|
Culture fungi definitive id mold
|
$129.30 |
$129.30 |
$129.30 |
$77.28
|
|
Culture fungi definitive id yeast
|
$138.00 |
$138.00 |
$138.00 |
$79.10
|
|
Culture fungi other (except blood)
|
$185.70 |
$185.70 |
$185.70 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$185.70 |
$185.70 |
$185.70 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$311.40 |
$311.40 |
$311.40 |
$89.70
|
|
Culture mycoplasma any source
|
$190.05 |
$190.05 |
$190.05 |
$85.26
|
|
Culture quantitative aerobic other source
|
$206.40 |
$206.40 |
$206.40 |
$90.35
|
|
Culture screening strep group a
|
$223.05 |
$223.05 |
$223.05 |
$81.00
|
|
Culture typing added method
|
$154.95 |
$154.95 |
$154.95 |
$38.58
|
|
Culture typing immunologic
|
$153.90 |
$153.90 |
$153.90 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$163.20 |
$163.20 |
$163.20 |
$133.90
|
|
Cutter lead
|
$7,740.00 |
$7,740.00 |
$7,740.00 |
$6,092.06
|
|
Cyanocobalamin unsat binding capacity
|
$87.00 |
$87.00 |
$87.00 |
$64.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$18.91 |
$18.91 |
$18.91 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$58.80 |
$58.80 |
$58.80 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,450.35 |
$1,450.35 |
$1,450.35 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$18.05 |
$18.05 |
$18.05 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$98.55 |
$98.55 |
$98.55 |
$140.78
|
|
Cyclosporine 2 hour
|
$200.40 |
$200.40 |
$200.40 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$5.44 |
$5.44 |
$5.44 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$902.34 |
$902.34 |
$902.34 |
$34.88
|
|
Cygnus matrix, per sq cm
|
$295.20 |
$295.20 |
$295.20 |
$295.20
|
|
Cygnus, per sq cm
|
$295.20 |
$295.20 |
$295.20 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$29,220.00 |
$29,220.00 |
$29,220.00 |
$22,803.38
|
|
Cymetra injectable
|
$371.46 |
$371.46 |
$371.46 |
$578.24
|
|
Cystogram >= 3 views supervision & interpretation
|
$622.35 |
$622.35 |
$622.35 |
$542.10
|
|
Cytarabine 20 mg/ml injection solution
|
$71.40 |
$71.40 |
$71.40 |
$89.94
|
|
Cytogenetics 25-99
|
$315.90 |
$315.90 |
$315.90 |
$190.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$128.70 |
$128.70 |
$128.70 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$23.85 |
$23.85 |
$23.85 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$159.45 |
$159.45 |
$159.45 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$147.00 |
$147.00 |
$147.00 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$114.90 |
$114.90 |
$114.90 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$150.00 |
$150.00 |
$150.00 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$590.40 |
$590.40 |
$590.40 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$632.10 |
$632.10 |
$632.10 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$322.35 |
$322.35 |
$322.35 |
$209.23
|
|
Cytopath smear oth prep screen & interp
|
$193.05 |
$193.05 |
$193.05 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$45.00 |
$45.00 |
$45.00 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$5,362.91 |
$5,362.91 |
$5,362.91 |
$3,024.59
|
|
Dalbavancin 500 mg intravenous solution
|
$3,522.68 |
$3,522.68 |
$3,522.68 |
$3,480.35
|
|
Dalteparin sodium
|
$469.55 |
$469.55 |
$469.55 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$140.40 |
$140.40 |
$140.40 |
$168.53
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$19,192.29 |
$19,192.29 |
$19,192.29 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,597.56 |
$4,597.56 |
$4,597.56 |
$6,072.48
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$20,196.00 |
$20,196.00 |
$20,196.00 |
$20,196.00
|
|
Deamidated gliadin antibody iga
|
$46.05 |
$46.05 |
$46.05 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$668.55 |
$668.55 |
$668.55 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$317.40 |
$317.40 |
$317.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$622.05 |
$622.05 |
$622.05 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,418.55 |
$1,418.55 |
$1,418.55 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,115.25 |
$1,115.25 |
$1,115.25 |
$810.50
|
|
Debride nail1-5 11720
|
$84.15 |
$84.15 |
$84.15 |
$148.80
|
|
Debride nail6 or more 11721
|
$84.15 |
$84.15 |
$84.15 |
$169.60
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,115.25 |
$1,115.25 |
$1,115.25 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,266.60 |
$1,266.60 |
$1,266.60 |
$1,160.00
|
|
Decalcification
|
$288.45 |
$288.45 |
$288.45 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$540.00 |
$540.00 |
$540.00 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$44.43 |
$44.43 |
$44.43 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$1,508.94 |
$1,508.94 |
$1,508.94 |
$1,807.08
|
|
Delivery of placenta 59414
|
$1,907.85 |
$1,907.85 |
$1,907.85 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$155.55 |
$155.55 |
$155.55 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,324.98 |
$6,324.98 |
$6,324.98 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$217.20 |
$217.20 |
$217.20 |
$408.10
|
|
Deodorant ostmy adapt lube 8ml
|
$1.98 |
$1.98 |
$1.98 |
$1.98
|
|
Depo-estradiol cypionate inj
|
$16.04 |
$16.04 |
$16.04 |
$71.51
|
|
Dermagraft
|
$193.11 |
$193.11 |
$193.11 |
$85.00
|
|
Dermapure 1 square cm
|
$608.85 |
$608.85 |
$608.85 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$68.79 |
$68.79 |
$68.79 |
$89.78
|
|
Destroy cervthor facet jnt 64633
|
$3,138.15 |
$3,138.15 |
$3,138.15 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,569.15 |
$1,569.15 |
$1,569.15 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$226.20 |
$226.20 |
$226.20 |
$199.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,569.15 |
$1,569.15 |
$1,569.15 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,138.15 |
$3,138.15 |
$3,138.15 |
$3,202.98
|
|
Device ablt adv novasure
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,867.20 |
$4,867.20 |
$4,867.20 |
$4,200.00
|
|
Device intraute mirena
|
$2,236.07 |
$2,236.07 |
$2,236.07 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,894.50 |
$1,894.50 |
$1,894.50 |
$1,894.50
|
|
Dexamethasone 4 mg tablet
|
$33.77 |
$33.77 |
$33.77 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$20.52 |
$20.52 |
$20.52 |
$21.17
|
|
Dexmedetomidine film, 1 mcg
|
$56.70 |
$56.70 |
$56.70 |
$171.39
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,086.05 |
$1,086.05 |
$1,086.05 |
$858.00
|
|
Dextran 40 infusion
|
$100.80 |
$100.80 |
$100.80 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$30.00 |
$30.00 |
$30.00 |
$47.48
|
|
Dhea-s (dehydroepiand sulfate)
|
$82.95 |
$82.95 |
$82.95 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$133.20 |
$133.20 |
$133.20 |
$79.20
|
|
Diab manage trn ind/group
|
$84.00 |
$84.00 |
$84.00 |
$56.55
|
|
Diab shoe for density insert
|
$147.56 |
$147.56 |
$147.56 |
$147.56
|
|
Diagnostic anoscopy spx 46600
|
$136.80 |
$136.80 |
$136.80 |
$190.68
|
|
Diagnostic laryngoscopy 31505
|
$163.35 |
$163.35 |
$163.35 |
$236.60
|
|
Diagnostic Mammogram (both breasts)
|
$366.15 |
$366.15 |
$366.15 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$366.15 |
$366.15 |
$366.15 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$900.00 |
$900.00 |
$900.00 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$84.83 |
$84.83 |
$84.83 |
$74.76
|
|
Dicyclomine injection
|
$90.79 |
$90.79 |
$90.79 |
$153.29
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$297.50 |
$297.50 |
$297.50 |
$69.03
|