|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$101.60 |
$101.60 |
$101.60 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$193.20 |
$193.20 |
$193.20 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2.40 |
$2.40 |
$2.40 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$20.20 |
$20.20 |
$20.20 |
$19.49
|
|
Cyclosporine 2 hour
|
$180.00 |
$180.00 |
$180.00 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$20.80 |
$20.80 |
$20.80 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$92.80 |
$92.80 |
$92.80 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$37,825.20 |
$37,825.20 |
$37,825.20 |
$24,728.89
|
|
Cyp2c9 gene com variants
|
$1,870.20 |
$1,870.20 |
$1,870.20 |
$275.10
|
|
Cyp2d6 gene com variants
|
$278.40 |
$278.40 |
$278.40 |
$570.70
|
|
Cystatin c
|
$205.80 |
$205.80 |
$205.80 |
$77.60
|
|
Cystic fibrosis cftr
|
$3,002.40 |
$3,002.40 |
$3,002.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$94.20 |
$94.20 |
$94.20 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$245.40 |
$245.40 |
$245.40 |
$586.95
|
|
Cystoscopy and treatment
|
$4,356.00 |
$4,356.00 |
$4,356.00 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$2,752.20 |
$2,752.20 |
$2,752.20 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$3,942.60 |
$3,942.60 |
$3,942.60 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$5,943.60 |
$5,943.60 |
$5,943.60 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$4,234.20 |
$4,234.20 |
$4,234.20 |
$3,245.90
|
|
Cytarabine 20 mg/ml injection solution
|
$189.00 |
$189.00 |
$189.00 |
$90.00
|
|
Cytogenetics 25-99
|
$420.60 |
$420.60 |
$420.60 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,364.40 |
$1,364.40 |
$1,364.40 |
$2,198.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$261.00 |
$261.00 |
$261.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$268.20 |
$268.20 |
$268.20 |
$100.00
|
|
Cyto/molecular report
|
$420.60 |
$420.60 |
$420.60 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$375.00 |
$375.00 |
$375.00 |
$159.90
|
|
Cytopathology concentration technique smears & interpretation
|
$153.00 |
$153.00 |
$153.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$106.20 |
$106.20 |
$106.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$66.60 |
$66.60 |
$66.60 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$148.20 |
$148.20 |
$148.20 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$288.00 |
$288.00 |
$288.00 |
$213.85
|
|
Dacarbazine 100 mg intravenous solution
|
$145.60 |
$145.60 |
$145.60 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$68.20 |
$68.20 |
$68.20 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,138.80 |
$1,138.80 |
$1,138.80 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$112.20 |
$112.20 |
$112.20 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$6,281.29
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$534.00 |
$534.00 |
$534.00 |
$20,196.00
|
|
Dch validity tests
|
$19.80 |
$19.80 |
$19.80 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$98.40 |
$98.40 |
$98.40 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$624.00 |
$624.00 |
$624.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$451.20 |
$451.20 |
$451.20 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$3,124.80 |
$3,124.80 |
$3,124.80 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,602.60 |
$1,602.60 |
$1,602.60 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,133.00 |
$2,133.00 |
$2,133.00 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$3,124.80 |
$3,124.80 |
$3,124.80 |
$835.20
|
|
Debride nail1-5 11720
|
$379.20 |
$379.20 |
$379.20 |
$149.60
|
|
Debride nail6 or more 11721
|
$476.40 |
$476.40 |
$476.40 |
$169.80
|
|
Debride skin bone at fx site
|
$7,701.60 |
$7,701.60 |
$7,701.60 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,602.60 |
$1,602.60 |
$1,602.60 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,956.60 |
$1,956.60 |
$1,956.60 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$3,123.00 |
$3,123.00 |
$3,123.00 |
$1,165.50
|
|
Decalcification
|
$272.40 |
$272.40 |
$272.40 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$184.80 |
$184.80 |
$184.80 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$294.60 |
$294.60 |
$294.60 |
$572.95
|
|
Degarelix 120 mg subcutaneous solution
|
$27.60 |
$27.60 |
$27.60 |
$1,856.85
|
|
Delivery of placenta 59414
|
$1,687.80 |
$1,687.80 |
$1,687.80 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$5,322.00 |
$5,322.00 |
$5,322.00 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$661.80 |
$661.80 |
$661.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,027.00 |
$3,027.00 |
$3,027.00 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$2,337.60 |
$2,337.60 |
$2,337.60 |
$401.60
|
|
Dermagraft
|
$147.00 |
$147.00 |
$147.00 |
$85.00
|
|
Descend thora aorta rpr/lt sub art 33880
|
$6,715.80 |
$6,715.80 |
$6,715.80 |
$6,288.45
|
|
Desmopressin 4 mcg/ml injection solution
|
$85.60 |
$85.60 |
$85.60 |
$91.84
|
|
Desoxycorticosterone
|
$505.80 |
$505.80 |
$505.80 |
$109.28
|
|
Destruction benign lesions < 14 lesions
|
$714.00 |
$714.00 |
$714.00 |
$240.24
|
|
Device intraute mirena
|
$3,239.20 |
$3,239.20 |
$3,239.20 |
$2,125.00
|
|
Device sut capio slim opn
|
$2,653.20 |
$2,653.20 |
$2,653.20 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$3,130.20 |
$3,130.20 |
$3,130.20 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$121.20 |
$121.20 |
$121.20 |
$227.25
|
|
Dexametha opth insert 0.1 mg
|
$528.00 |
$528.00 |
$528.00 |
$888.47
|
|
Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr
|
$1,665.00 |
$1,665.00 |
$1,665.00 |
$21.00
|
|
Dexamethasone 4 mg tablet
|
$20.40 |
$20.40 |
$20.40 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$12.80 |
$12.80 |
$12.80 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,746.00 |
$1,746.00 |
$1,746.00 |
$884.80
|
|
Dextran 40 infusion
|
$680.80 |
$680.80 |
$680.80 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$143.40 |
$143.40 |
$143.40 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$107.20 |
$107.20 |
$107.20 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$136.80 |
$136.80 |
$136.80 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$96.00 |
$96.00 |
$96.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$325.20 |
$325.20 |
$325.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$125.40 |
$125.40 |
$125.40 |
$79.30
|
|
Diab manage trn ind/group
|
$93.00 |
$93.00 |
$93.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$384.60 |
$384.60 |
$384.60 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$856.20 |
$856.20 |
$856.20 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$612.00 |
$612.00 |
$612.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$478.80 |
$478.80 |
$478.80 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$37.20 |
$37.20 |
$37.20 |
$79.71
|
|
Dicyclomine injection
|
$496.00 |
$496.00 |
$496.00 |
$154.33
|
|
Diffusing capacity
|
$298.80 |
$298.80 |
$298.80 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$78.40 |
$78.40 |
$78.40 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,528.80 |
$11,528.80 |
$11,528.80 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$181.80 |
$181.80 |
$181.80 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$574.40 |
$574.40 |
$574.40 |
$297.86
|
|
Dilate ic vasospasm ea add vsl same territory
|
$2,145.00 |
$2,145.00 |
$2,145.00 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$6,317.40 |
$6,317.40 |
$6,317.40 |
$5,151.95
|
|
Dilator fascial 10fx20cm
|
$415.20 |
$415.20 |
$415.20 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$2,365.80 |
$2,365.80 |
$2,365.80 |
$3,900.60
|
|
Dimenhydrinate injection
|
$14.40 |
$14.40 |
$14.40 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$9.60 |
$9.60 |
$9.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$84.80 |
$84.80 |
$84.80 |
$18.32
|
