|
Cytogenom microarray copy nmbr var
|
$971.50 |
$971.50 |
$971.50 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$103.00 |
$103.00 |
$103.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$84.50 |
$84.50 |
$84.50 |
$100.00
|
|
Cyto/molecular report
|
$346.00 |
$346.00 |
$346.00 |
$144.75
|
|
Cytopath c/v auto in fluid
|
$24.50 |
$24.50 |
$24.50 |
$56.00
|
|
Cytopath c/v thin layer redo
|
$32.50 |
$32.50 |
$32.50 |
$50.40
|
|
Cytopathology cellular enhancement technique non-gyn
|
$99.00 |
$99.00 |
$99.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$66.00 |
$66.00 |
$66.00 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$32.50 |
$32.50 |
$32.50 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$247.50 |
$247.50 |
$247.50 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$117.50 |
$117.50 |
$117.50 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$447.50 |
$447.50 |
$447.50 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$447.50 |
$447.50 |
$447.50 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$406.00 |
$406.00 |
$406.00 |
$209.92
|
|
Cytopath smear oth prep screen & interp
|
$124.00 |
$124.00 |
$124.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$9.50 |
$9.50 |
$9.50 |
$59.28
|
|
Cytotoxic antibody screening
|
$166.50 |
$166.50 |
$166.50 |
$193.80
|
|
Cytp urine 3-5 probes cmptr
|
$345.00 |
$345.00 |
$345.00 |
$664.80
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$40.37 |
$40.37 |
$40.37 |
$171.19
|
|
Dch pulmonary stress test
|
$984.50 |
$984.50 |
$984.50 |
$963.30
|
|
Dch validity tests
|
$43.00 |
$43.00 |
$43.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$10.50 |
$10.50 |
$10.50 |
$42.75
|
|
Debridement (>20 cm) charge pt
|
$483.50 |
$483.50 |
$483.50 |
$278.50
|
|
Decalcification
|
$292.00 |
$292.00 |
$292.00 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$86.62 |
$86.62 |
$86.62 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$148.50 |
$148.50 |
$148.50 |
$182.40
|
|
Dermapure 1 square cm
|
$185.62 |
$185.62 |
$185.62 |
$3,822.00
|
|
Design mlc device for imrt
|
$3,679.50 |
$3,679.50 |
$3,679.50 |
$1,739.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$79.87 |
$79.87 |
$79.87 |
$93.84
|
|
Desoxycorticosterone
|
$80.00 |
$80.00 |
$80.00 |
$98.80
|
|
Detect agent nos dna dir
|
$153.00 |
$153.00 |
$153.00 |
$145.80
|
|
Developmental screen/score/document 96110
|
$411.50 |
$411.50 |
$411.50 |
$143.13
|
|
Devel tst phys/qhp 1st hr
|
$432.50 |
$432.50 |
$432.50 |
$350.40
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$1,521.00 |
$1,521.00 |
$1,521.00 |
$4,200.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$217.00 |
$217.00 |
$217.00 |
$199.50
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$2.87 |
$2.87 |
$2.87 |
$21.20
|
|
Dhea-s (dehydroepiand sulfate)
|
$16.50 |
$16.50 |
$16.50 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$79.00 |
$79.00 |
$79.00 |
$79.20
|
|
Diab manage trn ind/group
|
$87.50 |
$87.50 |
$87.50 |
$54.99
|
|
Diagnostic digital breast tomosynthesis bil
|
$135.00 |
$135.00 |
$135.00 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$74.00 |
$74.00 |
$74.00 |
$75.93
|
|
Diagnostic Mammogram (both breasts)
|
$580.00 |
$580.00 |
$580.00 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$469.00 |
$469.00 |
$469.00 |
$312.72
|
|
Dialysis one evaluation
|
$3,632.50 |
$3,632.50 |
$3,632.50 |
$936.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$51.75 |
$51.75 |
$51.75 |
$77.25
|
|
Dicyclomine injection
|
$82.00 |
$82.00 |
$82.00 |
$150.91
|
|
Diffusing capacity
|
$415.50 |
$415.50 |
$415.50 |
$335.20
|
|
Digital analysis of eeg
|
$521.50 |
$521.50 |
$521.50 |
$551.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$11.62 |
$11.62 |
$11.62 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,267.25 |
$6,267.25 |
$6,267.25 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$292.00 |
$292.00 |
$292.00 |
$102.07
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.62 |
$1.62 |
$1.62 |
$18.35
|
|
Disaccharidases
|
$499.50 |
$499.50 |
$499.50 |
$224.31
|
|
Discography cerv/thor spine
|
$1,718.00 |
$1,718.00 |
$1,718.00 |
$2,481.50
|
|
Dmpk gene detc abnor allele
|
$292.50 |
$292.50 |
$292.50 |
$313.60
|
|
Dna antibody native/double stranded
|
$63.50 |
$63.50 |
$63.50 |
$100.00
|
|
Dna gardnerella
|
$16.00 |
$16.00 |
$16.00 |
$61.80
|
|
Dna trichomonas
|
$16.00 |
$16.00 |
$16.00 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$84.00 |
$84.00 |
$84.00 |
$98.29
|
|
Doppler echo complete
|
$690.50 |
$690.50 |
$690.50 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$643.00 |
$643.00 |
$643.00 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$2,459.00 |
$2,459.00 |
$2,459.00 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$654.00 |
$654.00 |
$654.00 |
$473.76
|
|
Dpyd gene common variants
|
$232.50 |
$232.50 |
$232.50 |
$423.60
|
|
Droperidol 2.5 mg/ml injection solution
|
$22.37 |
$22.37 |
$22.37 |
$31.26
|
|
Drsg oasis burn wound matrix 3x3.5cm 10.5sqcm-q4103-cost per sq cm
|
$11.75 |
$11.75 |
$11.75 |
$1,575.70
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$22.37 |
$22.37 |
$22.37 |
$58.20
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$11.75 |
$11.75 |
$11.75 |
$289.05
|
|
Drsg wnd 8.2x9cm sq bilayer theragenesis ster-74sq cm-cost per sq cm
|
$122.50 |
$122.50 |
$122.50 |
$122.50
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$174.00 |
$174.00 |
$174.00 |
$8,040.27
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$122.25 |
$122.25 |
$122.25 |
$400.98
|
|
Drug assay caffeine
|
$21.50 |
$21.50 |
$21.50 |
$81.61
|
|
Drug assay posaconazole
|
$48.00 |
$48.00 |
$48.00 |
$96.75
|
|
Drug assay rufinamide
|
$118.00 |
$118.00 |
$118.00 |
$85.80
|
|
Drug assay voriconazole
|
$48.50 |
$48.50 |
$48.50 |
$96.75
|
|
Drug of abuse screen urine
|
$64.50 |
$64.50 |
$64.50 |
$64.50
|
|
Drug screen quant tiagabine
|
$65.50 |
$65.50 |
$65.50 |
$107.59
|
|
Drug test prsmv instrmnt
|
$28.50 |
$28.50 |
$28.50 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$722.00 |
$722.00 |
$722.00 |
$280.95
|
|
Drvvt confirm - quest
|
$105.50 |
$105.50 |
$105.50 |
$109.20
|
|
Ductogram sgl duct
|
$534.00 |
$534.00 |
$534.00 |
$469.44
|
|
Duplex scan bilateral study 93985
|
$1,635.50 |
$1,635.50 |
$1,635.50 |
$692.40
|
|
Duplex scan unilateral study 93986
|
$1,307.50 |
$1,307.50 |
$1,307.50 |
$375.60
|
|
Dup scan/hemodialysis access 93990
|
$925.00 |
$925.00 |
$925.00 |
$486.02
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$307.00 |
$307.00 |
$307.00 |
$745.00
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,587.50 |
$1,587.50 |
$1,587.50 |
$903.50
|
|
Dura-guard dura repair patch 10x16cm -q4432-cost per sq cm-160sq cm
|
$35.71 |
$35.71 |
$35.71 |
$23,482.80
|
|
Ecg 12 lead tracing only
|
$315.50 |
$315.50 |
$315.50 |
$226.50
|
|
Ecg external < 48 hours recording
|
$131.00 |
$131.00 |
$131.00 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$1,112.50 |
$1,112.50 |
$1,112.50 |
$541.20
|
|
Ecg external > 48 hours up to 7 days recording
|
$64.50 |
$64.50 |
$64.50 |
$147.28
|
|
Ecg external >7 days up to 15 days recording
|
$64.50 |
$64.50 |
$64.50 |
$161.85
|
|
Echocardiogram (Heart Ultrasound)
|
$2,564.00 |
$2,564.00 |
$2,564.00 |
$1,977.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$1,088.00 |
$1,088.00 |
$1,088.00 |
$711.00
|
|
Echocardiograpy doppler follow up/limited study
|
$690.50 |
$690.50 |
$690.50 |
$371.25
|
|
Echo exam uterus 76831-
|
$705.50 |
$705.50 |
$705.50 |
$552.50
|
|
Echo guidance radiotherapy
|
$1,319.00 |
$1,319.00 |
$1,319.00 |
$812.00
|
|
Echo guide for amniocentesis
|
$328.00 |
$328.00 |
$328.00 |
$446.60
|
|
Echo guide for artery repair
|
$825.00 |
$825.00 |
$825.00 |
$687.35
|
|
Echo stress
|
$1,959.00 |
$1,959.00 |
$1,959.00 |
$1,606.44
|
