|
CT hrt c+ strux cgen hrt ds
|
$1,750.40 |
$1,750.40 |
$2,114.40 |
|
|
CT hrt w/3d image
|
$1,558.40 |
$1,558.40 |
$1,868.80 |
|
|
CT limited or localized follow-up study
|
$770.40 |
$808.80 |
$907.20 |
|
|
Ctlso a-p-l control with inter
|
$6,112.29 |
$6,112.29 |
$6,112.29 |
|
|
CT lwr extremity w/o&w/dye
|
$2,125.60 |
$2,125.60 |
$2,599.20 |
|
|
Ctrl nosebld postir subsq 30906
|
$350.40 |
$496.00 |
$515.20 |
|
|
CT scan for localization
|
$1,748.00 |
$1,748.00 |
$1,983.20 |
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,004.00 |
$3,004.00 |
$4,232.00 |
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,492.80 |
$2,492.80 |
$3,834.40 |
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,080.80 |
$2,080.80 |
$3,392.80 |
|
|
CT t-spine w /wo contrast
|
$2,262.40 |
$2,262.40 |
$2,922.40 |
|
|
CT uppr extremity w/o&w/dye
|
$2,068.00 |
$2,277.60 |
$2,344.00 |
|
|
Cultr oocyte/embryo <4 days
|
$840.00 |
$840.00 |
$840.00 |
|
|
Culture aerobic additional method definitive id each
|
$90.40 |
$90.40 |
$90.40 |
|
|
Culture afb any source
|
$70.40 |
$70.40 |
$70.40 |
|
|
Culture anaerobic additional method definitive id each
|
$43.20 |
$43.20 |
$43.20 |
|
|
Culture anaerobic except blood
|
$55.20 |
$55.20 |
$55.20 |
|
|
Culture bact stool aero addl path ea
|
$56.00 |
$56.00 |
$56.00 |
|
|
Culture body fluid
|
$54.40 |
$54.40 |
$54.40 |
|
|
Culture fungi definitive id mold
|
$62.40 |
$62.40 |
$62.40 |
|
|
Culture fungi definitive id yeast
|
$66.40 |
$66.40 |
$66.40 |
|
|
Culture fungi other (except blood)
|
$65.60 |
$65.60 |
$65.60 |
|
|
Culture fungi skin/hair/nail
|
$49.60 |
$49.60 |
$49.60 |
|
|
Culture screening strep group a
|
$36.00 |
$36.00 |
$36.00 |
|
|
Culture typing immunologic
|
$33.60 |
$33.60 |
$33.60 |
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$576.00 |
$576.00 |
$576.00 |
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$176.00 |
$176.00 |
$176.00 |
|
|
Culture urine each isolate
|
$44.80 |
$44.80 |
$44.80 |
|
|
Curette/treat cornea
|
$1,435.20 |
$1,435.20 |
$1,435.20 |
|
|
Cutter lead
|
$16,723.52 |
$16,723.52 |
$18,243.84 |
|
|
Cv line/pic reposition
|
$2,244.00 |
$2,244.00 |
$2,284.00 |
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$20.19 |
$27.16 |
$31.00 |
|
|
Cyclic citrullinated peptide antibody
|
$96.80 |
$96.80 |
$96.80 |
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$970.48 |
$970.48 |
$1,785.54 |
|
|
Cyclophosphamide 25 mg capsule
|
$13.87 |
$13.87 |
$18.00 |
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$69.73 |
$69.73 |
$126.40 |
|
|
Cyclosporine 2 hour
|
$112.80 |
$112.80 |
$112.80 |
|
|
Cyclosporine modified 25 mg capsule
|
$3.75 |
$3.75 |
$4.22 |
|
|
Cyclosporine oral 100 mg
|
$851.75 |
$851.75 |
$938.52 |
|
|
Cylinder pump set 20cm titan zero angl
|
$30,993.60 |
$30,993.60 |
$33,811.20 |
|
|
Cyp2c19 gene com variants
|
$256.00 |
$256.00 |
$256.00 |
|
|
Cystatin c
|
$99.20 |
$99.20 |
$99.20 |
|
|
Cystine urine quantitative
|
$101.60 |
$101.60 |
$101.60 |
|
|
Cystogram >= 3 views supervision & interpretation
|
$616.80 |
$616.80 |
$757.60 |
|
|
Cystoscopy and treatment
|
$3,097.60 |
$3,097.60 |
$3,345.60 |
|
|
Cystoscopy and treatment
|
$4,960.00 |
$4,960.00 |
$4,960.00 |
|
|
Cystoscopy (Bladder Scope)
|
$1,046.40 |
$1,046.40 |
$1,633.60 |
|
|
Cystoscopy removal of clots
|
$2,139.20 |
$2,139.20 |
$5,194.40 |
|
|
Cystoscopy & ureter catheter
|
$2,760.80 |
$2,760.80 |
$4,674.40 |
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,140.80 |
$3,140.80 |
$4,319.20 |
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,036.00 |
$3,036.00 |
$3,608.80 |
|
|
Cysto w/ureter stricture tx
|
$4,729.60 |
$4,729.60 |
$4,729.60 |
|
|
Cytarabine 20 mg/ml injection solution
|
$48.80 |
$48.80 |
$175.67 |
|
|
Cytogenetics 25-99
|
$103.20 |
$103.20 |
$103.20 |
|
|
Cytogenetics 3-5
|
$99.20 |
$99.20 |
$99.20 |
|
|
Cytomegalovirus (cmv) antibody igg
|
$86.40 |
$86.40 |
$86.40 |
|
|
Cytomegalovirus (cmv) antibody igm
|
$96.80 |
$96.80 |
$96.80 |
|
|
Cytopathology cellular enhancement technique non-gyn
|
$100.80 |
$100.80 |
$119.20 |
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$84.80 |
$100.80 |
$117.60 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$64.80 |
$99.20 |
$106.40 |
|
|
Cytopathology concentration technique smears & interpretation
|
$117.60 |
$127.20 |
$147.20 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$108.00 |
$108.00 |
$122.40 |
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$22.40 |
$22.40 |
$63.20 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$52.00 |
$52.00 |
$308.00 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$216.80 |
$216.80 |
$249.60 |
|
|
Cytopath smear other source
|
$110.40 |
$110.40 |
$137.60 |
|
|
Cytopath smear oth prep screen & interp
|
$109.60 |
$109.60 |
$142.40 |
|
|
Cytopath tbs c/v manual
|
$51.20 |
$51.20 |
$51.20 |
|
|
Dacarbazine 100 mg intravenous solution
|
$39.37 |
$39.37 |
$168.97 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,708.71 |
$1,708.71 |
$1,975.76 |
|
|
Dalbavancin 500 mg intravenous solution
|
$1,504.77 |
$1,504.77 |
$2,192.91 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$82.05 |
$122.40 |
$549.34 |
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$8,016.60 |
$8,016.60 |
$15,427.16 |
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,399.20 |
$2,758.36 |
$2,952.39 |
|
|
Darbepoetin alfa, esrd use
|
$327.60 |
$917.20 |
$2,952.39 |
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$11,181.23 |
$11,181.23 |
$17,207.56 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$201.10 |
$201.10 |
$210.11 |
|
|
D&c after delivery 59160
|
$3,246.40 |
$3,246.40 |
$3,800.80 |
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$4,112.00 |
$4,112.00 |
$4,112.00 |
|
|
Dch glucoscan
|
$16.00 |
$16.00 |
$16.00 |
|
|
Dch pulmonary stress test
|
$1,005.60 |
$1,005.60 |
$1,005.60 |
|
|
Dch validity tests
|
$16.00 |
$16.00 |
$16.00 |
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$7,444.00 |
$7,444.00 |
$8,163.20 |
|
|
Deamidated gliadin antibody iga
|
$54.40 |
$54.40 |
$54.40 |
|
|
Debr g/per/abd wall 11006
|
$2,452.00 |
$2,452.00 |
$2,452.00 |
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$869.60 |
$869.60 |
$885.60 |
|
|
Debridement (>20 cm) charge pt
|
$256.00 |
$359.20 |
$362.40 |
|
|
Debridement bone <= 20 sq cm
|
$2,592.00 |
$2,592.00 |
$2,723.20 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$604.00 |
$604.00 |
$705.60 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,757.60 |
$1,757.60 |
$2,048.80 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$759.20 |
$759.20 |
$1,445.60 |
|
|
Debride nail1-5 11720
|
$175.20 |
$175.20 |
$445.60 |
|
|
Debride nail6 or more 11721
|
$193.60 |
$193.60 |
$445.60 |
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,879.20 |
$1,879.20 |
$2,307.20 |
|
|
Debride skin bone at fx site
|
$3,516.00 |
$3,516.00 |
$3,984.00 |
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$688.00 |
$688.00 |
$758.40 |
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,094.40 |
$1,776.00 |
$1,992.00 |
|
|
Debr inf skin add-on 11001
|
$132.00 |
$132.00 |
$132.00 |
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,046.40 |
$1,046.40 |
$1,544.00 |
|
|
Decalcification
|
$21.60 |
$51.20 |
$88.00 |
|
