80 |
$2,383.80 |
$6,281.29
|
|
D&c after delivery 59160
|
$7,156.80 |
$7,156.80 |
$7,156.80 |
$3,827.25
|
|
Deamidated gliadin antibody iga
|
$28.20 |
$28.20 |
$28.20 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$178.80 |
$178.80 |
$178.80 |
$668.55
|
|
Debridement bone <= 20 sq cm
|
$532.80 |
$532.80 |
$532.80 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$178.80 |
$178.80 |
$178.80 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$909.00 |
$909.00 |
$909.00 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$178.80 |
$178.80 |
$178.80 |
$835.20
|
|
Debride nail1-5 11720
|
$56.40 |
$56.40 |
$56.40 |
$149.60
|
|
Debride nail6 or more 11721
|
$56.40 |
$56.40 |
$56.40 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$178.80 |
$178.80 |
$178.80 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$178.80 |
$178.80 |
$178.80 |
$1,165.50
|
|
Decalcification
|
$14.40 |
$14.40 |
$14.40 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$143.40 |
$143.40 |
$143.40 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$192.00 |
$192.00 |
$192.00 |
$572.95
|
|
Degarelix 120 mg subcutaneous solution
|
$13.80 |
$13.80 |
$13.80 |
$1,856.85
|
|
Delivery of placenta 59414
|
$981.60 |
$981.60 |
$981.60 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$149.40 |
$149.40 |
$149.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,731.20 |
$2,731.20 |
$2,731.20 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$89.40 |
$89.40 |
$89.40 |
$401.60
|
|
Design mlc device for imrt
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$468.60 |
$468.60 |
$468.60 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$3,635.40 |
$3,635.40 |
$3,635.40 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$3,219.00 |
$3,219.00 |
$3,219.00 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,409.80 |
$3,409.80 |
$3,409.80 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,409.80 |
$3,409.80 |
$3,409.80 |
$3,296.80
|
|
Device intraute mirena
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$121.20 |
$121.20 |
$121.20 |
$227.25
|
|
Dexametha opth insert 0.1 mg
|
$505.60 |
$505.60 |
$505.60 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$0.80 |
$0.80 |
$0.80 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.80 |
$0.80 |
$0.80 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,551.60 |
$1,551.60 |
$1,551.60 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$32.60 |
$32.60 |
$32.60 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$5.00 |
$5.00 |
$5.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$35.00 |
$35.00 |
$35.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$5.00 |
$5.00 |
$5.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$54.00 |
$54.00 |
$54.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$24.00 |
$24.00 |
$24.00 |
$79.30
|
|
Diab manage trn ind/group
|
$93.00 |
$93.00 |
$93.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$84.60 |
$84.60 |
$84.60 |
$195.50
|
