|
CT limited or localized follow-up study
|
$770.40 |
$770.40 |
$770.40 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$2,125.60 |
$2,125.60 |
$2,125.60 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$350.40 |
$350.40 |
$350.40 |
$422.80
|
|
CT scan for localization
|
$1,983.20 |
$1,983.20 |
$1,983.20 |
$1,216.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,120.80 |
$4,120.80 |
$4,120.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,756.80 |
$3,756.80 |
$3,756.80 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,392.80 |
$3,392.80 |
$3,392.80 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,262.40 |
$2,262.40 |
$2,262.40 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,068.00 |
$2,068.00 |
$2,068.00 |
$1,845.36
|
|
Cutter lead
|
$16,723.52 |
$16,723.52 |
$16,723.52 |
$6,581.45
|
|
Cv line/pic reposition
|
$2,284.00 |
$2,284.00 |
$2,284.00 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$27.31 |
$27.31 |
$27.31 |
$25.32
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$970.48 |
$970.48 |
$970.48 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$13.87 |
$13.87 |
$13.87 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$69.73 |
$69.73 |
$69.73 |
$140.78
|
|
Cyclosporine modified 25 mg capsule
|
$3.75 |
$3.75 |
$3.75 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$851.75 |
$851.75 |
$851.75 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$30,993.60 |
$30,993.60 |
$30,993.60 |
$24,728.89
|
|
Cystogram >= 3 views supervision & interpretation
|
$616.80 |
$616.80 |
$616.80 |
$586.95
|
|
Cystoscopy and treatment
|
$3,345.60 |
$3,345.60 |
$3,345.60 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$1,604.00 |
$1,604.00 |
$1,604.00 |
$1,493.80
|
|
Cystoscopy removal of clots
|
$5,194.40 |
$5,194.40 |
$5,194.40 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$4,674.40 |
$4,674.40 |
$4,674.40 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,140.80 |
$3,140.80 |
$3,140.80 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,608.80 |
$3,608.80 |
$3,608.80 |
$3,245.90
|
|
Cysto w/ureter stricture tx
|
$4,729.60 |
$4,729.60 |
$4,729.60 |
$4,081.37
|
|
Cytarabine 20 mg/ml injection solution
|
$175.67 |
$175.67 |
$175.67 |
$90.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$119.20 |
$119.20 |
$119.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$117.60 |
$117.60 |
$117.60 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$99.20 |
$99.20 |
$99.20 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$127.20 |
$127.20 |
$127.20 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$114.40 |
$114.40 |
$114.40 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$63.20 |
$63.20 |
$63.20 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$308.00 |
$308.00 |
$308.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$227.20 |
$227.20 |
$227.20 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$129.60 |
$129.60 |
$129.60 |
$96.20
|
|
Cytopath tbs c/v manual
|
$51.20 |
$51.20 |
$51.20 |
$59.28
|
|
Dacarbazine 100 mg intravenous solution
|
$168.97 |
$168.97 |
$168.97 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,708.71 |
$1,708.71 |
$1,708.71 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$2,192.91 |
$2,192.91 |
$2,192.91 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$122.40 |
$122.40 |
$122.40 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$8,016.60 |
$8,016.60 |
$8,016.60 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,758.36 |
$2,758.36 |
$2,758.36 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$2,758.36 |
$2,758.36 |
$2,758.36 |
$7.20
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$11,181.23 |
$11,181.23 |
$11,181.23 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$210.11 |
$210.11 |
$210.11 |
$259.58
|
|
D&c after delivery 59160
|
$3,800.80 |
$3,800.80 |
$3,800.80 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$4,112.00 |
$4,112.00 |
$4,112.00 |
$3,774.81
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$8,163.20 |
$8,163.20 |
$8,163.20 |
$5,121.00
|
|
Debr g/per/abd wall 11006
|
$2,452.00 |
$2,452.00 |
$2,452.00 |
$1,562.83
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$885.60 |
$885.60 |
$885.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$256.00 |
$256.00 |
$256.00 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,723.20 |
$2,723.20 |
$2,723.20 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$604.00 |
$604.00 |
$604.00 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,757.60 |
$1,757.60 |
$1,757.60 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$759.20 |
$759.20 |
$759.20 |
$835.20
|
|
Debride nail1-5 11720
|
$175.20 |
$175.20 |
$175.20 |
$149.60
|
|
Debride nail6 or more 11721
|
$193.60 |
$193.60 |
$193.60 |
$169.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$2,307.20 |
$2,307.20 |
$2,307.20 |
$1,163.24
|
|
Debride skin bone at fx site
|
$3,984.00 |
$3,984.00 |
$3,984.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$758.40 |
$758.40 |
$758.40 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,046.40 |
$1,046.40 |
$1,046.40 |
$1,165.50
|
|
Decalcification
|
$88.00 |
$88.00 |
$88.00 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$2,191.00 |
$2,191.00 |
$2,191.00 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$553.60 |
$553.60 |
$553.60 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$63.46 |
$63.46 |
$63.46 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$1,050.66 |
$1,050.66 |
$1,050.66 |
$1,856.85
|
|
Delivery of placenta 59414
|
$1,309.60 |
$1,309.60 |
$1,309.60 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$13,281.60 |
$13,281.60 |
$13,281.60 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$158.40 |
$158.40 |
$158.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,735.52 |
$2,735.52 |
$2,735.52 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$380.80 |
$380.80 |
$380.80 |
$401.60
|
|
Depo-estradiol cypionate inj
|
$88.06 |
$88.06 |
$88.06 |
$71.51
|
|
Descend thora aorta rpr/lt sub art 33880
|
$10,796.00 |
$10,796.00 |
$10,796.00 |
$6,288.45
|
|
Design mlc device for imrt
|
$815.20 |
$815.20 |
$815.20 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$60.29 |
$60.29 |
$60.29 |
$91.84
|
|
Des thora aorta rpr without left sub art 33881
|
$10,796.00 |
$10,796.00 |
$10,796.00 |
$5,267.20
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,998.40 |
$1,998.40 |
$1,998.40 |
$3,273.55
|
|
Destroy cervthor facet jnt 64633
|
$3,404.80 |
$3,404.80 |
$3,404.80 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$629.60 |
$629.60 |
$629.60 |
$1,441.44
|
|
Destruction anal lesion(s)
|
$3,071.20 |
$3,071.20 |
$3,071.20 |
$3,711.00
|
|
Destruction benign lesions < 14 lesions
|
$262.40 |
$262.40 |
$262.40 |
$240.24
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,612.80 |
$1,612.80 |
$1,612.80 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,221.60 |
$3,221.60 |
$3,221.60 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$128.80 |
$128.80 |
$128.80 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$572.00 |
$572.00 |
$572.00 |
$350.40
|
|
Device ablt adv novasure
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,400.00 |
$4,400.00 |
$4,400.00 |
$4,200.00
|
|
Device intraute mirena
|
$850.52 |
$850.52 |
$850.52 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$2,631.20 |
$2,631.20 |
$2,631.20 |
$2,515.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$286.40 |
$286.40 |
$286.40 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$138.40 |
$138.40 |
$138.40 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$42.57 |
$42.57 |
$42.57 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$35.19 |
$35.19 |
$35.19 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,154.43 |
$1,154.43 |
$1,154.43 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$100.00 |
$100.00 |
$100.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|