|
Culture bact stool aero addl path ea
|
$30.00 |
$30.00 |
$30.00 |
$52.50
|
|
Culture body fluid
|
$66.60 |
$66.60 |
$66.60 |
$126.75
|
|
Culture fungi definitive id yeast
|
$83.40 |
$83.40 |
$83.40 |
$80.00
|
|
Culture fungi other (except blood)
|
$58.80 |
$58.80 |
$58.80 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$66.60 |
$66.60 |
$66.60 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$205.80 |
$205.80 |
$205.80 |
$100.00
|
|
Culture mycoplasma any source
|
$186.60 |
$186.60 |
$186.60 |
$83.21
|
|
Culture screening strep group a
|
$78.60 |
$78.60 |
$78.60 |
$84.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$585.60 |
$585.60 |
$585.60 |
$140.80
|
|
Culture urine each isolate
|
$58.80 |
$58.80 |
$58.80 |
$55.50
|
|
Cutter lead
|
$288.60 |
$288.60 |
$288.60 |
$6,581.45
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$6.60 |
$6.60 |
$6.60 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$100.20 |
$100.20 |
$100.20 |
$72.36
|
|
Cyclosporine 2 hour
|
$100.20 |
$100.20 |
$100.20 |
$130.40
|
|
Cyclosporine oral 100 mg
|
$50.60 |
$50.60 |
$50.60 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$12,048.60 |
$12,048.60 |
$12,048.60 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$1,267.80 |
$1,267.80 |
$1,267.80 |
$524.00
|
|
Cyp2c9 gene com variants
|
$1,564.80 |
$1,564.80 |
$1,564.80 |
$275.10
|
|
Cyp2d6 gene com variants
|
$269.40 |
$269.40 |
$269.40 |
$570.70
|
|
Cystatin c
|
$78.60 |
$78.60 |
$78.60 |
$77.60
|
|
Cystine urine quantitative
|
$213.00 |
$213.00 |
$213.00 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$288.60 |
$288.60 |
$288.60 |
$586.95
|
|
Cystoscopy and treatment
|
$5,239.20 |
$5,239.20 |
$5,239.20 |
$2,867.70
|
|
Cystoscopy & ureter catheter
|
$5,026.80 |
$5,026.80 |
$5,026.80 |
$3,728.50
|
|
Cystourethroscop/calib/dilat stric 52281
|
$5,175.60 |
$5,175.60 |
$5,175.60 |
$3,245.90
|
|
Cytogenomic neo microra alys
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$2,198.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$91.20 |
$91.20 |
$91.20 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$83.40 |
$83.40 |
$83.40 |
$100.00
|
|
Cyto/molecular report
|
$23.40 |
$23.40 |
$23.40 |
$144.75
|
|
Cytopath c/v manual
|
$30.60 |
$30.60 |
$30.60 |
$36.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$591.60 |
$591.60 |
$591.60 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$78.00 |
$78.00 |
$78.00 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$61.20 |
$61.20 |
$61.20 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$100.20 |
$100.20 |
$100.20 |
$135.20
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$80.40 |
$80.40 |
$80.40 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$56.40 |
$56.40 |
$56.40 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$145.80 |
$145.80 |
$145.80 |
$213.85
|
|
Cytopath smear other source
|
$41.40 |
$41.40 |
$41.40 |
$92.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,282.20 |
$1,282.20 |
$1,282.20 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$109.20 |
$109.20 |
$109.20 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$43.40 |
$43.40 |
$43.40 |
$6,281.29
|
|
Dch validity tests
|
$37.20 |
$37.20 |
$37.20 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$100.20 |
$100.20 |
$100.20 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$640.80 |
$640.80 |
$640.80 |
$668.55
|
|
Debridement bone <= 20 sq cm
|
$4,799.40 |
$4,799.40 |
$4,799.40 |
$2,320.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,523.60 |
$2,523.60 |
$2,523.60 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,821.00 |
$1,821.00 |
$1,821.00 |
$835.20
|
|
Debride nail1-5 11720
|
$330.00 |
$330.00 |
$330.00 |
$149.60
|
|
Debride nail6 or more 11721
|
$441.60 |
$441.60 |
$441.60 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,456.20 |
$1,456.20 |
$1,456.20 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$5,263.20 |
$5,263.20 |
$5,263.20 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$4,799.40 |
$4,799.40 |
$4,799.40 |
$1,165.50
|
|
Decalcification
|
$83.40 |
$83.40 |
$83.40 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$393.60 |
$393.60 |
$393.60 |
$572.95
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$75.00 |
$75.00 |
$75.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,649.00 |
$2,649.00 |
$2,649.00 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$765.60 |
$765.60 |
$765.60 |
$91.84
|
|
Destruct cut vasl lesions <10cm 17106
|
$2,313.60 |
$2,313.60 |
$2,313.60 |
$666.75
|
|
Device ablt adv novasure
|
$4,507.20 |
$4,507.20 |
$4,507.20 |
$6,237.48
|
|
Device intraute mirena
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,125.00
|
|
Dexametha opth insert 0.1 mg
|
$505.60 |
$505.60 |
$505.60 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$1.20 |
$1.20 |
$1.20 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$5.00 |
$5.00 |
$5.00 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$60.00 |
$60.00 |
$60.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$90.40 |
$90.40 |
$90.40 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$62.00 |
$62.00 |
$62.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$76.20 |
$76.20 |
$76.20 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$100.20 |
$100.20 |
$100.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$66.60 |
$66.60 |
$66.60 |
$79.30
|
|
Diab manage trn ind/group
|
$93.00 |
$93.00 |
$93.00 |
$54.99
|
|
Diagnostic Mammogram (both breasts)
|
$609.00 |
$609.00 |
$609.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$502.20 |
$502.20 |
$502.20 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$31.20 |
$31.20 |
$31.20 |
$79.71
|
|
Diffusing capacity
|
$190.20 |
$190.20 |
$190.20 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$12.80 |
$12.80 |
$12.80 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,954.60 |
$3,954.60 |
$3,954.60 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$75.00 |
$75.00 |
$75.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$221.60 |
$221.60 |
$221.60 |
$297.86
|
|
Dilator fascial 10fx20cm
|
$57.00 |
$57.00 |
$57.00 |
$402.10
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$9.60 |
$9.60 |
$9.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$9.20 |
$9.20 |
$9.20 |
$18.32
|
|
Disaccharidases
|
$330.00 |
$330.00 |
$330.00 |
$230.40
|
|
Dna antibody native/double stranded
|
$75.00 |
$75.00 |
$75.00 |
$100.00
|
|
Dna gardnerella
|
$370.20 |
$370.20 |
$370.20 |
$61.83
|
|
Dna trichomonas
|
$385.20 |
$385.20 |
$385.20 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$118.20 |
$118.20 |
$118.20 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$31.20 |
$31.20 |
$31.20 |
$65.40
|
|
Doppler echo complete
|
$383.40 |
$383.40 |
$383.40 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$354.00 |
$354.00 |
$354.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$327.00 |
$327.00 |
$327.00 |
$481.65
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$565.80 |
$565.80 |
$565.80 |
$23,613.78
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$942.60 |
$942.60 |
$942.60 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$0.20 |
$0.20 |
$0.20 |
$89.34
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$897.00 |
$897.00 |
$897.00 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$1,383.60 |
$1,383.60 |
$1,383.60 |
$964.00
|
|
Drainage external ear simple 69000
|
$1,371.00 |
$1,371.00 |
$1,371.00 |
$790.40
|
|
Drainage of nose lesion int 30000
|
$11,524.20 |
$11,524.20 |
$11,524.20 |
$548.00
|
|
Drainage of urethra abscess 53060
|
$2,202.00 |
$2,202.00 |
$2,202.00 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$210.00 |
$210.00 |
$210.00 |
$182.40
|
