|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$289.11 |
$289.11 |
$289.11 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$60.03 |
$60.03 |
$60.03 |
$123.76
|
|
Culture urine each isolate
|
$14.03 |
$14.03 |
$14.03 |
$51.35
|
|
Cutter lead
|
$15,380.61 |
$15,380.61 |
$15,380.61 |
$5,790.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$25.91 |
$25.91 |
$25.91 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$11.73 |
$11.73 |
$11.73 |
$68.00
|
|
Cyclosporine 2 hour
|
$30.82 |
$30.82 |
$30.82 |
$126.00
|
|
Cymetra injectable
|
$432.94 |
$432.94 |
$432.94 |
$578.24
|
|
Cyp2c9 gene com variants
|
$220.80 |
$220.80 |
$220.80 |
$257.36
|
|
Cyp2d6 gene com variants
|
$634.11 |
$634.11 |
$634.11 |
$537.50
|
|
Cystatin c
|
$20.47 |
$20.47 |
$20.47 |
$78.75
|
|
Cystic fibrosis cftr
|
$1,020.28 |
$1,020.28 |
$1,020.28 |
$1,060.00
|
|
Cystine urine quantitative
|
$29.21 |
$29.21 |
$29.21 |
$101.60
|
|
Cytomegalovirus (cmv) antibody igg
|
$24.61 |
$24.61 |
$24.61 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$28.06 |
$28.06 |
$28.06 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$76.13 |
$76.13 |
$76.13 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$34.73 |
$34.73 |
$34.73 |
$87.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$84.64 |
$84.64 |
$84.64 |
$207.50
|
|
Cytopath smear other source
|
$42.78 |
$42.78 |
$42.78 |
$88.13
|
|
Cytotoxic antibody screening
|
$31.28 |
$31.28 |
$31.28 |
$75.20
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$985.18 |
$985.18 |
$985.18 |
$232.95
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3,941.90 |
$3,941.90 |
$3,941.90 |
$5,546.48
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$1,247.98 |
$1,247.98 |
$1,247.98 |
$3,769.92
|
|
Dch validity tests
|
$4.37 |
$4.37 |
$4.37 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$72.91 |
$72.91 |
$72.91 |
$44.20
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$153.87 |
$153.87 |
$153.87 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$75.67 |
$75.67 |
$75.67 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$470.35 |
$470.35 |
$470.35 |
$2,321.40
|
|
Debridement/bone/20 sq cm or less 11046
|
$26.91 |
$26.91 |
$26.91 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$452.18 |
$452.18 |
$452.18 |
$1,418.55
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$299.00 |
$299.00 |
$299.00 |
$810.50
|
|
Debride nail6 or more 11721
|
$24.38 |
$24.38 |
$24.38 |
$167.63
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$289.11 |
$289.11 |
$289.11 |
$1,149.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$111.32 |
$111.32 |
$111.32 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$338.79 |
$338.79 |
$338.79 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$30.59 |
$30.59 |
$30.59 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$284.74 |
$284.74 |
$284.74 |
$1,176.57
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$256.91 |
$256.91 |
$256.91 |
$540.00
|
|
Deep muscle biopsy 20205
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$3,386.84
|
|
Deferoxamine 500 mg solution for injection
|
$133.32 |
$133.32 |
$133.32 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$34.04 |
$34.04 |
$34.04 |
$192.72
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,620.41 |
$4,620.41 |
$4,620.41 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$201.94 |
$201.94 |
$201.94 |
$414.78
|
|
Dermagraft
|
$23.23 |
$23.23 |
$23.23 |
$85.00
|
|
Dermapure 1 square cm
|
$215.16 |
$215.16 |
$215.16 |
$1,915.73
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,925.99 |
$1,925.99 |
$1,925.99 |
$77.66
|
|
Desoxycorticosterone
|
$32.43 |
$32.43 |
$32.43 |
$108.75
|
|
Destroy premlg lesns;1st lesn 17000
|
$97.52 |
$97.52 |
$97.52 |
$199.50
|
|
Destruction benign lesions < 14 lesions
|
$38.64 |
$38.64 |
$38.64 |
$235.13
|
|
Devel tst phys/qhp 1st hr
|
$66.01 |
$66.01 |
$66.01 |
$307.20
|
|
Device ablt adv novasure
|
$10,557.35 |
$10,557.35 |
$10,557.35 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$5,486.26 |
$5,486.26 |
$5,486.26 |
$4,285.86
|
|
Device tiss remov myosure reach
|
$1,876.06 |
$1,876.06 |
$1,876.06 |
$2,529.60
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$33.12 |
$33.12 |
$33.12 |
$196.30
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$67.85 |
$67.85 |
$67.85 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$0.41 |
$0.41 |
$0.41 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$25.69 |
$25.69 |
$25.69 |
$22.05
|
|
Dextran 40 infusion
|
$27.23 |
$27.23 |
$27.23 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$11.13 |
$11.13 |
$11.13 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$11.13 |
$11.13 |
$11.13 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$11.13 |
$11.13 |
$11.13 |
$42.32
|
|
Dextrose 5 % IV bolus
|
$11.13 |
$11.13 |
$11.13 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$38.18 |
$38.18 |
$38.18 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$16.56 |
$16.56 |
$16.56 |
$79.52
|
|
Diagnostic anoscopy spx 46600
|
$135.70 |
$135.70 |
$135.70 |
$195.50
|
|
Diagnostic laryngoscopy 31575
|
$50.14 |
$50.14 |
$50.14 |
$367.19
|
|
Diagnostic Mammogram (both breasts)
|
$83.95 |
$83.95 |
$83.95 |
$399.94
|
|
Diagnostic Mammogram (one breast)
|
$72.68 |
$72.68 |
$72.68 |
$310.00
|
|
Dialysis one evaluation
|
$191.13 |
$191.13 |
$191.13 |
$842.10
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$104.32 |
$104.32 |
$104.32 |
$74.02
|
|
Dicyclomine injection
|
$146.24 |
$146.24 |
$146.24 |
$157.69
|
|
Diffusing capacity
|
$98.21 |
$98.21 |
$98.21 |
$332.01
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$5.16 |
$5.16 |
$5.16 |
$69.81
|
|
Digoxin immune fab 40 mg intravenous solution
|
$7,506.92 |
$7,506.92 |
$7,506.92 |
$8,930.80
|
|
Digoxin total therapeutic drug level
|
$23.00 |
$23.00 |
$23.00 |
$99.60
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$330.61 |
$330.61 |
$330.61 |
$304.16
|
|
Dilation of cervical canal 57800
|
$1,321.35 |
$1,321.35 |
$1,321.35 |
$4,350.00
|
|
Dilator fascial 10fx20cm
|
$595.86 |
$595.86 |
$595.86 |
$402.10
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$4.49 |
$4.49 |
$4.49 |
$17.38
|
|
Disability dlco
|
$46.69 |
$46.69 |
$46.69 |
$280.00
|
|
Disaccharidases
|
$30.82 |
$30.82 |
$30.82 |
$203.08
|
|
Dmd dup/delet analysis
|
$215.05 |
$215.05 |
$215.05 |
$385.02
|
|
Dna antibody native/double stranded
|
$23.69 |
$23.69 |
$23.69 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$21.15 |
$21.15 |
$21.15 |
$99.10
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$13.16 |
$13.16 |
$13.16 |
$65.00
|
|
Doppler echo complete
|
$220.11 |
$220.11 |
$220.11 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$247.71 |
$247.71 |
$247.71 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$225.17 |
$225.17 |
$225.17 |
$476.45
|
|
Dpyd gene common variants
|
$220.11 |
$220.11 |
$220.11 |
$362.05
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$65.32 |
$65.32 |
$65.32 |
$800.00
|
|
Drainage external ear simple 69000
|
$55.89 |
$55.89 |
$55.89 |
$789.60
|
|
Drainage mouth roof lesion
|
$144.67 |
$144.67 |
$144.67 |
$405.60
|
|
Drainage of urethra abscess 53060
|
$860.89 |
$860.89 |
$860.89 |
$2,424.12
|
|
Drain blood from under nail 11740
|
$40.25 |
$40.25 |
$40.25 |
$173.21
|
|
Drain cerebro spinal fluid 62272
|
$356.96 |
$356.96 |
$356.96 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$128.34 |
$128.34 |
$128.34 |
$442.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$224.02 |
$224.02 |
$224.02 |
$397.15
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$74.52 |
$74.52 |
$74.52 |
$355.80
|
|
Dress/debrid prtl-thick burn l 16030
|
$100.28 |
$100.28 |
$100.28 |
$526.40
|
|
Drill hole implt ventricular cath/device 61107
|
$262.20 |
$262.20 |
$262.20 |
$1,631.50
|
