|
Cytomegalovirus (cmv) antibody igm
|
$1,255.21 |
$1,255.21 |
$1,255.21 |
$97.50
|
|
Cytomegalovirus imm IV /vial
|
$10,537.17 |
$10,537.17 |
$10,537.17 |
$3,072.34
|
|
Cytopath c/v manual
|
$495.35 |
$495.35 |
$495.35 |
$36.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$322.20 |
$322.20 |
$322.20 |
$159.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$275.72 |
$275.72 |
$275.72 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$163.52 |
$163.52 |
$163.52 |
$209.23
|
|
Dacarbazine 100 mg intravenous solution
|
$430.46 |
$430.46 |
$430.46 |
$58.22
|
|
Dalteparin sodium
|
$545.54 |
$545.54 |
$545.54 |
$469.55
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$48,198.70 |
$48,198.70 |
$48,198.70 |
$21,063.03
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$3,423.81 |
$3,423.81 |
$3,423.81 |
$257.10
|
|
Dch pulmonary stress test
|
$1,455.16 |
$1,455.16 |
$1,455.16 |
$963.30
|
|
Decitabine 50 mg intravenous solution
|
$29,032.84 |
$29,032.84 |
$29,032.84 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$3,155.22 |
$3,155.22 |
$3,155.22 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$696.02 |
$696.02 |
$696.02 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$12,899.35 |
$12,899.35 |
$12,899.35 |
$1,807.08
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$580.35 |
$580.35 |
$580.35 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$23,531.40 |
$23,531.40 |
$23,531.40 |
$6,324.98
|
|
Depo-estradiol cypionate inj
|
$1,035.83 |
$1,035.83 |
$1,035.83 |
$71.51
|
|
Dermagraft
|
$9,051.40 |
$9,051.40 |
$9,051.40 |
$85.00
|
|
Descend thora aorta rpr/lt sub art 33880
|
$97,211.19 |
$97,211.19 |
$97,211.19 |
$6,687.93
|
|
Des thora aorta rpr without left sub art 33881
|
$97,211.19 |
$97,211.19 |
$97,211.19 |
$5,698.68
|
|
Detect agent nos dna dir
|
$915.35 |
$915.35 |
$915.35 |
$115.20
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$81,738.00 |
$81,738.00 |
$81,738.00 |
$4,200.00
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$6,941.58 |
$6,941.58 |
$6,941.58 |
$858.00
|
|
Dextrose 5 % IV bolus
|
$676.19 |
$676.19 |
$676.19 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,285.67 |
$1,285.67 |
$1,285.67 |
$112.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$208.95 |
$208.95 |
$208.95 |
$117.94
|
|
Diagnostic Mammogram (both breasts)
|
$1,662.56 |
$1,662.56 |
$1,662.56 |
$399.30
|
|
Dicyclomine injection
|
$589.93 |
$589.93 |
$589.93 |
$153.29
|
|
Diffusing capacity
|
$2,951.35 |
$2,951.35 |
$2,951.35 |
$332.00
|
|
Digital analysis of eeg
|
$2,284.39 |
$2,284.39 |
$2,284.39 |
$605.60
|
|
Digoxin immune fab 40 mg intravenous solution
|
$27,449.70 |
$27,449.70 |
$27,449.70 |
$10,079.82
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,305.84 |
$1,305.84 |
$1,305.84 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$13,295.49 |
$13,295.49 |
$13,295.49 |
$1,866.73
|
|
Dimethyl sulfoxide 50% 50 ml
|
$4,656.06 |
$4,656.06 |
$4,656.06 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$100.36 |
$100.36 |
$100.36 |
$17.75
|
|
Dissolve clot heart vessel
|
$6,491.69 |
$6,491.69 |
$6,491.69 |
$1,579.93
|
|
Dlyd plmt xtn prosth ea addl
|
$9,006.50 |
$9,006.50 |
$9,006.50 |
$1,582.68
|
|
Dna antibody native/double stranded
|
$602.75 |
$602.75 |
$602.75 |
$97.50
|
|
Doppler echo complete
|
$2,931.84 |
$2,931.84 |
$2,931.84 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$23,482.09 |
$23,482.09 |
$23,482.09 |
$2,777.60
|
|
Dornase alfa non-comp unit
|
$1,043.65 |
$1,043.65 |
$1,043.65 |
$446.75
|
|
Dorsi & plantar flex ass/res
|
$864.00 |
$864.00 |
$864.00 |
$163.50
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$50,967.49 |
$50,967.49 |
$50,967.49 |
$23,613.78
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$192.88 |
$192.88 |
$192.88 |
$84.80
|
|
Drainage of kidney lesion
|
$6,775.08 |
$6,775.08 |
$6,775.08 |
$1,506.00
|
|
Drain cerebro spinal fluid 62272
|
$3,110.02 |
$3,110.02 |
$3,110.02 |
$1,044.00
|
|
Drill hole implt ventricular cath/device 61107
|
$7,562.48 |
$7,562.48 |
$7,562.48 |
$1,515.00
|
|
Dronabinol 2.5mg oral
|
$340.87 |
$340.87 |
$340.87 |
$10.17
|
|
Drop lock knee
|
$1,646.00 |
$1,646.00 |
$1,646.00 |
$204.95
|
|
Drsg oasis fen mesh thick 3x7cm 21sqcm -cost per sq cm
|
$2,637.72 |
$2,637.72 |
$2,637.72 |
$127.14
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$1,279.00 |
$1,279.00 |
$1,279.00 |
$400.98
|
|
Drug admin & hemodynmic meas
|
$7,955.99 |
$7,955.99 |
$7,955.99 |
$569.75
|
|
Drug assay caffeine
|
$691.26 |
$691.26 |
$691.26 |
$83.40
|
|
Drug assay posaconazole
|
$529.01 |
$529.01 |
$529.01 |
$96.75
|
|
Drug assay voriconazole
|
$529.01 |
$529.01 |
$529.01 |
$96.75
|
|
Drug test def 1-7 classes
|
$1,413.92 |
$1,413.92 |
$1,413.92 |
$250.52
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$7,653.89 |
$7,653.89 |
$7,653.89 |
$887.25
|
|
Dxa bone density axl vrt fx
|
$577.74 |
$577.74 |
$577.74 |
$392.60
|
|
Echocardiogram (Heart Ultrasound)
|
$7,106.78 |
$7,106.78 |
$7,106.78 |
$2,001.17
|
|
Echocardiography doppler color flow mapping
|
$2,531.43 |
$2,531.43 |
$2,531.43 |
$469.95
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$7,050.28 |
$7,050.28 |
$7,050.28 |
$1,943.50
|
|
Echocardiography transthoracic 2d followup/limited
|
$4,836.88 |
$4,836.88 |
$4,836.88 |
$703.25
|
|
Echocardiography transthoracic 2d followup/limited w/contrast or without & w/contrast
|
$7,050.28 |
$7,050.28 |
$7,050.28 |
$851.50
|
|
Echocardiograpy doppler follow up/limited study
|
$2,171.43 |
$2,171.43 |
$2,171.43 |
$362.50
|
|
Echo exam of fetal heart
|
$3,909.68 |
$3,909.68 |
$3,909.68 |
$939.00
|
|
Echo guide for amniocentesis
|
$3,886.18 |
$3,886.18 |
$3,886.18 |
$456.30
|
|
Echo guide for artery repair
|
$2,806.86 |
$2,806.86 |
$2,806.86 |
$664.00
|
|
Echo stress
|
$9,546.22 |
$9,546.22 |
$9,546.22 |
$1,592.05
|
|
Echo tee probe placement image acquisition interpretation & report
|
$10,568.16 |
$10,568.16 |
$10,568.16 |
$1,849.50
|
|
Echo transthoracic
|
$6,454.56 |
$6,454.56 |
$6,454.56 |
$1,361.75
|
|
Echo transthoracic
|
$4,882.09 |
$4,882.09 |
$4,882.09 |
$953.10
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$8,152.95 |
$8,152.95 |
$8,152.95 |
$985.15
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$36,918.54 |
$36,918.54 |
$36,918.54 |
$18,199.20
|
|
Eculizumab injection
|
$36,918.54 |
$36,918.54 |
$36,918.54 |
$17,032.68
|
|
Eeg 41-60 minutes 95812-26
|
$4,792.25 |
$4,792.25 |
$4,792.25 |
$920.00
|
|
Eeg monitoring/function test
|
$4,196.11 |
$4,196.11 |
$4,196.11 |
$1,548.52
|
|
Eeg monitor/record/awake/drowsy 95816
|
$2,778.23 |
$2,778.23 |
$2,778.23 |
$835.00
|
|
Eeg over 1 hour 95813 - 26
|
$4,792.25 |
$4,792.25 |
$4,792.25 |
$1,102.05
|
|
Eeg/record in coma or sleep only 95822
|
$3,771.45 |
$3,771.45 |
$3,771.45 |
$907.80
|
|
Eeg recording awake and asleep
|
$3,665.24 |
$3,665.24 |
$3,665.24 |
$931.20
|
|
Eeg wo vid 2-12hr intmt mntr
|
$5,410.25 |
$5,410.25 |
$5,410.25 |
$671.00
|
|
Electrophysiology evaluation
|
$44,148.08 |
$44,148.08 |
$44,148.08 |
$8,979.45
|
|
Electrophysiology evaluation
|
$42,285.52 |
$42,285.52 |
$42,285.52 |
$10,233.60
|
|
Electrophysiology evaluation
|
$9,862.64 |
$9,862.64 |
$9,862.64 |
$6,760.00
|
|
Electrophysiology evaluation
|
$9,027.97 |
$9,027.97 |
$9,027.97 |
$5,854.80
|
|
Electrophysiology evaluation
|
$2,596.02 |
$2,596.02 |
$2,596.02 |
$2,451.90
|
|
Electrophysiology evaluation
|
$7,085.79 |
$7,085.79 |
$7,085.79 |
$2,821.00
|
|
Electrophysiology evaluation
|
$2,556.04 |
$2,556.04 |
$2,556.04 |
$1,869.13
|
|
Electrophys map 3d add-on
|
$18,311.03 |
$18,311.03 |
$18,311.03 |
$5,881.00
|
|
Embo or occlude vascular hemorrhage s&i
|
$87,462.69 |
$87,462.69 |
$87,462.69 |
$14,586.00
|
|
Emb/throm/fempop/aor/ilia/leg inc 34201
|
$27,282.17 |
$27,282.17 |
$27,282.17 |
$7,651.38
|
|
Emb/throm/pop-tib-pero art/leg inc 34203
|
$27,282.17 |
$27,282.17 |
$27,282.17 |
$6,708.28
|
|
Emr hd pmp elec/combo, rep
|
$2,592.00 |
$2,592.00 |
$2,592.00 |
$255.36
|
|
Endoluminal bx biliary tree
|
$4,826.54 |
$4,826.54 |
$4,826.54 |
$2,476.50
|
|
Endoluminl ivus oct c 1st
|
$4,512.37 |
$4,512.37 |
$4,512.37 |
$3,315.00
|
|
Endoluminl ivus oct c ea
|
$3,007.70 |
$3,007.70 |
$3,007.70 |
$2,203.49
|
|
Endoscopy swallow (fees) vid
|
$474.29 |
$474.29 |
$474.29 |
$402.35
|
|
Endovasc rpr a-biiliac endogft 34705
|
$15,557.54 |
$15,557.54 |
$15,557.54 |
$9,055.68
|
|
Entamoeba histolytica ag eia - sendout
|
$665.98 |
$665.98 |
$665.98 |
$56.89
|
