|
Culture mycoplasma any source
|
$109.20 |
$109.20 |
$109.20 |
$83.21
|
|
Culture screening strep group a
|
$74.40 |
$74.40 |
$74.40 |
$84.60
|
|
Culture typing immunologic
|
$33.00 |
$33.00 |
$33.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$357.00 |
$357.00 |
$357.00 |
$140.80
|
|
Culture urine each isolate
|
$60.60 |
$60.60 |
$60.60 |
$55.50
|
|
Cutter lead
|
$814.20 |
$814.20 |
$814.20 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$21.40 |
$21.40 |
$21.40 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$129.60 |
$129.60 |
$129.60 |
$72.36
|
|
Cyclosporine 2 hour
|
$114.60 |
$114.60 |
$114.60 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$54.00 |
$54.00 |
$54.00 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$58.20 |
$58.20 |
$58.20 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$25,417.80 |
$25,417.80 |
$25,417.80 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$1,017.60 |
$1,017.60 |
$1,017.60 |
$524.00
|
|
Cyp2c9 gene com variants
|
$1,870.20 |
$1,870.20 |
$1,870.20 |
$275.10
|
|
Cyp2d6 gene com variants
|
$269.40 |
$269.40 |
$269.40 |
$570.70
|
|
Cyp3a4 gene common variants
|
$438.60 |
$438.60 |
$438.60 |
$241.24
|
|
Cyp3a5 gene common variants
|
$438.60 |
$438.60 |
$438.60 |
$245.31
|
|
Cystatin c
|
$130.20 |
$130.20 |
$130.20 |
$77.60
|
|
Cystine urine quantitative
|
$108.60 |
$108.60 |
$108.60 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$340.20 |
$340.20 |
$340.20 |
$586.95
|
|
Cystoscopy and treatment
|
$3,255.60 |
$3,255.60 |
$3,255.60 |
$2,867.70
|
|
Cystoscopy prostatic imp 1-3
|
$6,010.20 |
$6,010.20 |
$6,010.20 |
$5,741.40
|
|
Cystoscopy & ureter catheter
|
$3,178.80 |
$3,178.80 |
$3,178.80 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$5,115.00 |
$5,115.00 |
$5,115.00 |
$4,129.45
|
|
Cytogenetics 25-99
|
$357.60 |
$357.60 |
$357.60 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$2,198.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$80.40 |
$80.40 |
$80.40 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$142.20 |
$142.20 |
$142.20 |
$100.00
|
|
Cyto/molecular report
|
$32.40 |
$32.40 |
$32.40 |
$144.75
|
|
Cytopath c/v manual
|
$30.60 |
$30.60 |
$30.60 |
$36.80
|
|
Cytopath fl nongyn filter
|
$57.00 |
$57.00 |
$57.00 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$355.80 |
$355.80 |
$355.80 |
$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
|
$52.80 |
$52.80 |
$52.80 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$85.20 |
$85.20 |
$85.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$39.60 |
$39.60 |
$39.60 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$109.20 |
$109.20 |
$109.20 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$265.20 |
$265.20 |
$265.20 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$49.20 |
$49.20 |
$49.20 |
$96.20
|
|
Cytopath tbs c/v manual
|
$30.60 |
$30.60 |
$30.60 |
$59.28
|
|
Dacarbazine 100 mg intravenous solution
|
$115.20 |
$115.20 |
$115.20 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$51.00 |
$51.00 |
$51.00 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$997.80 |
$997.80 |
$997.80 |
$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
|
$29.40 |
$29.40 |
$29.40 |
$6,281.29
|
|
Dch pulmonary stress test
|
$741.60 |
$741.60 |
$741.60 |
$963.30
|
|
Dch validity tests
|
$39.00 |
$39.00 |
$39.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$100.20 |
$100.20 |
$100.20 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$449.40 |
$449.40 |
$449.40 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$316.20 |
$316.20 |
$316.20 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,214.00 |
$2,214.00 |
$2,214.00 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$811.20 |
$811.20 |
$811.20 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$811.20 |
$811.20 |
$811.20 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,380.80 |
$2,380.80 |
$2,380.80 |
$835.20
|
|
Debride nail1-5 11720
|
$231.00 |
$231.00 |
$231.00 |
$149.60
|
|
Debride nail6 or more 11721
|
$265.80 |
$265.80 |
$265.80 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$811.20 |
$811.20 |
$811.20 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$3,774.00 |
$3,774.00 |
$3,774.00 |
$1,149.50
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,537.40 |
$2,537.40 |
$2,537.40 |
$1,165.50
|
|
Decalcification
|
$134.40 |
$134.40 |
$134.40 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$131.40 |
$131.40 |
$131.40 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$421.80 |
$421.80 |
$421.80 |
$572.95
|
|
Delivery of placenta 59414
|
$2,561.40 |
$2,561.40 |
$2,561.40 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$158.40 |
$158.40 |
$158.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,551.40 |
$3,551.40 |
$3,551.40 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,696.20 |
$1,696.20 |
$1,696.20 |
$401.60
|
|
Design mlc device for imrt
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$39.80 |
$39.80 |
$39.80 |
$91.84
|
|
Desoxycorticosterone
|
$253.80 |
$253.80 |
$253.80 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$2,396.40 |
$2,396.40 |
$2,396.40 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$2,396.40 |
$2,396.40 |
$2,396.40 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$732.60 |
$732.60 |
$732.60 |
$240.24
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,267.40 |
$2,267.40 |
$2,267.40 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,267.40 |
$2,267.40 |
$2,267.40 |
$3,296.80
|
|
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
|
|
Device sut capio slim opn
|
$1,431.60 |
$1,431.60 |
$1,431.60 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,842.20 |
$2,842.20 |
$2,842.20 |
$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
|
$505.60 |
$505.60 |
$505.60 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$9.00 |
$9.00 |
$9.00 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$10.20 |
$10.20 |
$10.20 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$75.80 |
$75.80 |
$75.80 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$84.80 |
$84.80 |
$84.80 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$55.40 |
$55.40 |
$55.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$71.80 |
$71.80 |
$71.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$304.80 |
$304.80 |
$304.80 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$64.20 |
$64.20 |
$64.20 |
$79.30
|
|
Diab manage trn ind/group
|
$93.00 |
$93.00 |
$93.00 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$373.20 |
$373.20 |
$373.20 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$749.40 |
$749.40 |
$749.40 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$591.00 |
$591.00 |
$591.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$537.60 |
$537.60 |
$537.60 |
$314.00
|
|
Dialysis one evaluation
|
$2,317.80 |
$2,317.80 |
$2,317.80 |
$936.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$91.80 |
$91.80 |
$91.80 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$11.40 |
$11.40 |
$11.40 |
$79.71
|
|
Dicyclomine injection
|
$159.20 |
$159.20 |
$159.20 |
$154.33
|
