|
CT scan for therapy guide
|
$360.75 |
$360.75 |
$360.75 |
$656.13
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,216.01 |
$1,216.01 |
$1,216.01 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,187.61 |
$1,187.61 |
$1,187.61 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$920.93 |
$920.93 |
$920.93 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$859.79 |
$859.79 |
$859.79 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$843.69 |
$843.69 |
$843.69 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$952.66 |
$952.66 |
$952.66 |
$418.50
|
|
CT t-spine w /wo contrast
|
$715.30 |
$715.30 |
$715.30 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$1,771.19 |
$1,771.19 |
$1,771.19 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$1,587.30 |
$1,587.30 |
$1,587.30 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,476.49 |
$1,476.49 |
$1,476.49 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$27.38 |
$27.38 |
$27.38 |
$61.03
|
|
Culture afb any source
|
$51.34 |
$51.34 |
$51.34 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$35.34 |
$35.34 |
$35.34 |
$73.00
|
|
Culture anaerobic except blood
|
$65.49 |
$65.49 |
$65.49 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$19.43 |
$19.43 |
$19.43 |
$49.40
|
|
Culture body fluid
|
$60.22 |
$60.22 |
$60.22 |
$111.15
|
|
Culture fungi definitive id mold
|
$27.10 |
$27.10 |
$27.10 |
$70.00
|
|
Culture fungi definitive id yeast
|
$41.90 |
$41.90 |
$41.90 |
$68.00
|
|
Culture fungi other (except blood)
|
$45.51 |
$45.51 |
$45.51 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$36.45 |
$36.45 |
$36.45 |
$74.75
|
|
Culture mycoplasma any source
|
$90.37 |
$90.37 |
$90.37 |
$94.00
|
|
Culture screening strep group a
|
$43.29 |
$43.29 |
$43.29 |
$76.00
|
|
Culture typing immunologic
|
$29.32 |
$29.32 |
$29.32 |
$38.58
|
|
Culture urine each isolate
|
$17.48 |
$17.48 |
$17.48 |
$44.80
|
|
Curette/treat cornea
|
$1,317.39 |
$1,317.39 |
$1,317.39 |
$1,175.85
|
|
Cv line/pic reposition
|
$1,516.26 |
$1,516.26 |
$1,516.26 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.71 |
$9.71 |
$9.71 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$65.68 |
$65.68 |
$65.68 |
$91.20
|
|
Cyclophosphamide 25 mg capsule
|
$22.40 |
$22.40 |
$22.40 |
$22.51
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$75.74 |
$75.74 |
$75.74 |
$179.92
|
|
Cyclosporine 2 hour
|
$87.88 |
$87.88 |
$87.88 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$1.30 |
$1.30 |
$1.30 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$263.81 |
$263.81 |
$263.81 |
$19.50
|
|
Cyp2c19 gene com variants
|
$657.12 |
$657.12 |
$657.12 |
$583.20
|
|
Cyp2c9 gene com variants
|
$318.85 |
$318.85 |
$318.85 |
$287.82
|
|
Cystatin c
|
$71.23 |
$71.23 |
$71.23 |
$83.20
|
|
Cystic fibrosis cftr
|
$184.63 |
$184.63 |
$184.63 |
$1,041.95
|
|
Cystine urine quantitative
|
$94.26 |
$94.26 |
$94.26 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$265.85 |
$265.85 |
$265.85 |
$487.04
|
|
Cystoscopy and biopsy
|
$4,057.88 |
$4,057.88 |
$4,057.88 |
$3,769.31
|
|
Cystoscopy (Bladder Scope)
|
$605.78 |
$605.78 |
$605.78 |
$1,633.60
|
|
Cystoscopy removal of clots
|
$1,528.84 |
$1,528.84 |
$1,528.84 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$1,757.59 |
$1,757.59 |
$1,757.59 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$976.15 |
$976.15 |
$976.15 |
$3,276.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$999.19 |
$999.19 |
$999.19 |
$2,874.36
|
|
Cysto w/ureter stricture tx
|
$2,708.31 |
$2,708.31 |
$2,708.31 |
$4,074.86
|
|
Cytarabine 20 mg/ml injection solution
|
$28.25 |
$28.25 |
$28.25 |
$59.31
|
|
Cytogenom microarray copy nmbr var
|
$629.65 |
$629.65 |
$629.65 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$49.03 |
$49.03 |
$49.03 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$49.40 |
$49.40 |
$49.40 |
$95.00
|
|
Cytomegalovirus imm IV /vial
|
$941.58 |
$941.58 |
$941.58 |
$2,635.28
|
|
Cyto/molecular report
|
$235.90 |
$235.90 |
$235.90 |
$91.65
|
|
Cytopathology cellular enhancement technique non-gyn
|
$47.64 |
$47.64 |
$47.64 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$48.56 |
$48.56 |
$48.56 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$40.70 |
$40.70 |
$40.70 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$27.29 |
$27.29 |
$27.29 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$26.92 |
$26.92 |
$26.92 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$73.26 |
$73.26 |
$73.26 |
$205.00
|
|
Cytopath smear other source
|
$41.07 |
$41.07 |
$41.07 |
$88.13
|
|
Cytopath smear other source
|
$55.50 |
$55.50 |
$55.50 |
$145.31
|
|
Cytopath smear oth prep screen & interp
|
$32.75 |
$32.75 |
$32.75 |
$95.00
|
|
Cytotoxic antibody screening
|
$184.63 |
$184.63 |
$184.63 |
$184.63
|
|
Dacarbazine 100 mg intravenous solution
|
$29.80 |
$29.80 |
$29.80 |
$39.53
|
|
Dactinomycin 0.5 mg intravenous solution
|
$803.44 |
$803.44 |
$803.44 |
$1,225.86
|
|
Dalbavancin 500 mg intravenous solution
|
$2,077.81 |
$2,077.81 |
$2,077.81 |
$3,480.61
|
|
Dalteparin sodium
|
$55.19 |
$55.19 |
$55.19 |
$55.19
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.58 |
$0.58 |
$0.58 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$556.33 |
$556.33 |
$556.33 |
$4,542.99
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$11,312.75 |
$11,312.75 |
$11,312.75 |
$14,514.57
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$130.13 |
$130.13 |
$130.13 |
$130.13
|
|
D&c after delivery 59160
|
$3,273.85 |
$3,273.85 |
$3,273.85 |
$3,441.98
|
|
Dch pulmonary stress test
|
$246.61 |
$246.61 |
$246.61 |
$964.41
|
|
Dch validity tests
|
$18.59 |
$18.59 |
$18.59 |
$25.00
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$555.65 |
$555.65 |
$555.65 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$186.76 |
$186.76 |
$186.76 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$363.80 |
$363.80 |
$363.80 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,283.44 |
$1,283.44 |
$1,283.44 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$406.35 |
$406.35 |
$406.35 |
$779.35
|
|
Debride nail1-5 11720
|
$110.35 |
$110.35 |
$110.35 |
$186.88
|
|
Debride nail6 or more 11721
|
$64.84 |
$64.84 |
$64.84 |
$200.21
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$567.77 |
$567.77 |
$567.77 |
$1,206.20
|
|
Debride skin bone at fx site
|
$2,379.93 |
$2,379.93 |
$2,379.93 |
$3,127.88
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$363.80 |
$363.80 |
$363.80 |
$728.40
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$847.49 |
$847.49 |
$847.49 |
$1,146.60
|
|
Debr inf skin add-on 11001
|
$280.00 |
$280.00 |
$280.00 |
$106.86
|
|
Debr musc/fascia 20sq cm/< 11043
|
$381.66 |
$381.66 |
$381.66 |
$1,101.10
|
|
Decalcification
|
$7.31 |
$7.31 |
$7.31 |
$72.15
|
|
Decitabine 50 mg intravenous solution
|
$81.81 |
$81.81 |
$81.81 |
$225.55
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$165.58 |
$165.58 |
$165.58 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$23.75 |
$23.75 |
$23.75 |
$47.62
|
|
Degarelix 120 mg subcutaneous solution
|
$30.47 |
$30.47 |
$30.47 |
$2,303.24
|
|
Delivery of placenta 59414
|
$1,017.13 |
$1,017.13 |
$1,017.13 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$85.56 |
$85.56 |
$85.56 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,257.70 |
$2,257.70 |
$2,257.70 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$105.64 |
$105.64 |
$105.64 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$17.80 |
$17.80 |
$17.80 |
$337.07
|
|
Dermagraft
|
$67.62 |
$67.62 |
$67.62 |
$100.50
|
|
Design mlc device for imrt
|
$1,282.33 |
$1,282.33 |
$1,282.33 |
$1,677.86
|
