|
Culture anaerobic additional method definitive id each
|
$148.80 |
$148.80 |
$148.80 |
$79.00
|
|
Culture anaerobic except blood
|
$420.60 |
$420.60 |
$420.60 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$22.80 |
$22.80 |
$22.80 |
$51.45
|
|
Culture body fluid
|
$240.60 |
$240.60 |
$240.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$246.00 |
$246.00 |
$246.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$112.80 |
$112.80 |
$112.80 |
$79.10
|
|
Culture fungi other (except blood)
|
$216.60 |
$216.60 |
$216.60 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$74.40 |
$74.40 |
$74.40 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$294.60 |
$294.60 |
$294.60 |
$89.70
|
|
Culture mycoplasma any source
|
$147.60 |
$147.60 |
$147.60 |
$85.26
|
|
Culture screening strep group a
|
$136.20 |
$136.20 |
$136.20 |
$81.00
|
|
Culture typing immunologic
|
$73.20 |
$73.20 |
$73.20 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$832.80 |
$832.80 |
$832.80 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$135.00 |
$135.00 |
$135.00 |
$133.90
|
|
Culture urine each isolate
|
$94.80 |
$94.80 |
$94.80 |
$57.00
|
|
Cutter lead
|
$18,560.43 |
$18,560.43 |
$18,560.43 |
$6,092.06
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$121.20 |
$121.20 |
$121.20 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$873.00 |
$873.00 |
$873.00 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$121.24 |
$121.24 |
$121.24 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$672.61 |
$672.61 |
$672.61 |
$140.78
|
|
Cyclosporine 2 hour
|
$226.80 |
$226.80 |
$226.80 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$31.22 |
$31.22 |
$31.22 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$124.60 |
$124.60 |
$124.60 |
$34.88
|
|
Cygnus, per sq cm
|
$23,395.50 |
$23,395.50 |
$23,395.50 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$75,754.89 |
$75,754.89 |
$75,754.89 |
$22,803.38
|
|
Cyp2c9 gene com variants
|
$550.80 |
$550.80 |
$550.80 |
$275.10
|
|
Cyp3a4 gene common variants
|
$524.40 |
$524.40 |
$524.40 |
$245.31
|
|
Cyp3a5 gene common variants
|
$524.40 |
$524.40 |
$524.40 |
$245.31
|
|
Cystatin c
|
$130.80 |
$130.80 |
$130.80 |
$77.50
|
|
Cystic fibrosis cftr
|
$2,676.60 |
$2,676.60 |
$2,676.60 |
$1,100.00
|
|
Cystine urine quantitative
|
$74.40 |
$74.40 |
$74.40 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$843.00 |
$843.00 |
$843.00 |
$542.10
|
|
Cystoscopy and treatment
|
$16,927.26 |
$16,927.26 |
$16,927.26 |
$4,081.37
|
|
Cystoscopy and treatment
|
$12,159.60 |
$12,159.60 |
$12,159.60 |
$5,162.50
|
|
Cystoscopy and treatment
|
$17,539.87 |
$17,539.87 |
$17,539.87 |
$5,995.60
|
|
Cystoscopy and treatment
|
$20,369.83 |
$20,369.83 |
$20,369.83 |
$6,475.26
|
|
Cystoscopy and treatment
|
$13,081.88 |
$13,081.88 |
$13,081.88 |
$2,424.12
|
|
Cystoscopy and treatment
|
$1,546.20 |
$1,546.20 |
$1,546.20 |
$2,874.36
|
|
Cystoscopy and treatment
|
$1,546.20 |
$1,546.20 |
$1,546.20 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$41,439.20 |
$41,439.20 |
$41,439.20 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$7,904.77 |
$7,904.77 |
$7,904.77 |
$3,786.00
|
|
Cystouretero & or pyeloscope
|
$15,998.08 |
$15,998.08 |
$15,998.08 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$13,060.84 |
$13,060.84 |
$13,060.84 |
$4,846.99
|
|
Cysto/uretero w/lithotripsy
|
$27,308.19 |
$27,308.19 |
$27,308.19 |
$9,002.88
|
|
Cystouretero w/lithotripsy
|
$17,733.35 |
$17,733.35 |
$17,733.35 |
$7,061.60
|
|
Cystourethroscop/calib/dilat stric 52281
|
$8,940.32 |
$8,940.32 |
$8,940.32 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$118.27 |
$118.27 |
$118.27 |
$89.94
|
|
Cytogenomic neo microra alys
|
$1,837.80 |
$1,837.80 |
$1,837.80 |
$2,020.20
|
|
Cytomegalovirus (cmv) antibody igg
|
$158.40 |
$158.40 |
$158.40 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$162.00 |
$162.00 |
$162.00 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$544.20 |
$544.20 |
$544.20 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$92.40 |
$92.40 |
$92.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$67.80 |
$67.80 |
$67.80 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$152.40 |
$152.40 |
$152.40 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$80.40 |
$80.40 |
$80.40 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$105.60 |
$105.60 |
$105.60 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$187.80 |
$187.80 |
$187.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$423.00 |
$423.00 |
$423.00 |
$209.23
|
|
Cytopath smear other source
|
$93.60 |
$93.60 |
$93.60 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$113.40 |
$113.40 |
$113.40 |
$96.20
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$61,528.26 |
$61,528.26 |
$61,528.26 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$22,291.20 |
$22,291.20 |
$22,291.20 |
$6,072.48
|
|
Dch validity tests
|
$51.00 |
$51.00 |
$51.00 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$40.20 |
$40.20 |
$40.20 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,210.80 |
$1,210.80 |
$1,210.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$307.80 |
$307.80 |
$307.80 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$4,266.60 |
$4,266.60 |
$4,266.60 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$11,823.51 |
$11,823.51 |
$11,823.51 |
$663.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$9,604.70 |
$9,604.70 |
$9,604.70 |
$810.50
|
|
Debride nail1-5 11720
|
$89.40 |
$89.40 |
$89.40 |
$148.80
|
|
Debride nail6 or more 11721
|
$229.80 |
$229.80 |
$229.80 |
$169.60
|
|
Debride skin bone at fx site
|
$5,012.47 |
$5,012.47 |
$5,012.47 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$690.60 |
$690.60 |
$690.60 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$10,046.96 |
$10,046.96 |
$10,046.96 |
$1,160.00
|
|
Decalcification
|
$79.20 |
$79.20 |
$79.20 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$582.00 |
$582.00 |
$582.00 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$708.00 |
$708.00 |
$708.00 |
$543.00
|
|
Deep muscle biopsy 20205
|
$24,618.45 |
$24,618.45 |
$24,618.45 |
$3,339.00
|
|
Deferoxamine 500 mg solution for injection
|
$139.48 |
$139.48 |
$139.48 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$4,435.37 |
$4,435.37 |
$4,435.37 |
$1,807.08
|
|
Delayed breast prosthesis 19342
|
$31,443.82 |
$31,443.82 |
$31,443.82 |
$10,457.82
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$185.40 |
$185.40 |
$185.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$19,870.51 |
$19,870.51 |
$19,870.51 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$97.20 |
$97.20 |
$97.20 |
$408.10
|
|
Dermapure 1 square cm
|
$10,372.01 |
$10,372.01 |
$10,372.01 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$89.78 |
$89.78 |
$89.78 |
$89.78
|
|
Desoxycorticosterone
|
$166.20 |
$166.20 |
$166.20 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$6,170.15 |
$6,170.15 |
$6,170.15 |
$3,011.50
|
|
Destroy premlg lesns;1st lesn 17000
|
$376.20 |
$376.20 |
$376.20 |
$199.50
|
|
Destruct ben lesion 15/> 17111
|
$376.20 |
$376.20 |
$376.20 |
$235.13
|
|
Destruction 2-14 lesions 17003
|
$188.40 |
$188.40 |
$188.40 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$150.60 |
$150.60 |
$150.60 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$5,834.30 |
$5,834.30 |
$5,834.30 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$6,037.20 |
$6,037.20 |
$6,037.20 |
$3,202.98
|
|
Destruction premal lesions 15/> 17004
|
$778.20 |
$778.20 |
$778.20 |
$436.64
|
|
Developmental screen/score/document 96110
|
$17.40 |
$17.40 |
$17.40 |
$130.65
|
|
Device ablt adv novasure
|
$25,215.15 |
$25,215.15 |
$25,215.15 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$12,997.50 |
$12,997.50 |
$12,997.50 |
$4,200.00
|
|
Device sut capio slim opn
|
$5,947.66 |
$5,947.66 |
$5,947.66 |
$1,894.50
|
