|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$103.80 |
$103.80 |
$103.80 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$103.80 |
$103.80 |
$103.80 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$164.40 |
$164.40 |
$164.40 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$163.80 |
$163.80 |
$163.80 |
$128.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$118.80 |
$118.80 |
$118.80 |
$66.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$193.80 |
$193.80 |
$193.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$162.00 |
$162.00 |
$162.00 |
$207.50
|
|
Cytopath smear other source
|
$144.00 |
$144.00 |
$144.00 |
$88.13
|
|
Cytopath smear other source
|
$190.20 |
$190.20 |
$190.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$143.40 |
$143.40 |
$143.40 |
$95.00
|
|
Cytopath tbs c/v manual
|
$49.20 |
$49.20 |
$49.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$243.60 |
$243.60 |
$243.60 |
$189.00
|
|
Cytp urine 3-5 probes cmptr
|
$941.40 |
$941.40 |
$941.40 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$58.22
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$16,718.40 |
$16,718.40 |
$16,718.40 |
$6,269.40
|
|
Deamidated gliadin antibody iga
|
$19.80 |
$19.80 |
$19.80 |
$43.86
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$827.40 |
$827.40 |
$827.40 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$550.20 |
$550.20 |
$550.20 |
$259.20
|
|
Debridement bone <= 20 sq cm
|
$7,011.00 |
$7,011.00 |
$7,011.00 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,579.20 |
$1,579.20 |
$1,579.20 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$5,005.20 |
$5,005.20 |
$5,005.20 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$7,319.40 |
$7,319.40 |
$7,319.40 |
$810.50
|
|
Debride nail1-5 11720
|
$265.80 |
$265.80 |
$265.80 |
$149.04
|
|
Debride nail6 or more 11721
|
$404.40 |
$404.40 |
$404.40 |
$170.88
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,337.40 |
$1,337.40 |
$1,337.40 |
$1,012.80
|
|
Debride skin bone at fx site
|
$12,134.27 |
$12,134.27 |
$12,134.27 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,476.60 |
$1,476.60 |
$1,476.60 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$719.40 |
$719.40 |
$719.40 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$7,588.37 |
$7,588.37 |
$7,588.37 |
$1,160.00
|
|
Decalcification
|
$53.40 |
$53.40 |
$53.40 |
$68.40
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$324.60 |
$324.60 |
$324.60 |
$541.60
|
|
Decompression of lower leg
|
$19,136.76 |
$19,136.76 |
$19,136.76 |
$3,839.54
|
|
Decompression of thigh/knee
|
$13,418.40 |
$13,418.40 |
$13,418.40 |
$4,192.86
|
|
Deep muscle biopsy 20205
|
$3,138.60 |
$3,138.60 |
$3,138.60 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$56.40 |
$56.40 |
$56.40 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$3,886.68 |
$3,886.68 |
$3,886.68 |
$1,807.08
|
|
Delayed breast prosthesis 19342
|
$24,747.73 |
$24,747.73 |
$24,747.73 |
$10,457.82
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$203.40 |
$203.40 |
$203.40 |
$186.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$14,902.92 |
$14,902.92 |
$14,902.92 |
$6,324.98
|
|
Dermapure 1 square cm
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$91.56 |
$91.56 |
$91.56 |
$89.78
|
|
Desoxycorticosterone
|
$83.40 |
$83.40 |
$83.40 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$8,934.58 |
$8,934.58 |
$8,934.58 |
$2,998.30
|
|
Destroy cth facet jnt addl 64634
|
$8,954.68 |
$8,954.68 |
$8,954.68 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$10,555.50 |
$10,555.50 |
$10,555.50 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$8,768.08 |
$8,768.08 |
$8,768.08 |
$1,612.80
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$8,744.80 |
$8,744.80 |
$8,744.80 |
$3,153.00
|
|
Device ablt adv novasure
|
$12,727.47 |
$12,727.47 |
$12,727.47 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,560.55 |
$6,560.55 |
$6,560.55 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,002.11 |
$3,002.11 |
$3,002.11 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,430.68 |
$2,430.68 |
$2,430.68 |
$2,541.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$503.40 |
$503.40 |
$503.40 |
$222.50
|
|
Dexamethasone 4 mg tablet
|
$3.06 |
$3.06 |
$3.06 |
$5.98
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$284.76 |
$284.76 |
$284.76 |
$21.17
|
|
Dextran 40 infusion
|
$300.06 |
$300.06 |
$300.06 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.80 |
$37.80 |
$37.80 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$37.80 |
$37.80 |
$37.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$139.80 |
$139.80 |
$139.80 |
$111.50
|
|
Diabetes (HbA1c) Test
|
$90.60 |
$90.60 |
$90.60 |
$79.30
|
|
Diag laparo separate proc 49320
|
$33,084.19 |
$33,084.19 |
$33,084.19 |
$6,904.15
|
|
Diagnostic laryngoscopy 31505
|
$380.40 |
$380.40 |
$380.40 |
$238.58
|
|
Diagnostic laryngoscopy 31575
|
$426.60 |
$426.60 |
$426.60 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$369.00 |
$369.00 |
$369.00 |
$397.95
|
|
Diagnostic Mammogram (one breast)
|
$335.40 |
$335.40 |
$335.40 |
$297.05
|
|
Diagnostic radio unlisted proc
|
$772.80 |
$772.80 |
$772.80 |
$214.08
|
|
Dialysis circuit perm vascular embolization 36909
|
$15,156.00 |
$15,156.00 |
$15,156.00 |
$5,543.85
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$37.98 |
$37.98 |
$37.98 |
$74.02
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.24 |
$6.24 |
$6.24 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$21,487.68 |
$21,487.68 |
$21,487.68 |
$10,079.82
|
|
Dilate biliary duct/ampulla
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$6,228.60 |
$6,228.60 |
$6,228.60 |
$1,484.17
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,081.37
|
|
Dilat xst trc new access rcs
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,213.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$51.54 |
$51.54 |
$51.54 |
$47.94
|
|
Dimenhydrinate injection
|
$29.70 |
$29.70 |
$29.70 |
$30.48
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$17.75
|
|
Disaccharidases
|
$175.20 |
$175.20 |
$175.20 |
$207.24
|
|
Dise eval slp do brth flx dx
|
$7,803.70 |
$7,803.70 |
$7,803.70 |
$1,120.00
|
|
Dist revas ligation hemo
|
$44,992.66 |
$44,992.66 |
$44,992.66 |
$6,396.89
|
|
Dmd dup/delet analysis
|
$499.20 |
$499.20 |
$499.20 |
$404.03
|
|
Dna antibody native/double stranded
|
$58.20 |
$58.20 |
$58.20 |
$94.60
|
|
Dna gardnerella
|
$33.60 |
$33.60 |
$33.60 |
$62.50
|
|
Dna trichomonas
|
$33.60 |
$33.60 |
$33.60 |
$67.73
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$180.48 |
$180.48 |
$180.48 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,606.50 |
$1,606.50 |
$1,606.50 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$64.32 |
$64.32 |
$64.32 |
$65.40
|
|
Dornase alfa non-comp unit
|
$603.60 |
$603.60 |
$603.60 |
$446.75
|
|
Dornhoffer fixed part w/window
|
$67,573.67 |
$67,573.67 |
$67,573.67 |
$34,278.00
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$118.86 |
$118.86 |
$118.86 |
$84.80
|
|
Dpyd gene common variants
|
$351.60 |
$351.60 |
$351.60 |
$380.50
|
|
Drainage of arm bursa 23931
|
$3,010.80 |
$3,010.80 |
$3,010.80 |
$2,197.48
|
|
Drainage of kidney lesion
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,506.00
|
|
Drainage of nose lesion sept 30020
|
$847.20 |
$847.20 |
$847.20 |
$781.44
|
|
Drain blood from under nail 11740
|
$283.80 |
$283.80 |
$283.80 |
$171.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$2,786.40 |
$2,786.40 |
$2,786.40 |
$2,540.00
|