|
CT upper extremity without contrast (both sides)
|
$649.11 |
$649.11 |
$649.11 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$741.72 |
$741.72 |
$741.72 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$91.35 |
$91.35 |
$91.35 |
$68.64
|
|
Culture afb any source
|
$23.94 |
$23.94 |
$23.94 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$125.16 |
$125.16 |
$125.16 |
$79.00
|
|
Culture anaerobic except blood
|
$125.16 |
$125.16 |
$125.16 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$127.05 |
$127.05 |
$127.05 |
$51.51
|
|
Culture body fluid
|
$125.16 |
$125.16 |
$125.16 |
$126.72
|
|
Culture fungi definitive id mold
|
$20.16 |
$20.16 |
$20.16 |
$76.72
|
|
Culture fungi definitive id yeast
|
$20.16 |
$20.16 |
$20.16 |
$79.10
|
|
Culture fungi other (except blood)
|
$140.91 |
$140.91 |
$140.91 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$6.30 |
$6.30 |
$6.30 |
$74.75
|
|
Culture mycoplasma any source
|
$105.21 |
$105.21 |
$105.21 |
$85.26
|
|
Culture quantitative aerobic other source
|
$166.95 |
$166.95 |
$166.95 |
$90.35
|
|
Culture screening strep group a
|
$147.84 |
$147.84 |
$147.84 |
$81.00
|
|
Culture typing immunologic
|
$7.77 |
$7.77 |
$7.77 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$154.35 |
$154.35 |
$154.35 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$23.10 |
$23.10 |
$23.10 |
$133.90
|
|
Culture urine each isolate
|
$5.67 |
$5.67 |
$5.67 |
$57.00
|
|
Cutter lead
|
$168.63 |
$168.63 |
$168.63 |
$6,092.06
|
|
Cv line/pic reposition
|
$649.74 |
$649.74 |
$649.74 |
$1,720.93
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$155.97 |
$155.97 |
$155.97 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$39.27 |
$39.27 |
$39.27 |
$70.98
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$675.83 |
$675.83 |
$675.83 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$3.34 |
$3.34 |
$3.34 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$57.01 |
$57.01 |
$57.01 |
$140.78
|
|
Cyclosporine 2 hour
|
$184.17 |
$184.17 |
$184.17 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$1.03 |
$1.03 |
$1.03 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$31.51 |
$31.51 |
$31.51 |
$34.88
|
|
Cyp2c19 gene com variants
|
$154.56 |
$154.56 |
$154.56 |
$504.00
|
|
Cyp2d6 gene com variants
|
$441.21 |
$441.21 |
$441.21 |
$554.00
|
|
Cystatin c
|
$54.81 |
$54.81 |
$54.81 |
$77.50
|
|
Cystic fibrosis cftr
|
$353.64 |
$353.64 |
$353.64 |
$1,100.00
|
|
Cystine urine quantitative
|
$67.62 |
$67.62 |
$67.62 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$143.01 |
$143.01 |
$143.01 |
$539.55
|
|
Cystometrogram w/up 51727
|
$427.56 |
$427.56 |
$427.56 |
$908.59
|
|
Cystoscopy and treatment
|
$1,201.41 |
$1,201.41 |
$1,201.41 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$337.47 |
$337.47 |
$337.47 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$683.34 |
$683.34 |
$683.34 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$11.67 |
$11.67 |
$11.67 |
$89.94
|
|
Cytogenomic neo microra alys
|
$855.12 |
$855.12 |
$855.12 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$1,139.67 |
$1,139.67 |
$1,139.67 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$85.05 |
$85.05 |
$85.05 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$85.05 |
$85.05 |
$85.05 |
$97.50
|
|
Cytomegalovirus dfa
|
$81.27 |
$81.27 |
$81.27 |
$79.34
|
|
Cytopath fl nongyn filter
|
$13.23 |
$13.23 |
$13.23 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$29.19 |
$29.19 |
$29.19 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$34.02 |
$34.02 |
$34.02 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$23.52 |
$23.52 |
$23.52 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$13.23 |
$13.23 |
$13.23 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$13.23 |
$13.23 |
$13.23 |
$129.28
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$2.10 |
$2.10 |
$2.10 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$56.28 |
$56.28 |
$56.28 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$29.19 |
$29.19 |
$29.19 |
$208.60
|
|
Cytopath smear oth prep screen & interp
|
$13.23 |
$13.23 |
$13.23 |
$96.20
|
|
Cytotoxic antibody screening
|
$190.47 |
$190.47 |
$190.47 |
$189.00
|
|
Cytotoxic antibody screening
|
$121.17 |
$121.17 |
$121.17 |
$133.25
|
|
Cytp urine 3-5 probes cmptr
|
$225.33 |
$225.33 |
$225.33 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$7.15 |
$7.15 |
$7.15 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$885.03 |
$885.03 |
$885.03 |
$3,024.59
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$649.07 |
$649.07 |
$649.07 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$26.22 |
$26.22 |
$26.22 |
$56.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$180.09 |
$180.09 |
$180.09 |
$257.10
|
|
Dch pulmonary stress test
|
$413.07 |
$413.07 |
$413.07 |
$963.30
|
|
Dch validity tests
|
$42.42 |
$42.42 |
$42.42 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$7.98 |
$7.98 |
$7.98 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$165.27 |
$165.27 |
$165.27 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$95.76 |
$95.76 |
$95.76 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$660.03 |
$660.03 |
$660.03 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$496.44 |
$496.44 |
$496.44 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$496.44 |
$496.44 |
$496.44 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$339.78 |
$339.78 |
$339.78 |
$810.50
|
|
Debride nail1-5 11720
|
$35.28 |
$35.28 |
$35.28 |
$148.80
|
|
Debride nail6 or more 11721
|
$23.52 |
$23.52 |
$23.52 |
$169.60
|
|
Debride skin bone at fx site
|
$796.53 |
$796.53 |
$796.53 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$496.44 |
$496.44 |
$496.44 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$363.72 |
$363.72 |
$363.72 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$509.25 |
$509.25 |
$509.25 |
$1,160.00
|
|
Decalcification
|
$7.98 |
$7.98 |
$7.98 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$514.56 |
$514.56 |
$514.56 |
$1,026.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$237.30 |
$237.30 |
$237.30 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$60.04 |
$60.04 |
$60.04 |
$95.85
|
|
Delivery of placenta 59414
|
$1,017.24 |
$1,017.24 |
$1,017.24 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$54.60 |
$54.60 |
$54.60 |
$408.10
|
|
Design mlc device for imrt
|
$710.22 |
$710.22 |
$710.22 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$468.31 |
$468.31 |
$468.31 |
$91.56
|
|
Desoxycorticosterone
|
$360.15 |
$360.15 |
$360.15 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$678.30 |
$678.30 |
$678.30 |
$3,011.50
|
|
Destroy premlg lesns;1st lesn 17000
|
$68.88 |
$68.88 |
$68.88 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$34.44 |
$34.44 |
$34.44 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$45.36 |
$45.36 |
$45.36 |
$235.13
|
|
Device ablt adv novasure
|
$1,767.15 |
$1,767.15 |
$1,767.15 |
$6,097.50
|
|
Device sut capio slim opn
|
$21.21 |
$21.21 |
$21.21 |
$1,894.50
|
|
Devlopment test interpt&rep
|
$151.20 |
$151.20 |
$151.20 |
$109.46
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$101.64 |
$101.64 |
$101.64 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$84.98 |
$84.98 |
$84.98 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$49.47 |
$49.47 |
$49.47 |
$21.18
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$114.23 |
$114.23 |
$114.23 |
$858.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$48.30 |
$48.30 |
$48.30 |
$39.60
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$53.13 |
$53.13 |
$53.13 |
$45.80
|