|
Cyp2d6 gene com variants
|
$678.45 |
$678.45 |
$678.45 |
$554.00
|
|
Cystatin c
|
$20.85 |
$20.85 |
$20.85 |
$77.50
|
|
Cystic fibrosis cftr
|
$1,039.65 |
$1,039.65 |
$1,039.65 |
$1,100.00
|
|
Cystine urine quantitative
|
$29.55 |
$29.55 |
$29.55 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$119.55 |
$119.55 |
$119.55 |
$539.55
|
|
Cystoscopy and treatment
|
$1,345.50 |
$1,345.50 |
$1,345.50 |
$4,081.37
|
|
Cystoscopy and treatment
|
$2,989.95 |
$2,989.95 |
$2,989.95 |
$4,160.10
|
|
Cystoscopy and treatment
|
$2,989.95 |
$2,989.95 |
$2,989.95 |
$5,162.50
|
|
Cystoscopy and treatment
|
$1,345.50 |
$1,345.50 |
$1,345.50 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$271.35 |
$271.35 |
$271.35 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$1,345.50 |
$1,345.50 |
$1,345.50 |
$2,704.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$437.10 |
$437.10 |
$437.10 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$46.80 |
$46.80 |
$46.80 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$28.50 |
$28.50 |
$28.50 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$77.55 |
$77.55 |
$77.55 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$23.40 |
$23.40 |
$23.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$35.40 |
$35.40 |
$35.40 |
$87.50
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$51.45 |
$51.45 |
$51.45 |
$129.28
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$9.75 |
$9.75 |
$9.75 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$47.40 |
$47.40 |
$47.40 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$86.10 |
$86.10 |
$86.10 |
$208.60
|
|
Cytopath smear other source
|
$43.65 |
$43.65 |
$43.65 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$52.50 |
$52.50 |
$52.50 |
$96.20
|
|
Cytotoxic antibody screening
|
$31.80 |
$31.80 |
$31.80 |
$133.25
|
|
Dacarbazine 100 mg intravenous solution
|
$40.13 |
$40.13 |
$40.13 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,555.02 |
$1,555.02 |
$1,555.02 |
$3,024.59
|
|
Dalbavancin 500 mg intravenous solution
|
$1,856.69 |
$1,856.69 |
$1,856.69 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$642.51 |
$642.51 |
$642.51 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$856.93 |
$856.93 |
$2,570.80 |
$6,269.40
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$1,271.85 |
$1,271.85 |
$1,271.85 |
$3,774.81
|
|
Dch glucoscan
|
$5.70 |
$5.70 |
$5.70 |
$28.10
|
|
Dch pulmonary stress test
|
$247.50 |
$247.50 |
$247.50 |
$963.30
|
|
Dch validity tests
|
$4.35 |
$4.35 |
$4.35 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$74.55 |
$74.55 |
$74.55 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$156.75 |
$156.75 |
$156.75 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$76.95 |
$76.95 |
$76.95 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$306.75 |
$306.75 |
$306.75 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$27.45 |
$27.45 |
$27.45 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$294.90 |
$294.90 |
$294.90 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$304.65 |
$304.65 |
$304.65 |
$810.50
|
|
Debride nail1-5 11720
|
$16.50 |
$16.50 |
$16.50 |
$148.80
|
|
Debride nail6 or more 11721
|
$24.90 |
$24.90 |
$24.90 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$294.75 |
$294.75 |
$294.75 |
$1,012.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$113.40 |
$113.40 |
$113.40 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$345.30 |
$345.30 |
$345.30 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$31.20 |
$31.20 |
$31.20 |
$114.10
|
|
Debr musc/fascia 20sq cm/< 11043
|
$290.10 |
$290.10 |
$290.10 |
$1,160.00
|
|
Decalcification
|
$9.00 |
$9.00 |
$9.00 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$337.34 |
$337.34 |
$337.34 |
$1,026.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$261.75 |
$261.75 |
$261.75 |
$543.00
|
|
Deep muscle biopsy 20205
|
$1,124.85 |
$1,124.85 |
$1,124.85 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$31.67 |
$31.67 |
$67.65 |
$95.85
|
|
Delivery of placenta 59414
|
$863.40 |
$863.40 |
$863.40 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$34.80 |
$34.80 |
$34.80 |
$185.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,013.31 |
$3,013.31 |
$3,013.31 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$205.50 |
$205.50 |
$205.50 |
$408.10
|
|
Dermagraft
|
$23.40 |
$23.40 |
$23.40 |
$85.00
|
|
Dermapure 1 square cm
|
$140.32 |
$140.32 |
$140.32 |
$3,822.00
|
|
Design mlc device for imrt
|
$391.95 |
$391.95 |
$391.95 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$124.07 |
$124.07 |
$1,256.08 |
$91.56
|
|
Desoxycorticosterone
|
$33.15 |
$33.15 |
$33.15 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,285.95 |
$1,285.95 |
$1,285.95 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$761.70 |
$761.70 |
$761.70 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$99.60 |
$99.60 |
$99.60 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$27.60 |
$27.60 |
$27.60 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$39.15 |
$39.15 |
$39.15 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$168.60 |
$168.60 |
$168.60 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$421.20 |
$421.20 |
$421.20 |
$3,202.98
|
|
Destruction premal lesions 15/> 17004
|
$159.90 |
$159.90 |
$159.90 |
$436.64
|
|
Destruction vag lesions simple 57061
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$3,815.20
|
|
Destruct penis les/smp/electrodesi 54055
|
$1,345.50 |
$1,345.50 |
$1,345.50 |
$2,837.09
|
|
Developmental screen/score/document 96110
|
$40.65 |
$40.65 |
$40.65 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$67.20 |
$67.20 |
$67.20 |
$337.50
|
|
Device ablt adv novasure
|
$6,885.23 |
$6,885.23 |
$6,885.23 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,578.00 |
$3,578.00 |
$3,578.00 |
$4,200.00
|
|
Device tiss remov myosure reach
|
$1,223.52 |
$1,223.52 |
$1,223.52 |
$2,541.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$33.75 |
$33.75 |
$33.75 |
$200.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$69.30 |
$69.30 |
$69.30 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$0.20 |
$0.20 |
$8.56 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$16.75 |
$16.75 |
$23.77 |
$21.18
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$614.51 |
$614.51 |
$614.51 |
$858.00
|
|
Dextran 40 infusion
|
$18.06 |
$18.06 |
$18.06 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$7.26 |
$7.26 |
$7.26 |
$39.60
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$7.26 |
$7.26 |
$7.26 |
$45.80
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$7.26 |
$7.26 |
$7.26 |
$47.48
|
|
Dextrose 5 % IV bolus
|
$7.26 |
$7.26 |
$7.26 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$38.85 |
$38.85 |
$38.85 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$16.95 |
$16.95 |
$16.95 |
$79.20
|
|
Diab manage trn ind/group
|
$11.85 |
$11.85 |
$11.85 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$138.30 |
$138.30 |
$138.30 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$51.30 |
$51.30 |
$51.30 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$85.50 |
$85.50 |
$85.50 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$74.10 |
$74.10 |
$74.10 |
$301.55
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,533.70 |
$3,533.70 |
$3,533.70 |
$5,419.00
|
|
Dialysis one evaluation
|
$194.55 |
$194.55 |
$194.55 |
$919.44
|
|
Diatrizoate meglumine 18 % urethral solution
|
$22.41 |
$22.41 |
$22.41 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$97.60 |
$97.60 |
$99.06 |
$74.17
|
|
Dicyclomine injection
|
$177.39 |
$177.39 |
$177.39 |
$153.29
|
|
Diffusing capacity
|
$100.35 |
$100.35 |
$100.35 |
$332.00
|