|
Cytopathology fna adequacy evaluation first episode each site
|
$129.60 |
$129.60 |
$129.60 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$586.20 |
$586.20 |
$586.20 |
$207.50
|
|
Cytopath smear other source
|
$220.80 |
$220.80 |
$220.80 |
$88.13
|
|
Cytopath smear other source
|
$442.20 |
$442.20 |
$442.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$289.20 |
$289.20 |
$289.20 |
$96.20
|
|
Cytopath tbs c/v manual
|
$107.40 |
$107.40 |
$107.40 |
$59.01
|
|
Cytotoxic antibody screening
|
$223.20 |
$223.20 |
$223.20 |
$184.63
|
|
Dacarbazine 100 mg intravenous solution
|
$75.00 |
$75.00 |
$75.00 |
$62.70
|
|
Dalbavancin 500 mg intravenous solution
|
$6,831.90 |
$6,831.90 |
$6,831.90 |
$3,401.41
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$115.20 |
$115.20 |
$115.20 |
$232.95
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$41,674.32 |
$41,674.32 |
$41,674.32 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$14,860.80 |
$14,860.80 |
$14,860.80 |
$5,546.48
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$104.46 |
$104.46 |
$104.46 |
$259.58
|
|
D&c after delivery 59160
|
$23,889.74 |
$23,889.74 |
$23,889.74 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$17,312.24 |
$17,312.24 |
$17,312.24 |
$3,769.92
|
|
Dch validity tests
|
$39.60 |
$39.60 |
$39.60 |
$24.50
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$5,911.80 |
$5,911.80 |
$5,911.80 |
$4,478.50
|
|
Deamidated gliadin antibody iga
|
$19.80 |
$19.80 |
$19.80 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$897.60 |
$897.60 |
$897.60 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$9,652.80 |
$9,652.80 |
$9,652.80 |
$2,321.40
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,678.20 |
$1,678.20 |
$1,678.20 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$4,342.20 |
$4,342.20 |
$4,342.20 |
$1,418.55
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,978.40 |
$2,978.40 |
$2,978.40 |
$810.50
|
|
Debride nail1-5 11720
|
$500.40 |
$500.40 |
$500.40 |
$155.40
|
|
Debride nail6 or more 11721
|
$500.40 |
$500.40 |
$500.40 |
$167.63
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$3,907.80 |
$3,907.80 |
$3,907.80 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$9,131.48 |
$9,131.48 |
$9,131.48 |
$1,176.57
|
|
Decalcification
|
$174.60 |
$174.60 |
$174.60 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$182.82 |
$182.82 |
$182.82 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$820.80 |
$820.80 |
$820.80 |
$540.00
|
|
Deferoxamine 500 mg solution for injection
|
$193.02 |
$193.02 |
$193.02 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$509.40 |
$509.40 |
$509.40 |
$187.20
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$13,247.04 |
$13,247.04 |
$13,247.04 |
$6,324.98
|
|
Dermapure 1 square cm
|
$5,235.32 |
$5,235.32 |
$5,235.32 |
$1,915.73
|
|
Descend thora aorta rpr/lt sub art 33880
|
$35,085.60 |
$35,085.60 |
$35,085.60 |
$5,976.81
|
|
Design mlc device for imrt
|
$1,043.40 |
$1,043.40 |
$1,043.40 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$45.06 |
$45.06 |
$45.06 |
$74.09
|
|
Desoxycorticosterone
|
$302.40 |
$302.40 |
$302.40 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$29,315.40 |
$29,315.40 |
$29,315.40 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$5,980.20 |
$5,980.20 |
$5,980.20 |
$2,727.20
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$3,443.40 |
$3,443.40 |
$3,443.40 |
$1,626.95
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,443.40 |
$3,443.40 |
$3,443.40 |
$3,148.11
|
|
Detect agent nos dna dir
|
$181.80 |
$181.80 |
$181.80 |
$80.08
|
|
Detect agnt mult dna direc
|
$153.60 |
$153.60 |
$153.60 |
$147.75
|
|
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 |
$4,285.86
|
|
Device sut capio slim opn
|
$3,002.11 |
$3,002.11 |
$3,002.11 |
$1,936.74
|
|
Device tiss remov myosure reach
|
$2,430.68 |
$2,430.68 |
$2,430.68 |
$2,529.60
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$106.20 |
$106.20 |
$106.20 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$96.60 |
$96.60 |
$96.60 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$17.82 |
$17.82 |
$17.82 |
$22.05
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$884.34 |
$884.34 |
$884.34 |
$842.88
|
|
Dextran 40 infusion
|
$315.24 |
$315.24 |
$315.24 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$26.40 |
$26.40 |
$26.40 |
$35.57
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$19.80 |
$19.80 |
$19.80 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$37.98 |
$37.98 |
$37.98 |
$42.32
|
|
Dextrose 5 % IV bolus
|
$39.60 |
$39.60 |
$39.60 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$156.00 |
$156.00 |
$156.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$113.40 |
$113.40 |
$113.40 |
$79.30
|
|
Diag laparo separate proc 49320
|
$15,266.24 |
$15,266.24 |
$15,266.24 |
$6,904.15
|
|
Diagnostic Mammogram (both breasts)
|
$309.00 |
$309.00 |
$309.00 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$240.60 |
$240.60 |
$240.60 |
$310.00
|
|
Diagnostic radio unlisted proc
|
$515.40 |
$515.40 |
$515.40 |
$239.25
|
|
Dialysis circuit perm vascular embolization 36909
|
$15,199.80 |
$15,199.80 |
$15,199.80 |
$6,185.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$74.52 |
$74.52 |
$74.52 |
$114.18
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$274.32 |
$274.32 |
$274.32 |
$74.02
|
|
Dicyclomine injection
|
$92.46 |
$92.46 |
$92.46 |
$157.16
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.50 |
$7.50 |
$7.50 |
$69.88
|
|
Digoxin immune fab 40 mg intravenous solution
|
$19,100.16 |
$19,100.16 |
$19,100.16 |
$8,843.78
|
|
Digoxin total therapeutic drug level
|
$102.00 |
$102.00 |
$102.00 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$248.88 |
$248.88 |
$248.88 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$2,863.20 |
$2,863.20 |
$2,863.20 |
$1,924.05
|
|
Dilate esophagus 1/mult pass
|
$5,289.96 |
$5,289.96 |
$5,289.96 |
$1,484.17
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$486.60 |
$486.60 |
$486.60 |
$3,641.30
|
|
Dilate ic vasospasm ea add vsl same territory
|
$166.80 |
$166.80 |
$166.80 |
$1,950.85
|
|
Dilate ic vasospasm init
|
$466.20 |
$466.20 |
$466.20 |
$5,741.00
|
|
Dilator fascial 10fx20cm
|
$832.93 |
$832.93 |
$832.93 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$4,056.65
|
|
Dilat xst trc new access rcs
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$7.50 |
$7.50 |
$7.50 |
$51.12
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.50 |
$7.50 |
$7.50 |
$17.38
|
|
Disaccharidases
|
$374.40 |
$374.40 |
$374.40 |
$203.08
|
|
Discography cerv/thor spine
|
$2,595.00 |
$2,595.00 |
$2,595.00 |
$2,360.70
|
|
Dlyd plmt xtn prosth ea addl
|
$5,167.20 |
$5,167.20 |
$5,167.20 |
$1,864.35
|
|
Dmd dup/delet analysis
|
$496.20 |
$496.20 |
$496.20 |
$385.02
|
|
Dna antibody native/double stranded
|
$283.80 |
$283.80 |
$283.80 |
$100.00
|
|
Dna gardnerella
|
$63.00 |
$63.00 |
$63.00 |
$62.50
|
|
Dna probe chlamydia
|
$260.40 |
$260.40 |
$260.40 |
$82.20
|
|
Dna trichomonas
|
$60.00 |
$60.00 |
$60.00 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$184.86 |
$184.86 |
$184.86 |
$99.10
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$430.50 |
$430.50 |
$430.50 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$67.56 |
$67.56 |
$67.56 |
$65.00
|
|
Dornase alfa non-comp unit
|
$634.14 |
$634.14 |
$634.14 |
$350.67
|
|
Dornhoffer fixed part w/window
|
$67,573.67 |
$67,573.67 |
$67,573.67 |
$34,278.00
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,036.92 |
$1,036.92 |
$1,036.92 |
$433.58
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,937.10 |
$1,937.10 |
$1,937.10 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$124.86 |
$124.86 |
$124.86 |
$84.33
|
|
Dpyd gene common variants
|
$423.60 |
$423.60 |
$423.60 |
$362.05
|
|
Drainage of kidney lesion
|
$1,843.20 |
$1,843.20 |
$1,843.20 |
$1,534.80
|
|
Drain blood from under nail 11740
|
$127.80 |
$127.80 |
$127.80 |
$173.21
|