|
Culture afb any source
|
$122.85 |
$122.85 |
$122.85 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$100.75 |
$100.75 |
$100.75 |
$73.00
|
|
Culture anaerobic except blood
|
$123.50 |
$123.50 |
$123.50 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$50.70 |
$50.70 |
$50.70 |
$49.40
|
|
Culture body fluid
|
$125.45 |
$125.45 |
$125.45 |
$111.15
|
|
Culture fungi definitive id mold
|
$87.10 |
$87.10 |
$87.10 |
$70.00
|
|
Culture fungi definitive id yeast
|
$87.10 |
$87.10 |
$87.10 |
$68.00
|
|
Culture fungi other (except blood)
|
$105.95 |
$105.95 |
$105.95 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$84.50 |
$84.50 |
$84.50 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$75.40 |
$75.40 |
$75.40 |
$79.00
|
|
Culture mycoplasma any source
|
$172.25 |
$172.25 |
$172.25 |
$94.00
|
|
Culture screening strep group a
|
$87.75 |
$87.75 |
$87.75 |
$76.00
|
|
Culture typing added method
|
$57.20 |
$57.20 |
$57.20 |
$31.00
|
|
Culture typing immunologic
|
$41.60 |
$41.60 |
$41.60 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$754.65 |
$754.65 |
$754.65 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$31.20 |
$31.20 |
$31.20 |
$100.20
|
|
Cv stress test/supervision only 93016
|
$81.90 |
$81.90 |
$81.90 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$105.95 |
$105.95 |
$105.95 |
$91.20
|
|
Cyclosporine 2 hour
|
$180.70 |
$180.70 |
$180.70 |
$126.10
|
|
Cystatin c
|
$92.30 |
$92.30 |
$92.30 |
$83.20
|
|
Cystic fibrosis cftr
|
$1,190.80 |
$1,190.80 |
$1,190.80 |
$1,041.95
|
|
Cystogram >= 3 views supervision & interpretation
|
$514.80 |
$514.80 |
$514.80 |
$487.04
|
|
Cytogenetics 25-99
|
$104.65 |
$104.65 |
$104.65 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$102.70 |
$102.70 |
$102.70 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$94.90 |
$94.90 |
$94.90 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$169.00 |
$169.00 |
$169.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$76.70 |
$76.70 |
$76.70 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$72.80 |
$72.80 |
$72.80 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$141.70 |
$141.70 |
$141.70 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$132.60 |
$132.60 |
$132.60 |
$129.90
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$149.50 |
$149.50 |
$149.50 |
$205.00
|
|
Cytopath smear oth prep screen & interp
|
$87.75 |
$87.75 |
$87.75 |
$95.00
|
|
Cytopath tbs c/v manual
|
$49.40 |
$49.40 |
$49.40 |
$57.94
|
|
Dalbavancin 500 mg intravenous solution
|
$4,741.39 |
$4,741.39 |
$4,741.39 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$146.25 |
$146.25 |
$146.25 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,062.71 |
$2,062.71 |
$2,062.71 |
$4,542.99
|
|
D&c after delivery 59160
|
$119.60 |
$119.60 |
$119.60 |
$3,441.98
|
|
Dch validity tests
|
$22.10 |
$22.10 |
$22.10 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$93.60 |
$93.60 |
$93.60 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$286.00 |
$286.00 |
$286.00 |
$313.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,101.10 |
$1,101.10 |
$1,101.10 |
$1,101.10
|
|
Decalcification
|
$73.45 |
$73.45 |
$73.45 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$323.70 |
$323.70 |
$323.70 |
$482.35
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$147.55 |
$147.55 |
$147.55 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$5,656.70 |
$5,656.70 |
$5,656.70 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$360.10 |
$360.10 |
$360.10 |
$460.50
|
|
Destroy premlg lesns;1st lesn 17000
|
$133.25 |
$133.25 |
$133.25 |
$199.50
|
|
Destruct ben lesion 15/> 17111
|
$175.50 |
$175.50 |
$175.50 |
$250.20
|
|
Destruction 2-14 lesions 17003
|
$146.25 |
$146.25 |
$146.25 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$193.70 |
$193.70 |
$193.70 |
$231.52
|
|
Destruction premal lesions 15/> 17004
|
$259.35 |
$259.35 |
$259.35 |
$442.61
|
|
Dexamethasone 4 mg tablet
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.62 |
$14.62 |
$14.62 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$42.25 |
$42.25 |
$42.25 |
$37.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$42.25 |
$42.25 |
$42.25 |
$48.56
|
|
Dhea-s (dehydroepiand sulfate)
|
$109.20 |
$109.20 |
$109.20 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$84.50 |
$84.50 |
$84.50 |
$70.00
|
|
Diab manage trn ind/group
|
$48.75 |
$48.75 |
$48.75 |
$56.55
|
|
Dialysis one evaluation
|
$720.20 |
$720.20 |
$720.20 |
$920.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$15.04 |
$15.04 |
$15.04 |
$42.12
|
|
Dicyclomine injection
|
$59.08 |
$59.08 |
$59.08 |
$153.53
|
|
Digital analysis of eeg
|
$432.90 |
$432.90 |
$432.90 |
$649.63
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.29 |
$7.29 |
$7.29 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$80.60 |
$80.60 |
$80.60 |
$92.95
|
|
Diltiazem 5 mg/ml intravenous solution
|
$7.15 |
$7.15 |
$7.15 |
$49.92
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$9.29
|
|
Disaccharidases
|
$21.45 |
$21.45 |
$21.45 |
$224.58
|
|
Dna antibody native/double stranded
|
$104.00 |
$104.00 |
$104.00 |
$101.40
|
|
Dna gardnerella
|
$70.85 |
$70.85 |
$70.85 |
$67.68
|
|
Dna probe gc
|
$89.05 |
$89.05 |
$89.05 |
$88.67
|
|
Dna trichomonas
|
$75.40 |
$75.40 |
$75.40 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$109.69 |
$109.69 |
$109.69 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$69.47 |
$69.47 |
$69.47 |
$60.21
|
|
Doppler echo complete
|
$510.90 |
$510.90 |
$510.90 |
$517.94
|
|
Doppler intravascular pressure flow initial vessel
|
$2,646.15 |
$2,646.15 |
$2,646.15 |
$3,026.62
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$628.55 |
$628.55 |
$628.55 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$326.95 |
$326.95 |
$326.95 |
$463.20
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$78.00 |
$78.00 |
$78.00 |
$81.30
|
|
Drainage external ear complex 69005
|
$410.80 |
$410.80 |
$410.80 |
$3,016.11
|
|
Drainage external ear simple 69000
|
$341.90 |
$341.90 |
$341.90 |
$800.00
|
|
Drainage mouth roof lesion
|
$360.75 |
$360.75 |
$360.75 |
$408.80
|
|
Drain blood from under nail 11740
|
$79.30 |
$79.30 |
$79.30 |
$173.21
|
|
Drain finger abscess;simple 26010
|
$440.05 |
$440.05 |
$440.05 |
$451.20
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$291.20 |
$291.20 |
$291.20 |
$387.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$180.05 |
$180.05 |
$180.05 |
$353.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$364.00 |
$364.00 |
$364.00 |
$515.00
|
|
Drng of eyelid abscess 67700
|
$382.20 |
$382.20 |
$382.20 |
$718.05
|
|
Drng of finger abscess comp 26011
|
$731.25 |
$731.25 |
$731.25 |
$1,908.09
|
|
Droperidol 2.5 mg/ml injection solution
|
$51.82 |
$51.82 |
$51.82 |
$32.82
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$37.05 |
$37.05 |
$37.05 |
$57.00
|
|
Drug assay caffeine
|
$110.50 |
$110.50 |
$110.50 |
$89.17
|
|
Drug assay posaconazole
|
$143.65 |
$143.65 |
$143.65 |
$96.75
|
|
Drug assay voriconazole
|
$102.70 |
$102.70 |
$102.70 |
$96.75
|
|
Drug test prsmv instrmnt
|
$98.80 |
$98.80 |
$98.80 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$236.60 |
$236.60 |
$236.60 |
$278.85
|
|
Drvvt confirm - quest
|
$111.80 |
$111.80 |
$111.80 |
$108.55
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$454.35 |
$454.35 |
$454.35 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$702.00 |
$702.00 |
$702.00 |
$852.57
|
|
Ear irrigation 69209
|
$111.80 |
$111.80 |
$111.80 |
$152.50
|
