|
Culture mycoplasma any source
|
$18.00 |
$18.00 |
$18.00 |
$90.37
|
|
Culture screening strep group a
|
$66.15 |
$66.15 |
$66.15 |
$81.60
|
|
Culture typing immunologic
|
$10.50 |
$10.50 |
$10.50 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$27.54 |
$27.54 |
$27.54 |
$124.40
|
|
Culture virus isolation
|
$112.76 |
$112.76 |
$112.76 |
$39.20
|
|
Cutter lead
|
$905.79 |
$905.79 |
$905.79 |
$5,538.98
|
|
Cv line/pic reposition
|
$339.15 |
$339.15 |
$339.15 |
$1,829.42
|
|
Cyanocobalamin unsat binding capacity
|
$33.30 |
$33.30 |
$33.30 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$34.65 |
$34.65 |
$34.65 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$60.90 |
$60.90 |
$60.90 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,542.07 |
$2,542.07 |
$2,542.07 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$12.49 |
$12.49 |
$12.49 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$150.79 |
$150.79 |
$150.79 |
$179.10
|
|
Cyclosporine 2 hour
|
$130.82 |
$130.82 |
$130.82 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$5.85 |
$5.85 |
$5.85 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$22.56 |
$22.56 |
$22.56 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$22,594.80 |
$22,594.80 |
$22,594.80 |
$22,594.80
|
|
Cystatin c
|
$33.60 |
$33.60 |
$33.60 |
$82.26
|
|
Cystine urine quantitative
|
$46.65 |
$46.65 |
$46.65 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$312.60 |
$312.60 |
$312.60 |
$539.55
|
|
Cystostomy cystotomy w/drainage 51040
|
$839.21 |
$839.21 |
$839.21 |
$3,774.40
|
|
Cytogenom microarray copy nmbr var
|
$305.27 |
$305.27 |
$305.27 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$61.50 |
$61.50 |
$61.50 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$53.85 |
$53.85 |
$53.85 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$3,058.32 |
$3,058.32 |
$3,058.32 |
$3,113.07
|
|
Cytopath c/v auto in fluid
|
$40.50 |
$40.50 |
$40.50 |
$35.01
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$21.90 |
$21.90 |
$21.90 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$28.65 |
$28.65 |
$28.65 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$63.90 |
$63.90 |
$63.90 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$53.82 |
$53.82 |
$53.82 |
$124.80
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$49.05 |
$49.05 |
$49.05 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$62.37 |
$62.37 |
$62.37 |
$205.00
|
|
Cytopath tbs c/v manual
|
$25.05 |
$25.05 |
$25.05 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$65.60 |
$65.60 |
$65.60 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,157.32 |
$2,157.32 |
$2,157.32 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$6,174.31 |
$6,174.31 |
$6,174.31 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,546.04 |
$1,546.04 |
$1,546.04 |
$315.32
|
|
Daptomycin (xellia) unrefrig
|
$208.23 |
$208.23 |
$208.23 |
$0.04
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$122.77 |
$122.77 |
$122.77 |
$260.95
|
|
Deamidated gliadin antibody iga
|
$59.83 |
$59.83 |
$59.83 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$65.55 |
$65.55 |
$65.55 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,047.45 |
$1,047.45 |
$1,047.45 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$245.40 |
$245.40 |
$245.40 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$432.75 |
$432.75 |
$432.75 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$275.70 |
$275.70 |
$275.70 |
$810.50
|
|
Debride nail1-5 11720
|
$52.20 |
$52.20 |
$52.20 |
$173.25
|
|
Debride nail6 or more 11721
|
$60.75 |
$60.75 |
$60.75 |
$195.20
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$118.65 |
$118.65 |
$118.65 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$700.20 |
$700.20 |
$700.20 |
$1,193.40
|
|
Decalcification
|
$22.05 |
$22.05 |
$22.05 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$5,937.86 |
$5,937.86 |
$5,937.86 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$69.45 |
$69.45 |
$69.45 |
$545.90
|
|
Deferoxamine 500 mg solution for injection
|
$223.70 |
$223.70 |
$223.70 |
$110.82
|
|
Degarelix 120 mg subcutaneous solution
|
$4,685.74 |
$4,685.74 |
$4,685.74 |
$2,086.82
|
|
Delivery of placenta 59414
|
$371.85 |
$371.85 |
$371.85 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$70.88 |
$70.88 |
$70.88 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,508.51 |
$6,508.51 |
$6,508.51 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$83.63 |
$83.63 |
$83.63 |
$460.50
|
|
Dermagraft
|
$31.52 |
$31.52 |
$31.52 |
$1,912.31
|
|
Design mlc device for imrt
|
$311.10 |
$311.10 |
$311.10 |
$1,669.85
|
|
Desmopressin 4 mcg/ml injection solution
|
$229.25 |
$229.25 |
$229.25 |
$102.32
|
|
Desoxycorticosterone
|
$21.45 |
$21.45 |
$21.45 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$1,054.20 |
$1,054.20 |
$1,054.20 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$358.50 |
$358.50 |
$358.50 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$316.35 |
$316.35 |
$316.35 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,054.20 |
$1,054.20 |
$1,054.20 |
$3,375.00
|
|
Device ablt adv novasure
|
$3,261.67 |
$3,261.67 |
$3,261.67 |
$6,097.50
|
|
Device sut capio slim opn
|
$3,313.65 |
$3,313.65 |
$3,313.65 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$670.95 |
$670.95 |
$670.95 |
$2,440.98
|
|
Dexamethasone 4 mg tablet
|
$5.85 |
$5.85 |
$5.85 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$45.55 |
$45.55 |
$45.55 |
$30.00
|
|
Dextran 40 infusion
|
$80.28 |
$80.28 |
$80.28 |
$171.76
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$18.22 |
$18.22 |
$18.22 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$47.66 |
$47.66 |
$47.66 |
$49.75
|
|
Dhea-s (dehydroepiand sulfate)
|
$111.00 |
$111.00 |
$111.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$57.90 |
$57.90 |
$57.90 |
$78.03
|
|
Diabetes training group per 30 min g0109
|
$16.95 |
$16.95 |
$16.95 |
$34.50
|
|
Diab manage trn ind/group
|
$15.45 |
$15.45 |
$15.45 |
$49.50
|
|
Diagnostic anoscopy spx 46600
|
$12.60 |
$12.60 |
$12.60 |
$245.35
|
|
Diagnostic laryngoscopy 31575
|
$104.25 |
$104.25 |
$104.25 |
$385.20
|
|
Diagnostic Mammogram (both breasts)
|
$152.10 |
$152.10 |
$152.10 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$100.35 |
$100.35 |
$100.35 |
$301.55
|
|
Dialysis one evaluation
|
$403.95 |
$403.95 |
$403.95 |
$842.10
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.52 |
$0.52 |
$0.52 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$85.43 |
$85.43 |
$85.43 |
$72.34
|
|
Dicyclomine injection
|
$262.55 |
$262.55 |
$262.55 |
$211.81
|
|
Diffusing capacity
|
$228.60 |
$228.60 |
$228.60 |
$360.10
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$207.88 |
$207.88 |
$207.88 |
$69.79
|
|
Digoxin immune fab 40 mg intravenous solution
|
$12,628.79 |
$12,628.79 |
$12,628.79 |
$10,945.58
|
|
Digoxin total therapeutic drug level
|
$48.30 |
$48.30 |
$48.30 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$576.48 |
$576.48 |
$576.48 |
$334.68
|
|
Dilator fascial 10fx20cm
|
$107.42 |
$107.42 |
$107.42 |
$305.68
|
|
Dilat xst trc new access rcs
|
$1,439.10 |
$1,439.10 |
$1,439.10 |
$5,020.00
|
|
Dimethyl sulfoxide 50% 50 ml
|
$42.94 |
$42.94 |
$42.94 |
$1,155.52
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.49 |
$0.49 |
$0.49 |
$2.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$9.55 |
$9.55 |
$9.55 |
$26.87
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$133.96 |
$133.96 |
$133.96 |
$106.59
|
|
Disability dlco
|
$90.30 |
$90.30 |
$90.30 |
$307.58
|
|
Disaccharidases
|
$103.20 |
$103.20 |
$103.20 |
$223.80
|
|
Dna antibody native/double stranded
|
$64.26 |
$64.26 |
$64.26 |
$102.60
|