|
CT guidance for needle placement
|
$567.44 |
$567.44 |
$567.44 |
$1,425.85
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$618.00 |
$618.00 |
$618.00 |
$1,007.29
|
|
CT heart w/evaluation of calcium without contrast
|
$101.15 |
$101.15 |
$101.15 |
$176.89
|
|
CT limited or localized follow-up study
|
$247.43 |
$247.43 |
$247.43 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$732.74 |
$732.74 |
$732.74 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$701.21 |
$701.21 |
$701.21 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$753.93 |
$753.93 |
$753.93 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,120.97 |
$1,120.97 |
$1,120.97 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$764.10 |
$764.10 |
$764.10 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,185.41 |
$1,185.41 |
$1,185.41 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$740.12 |
$740.12 |
$740.12 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$699.03 |
$699.03 |
$699.03 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$643.59 |
$643.59 |
$643.59 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,001.08 |
$2,001.08 |
$2,001.08 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,810.25 |
$1,810.25 |
$1,810.25 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,721.63 |
$1,721.63 |
$1,721.63 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$783.14 |
$783.14 |
$783.14 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$859.25 |
$859.25 |
$859.25 |
$1,381.20
|
|
CT upper extremity w/contrast (both sides)
|
$668.72 |
$668.72 |
$668.72 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$725.55 |
$725.55 |
$725.55 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$811.20 |
$811.20 |
$811.20 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$27.60 |
$27.60 |
$27.60 |
$61.03
|
|
Culture afb any source
|
$77.37 |
$77.37 |
$77.37 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$54.47 |
$54.47 |
$54.47 |
$73.00
|
|
Culture anaerobic except blood
|
$254.52 |
$254.52 |
$254.52 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$105.90 |
$105.90 |
$105.90 |
$49.40
|
|
Culture body fluid
|
$79.47 |
$79.47 |
$79.47 |
$111.15
|
|
Culture fungi definitive id mold
|
$83.42 |
$83.42 |
$83.42 |
$70.00
|
|
Culture fungi definitive id yeast
|
$34.70 |
$34.70 |
$34.70 |
$68.00
|
|
Culture fungi other (except blood)
|
$77.37 |
$77.37 |
$77.37 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$77.37 |
$77.37 |
$77.37 |
$74.75
|
|
Culture mycoplasma any source
|
$122.48 |
$122.48 |
$122.48 |
$94.00
|
|
Culture quantitative aerobic other source
|
$10.49 |
$10.49 |
$10.49 |
$63.45
|
|
Culture screening strep group a
|
$120.29 |
$120.29 |
$120.29 |
$76.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$1,093.32 |
$1,093.32 |
$1,093.32 |
$100.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$14.87 |
$14.87 |
$14.87 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$99.14 |
$99.14 |
$99.14 |
$91.20
|
|
Cystatin c
|
$175.49 |
$175.49 |
$175.49 |
$83.20
|
|
Cystogram >= 3 views supervision & interpretation
|
$497.66 |
$497.66 |
$497.66 |
$487.04
|
|
Cytomegalovirus (cmv) antibody igg
|
$51.12 |
$51.12 |
$51.12 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$72.51 |
$72.51 |
$72.51 |
$95.00
|
|
Cytomegalovirus dfa
|
$79.34 |
$79.34 |
$79.34 |
$101.58
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$121.64 |
$121.64 |
$121.64 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$71.28 |
$71.28 |
$71.28 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$28.98 |
$28.98 |
$28.98 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$31.35 |
$31.35 |
$31.35 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$104.07 |
$104.07 |
$104.07 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$27.65 |
$27.65 |
$27.65 |
$205.00
|
|
Cytopath smear other source
|
$26.81 |
$26.81 |
$26.81 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$26.81 |
$26.81 |
$26.81 |
$95.00
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.54 |
$0.54 |
$0.54 |
$1.80
|
|
Deamidated gliadin antibody iga
|
$13.20 |
$13.20 |
$13.20 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$198.27 |
$198.27 |
$198.27 |
$313.30
|
|
Decalcification
|
$51.62 |
$51.62 |
$51.62 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$359.58 |
$359.58 |
$359.58 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$20.33 |
$20.33 |
$20.33 |
$47.62
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$128.94 |
$128.94 |
$128.94 |
$165.60
|
|
Depo-estradiol cypionate inj
|
$87.27 |
$87.27 |
$87.27 |
$337.07
|
|
Desmopressin 4 mcg/ml injection solution
|
$43.59 |
$43.59 |
$43.59 |
$37.26
|
|
Detect agnt mult dna direc
|
$166.77 |
$166.77 |
$166.77 |
$115.50
|
|
Developmental screen/score/document 96110
|
$199.26 |
$199.26 |
$199.26 |
$126.75
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$1.61 |
$1.61 |
$1.61 |
$8.23
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$46.35 |
$46.35 |
$46.35 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$71.87 |
$71.87 |
$71.87 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$41.96 |
$41.96 |
$41.96 |
$70.00
|
|
Diag bronchoscope/catheter
|
$1,345.43 |
$1,345.43 |
$1,345.43 |
$1,910.40
|
|
Diagnostic laryngoscopy 31505
|
$132.84 |
$132.84 |
$132.84 |
$229.07
|
|
Diagnostic Mammogram (both breasts)
|
$244.26 |
$244.26 |
$244.26 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$215.58 |
$215.58 |
$215.58 |
$276.60
|
|
Dialysis one evaluation
|
$753.99 |
$753.99 |
$753.99 |
$920.00
|
|
Dicyclomine injection
|
$180.66 |
$180.66 |
$180.66 |
$153.53
|
|
Diffusing capacity
|
$263.46 |
$263.46 |
$263.46 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$11.82 |
$11.82 |
$11.82 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$10,279.62 |
$10,279.62 |
$10,279.62 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$44.45 |
$44.45 |
$44.45 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$321.30 |
$321.30 |
$321.30 |
$297.86
|
|
Dilate esophagus 1/mult pass
|
$840.86 |
$840.86 |
$840.86 |
$1,349.05
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,493.66 |
$1,493.66 |
$1,493.66 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.64 |
$4.64 |
$4.64 |
$9.29
|
|
Disability dlco
|
$204.50 |
$204.50 |
$204.50 |
$289.08
|
|
Disaccharidases
|
$247.73 |
$247.73 |
$247.73 |
$224.58
|
|
Dna antibody native/double stranded
|
$36.84 |
$36.84 |
$36.84 |
$101.40
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$16.53 |
$16.53 |
$16.53 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$2.97 |
$2.97 |
$2.97 |
$60.21
|
|
Doppler echo complete
|
$689.00 |
$689.00 |
$689.00 |
$517.94
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$272.97 |
$272.97 |
$272.97 |
$642.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$272.97 |
$272.97 |
$272.97 |
$463.20
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.86 |
$22.86 |
$22.86 |
$32.82
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$276.84 |
$276.84 |
$276.84 |
$448.16
|
|
Drug assay voriconazole
|
$466.46 |
$466.46 |
$466.46 |
$96.75
|
|
Drug test def 1-7 classes
|
$416.19 |
$416.19 |
$416.19 |
$316.80
|
|
Drug test def 8-14 classes
|
$48.93 |
$48.93 |
$48.93 |
$249.10
|
|
Drug test prsmv instrmnt
|
$58.79 |
$58.79 |
$58.79 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$495.35 |
$495.35 |
$495.35 |
$278.85
|
|
Drvvt confirm - quest
|
$101.66 |
$101.66 |
$101.66 |
$108.55
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$293.79 |
$293.79 |
$293.79 |
$740.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$384.66 |
$384.66 |
$384.66 |
$852.57
|
|
Dx bronchoscope/brush 31623
|
$1,860.63 |
$1,860.63 |
$1,860.63 |
$2,283.00
|
|
Dx bronchoscope/lavage 31624
|
$1,860.63 |
$1,860.63 |
$1,860.63 |
$2,858.00
|
