|
CT limited or localized follow-up study
|
$907.20 |
$907.20 |
$907.20 |
$636.55
|
|
Ctlso a-p-l control with inter
|
$6,112.29 |
$6,112.29 |
$6,112.29 |
$4,186.78
|
|
CT lwr extremity w/o&w/dye
|
$2,599.20 |
$2,599.20 |
$2,599.20 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$515.20 |
$515.20 |
$515.20 |
$422.80
|
|
CT scan for localization
|
$1,748.00 |
$1,748.00 |
$1,748.00 |
$1,216.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,232.00 |
$4,232.00 |
$4,232.00 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,834.40 |
$3,834.40 |
$3,834.40 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,200.80 |
$3,200.80 |
$3,200.80 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,922.40 |
$2,922.40 |
$2,922.40 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,344.00 |
$2,344.00 |
$2,344.00 |
$1,845.36
|
|
Cultr oocyte/embryo <4 days
|
$840.00 |
$840.00 |
$840.00 |
$1,291.35
|
|
Curette/treat cornea
|
$1,435.20 |
$1,435.20 |
$1,435.20 |
$1,365.60
|
|
Cutter lead
|
$18,243.84 |
$18,243.84 |
$18,243.84 |
$6,581.45
|
|
Cv line/pic reposition
|
$2,244.00 |
$2,244.00 |
$2,244.00 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$20.19 |
$20.19 |
$20.19 |
$25.32
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,785.54 |
$1,785.54 |
$1,785.54 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$18.00 |
$18.00 |
$18.00 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$126.40 |
$126.40 |
$126.40 |
$140.78
|
|
Cyclosporine modified 25 mg capsule
|
$4.22 |
$4.22 |
$4.22 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$938.52 |
$938.52 |
$938.52 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$33,811.20 |
$33,811.20 |
$33,811.20 |
$24,728.89
|
|
Cystogram >= 3 views supervision & interpretation
|
$757.60 |
$757.60 |
$757.60 |
$586.95
|
|
Cystoscopy and treatment
|
$3,097.60 |
$3,097.60 |
$3,097.60 |
$2,867.70
|
|
Cystoscopy and treatment
|
$4,960.00 |
$4,960.00 |
$4,960.00 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$1,633.60 |
$1,633.60 |
$1,633.60 |
$1,493.80
|
|
Cystoscopy removal of clots
|
$2,139.20 |
$2,139.20 |
$2,139.20 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$2,760.80 |
$2,760.80 |
$2,760.80 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$4,319.20 |
$4,319.20 |
$4,319.20 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,448.80 |
$3,448.80 |
$3,448.80 |
$3,245.90
|
|
Cytarabine 20 mg/ml injection solution
|
$48.80 |
$48.80 |
$48.80 |
$90.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$103.20 |
$103.20 |
$103.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$84.80 |
$84.80 |
$84.80 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$64.80 |
$64.80 |
$64.80 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$117.60 |
$117.60 |
$117.60 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$122.40 |
$122.40 |
$122.40 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$22.40 |
$22.40 |
$22.40 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$54.40 |
$54.40 |
$54.40 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$249.60 |
$249.60 |
$249.60 |
$213.85
|
|
Cytopath smear other source
|
$137.60 |
$137.60 |
$137.60 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$142.40 |
$142.40 |
$142.40 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$39.37 |
$39.37 |
$39.37 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,975.76 |
$1,975.76 |
$1,975.76 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$1,504.77 |
$1,504.77 |
$1,504.77 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$82.05 |
$82.05 |
$82.05 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$15,427.16 |
$15,427.16 |
$15,427.16 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,952.39 |
$2,952.39 |
$2,952.39 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$2,952.39 |
$2,952.39 |
$2,952.39 |
$7.20
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$17,207.56 |
$17,207.56 |
$17,207.56 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$201.10 |
$201.10 |
$201.10 |
$259.58
|
|
D&c after delivery 59160
|
$3,246.40 |
$3,246.40 |
$3,246.40 |
$3,827.25
|
|
Dch pulmonary stress test
|
$1,005.60 |
$1,005.60 |
$1,005.60 |
$963.30
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$7,444.00 |
$7,444.00 |
$7,444.00 |
$5,121.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$869.60 |
$869.60 |
$869.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$362.40 |
$362.40 |
$362.40 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$705.60 |
$705.60 |
$705.60 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,048.80 |
$2,048.80 |
$2,048.80 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,445.60 |
$1,445.60 |
$1,445.60 |
$835.20
|
|
Debride nail1-5 11720
|
$445.60 |
$445.60 |
$445.60 |
$149.60
|
|
Debride nail6 or more 11721
|
$445.60 |
$445.60 |
$445.60 |
$169.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,879.20 |
$1,879.20 |
$1,879.20 |
$1,163.24
|
|
Debride skin bone at fx site
|
$3,516.00 |
$3,516.00 |
$3,516.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$688.00 |
$688.00 |
$688.00 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,992.00 |
$1,992.00 |
$1,992.00 |
$1,149.50
|
|
Debr inf skin add-on 11001
|
$132.00 |
$132.00 |
$132.00 |
$124.08
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,544.00 |
$1,544.00 |
$1,544.00 |
$1,165.50
|
|
Decalcification
|
$21.60 |
$21.60 |
$21.60 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$3,901.08 |
$3,901.08 |
$3,901.08 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$672.80 |
$672.80 |
$672.80 |
$572.95
|
|
Decompress fasciotomyhand 26037
|
$3,498.40 |
$3,498.40 |
$3,498.40 |
$3,839.54
|
|
Decompression unspecified nerve 64722
|
$2,944.00 |
$2,944.00 |
$2,944.00 |
$2,310.83
|
|
Decompress small bowel
|
$969.60 |
$969.60 |
$969.60 |
$1,503.60
|
|
Deep muscle biopsy 20205
|
$4,823.20 |
$4,823.20 |
$4,823.20 |
$3,386.84
|
|
Deferoxamine 500 mg solution for injection
|
$133.18 |
$133.18 |
$133.18 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$1,533.16 |
$1,533.16 |
$1,533.16 |
$1,856.85
|
|
Delivery of placenta 59414
|
$3,271.20 |
$3,271.20 |
$3,271.20 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$12,841.60 |
$12,841.60 |
$12,841.60 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$248.80 |
$248.80 |
$248.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,899.65 |
$7,899.65 |
$7,899.65 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$572.80 |
$572.80 |
$572.80 |
$401.60
|
|
Descend thora aorta rpr/lt sub art 33880
|
$8,108.80 |
$8,108.80 |
$8,108.80 |
$6,288.45
|
|
Design mlc device for imrt
|
$1,980.80 |
$1,980.80 |
$1,980.80 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$85.94 |
$85.94 |
$85.94 |
$91.84
|
|
Des thora aorta rpr without left sub art 33881
|
$8,108.80 |
$8,108.80 |
$8,108.80 |
$5,267.20
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$5,459.20 |
$5,459.20 |
$5,459.20 |
$3,273.55
|
|
Destroy cervthor facet jnt 64633
|
$3,164.80 |
$3,164.80 |
$3,164.80 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,268.80 |
$1,268.80 |
$1,268.80 |
$1,441.44
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$656.00 |
$656.00 |
$656.00 |
$966.60
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,659.20 |
$1,659.20 |
$1,659.20 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,500.80 |
$3,500.80 |
$3,500.80 |
$3,296.80
|
|
Device ablt adv novasure
|
$12,960.00 |
$12,960.00 |
$12,960.00 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,600.00 |
$5,600.00 |
$5,600.00 |
$4,200.00
|
|
Device intraute mirena
|
$692.26 |
$692.26 |
$692.26 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,668.91 |
$1,668.91 |
$1,668.91 |
$1,860.95
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$95.20 |
$95.20 |
$95.20 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$92.28 |
$92.28 |
$92.28 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$48.65 |
$48.65 |
$48.65 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,642.66 |
$1,642.66 |
$1,642.66 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$16.80 |
$16.80 |
$16.80 |
$36.05
|
|
Diag bronchoscope/catheter
|
$2,948.00 |
$2,948.00 |
$2,948.00 |
$2,360.15
|
