|
Culture fungi definitive id mold
|
$10.12 |
$10.12 |
$10.12 |
$76.72
|
|
Culture fungi definitive id yeast
|
$12.42 |
$12.42 |
$12.42 |
$79.10
|
|
Culture fungi other (except blood)
|
$57.96 |
$57.96 |
$57.96 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$6.67 |
$6.67 |
$6.67 |
$74.75
|
|
Culture screening strep group a
|
$60.26 |
$60.26 |
$60.26 |
$81.00
|
|
Culture typing immunologic
|
$8.51 |
$8.51 |
$8.51 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$169.05 |
$169.05 |
$169.05 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$25.30 |
$25.30 |
$25.30 |
$133.90
|
|
Cv line/pic reposition
|
$684.25 |
$684.25 |
$684.25 |
$1,720.93
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$170.83 |
$170.83 |
$170.83 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$24.38 |
$24.38 |
$24.38 |
$70.98
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$740.20 |
$740.20 |
$740.20 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$3.66 |
$3.66 |
$3.66 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$62.44 |
$62.44 |
$62.44 |
$140.78
|
|
Cyclosporine 2 hour
|
$116.15 |
$116.15 |
$116.15 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$1.12 |
$1.12 |
$1.12 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$34.51 |
$34.51 |
$34.51 |
$34.88
|
|
Cystatin c
|
$69.46 |
$69.46 |
$69.46 |
$77.50
|
|
Cystic fibrosis cftr
|
$387.32 |
$387.32 |
$387.32 |
$1,100.00
|
|
Cystine urine quantitative
|
$19.32 |
$19.32 |
$19.32 |
$103.35
|
|
Cystoscopy and treatment
|
$1,261.09 |
$1,261.09 |
$1,261.09 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$369.61 |
$369.61 |
$369.61 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$604.21 |
$604.21 |
$604.21 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$12.78 |
$12.78 |
$12.78 |
$89.94
|
|
Cytogenomic neo microra alys
|
$936.56 |
$936.56 |
$936.56 |
$2,020.20
|
|
Cytog genom-wid alys hem mal
|
$871.93 |
$871.93 |
$871.93 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$24.38 |
$24.38 |
$24.38 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$24.38 |
$24.38 |
$24.38 |
$97.50
|
|
Cytomegalovirus dfa
|
$24.38 |
$24.38 |
$24.38 |
$79.34
|
|
Cytopath fl nongyn filter
|
$14.49 |
$14.49 |
$14.49 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$31.97 |
$31.97 |
$31.97 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$25.76 |
$25.76 |
$25.76 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$14.49 |
$14.49 |
$14.49 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$14.49 |
$14.49 |
$14.49 |
$129.28
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$56.12 |
$56.12 |
$56.12 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$31.97 |
$31.97 |
$31.97 |
$208.60
|
|
Cytopath smear oth prep screen & interp
|
$14.49 |
$14.49 |
$14.49 |
$96.20
|
|
Cytp urine 3-5 probes cmptr
|
$246.79 |
$246.79 |
$246.79 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$7.83 |
$7.83 |
$7.83 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$969.32 |
$969.32 |
$969.32 |
$3,024.59
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$710.89 |
$710.89 |
$710.89 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$28.72 |
$28.72 |
$28.72 |
$56.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$197.24 |
$197.24 |
$197.24 |
$257.10
|
|
Dch validity tests
|
$9.66 |
$9.66 |
$9.66 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$8.74 |
$8.74 |
$8.74 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$165.60 |
$165.60 |
$165.60 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$109.94 |
$109.94 |
$109.94 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$478.17 |
$478.17 |
$478.17 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$176.87 |
$176.87 |
$176.87 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$478.17 |
$478.17 |
$478.17 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$168.59 |
$168.59 |
$168.59 |
$810.50
|
|
Debride nail1-5 11720
|
$60.26 |
$60.26 |
$60.26 |
$148.80
|
|
Debride nail6 or more 11721
|
$75.90 |
$75.90 |
$75.90 |
$169.60
|
|
Debride skin bone at fx site
|
$789.82 |
$789.82 |
$789.82 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$168.59 |
$168.59 |
$168.59 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$278.53 |
$278.53 |
$278.53 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$176.87 |
$176.87 |
$176.87 |
$1,160.00
|
|
Decalcification
|
$8.74 |
$8.74 |
$8.74 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$563.56 |
$563.56 |
$563.56 |
$1,026.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$102.81 |
$102.81 |
$102.81 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$65.76 |
$65.76 |
$65.76 |
$95.85
|
|
Delivery of placenta 59414
|
$765.67 |
$765.67 |
$765.67 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$59.80 |
$59.80 |
$59.80 |
$408.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$512.91 |
$512.91 |
$512.91 |
$91.56
|
|
Destroy cervthor facet jnt 64633
|
$742.90 |
$742.90 |
$742.90 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$371.45 |
$371.45 |
$371.45 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$60.26 |
$60.26 |
$60.26 |
$199.50
|
|
Destruct cut vasl lesions <10cm 17106
|
$377.66 |
$377.66 |
$377.66 |
$660.00
|
|
Destruction 2-14 lesions 17003
|
$60.26 |
$60.26 |
$60.26 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$56.12 |
$56.12 |
$56.12 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$371.45 |
$371.45 |
$371.45 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$742.90 |
$742.90 |
$742.90 |
$3,202.98
|
|
Detect agent nos dna dir
|
$18.17 |
$18.17 |
$18.17 |
$115.20
|
|
Devlopment test interpt&rep
|
$46.92 |
$46.92 |
$46.92 |
$109.46
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$45.08 |
$45.08 |
$45.08 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$93.08 |
$93.08 |
$93.08 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$54.18 |
$54.18 |
$54.18 |
$21.18
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$125.11 |
$125.11 |
$125.11 |
$858.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$52.90 |
$52.90 |
$52.90 |
$39.60
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$58.19 |
$58.19 |
$58.19 |
$45.80
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$42.32 |
$42.32 |
$42.32 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$63.48 |
$63.48 |
$63.48 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$153.41 |
$153.41 |
$153.41 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$37.95 |
$37.95 |
$37.95 |
$79.20
|
|
Diab manage trn ind/group
|
$14.26 |
$14.26 |
$14.26 |
$56.55
|
|
Diagnostic digital breast tomosynthesis bil
|
$24.15 |
$24.15 |
$24.15 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$24.15 |
$24.15 |
$24.15 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$50.60 |
$50.60 |
$50.60 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$165.60 |
$165.60 |
$165.60 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$126.50 |
$126.50 |
$126.50 |
$301.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$106.29 |
$106.29 |
$106.29 |
$74.17
|
|
Dicyclomine injection
|
$62.23 |
$62.23 |
$62.23 |
$153.29
|
|
Diffusing capacity
|
$69.46 |
$69.46 |
$69.46 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$5.01 |
$5.01 |
$5.01 |
$68.22
|
|
Digoxin total therapeutic drug level
|
$99.59 |
$99.59 |
$99.59 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$209.61 |
$209.61 |
$209.61 |
$297.86
|
|
Dilate urethra stricture
|
$83.26 |
$83.26 |
$83.26 |
$490.00
|
|
Dilation/urethral strict/male/ini 53620
|
$551.77 |
$551.77 |
$551.77 |
$1,372.80
|
|
Dimenhydrinate injection
|
$9.27 |
$9.27 |
$9.27 |
$30.48
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.14 |
$0.14 |
$0.14 |
$1.20
|
