|
Cystine urine quantitative
|
$116.40 |
$116.40 |
$116.40 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$896.40 |
$896.40 |
$896.40 |
$586.95
|
|
Cystoscopy and treatment
|
$784.80 |
$784.80 |
$784.80 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$1,815.60 |
$1,815.60 |
$1,815.60 |
$1,493.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$4,129.45
|
|
Cystouretero & or pyeloscope
|
$4,730.40 |
$4,730.40 |
$4,730.40 |
$4,315.98
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,428.80 |
$2,428.80 |
$2,428.80 |
$3,245.90
|
|
Cytarabine 20 mg/ml injection solution
|
$0.60 |
$0.60 |
$0.60 |
$90.00
|
|
Cytogenetics 25-99
|
$136.80 |
$136.80 |
$136.80 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$81.00 |
$81.00 |
$81.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$94.20 |
$94.20 |
$94.20 |
$100.00
|
|
Cyto/molecular report
|
$57.60 |
$57.60 |
$57.60 |
$144.75
|
|
Cytopath c/v index add-on
|
$34.20 |
$34.20 |
$34.20 |
$34.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$116.40 |
$116.40 |
$116.40 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$64.20 |
$64.20 |
$64.20 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$48.60 |
$48.60 |
$48.60 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$78.60 |
$78.60 |
$78.60 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$78.60 |
$78.60 |
$78.60 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$132.00 |
$132.00 |
$132.00 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$337.20 |
$337.20 |
$337.20 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$116.40 |
$116.40 |
$116.40 |
$213.85
|
|
Cytopath smear other source
|
$54.60 |
$54.60 |
$54.60 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$54.60 |
$54.60 |
$54.60 |
$96.20
|
|
Cytopath tbs c/v manual
|
$36.60 |
$36.60 |
$36.60 |
$59.28
|
|
Dacarbazine 100 mg intravenous solution
|
$19.20 |
$19.20 |
$19.20 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,624.80 |
$1,624.80 |
$1,624.80 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$1,067.40 |
$1,067.40 |
$1,067.40 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$267.00 |
$267.00 |
$267.00 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$387.60 |
$387.60 |
$387.60 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,322.00 |
$2,322.00 |
$2,322.00 |
$6,281.29
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$19.80 |
$19.80 |
$19.80 |
$259.58
|
|
Dch pulmonary stress test
|
$650.40 |
$650.40 |
$650.40 |
$963.30
|
|
Dch validity tests
|
$25.20 |
$25.20 |
$25.20 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$58.80 |
$58.80 |
$58.80 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,488.00 |
$1,488.00 |
$1,488.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$483.60 |
$483.60 |
$483.60 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,320.80 |
$2,320.80 |
$2,320.80 |
$2,320.80
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,580.40 |
$1,580.40 |
$1,580.40 |
$835.20
|
|
Debride nail1-5 11720
|
$232.20 |
$232.20 |
$232.20 |
$149.60
|
|
Debride skin bone at fx site
|
$3,515.40 |
$3,515.40 |
$3,515.40 |
$3,015.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$1,165.50
|
|
Decalcification
|
$124.80 |
$124.80 |
$124.80 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$1,026.60 |
$1,026.60 |
$1,026.60 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$740.40 |
$740.40 |
$740.40 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$20.40 |
$20.40 |
$20.40 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$457.20 |
$457.20 |
$457.20 |
$1,856.85
|
|
Delivery of placenta 59414
|
$3,786.60 |
$3,786.60 |
$3,786.60 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$8,864.40 |
$8,864.40 |
$8,864.40 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$325.80 |
$325.80 |
$325.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$1,127.40 |
$1,127.40 |
$1,127.40 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$734.40 |
$734.40 |
$734.40 |
$401.60
|
|
Design mlc device for imrt
|
$1,479.60 |
$1,479.60 |
$1,479.60 |
$1,753.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$49.20 |
$49.20 |
$49.20 |
$91.84
|
|
Desoxycorticosterone
|
$67.20 |
$67.20 |
$67.20 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$9,807.60 |
$9,807.60 |
$9,807.60 |
$5,267.20
|
|
Destroy cervthor facet jnt 64633
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$2,099.40 |
$2,099.40 |
$2,099.40 |
$1,441.44
|
|
Destroy internal hemorrhoids destroy 46930
|
$1,522.80 |
$1,522.80 |
$1,522.80 |
$1,395.28
|
|
Destroy premlg lesns;1st lesn 17000
|
$520.80 |
$520.80 |
$520.80 |
$202.40
|
|
Destruction 2-14 lesions 17003
|
$72.60 |
$72.60 |
$72.60 |
$78.61
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,224.80 |
$2,224.80 |
$2,224.80 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,908.20 |
$2,908.20 |
$2,908.20 |
$3,296.80
|
|
Destruction premal lesions 15/> 17004
|
$532.80 |
$532.80 |
$532.80 |
$442.61
|
|
Device intraute mirena
|
$693.60 |
$693.60 |
$693.60 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$188.40 |
$188.40 |
$188.40 |
$227.25
|
|
Dexametha opth insert 0.1 mg
|
$354.00 |
$354.00 |
$354.00 |
$888.47
|
|
Dexamethasone 4 mg tablet
|
$0.60 |
$0.60 |
$0.60 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$4.20 |
$4.20 |
$4.20 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$328.80 |
$328.80 |
$328.80 |
$884.80
|
|
Dhea-s (dehydroepiand sulfate)
|
$113.40 |
$113.40 |
$113.40 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$49.20 |
$49.20 |
$49.20 |
$79.30
|
|
Diab manage trn ind/group
|
$16.80 |
$16.80 |
$16.80 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$432.60 |
$432.60 |
$432.60 |
$195.50
|
|
Diagnostic laryngoscopy 31505
|
$432.60 |
$432.60 |
$432.60 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$956.40 |
$956.40 |
$956.40 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$310.20 |
$310.20 |
$310.20 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$243.60 |
$243.60 |
$243.60 |
$314.00
|
|
Diagnostic radio unlisted proc
|
$170.40 |
$170.40 |
$170.40 |
$259.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,160.60 |
$2,160.60 |
$2,160.60 |
$5,741.00
|
|
Dialysis one evaluation
|
$970.80 |
$970.80 |
$970.80 |
$936.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$9.60 |
$9.60 |
$9.60 |
$79.71
|
|
Dicyclomine injection
|
$25.20 |
$25.20 |
$25.20 |
$154.33
|
|
Diffusing capacity
|
$970.20 |
$970.20 |
$970.20 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$85.80 |
$85.80 |
$85.80 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$2,869.80 |
$2,869.80 |
$2,869.80 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$96.00 |
$96.00 |
$96.00 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$89.40 |
$89.40 |
$89.40 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$2,304.60 |
$2,304.60 |
$2,304.60 |
$1,866.73
|
|
Dilate ic vasospasm ea add vsl same territory
|
$1,257.00 |
$1,257.00 |
$1,257.00 |
$1,931.80
|
|
Dilate ic vasospasm init
|
$3,575.40 |
$3,575.40 |
$3,575.40 |
$5,151.95
|
|
Dilate urethra stricture
|
$534.00 |
$534.00 |
$534.00 |
$513.00
|
|
Dilat xst trc ndurlgc px
|
$9,487.80 |
$9,487.80 |
$9,487.80 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$11,311.20 |
$11,311.20 |
$11,311.20 |
$4,258.20
|
|
Diltiazem 5 mg/ml intravenous solution
|
$12.60 |
$12.60 |
$12.60 |
$45.60
|
|
Dimenhydrinate injection
|
$6.60 |
$6.60 |
$6.60 |
$30.48
|
|
Dimethyl sulfoxide 50% 50 ml
|
$7.80 |
$7.80 |
$7.80 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.60 |
$0.60 |
$0.60 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.80 |
$1.80 |
$1.80 |
$18.32
|
|
Disability dlco
|
$886.80 |
$886.80 |
$886.80 |
$293.76
|
|
Disaccharidases
|
$112.80 |
$112.80 |
$112.80 |
$230.40
|