|
Culture typing immunologic
|
$27.60 |
$27.60 |
$27.60 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$360.60 |
$360.60 |
$360.60 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$94.80 |
$94.80 |
$94.80 |
$130.38
|
|
Culture urine each isolate
|
$86.40 |
$86.40 |
$86.40 |
$52.65
|
|
Curette/treat cornea
|
$1,865.40 |
$1,865.40 |
$1,865.40 |
$1,331.61
|
|
Cutter lead
|
$9,368.47 |
$9,368.47 |
$9,368.47 |
$5,875.79
|
|
Cv line/pic reposition
|
$1,482.60 |
$1,482.60 |
$1,482.60 |
$1,719.44
|
|
Cyanocobalamin unsat binding capacity
|
$33.60 |
$33.60 |
$33.60 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$35.40 |
$35.40 |
$35.40 |
$72.00
|
|
Cyclosporine 2 hour
|
$93.60 |
$93.60 |
$93.60 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$3.00 |
$3.00 |
$3.00 |
$7.48
|
|
Cygnus, per sq cm
|
$11,808.99 |
$11,808.99 |
$11,808.99 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$38,237.64 |
$38,237.64 |
$38,237.64 |
$24,107.80
|
|
Cyp2c19 gene com variants
|
$239.40 |
$239.40 |
$239.40 |
$433.00
|
|
Cyp2d6 gene com variants
|
$508.80 |
$508.80 |
$508.80 |
$525.95
|
|
Cystic fibrosis cftr
|
$1,597.20 |
$1,597.20 |
$1,597.20 |
$1,060.00
|
|
Cystine urine quantitative
|
$121.20 |
$121.20 |
$121.20 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$432.60 |
$432.60 |
$432.60 |
$542.10
|
|
Cystoscopy and treatment
|
$5,518.68 |
$5,518.68 |
$5,518.68 |
$2,874.36
|
|
Cysto/uretero w/lithotripsy
|
$33,202.64 |
$33,202.64 |
$33,202.64 |
$7,372.68
|
|
Cytogenetics 25-99
|
$73.80 |
$73.80 |
$73.80 |
$189.80
|
|
Cytogenomic neo microra alys
|
$4,171.20 |
$4,171.20 |
$4,171.20 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$57.00 |
$57.00 |
$57.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$59.40 |
$59.40 |
$59.40 |
$95.00
|
|
Cytopath c/v index add-on
|
$37.80 |
$37.80 |
$37.80 |
$34.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$87.60 |
$87.60 |
$87.60 |
$159.45
|
|
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 |
$87.29
|
|
Cytopathology concentration technique smears & interpretation
|
$164.40 |
$164.40 |
$164.40 |
$134.70
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$163.80 |
$163.80 |
$163.80 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$118.80 |
$118.80 |
$118.80 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$193.80 |
$193.80 |
$193.80 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$162.00 |
$162.00 |
$162.00 |
$207.50
|
|
Cytopath smear other source
|
$114.00 |
$114.00 |
$114.00 |
$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 |
$95.89
|
|
Cytopath tbs c/v manual
|
$38.40 |
$38.40 |
$38.40 |
$59.15
|
|
Cytotoxic antibody screening
|
$193.80 |
$193.80 |
$193.80 |
$184.63
|
|
Cytp urine 3-5 probes cmptr
|
$941.40 |
$941.40 |
$941.40 |
$690.00
|
|
Dch pulmonary stress test
|
$1,042.80 |
$1,042.80 |
$1,042.80 |
$963.30
|
|
Dch validity tests
|
$15.00 |
$15.00 |
$15.00 |
$24.00
|
|
Deamidated gliadin antibody iga
|
$19.80 |
$19.80 |
$19.80 |
$44.00
|
|
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 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$5,005.20 |
$5,005.20 |
$5,005.20 |
$2,320.80
|
|
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 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,052.00 |
$2,052.00 |
$2,052.00 |
$814.80
|
|
Debride nail1-5 11720
|
$265.80 |
$265.80 |
$265.80 |
$148.80
|
|
Debride nail6 or more 11721
|
$404.40 |
$404.40 |
$404.40 |
$166.17
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$2,059.20 |
$2,059.20 |
$2,059.20 |
$639.60
|
|
Debr inf skin add-on 11001
|
$719.40 |
$719.40 |
$719.40 |
$106.86
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,005.80 |
$2,005.80 |
$2,005.80 |
$1,193.40
|
|
Decalcification
|
$53.40 |
$53.40 |
$53.40 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$324.60 |
$324.60 |
$324.60 |
$540.00
|
|
Delayed breast prosthesis 19342
|
$20,178.78 |
$20,178.78 |
$20,178.78 |
$7,698.09
|
|
Delivery of placenta 59414
|
$5,455.80 |
$5,455.80 |
$5,455.80 |
$2,978.91
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$203.40 |
$203.40 |
$203.40 |
$186.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$283.80 |
$283.80 |
$283.80 |
$408.10
|
|
Dermapure 1 square cm
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$2,319.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$91.56 |
$91.56 |
$91.56 |
$70.80
|
|
Desoxycorticosterone
|
$83.40 |
$83.40 |
$83.40 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$3,018.00 |
$3,018.00 |
$3,018.00 |
$2,998.30
|
|
Destroy cth facet jnt addl 64634
|
$1,509.60 |
$1,509.60 |
$1,509.60 |
$1,426.75
|
|
Destruct ben lesion 15/> 17111
|
$518.40 |
$518.40 |
$518.40 |
$235.13
|
|
Destruction benign lesions < 14 lesions
|
$758.40 |
$758.40 |
$758.40 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$2,273.40 |
$2,273.40 |
$2,273.40 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,577.40 |
$1,577.40 |
$1,577.40 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,153.00 |
$3,153.00 |
$3,153.00 |
$3,148.11
|
|
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 |
$4,265.58
|
|
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 |
$2,518.78
|
|
Dexamethasone 4 mg tablet
|
$3.06 |
$3.06 |
$3.06 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$6.00 |
$6.00 |
$6.00 |
$21.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$37.80
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$43.65
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.80 |
$37.80 |
$37.80 |
$44.16
|
|
Dhea-s (dehydroepiand sulfate)
|
$139.80 |
$139.80 |
$139.80 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$90.60 |
$90.60 |
$90.60 |
$79.30
|
|
Diagnostic anoscopy spx 46600
|
$246.60 |
$246.60 |
$246.60 |
$182.95
|
|
Diagnostic laryngoscopy 31505
|
$380.40 |
$380.40 |
$380.40 |
$235.00
|
|
Diagnostic laryngoscopy 31575
|
$426.60 |
$426.60 |
$426.60 |
$338.00
|
|
Diagnostic radio unlisted proc
|
$598.80 |
$598.80 |
$598.80 |
$239.25
|
|
Dialysis circuit perm vascular embolization 36909
|
$15,156.00 |
$15,156.00 |
$15,156.00 |
$5,663.50
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$19.56 |
$19.56 |
$19.56 |
$73.22
|
|
Dicyclomine injection
|
$54.42 |
$54.42 |
$54.42 |
$153.53
|
|
Diffusing capacity
|
$378.00 |
$378.00 |
$378.00 |
$331.76
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$6.24 |
$6.24 |
$6.24 |
$66.92
|
|
Digoxin immune fab 40 mg intravenous solution
|
$21,487.68 |
$21,487.68 |
$21,487.68 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$156.00 |
$156.00 |
$156.00 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$236.88 |
$236.88 |
$236.88 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$1,866.73
|
|
Dilate esophagus 1/mult pass
|
$7,208.34 |
$7,208.34 |
$7,208.34 |
$1,484.17
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$403.61
|
|
Dilat xst trc ndurlgc px
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,061.71
|
|
Dilat xst trc new access rcs
|
$2,270.40 |
$2,270.40 |
$2,270.40 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$48.75
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$16.80
|
