|
Culture afb any source
|
$33.50 |
$33.50 |
$33.50 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$188.00 |
$188.00 |
$188.00 |
$84.76
|
|
Culture anaerobic except blood
|
$333.50 |
$333.50 |
$333.50 |
$120.54
|
|
Culture bact stool aero addl path ea
|
$101.00 |
$101.00 |
$101.00 |
$52.50
|
|
Culture body fluid
|
$195.50 |
$195.50 |
$195.50 |
$126.00
|
|
Culture fungi definitive id mold
|
$195.50 |
$195.50 |
$195.50 |
$80.00
|
|
Culture fungi definitive id yeast
|
$188.00 |
$188.00 |
$188.00 |
$79.50
|
|
Culture fungi other (except blood)
|
$186.00 |
$186.00 |
$186.00 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$186.00 |
$186.00 |
$186.00 |
$74.40
|
|
Culture mycoplasma any source
|
$18.00 |
$18.00 |
$18.00 |
$81.62
|
|
Culture quantitative aerobic other source
|
$201.00 |
$201.00 |
$201.00 |
$90.35
|
|
Culture screening strep group a
|
$101.00 |
$101.00 |
$101.00 |
$83.16
|
|
Culture typing added method
|
$54.00 |
$54.00 |
$54.00 |
$38.70
|
|
Culture typing immunologic
|
$195.50 |
$195.50 |
$195.50 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$165.00 |
$165.00 |
$165.00 |
$138.40
|
|
Culture urine each isolate
|
$43.00 |
$43.00 |
$43.00 |
$54.78
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$13.12 |
$13.12 |
$13.12 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$12.00 |
$12.00 |
$12.00 |
$72.15
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$395.12 |
$395.12 |
$395.12 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$14.37 |
$14.37 |
$14.37 |
$19.49
|
|
Cyclosporine 2 hour
|
$711.00 |
$711.00 |
$711.00 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$8.87 |
$8.87 |
$8.87 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$464.37 |
$464.37 |
$464.37 |
$35.57
|
|
Cygnus matrix, per sq cm
|
$60.94 |
$60.94 |
$60.94 |
$295.20
|
|
Cyp2c19 gene com variants
|
$169.00 |
$169.00 |
$169.00 |
$502.45
|
|
Cyp2c9 gene com variants
|
$60.00 |
$60.00 |
$60.00 |
$266.50
|
|
Cyp3a4 gene common variants
|
$240.00 |
$240.00 |
$240.00 |
$241.24
|
|
Cystatin c
|
$55.50 |
$55.50 |
$55.50 |
$76.48
|
|
Cystic fibrosis cftr
|
$900.00 |
$900.00 |
$900.00 |
$1,104.40
|
|
Cystine urine quantitative
|
$12.50 |
$12.50 |
$12.50 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$536.00 |
$536.00 |
$536.00 |
$564.85
|
|
Cystometrogram w/up 51727
|
$774.00 |
$774.00 |
$774.00 |
$908.59
|
|
Cytarabine 20 mg/ml injection solution
|
$112.62 |
$112.62 |
$112.62 |
$90.00
|
|
Cytogenetics 25-99
|
$78.00 |
$78.00 |
$78.00 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$2,156.05
|
|
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
|
|
Dacarbazine 100 mg intravenous solution
|
$76.25 |
$76.25 |
$76.25 |
$62.70
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$111.62 |
$111.62 |
$111.62 |
$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
|
|
Decitabine 50 mg intravenous solution
|
$826.00 |
$826.00 |
$826.00 |
$1,073.52
|
|
Deferoxamine 500 mg solution for injection
|
$82.62 |
$82.62 |
$82.62 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$148.50 |
$148.50 |
$148.50 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,434.00 |
$2,434.00 |
$2,434.00 |
$6,324.98
|
|
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
|
$151.00 |
$151.00 |
$151.00 |
$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 4 mg tablet
|
$42.00 |
$42.00 |
$42.00 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$3.87 |
$3.87 |
$3.87 |
$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)
|
$84.00 |
$84.00 |
$84.00 |
$77.25
|
|
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
|
|
Dimethyl sulfoxide 50% 50 ml
|
$919.50 |
$919.50 |
$919.50 |
$1,258.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$5.62 |
$5.62 |
$5.62 |
$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
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$3,118.37 |
$3,118.37 |
$3,118.37 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$8.37 |
$8.37 |
$8.37 |
$67.28
|
