|
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 |
$542.10
|
|
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
|
|
Cytogenetics 25-99
|
$33.60 |
$33.60 |
$33.60 |
$190.00
|
|
Cytogenetics 3-5
|
$21.90 |
$21.90 |
$21.90 |
$170.27
|
|
Cytogenom microarray copy nmbr var
|
$532.35 |
$532.35 |
$532.35 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$28.50 |
$28.50 |
$28.50 |
$97.50
|
|
Cytopath c/v index add-on
|
$10.35 |
$10.35 |
$10.35 |
$35.57
|
|
Cytopath fl nongyn filter
|
$74.70 |
$74.70 |
$74.70 |
$92.63
|
|
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 concentration technique smears & interpretation
|
$64.05 |
$64.05 |
$64.05 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$51.45 |
$51.45 |
$51.45 |
$129.35
|
|
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 |
$209.23
|
|
Cytopath smear other source
|
$43.65 |
$43.65 |
$43.65 |
$88.13
|
|
Cytopath smear other source
|
$64.05 |
$64.05 |
$64.05 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$52.50 |
$52.50 |
$52.50 |
$96.20
|
|
Cytopath tbs c/v manual
|
$18.60 |
$18.60 |
$18.60 |
$59.28
|
|
Cytotoxic antibody screening
|
$31.80 |
$31.80 |
$31.80 |
$133.25
|
|
Dacarbazine 100 mg intravenous solution
|
$69.33 |
$69.33 |
$69.33 |
$58.22
|
|
Dalbavancin 500 mg intravenous solution
|
$1,856.69 |
$1,856.69 |
$1,856.69 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$73.86 |
$73.86 |
$642.51 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,570.80 |
$2,570.80 |
$2,570.80 |
$6,072.48
|
|
Dark field exam spec collj
|
$6.30 |
$6.30 |
$6.30 |
$31.20
|
|
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 |
$43.60
|
|
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 skin bone at fx site
|
$362.55 |
$362.55 |
$362.55 |
$3,015.00
|
|
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
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$261.75 |
$261.75 |
$261.75 |
$543.00
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$1,478.40 |
$1,478.40 |
$1,478.40 |
$4,914.00
|
|
Deep muscle biopsy 20205
|
$1,124.85 |
$1,124.85 |
$1,124.85 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$86.95 |
$86.95 |
$86.95 |
$95.85
|
|
Delivery of placenta 59414
|
$863.40 |
$863.40 |
$863.40 |
$3,070.56
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$565.65 |
$565.65 |
$565.65 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$34.80 |
$34.80 |
$34.80 |
$185.17
|
|
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
|
|
Descend thora aorta rpr/lt sub art 33880
|
$997.95 |
$997.95 |
$997.95 |
$6,687.93
|
|
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 |
$89.78
|
|
Desoxycorticosterone
|
$33.15 |
$33.15 |
$33.15 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$1,309.80 |
$1,309.80 |
$1,309.80 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$823.20 |
$823.20 |
$823.20 |
$2,727.20
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$83.55 |
$83.55 |
$83.55 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$91.95 |
$91.95 |
$91.95 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$101.10 |
$101.10 |
$101.10 |
$408.50
|
|
Dest mal lesion snhfg <0.5cm 17270
|
$83.55 |
$83.55 |
$83.55 |
$273.72
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$91.95 |
$91.95 |
$91.95 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$101.10 |
$101.10 |
$101.10 |
$317.00
|
|
Dest mal lesion tal <0.5 17260
|
$83.55 |
$83.55 |
$83.55 |
$238.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$91.95 |
$91.95 |
$91.95 |
$262.60
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$101.10 |
$101.10 |
$101.10 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$111.15 |
$111.15 |
$111.15 |
$364.50
|
|
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 internal hemorrhoids destroy 46930
|
$387.00 |
$387.00 |
$387.00 |
$1,344.85
|
|
Destroy premlg lesns;1st lesn 17000
|
$99.60 |
$99.60 |
$99.60 |
$199.50
|
|
Destroy vulva lesion extensive 56515
|
$1,369.20 |
$1,369.20 |
$1,369.20 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$373.50 |
$373.50 |
$373.50 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$83.55 |
$83.55 |
$83.55 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$247.65 |
$247.65 |
$247.65 |
$966.60
|
|
Destruct cut vasl lesions <10cm 17106
|
$159.90 |
$159.90 |
$159.90 |
$660.00
|
|
Destruct cut vasl lesions >50cm 17108
|
$780.45 |
$780.45 |
$780.45 |
$2,142.40
|
|
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 mal lsn s/n/h/f/g 2.1-3cm
|
$111.15 |
$111.15 |
$111.15 |
$513.60
|
|
Destruction mal lsn s/n/h/f/g 3.1-4cm
|
$122.25 |
$122.25 |
$122.25 |
$558.97
|
