|
CT hrt w/3d image
|
$325.20 |
$325.20 |
$325.20 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$211.80 |
$211.80 |
$211.80 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$878.40 |
$878.40 |
$878.40 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$824.40 |
$824.40 |
$824.40 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$1,126.20 |
$1,126.20 |
$1,126.20 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$337.50 |
$337.50 |
$337.50 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$321.00 |
$321.00 |
$321.00 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$494.10 |
$494.10 |
$494.10 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$444.30 |
$444.30 |
$444.30 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$337.50 |
$337.50 |
$337.50 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$299.40 |
$299.40 |
$299.40 |
$1,360.00
|
|
CT scan for localization
|
$556.80 |
$556.80 |
$556.80 |
$1,205.14
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,187.40 |
$1,187.40 |
$1,187.40 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$792.00 |
$792.00 |
$792.00 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$792.00 |
$792.00 |
$792.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$544.20 |
$544.20 |
$544.20 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$544.20 |
$544.20 |
$544.20 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$477.00 |
$477.00 |
$477.00 |
$331.50
|
|
CT t-spine w /wo contrast
|
$816.30 |
$816.30 |
$816.30 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$785.40 |
$785.40 |
$785.40 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$658.20 |
$658.20 |
$658.20 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$897.00 |
$897.00 |
$897.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$33.90 |
$33.90 |
$33.90 |
$68.64
|
|
Culture afb any source
|
$32.70 |
$32.70 |
$32.70 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$24.30 |
$24.30 |
$24.30 |
$79.00
|
|
Culture anaerobic except blood
|
$28.50 |
$28.50 |
$28.50 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$7.20 |
$7.20 |
$7.20 |
$51.45
|
|
Culture body fluid
|
$26.10 |
$26.10 |
$26.10 |
$126.75
|
|
Culture fungi definitive id mold
|
$42.30 |
$42.30 |
$42.30 |
$77.28
|
|
Culture fungi definitive id yeast
|
$53.10 |
$53.10 |
$53.10 |
$79.10
|
|
Culture fungi other (except blood)
|
$25.50 |
$25.50 |
$25.50 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$23.40 |
$23.40 |
$23.40 |
$74.88
|
|
Culture screening strep group a
|
$22.50 |
$22.50 |
$22.50 |
$81.00
|
|
Culture typing immunologic
|
$15.30 |
$15.30 |
$15.30 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$457.80 |
$457.80 |
$457.80 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$38.10 |
$38.10 |
$38.10 |
$133.90
|
|
Culture urine each isolate
|
$24.60 |
$24.60 |
$24.60 |
$57.00
|
|
Cutter lead
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$6,092.06
|
|
Cv line/pic reposition
|
$256.80 |
$256.80 |
$256.80 |
$1,720.93
|
|
Cv stress test i&r only 93018
|
$13.34 |
$13.34 |
$13.34 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$13.34 |
$13.34 |
$13.34 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.80 |
$7.80 |
$7.80 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$13.50 |
$13.50 |
$13.50 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,497.82 |
$1,497.82 |
$1,497.82 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$5.15 |
$5.15 |
$5.15 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$126.49 |
$126.49 |
$126.49 |
$140.78
|
|
Cyclosporine 2 hour
|
$19.50 |
$19.50 |
$19.50 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$1.73 |
$1.73 |
$1.73 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$6.02 |
$6.02 |
$6.02 |
$34.88
|
|
Cylinder pump set 20cm titan zero angl
|
$20,050.80 |
$20,050.80 |
$20,050.80 |
$22,803.38
|
|
Cystatin c
|
$39.00 |
$39.00 |
$39.00 |
$77.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$169.20 |
$169.20 |
$169.20 |
$542.10
|
|
Cytarabine 20 mg/ml injection solution
|
$59.58 |
$59.58 |
$59.58 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$12.30 |
$12.30 |
$12.30 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$12.90 |
$12.90 |
$12.90 |
$97.50
|
|
Cytopath fl nongyn filter
|
$48.60 |
$48.60 |
$48.60 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$38.10 |
$38.10 |
$38.10 |
$159.45
|
|
Cytopathology concentration technique smears & interpretation
|
$43.20 |
$43.20 |
$43.20 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$45.00 |
$45.00 |
$45.00 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$6.90 |
$6.90 |
$6.90 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$19.80 |
$19.80 |
$19.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$92.10 |
$92.10 |
$92.10 |
$209.23
|
|
Cytopath smear other source
|
$50.70 |
$50.70 |
$50.70 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$52.50 |
$52.50 |
$52.50 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$21.59 |
$21.59 |
$21.59 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$511.20 |
$511.20 |
$511.20 |
$3,024.59
|
|
Dalbavancin 500 mg intravenous solution
|
$1,818.99 |
$1,818.99 |
$1,818.99 |
$3,480.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$10,247.14 |
$10,247.14 |
$10,247.14 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3,956.69 |
$3,956.69 |
$3,956.69 |
$6,072.48
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$11,225.95 |
$11,225.95 |
$11,225.95 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$233.73 |
$233.73 |
$233.73 |
$257.10
|
|
Dch validity tests
|
$7.80 |
$7.80 |
$7.80 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$14.70 |
$14.70 |
$14.70 |
$43.60
|
|
Debridement (>20 cm) charge pt
|
$45.00 |
$45.00 |
$45.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$482.40 |
$482.40 |
$482.40 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$397.80 |
$397.80 |
$397.80 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$482.40 |
$482.40 |
$482.40 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$397.80 |
$397.80 |
$397.80 |
$810.50
|
|
Debride nail1-5 11720
|
$227.70 |
$227.70 |
$227.70 |
$148.80
|
|
Debride nail6 or more 11721
|
$227.70 |
$227.70 |
$227.70 |
$169.60
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$397.80 |
$397.80 |
$397.80 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$397.80 |
$397.80 |
$397.80 |
$1,160.00
|
|
Decalcification
|
$8.40 |
$8.40 |
$8.40 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$1,661.86 |
$1,661.86 |
$1,661.86 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$783.00 |
$783.00 |
$783.00 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$70.96 |
$70.96 |
$70.96 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$779.16 |
$779.16 |
$779.16 |
$1,807.08
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$3,527.02 |
$3,527.02 |
$3,527.02 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$428.03 |
$428.03 |
$428.03 |
$71.51
|
|
Design mlc device for imrt
|
$172.20 |
$172.20 |
$172.20 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$688.25 |
$688.25 |
$688.25 |
$89.78
|
|
Destroy premlg lesns;1st lesn 17000
|
$227.70 |
$227.70 |
$227.70 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$227.70 |
$227.70 |
$227.70 |
$72.60
|
|
Destruction premal lesions 15/> 17004
|
$305.40 |
$305.40 |
$305.40 |
$436.64
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,750.00 |
$3,750.00 |
$3,750.00 |
$4,200.00
|
|
Device intraute mirena
|
$1,241.84 |
$1,241.84 |
$1,241.84 |
$2,125.00
|
|
Device tiss remov myosure reach
|
$1,449.00 |
$1,449.00 |
$1,449.00 |
$2,541.00
|
|
Devlopment test interpt&rep
|
$46.80 |
$46.80 |
$46.80 |
$109.46
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$68.70 |
$68.70 |
$68.70 |
$227.15
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$85.59 |
$85.59 |
$85.59 |
$21.17
|