|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$49.40 |
$49.40 |
$49.40 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$454.01 |
$454.01 |
$454.01 |
$85.03
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$717.76 |
$717.76 |
$717.76 |
$779.37
|
|
Cyclophosphamide 25 mg capsule
|
$130.76 |
$130.76 |
$130.76 |
$22.51
|
|
Cyclosporine 2 hour
|
$846.84 |
$846.84 |
$846.84 |
$119.40
|
|
Cyp2c19 gene com variants
|
$2,743.40 |
$2,743.40 |
$2,743.40 |
$553.00
|
|
Cystatin c
|
$162.50 |
$162.50 |
$162.50 |
$82.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$5,267.85 |
$5,267.85 |
$5,267.85 |
$527.50
|
|
Cystoscopy and treatment
|
$11,453.48 |
$11,453.48 |
$11,453.48 |
$2,874.36
|
|
Cytogenetics 25-99
|
$1,318.57 |
$1,318.57 |
$1,318.57 |
$180.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,217.14 |
$1,217.14 |
$1,217.14 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$550.61 |
$550.61 |
$550.61 |
$101.94
|
|
Cytopath c/v index add-on
|
$1,057.76 |
$1,057.76 |
$1,057.76 |
$29.60
|
|
Cytopath fl nongyn filter
|
$1,500.50 |
$1,500.50 |
$1,500.50 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$303.09 |
$303.09 |
$303.09 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$758.30 |
$758.30 |
$758.30 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$576.37 |
$576.37 |
$576.37 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$606.96 |
$606.96 |
$606.96 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$2,511.50 |
$2,511.50 |
$2,511.50 |
$75.60
|
|
Dacarbazine 100 mg intravenous solution
|
$366.33 |
$366.33 |
$366.33 |
$61.64
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$197.45 |
$197.45 |
$197.45 |
$544.35
|
|
Dch glucoscan
|
$147.71 |
$147.71 |
$147.71 |
$23.25
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,758.40 |
$1,758.40 |
$1,758.40 |
$798.23
|
|
Decalcification
|
$304.30 |
$304.30 |
$304.30 |
$75.38
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,517.60 |
$1,517.60 |
$1,517.60 |
$497.14
|
|
Deferoxamine 500 mg solution for injection
|
$827.21 |
$827.21 |
$827.21 |
$112.87
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$41,447.92 |
$41,447.92 |
$41,447.92 |
$8,127.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$210.18 |
$210.18 |
$210.18 |
$182.40
|
|
Depo-estradiol cypionate inj
|
$1,208.76 |
$1,208.76 |
$1,208.76 |
$87.27
|
|
Descend thora aorta rpr/lt sub art 33880
|
$65,765.70 |
$65,765.70 |
$65,765.70 |
$5,702.04
|
|
Design mlc device for imrt
|
$1,686.63 |
$1,686.63 |
$1,686.63 |
$1,641.90
|
|
Des thora aorta rpr without left sub art 33881
|
$54,669.93 |
$54,669.93 |
$54,669.93 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$51,076.35 |
$51,076.35 |
$51,076.35 |
$2,727.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$2,349.13 |
$2,349.13 |
$2,349.13 |
$222.30
|
|
Dexametha opth insert 0.1 mg
|
$3,220.35 |
$3,220.35 |
$3,220.35 |
$354.00
|
|
Dextran 40 infusion
|
$317.15 |
$317.15 |
$317.15 |
$173.97
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$370.65 |
$370.65 |
$370.65 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,626.08 |
$1,626.08 |
$1,626.08 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$587.65 |
$587.65 |
$587.65 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$1,813.19 |
$1,813.19 |
$1,813.19 |
$403.32
|
|
Diagnostic radio unlisted proc
|
$1,586.47 |
$1,586.47 |
$1,586.47 |
$236.93
|
|
Diatrizoate meglumine 18 % urethral solution
|
$810.86 |
$810.86 |
$810.86 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$393.94 |
$393.94 |
$393.94 |
$67.89
|
|
Dicyclomine injection
|
$675.03 |
$675.03 |
$675.03 |
$210.00
|
|
Diffusing capacity
|
$1,957.99 |
$1,957.99 |
$1,957.99 |
$357.50
|
|
Digoxin immune fab 40 mg intravenous solution
|
$33,865.73 |
$33,865.73 |
$33,865.73 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$603.74 |
$603.74 |
$603.74 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$3,045.90 |
$3,045.90 |
$3,045.90 |
$308.90
|
|
Dilate ic vasospasm ea add vsl same territory
|
$5,119.01 |
$5,119.01 |
$5,119.01 |
$2,145.00
|
|
Dilate ic vasospasm init
|
$8,777.10 |
$8,777.10 |
$8,777.10 |
$5,893.50
|
|
Dilat xst trc ndurlgc px
|
$6,843.72 |
$6,843.72 |
$6,843.72 |
$4,081.37
|
|
Dimethyl sulfoxide 50% 50 ml
|
$2,267.96 |
$2,267.96 |
$2,267.96 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$49.40 |
$49.40 |
$49.40 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$1,011.19 |
$1,011.19 |
$1,011.19 |
$100.80
|
|
Disability dlco
|
$3,017.65 |
$3,017.65 |
$3,017.65 |
$302.40
|
|
Disaccharidases
|
$1,305.70 |
$1,305.70 |
$1,305.70 |
$224.58
|
|
Dlyd plmt xtn prosth ea addl
|
$18,307.21 |
$18,307.21 |
$18,307.21 |
$2,001.55
|
|
Dna antibody native/double stranded
|
$547.39 |
$547.39 |
$547.39 |
$101.40
|
|
Dna probe chlamydia
|
$552.23 |
$552.23 |
$552.23 |
$82.20
|
|
Dna probe gc
|
$520.03 |
$520.03 |
$520.03 |
$88.67
|
|
Dna trichomonas
|
$210.92 |
$210.92 |
$210.92 |
$68.50
|
|
Doppler echo complete
|
$5,962.95 |
$5,962.95 |
$5,962.95 |
$644.00
|
|
Doppler intravascular pressure flow initial vessel
|
$12,494.63 |
$12,494.63 |
$12,494.63 |
$3,006.25
|
|
Dornase alfa non-comp unit
|
$962.39 |
$962.39 |
$962.39 |
$500.29
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$1,008.44 |
$1,008.44 |
$1,008.44 |
$232.80
|
|
Drainage of kidney lesion
|
$11,431.78 |
$11,431.78 |
$11,431.78 |
$1,619.40
|
|
Drain cath image guided visceral pq
|
$8,177.71 |
$8,177.71 |
$8,177.71 |
$2,996.80
|
|
Drain cerebro spinal fluid 62272
|
$3,845.10 |
$3,845.10 |
$3,845.10 |
$1,082.90
|
|
Drill hole implt ventricular cath/device 61107
|
$2,195.90 |
$2,195.90 |
$2,195.90 |
$1,723.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$152.68 |
$152.68 |
$152.68 |
$33.99
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$35.97 |
$35.97 |
$35.97 |
$189.68
|
|
Drug admin & hemodynmic meas
|
$2,285.85 |
$2,285.85 |
$2,285.85 |
$542.23
|
|
Drug assay caffeine
|
$210.92 |
$210.92 |
$210.92 |
$86.45
|
|
Drug test def 1-7 classes
|
$3,229.63 |
$3,229.63 |
$3,229.63 |
$263.86
|
|
Drvvt confirm - quest
|
$1,271.07 |
$1,271.07 |
$1,271.07 |
$102.30
|
|
Duplex scan bilateral study 93985
|
$4,136.30 |
$4,136.30 |
$4,136.30 |
$690.95
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$11,370.33 |
$11,370.33 |
$11,370.33 |
$750.20
|
|
Ecg 12 lead tracing only
|
$2,191.41 |
$2,191.41 |
$2,191.41 |
$243.61
|
|
Ecg/1-3 leads/tracing only 93041
|
$1,481.49 |
$1,481.49 |
$1,481.49 |
$129.83
|
|
Ecg external < 48 hours scanning analysis w/report
|
$3,043.61 |
$3,043.61 |
$3,043.61 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$19,964.77 |
$19,964.77 |
$19,964.77 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$3,375.86 |
$3,375.86 |
$3,375.86 |
$461.61
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$18,772.48 |
$18,772.48 |
$18,772.48 |
$1,818.05
|
|
Echocardiography transthoracic 2d followup/limited
|
$6,776.07 |
$6,776.07 |
$6,776.07 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$4,087.58 |
$4,087.58 |
$4,087.58 |
$354.90
|
|
Echo exam of fetal heart
|
$983.75 |
$983.75 |
$983.75 |
$323.40
|
|
Echograp trans r pros study
|
$1,794.95 |
$1,794.95 |
$1,794.95 |
$445.25
|
|
Echo guidance radiotherapy
|
$2,169.37 |
$2,169.37 |
$2,169.37 |
$769.18
|
|
Echo stress
|
$10,274.00 |
$10,274.00 |
$10,274.00 |
$1,607.45
|
|
Echo tee guidance
|
$9,126.00 |
$9,126.00 |
$9,126.00 |
$2,007.00
|
|
Echo transesophageal
|
$5,344.10 |
$5,344.10 |
$5,344.10 |
$913.33
|
|
Echo transesophageal intraop
|
$5,845.44 |
$5,845.44 |
$5,845.44 |
$1,571.70
|
|
Echo transthoracic
|
$2,990.18 |
$2,990.18 |
$2,990.18 |
$1,475.25
|
|
Echo transthoracic
|
$1,456.33 |
$1,456.33 |
$1,456.33 |
$944.14
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$4,208.23 |
$4,208.23 |
$4,208.23 |
$1,020.09
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$25,572.77 |
$25,572.77 |
$25,572.77 |
$17,641.10
|
|
Eeg 41-60 minutes 95812-26
|
$19,079.10 |
$19,079.10 |
$19,079.10 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$5,086.39 |
$5,086.39 |
$5,086.39 |
$1,048.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$8,961.66 |
$8,961.66 |
$8,961.66 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$3,995.43 |
$3,995.43 |
$3,995.43 |
$1,100.40
|