|
Cystouretero w/biopsy
|
$22,479.74 |
$22,479.74 |
$22,479.74 |
$5,986.78
|
|
Cysto/uretero w/lithotripsy
|
$26,272.37 |
$26,272.37 |
$26,272.37 |
$9,002.88
|
|
Cystouretero w/lithotripsy
|
$38,328.77 |
$38,328.77 |
$38,328.77 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$21,749.16 |
$21,749.16 |
$21,749.16 |
$5,110.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$10,787.24 |
$10,787.24 |
$10,787.24 |
$3,065.15
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$27,055.70 |
$27,055.70 |
$27,055.70 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$89.94
|
|
Cytogenetics 25-99
|
$316.20 |
$316.20 |
$316.20 |
$190.00
|
|
Cytogenomic neo microra alys
|
$1,837.80 |
$1,837.80 |
$1,837.80 |
$2,020.20
|
|
Cytomegalovirus (cmv) antibody igg
|
$84.60 |
$84.60 |
$84.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$118.20 |
$118.20 |
$118.20 |
$97.50
|
|
Cytopath c/v index add-on
|
$44.40 |
$44.40 |
$44.40 |
$35.57
|
|
Cytopathology cellular enhancement technique non-gyn
|
$594.00 |
$594.00 |
$594.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$280.20 |
$280.20 |
$280.20 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$134.40 |
$134.40 |
$134.40 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$161.40 |
$161.40 |
$161.40 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$145.20 |
$145.20 |
$145.20 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$111.60 |
$111.60 |
$111.60 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$200.40 |
$200.40 |
$200.40 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$365.40 |
$365.40 |
$365.40 |
$209.23
|
|
Cytopath smear other source
|
$83.40 |
$83.40 |
$83.40 |
$88.13
|
|
Cytopath smear other source
|
$85.20 |
$85.20 |
$85.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$99.60 |
$99.60 |
$99.60 |
$96.20
|
|
Cytopath tbs c/v manual
|
$76.80 |
$76.80 |
$76.80 |
$59.28
|
|
Cytp urine 3-5 probes cmptr
|
$322.20 |
$322.20 |
$322.20 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$58.22
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$104.63 |
$104.63 |
$104.63 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$10,797.30 |
$10,797.30 |
$10,797.30 |
$6,072.48
|
|
Deamidated gliadin antibody iga
|
$40.20 |
$40.20 |
$40.20 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$807.00 |
$807.00 |
$807.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$332.40 |
$332.40 |
$332.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,704.80 |
$2,704.80 |
$2,704.80 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$927.00 |
$927.00 |
$927.00 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,412.40 |
$1,412.40 |
$1,412.40 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$8,682.24 |
$8,682.24 |
$8,682.24 |
$810.50
|
|
Debride skin bone at fx site
|
$3,588.60 |
$3,588.60 |
$3,588.60 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$860.40 |
$860.40 |
$860.40 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$12,892.85 |
$12,892.85 |
$12,892.85 |
$1,160.00
|
|
Decalcification
|
$84.60 |
$84.60 |
$84.60 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$756.00 |
$756.00 |
$756.00 |
$543.00
|
|
Degarelix 120 mg subcutaneous solution
|
$3,155.06 |
$3,155.06 |
$3,155.06 |
$1,807.08
|
|
Delayed breast prosthesis 19342
|
$56,711.92 |
$56,711.92 |
$56,711.92 |
$10,457.82
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$107.40 |
$107.40 |
$107.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$16,041.29 |
$16,041.29 |
$16,041.29 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$162.00 |
$162.00 |
$162.00 |
$408.10
|
|
Dermapure 1 square cm
|
$9,240.84 |
$9,240.84 |
$9,240.84 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$68.12 |
$68.12 |
$68.12 |
$89.78
|
|
Destruction benign lesions < 14 lesions
|
$251.40 |
$251.40 |
$251.40 |
$235.13
|
|
Device ablt adv novasure
|
$22,465.20 |
$22,465.20 |
$22,465.20 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$11,580.00 |
$11,580.00 |
$11,580.00 |
$4,200.00
|
|
Device sut capio slim opn
|
$5,299.01 |
$5,299.01 |
$5,299.01 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$4,290.39 |
$4,290.39 |
$4,290.39 |
$2,541.00
|
|
Dexamethasone 4 mg tablet
|
$10.20 |
$10.20 |
$10.20 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$26.89 |
$26.89 |
$26.89 |
$21.17
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$84.00 |
$84.00 |
$84.00 |
$47.48
|
|
Dhea-s (dehydroepiand sulfate)
|
$142.20 |
$142.20 |
$142.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$120.00 |
$120.00 |
$120.00 |
$79.20
|
|
Diag laparo separate proc 49320
|
$20,056.82 |
$20,056.82 |
$20,056.82 |
$6,904.15
|
|
Diagnostic anoscopy spx 46600
|
$162.00 |
$162.00 |
$162.00 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$249.00 |
$249.00 |
$249.00 |
$331.58
|
|
Dialysis one evaluation
|
$487.80 |
$487.80 |
$487.80 |
$919.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$256.50 |
$256.50 |
$256.50 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$31.07 |
$31.07 |
$31.07 |
$74.76
|
|
Diffusing capacity
|
$366.60 |
$366.60 |
$366.60 |
$332.00
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$21.00 |
$21.00 |
$21.00 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$23,129.10 |
$23,129.10 |
$23,129.10 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$97.20 |
$97.20 |
$97.20 |
$102.00
|
|
Dilate esophagus 1/mult pass
|
$4,195.12 |
$4,195.12 |
$4,195.12 |
$1,484.17
|
|
Dilation/urethral strict/male/ini 53620
|
$869.40 |
$869.40 |
$869.40 |
$1,372.80
|
|
Dilator fascial 10fx20cm
|
$1,470.20 |
$1,470.20 |
$1,470.20 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$81.82 |
$81.82 |
$81.82 |
$47.94
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$21.00 |
$21.00 |
$21.00 |
$17.75
|
|
Disaccharidases
|
$98.40 |
$98.40 |
$98.40 |
$216.00
|
|
Dise eval slp do brth flx dx
|
$7,695.05 |
$7,695.05 |
$7,695.05 |
$1,120.00
|
|
Dmpk gene detc abnor allele
|
$431.40 |
$431.40 |
$431.40 |
$313.60
|
|
Dna antibody native/double stranded
|
$127.20 |
$127.20 |
$127.20 |
$97.50
|
|
Dna gardnerella
|
$112.80 |
$112.80 |
$112.80 |
$62.50
|
|
Dna trichomonas
|
$112.80 |
$112.80 |
$112.80 |
$67.80
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$279.63 |
$279.63 |
$279.63 |
$98.43
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,043.55 |
$1,043.55 |
$1,043.55 |
$904.81
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$112.93 |
$112.93 |
$112.93 |
$65.40
|
|
Doppler echo complete
|
$663.00 |
$663.00 |
$663.00 |
$540.00
|
|
Doppler intravascular pressure flow initial vessel
|
$3,467.40 |
$3,467.40 |
$3,467.40 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$571.20 |
$571.20 |
$571.20 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$415.80 |
$415.80 |
$415.80 |
$471.17
|
|
Dornase alfa non-comp unit
|
$959.14 |
$959.14 |
$959.14 |
$446.75
|
|
Dornhoffer fixed part w/window
|
$119,274.00 |
$119,274.00 |
$119,274.00 |
$34,278.00
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$1,653.00 |
$1,653.00 |
$1,653.00 |
$1,718.24
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$105.22 |
$105.22 |
$105.22 |
$84.80
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$901.80 |
$901.80 |
$901.80 |
$800.00
|
|
Drainage ext aud canal abscess 69020
|
$901.80 |
$901.80 |
$901.80 |
$914.34
|
|
Drainage external ear complex 69005
|
$1,452.60 |
$1,452.60 |
$1,452.60 |
$2,726.90
|
|
Drainage external ear simple 69000
|
$901.80 |
$901.80 |
$901.80 |
$789.60
|
|
Drainage mouth roof lesion
|
$289.20 |
$289.20 |
$289.20 |
$390.39
|
|
Drainage of arm bursa 23931
|
$2,083.80 |
$2,083.80 |
$2,083.80 |
$2,197.48
|
|
Drainage of mouth lesion
|
$962.40 |
$962.40 |
$962.40 |
$962.40
|
|
Drainage of rectal abscess
|
$4,205.40 |
$4,205.40 |
$4,205.40 |
$2,111.46
|
|
Drain blood from under nail 11740
|
$112.80 |
$112.80 |
$112.80 |
$170.50
|
|
Drain finger abscess;simple 26010
|
$428.40 |
$428.40 |
$428.40 |
$419.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$441.60 |
$441.60 |
$441.60 |
$392.40
|
