|
Cystogram >= 3 views supervision & interpretation
|
$561.20 |
$561.20 |
$561.20 |
$564.85
|
|
Cystoscopy (Bladder Scope)
|
$1,827.60 |
$1,827.60 |
$1,827.60 |
$1,445.41
|
|
Cystoscopy removal of clots
|
$3,235.60 |
$3,235.60 |
$3,235.60 |
$4,051.50
|
|
Cystouretero & or pyeloscope
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$4,315.98
|
|
Cytogenetics 25-99
|
$86.00 |
$86.00 |
$86.00 |
$189.80
|
|
Cytogenomic neo microra alys
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$2,156.05
|
|
Cytogenom microarray copy nmbr var
|
$649.60 |
$649.60 |
$649.60 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$33.60 |
$33.60 |
$33.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$42.00 |
$42.00 |
$42.00 |
$100.00
|
|
Cyto/molecular report
|
$68.40 |
$68.40 |
$68.40 |
$144.75
|
|
Cytopath fl nongyn filter
|
$76.00 |
$76.00 |
$76.00 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$158.00 |
$158.00 |
$158.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$55.60 |
$55.60 |
$55.60 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$49.60 |
$49.60 |
$49.60 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$120.40 |
$120.40 |
$120.40 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$58.00 |
$58.00 |
$58.00 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$48.00 |
$48.00 |
$48.00 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$153.20 |
$153.20 |
$153.20 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$158.00 |
$158.00 |
$158.00 |
$209.92
|
|
Cytopath smear other source
|
$82.40 |
$82.40 |
$82.40 |
$91.20
|
|
Cytopath smear other source
|
$158.40 |
$158.40 |
$158.40 |
$140.07
|
|
Cytopath smear oth prep screen & interp
|
$65.60 |
$65.60 |
$65.60 |
$96.20
|
|
Cytopath tbs c/v manual
|
$30.40 |
$30.40 |
$30.40 |
$59.28
|
|
Cytotoxic antibody screening
|
$84.00 |
$84.00 |
$84.00 |
$193.80
|
|
Cytp urine 3-5 probes cmptr
|
$909.20 |
$909.20 |
$909.20 |
$664.80
|
|
Dalbavancin 500 mg intravenous solution
|
$14.86 |
$14.86 |
$14.86 |
$3,480.87
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.36 |
$0.36 |
$0.36 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$58.72 |
$58.72 |
$58.72 |
$6,273.69
|
|
Darbepoetin alfa, esrd use
|
$28.72 |
$28.72 |
$28.72 |
$6.28
|
|
D&c after delivery 59160
|
$2,917.20 |
$2,917.20 |
$2,917.20 |
$3,827.25
|
|
Dch glucoscan
|
$9.20 |
$9.20 |
$9.20 |
$29.16
|
|
Dch pulmonary stress test
|
$647.60 |
$647.60 |
$647.60 |
$963.30
|
|
Dch validity tests
|
$6.40 |
$6.40 |
$6.40 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$3,586.80 |
$3,586.80 |
$3,586.80 |
$5,110.00
|
|
Deamidated gliadin antibody iga
|
$24.00 |
$24.00 |
$24.00 |
$42.75
|
|
Debridement (>20 cm) charge pt
|
$284.00 |
$284.00 |
$284.00 |
$278.50
|
|
Debridement bone <= 20 sq cm
|
$1,906.40 |
$1,906.40 |
$1,906.40 |
$2,293.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$724.00 |
$724.00 |
$724.00 |
$687.35
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$821.60 |
$821.60 |
$821.60 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$724.00 |
$724.00 |
$724.00 |
$820.15
|
|
Debride nail1-5 11720
|
$112.00 |
$112.00 |
$112.00 |
$149.04
|
|
Debride nail6 or more 11721
|
$140.80 |
$140.80 |
$140.80 |
$167.63
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$512.40 |
$512.40 |
$512.40 |
$641.52
|
|
Debrid mastoidectomy cavity simple 69220
|
$318.00 |
$318.00 |
$318.00 |
$235.13
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,022.00 |
$1,022.00 |
$1,022.00 |
$1,160.00
|
|
Decalcification
|
$48.00 |
$48.00 |
$48.00 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$412.80 |
$412.80 |
$412.80 |
$546.84
|
|
Delivery of placenta 59414
|
$1,324.80 |
$1,324.80 |
$1,324.80 |
$2,822.68
|
|
Demonstrate use home inr mon
|
$273.20 |
$273.20 |
$273.20 |
$294.75
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$135.60 |
$135.60 |
$135.60 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$49.53 |
$49.53 |
$49.53 |
$6,324.98
|
|
Design mlc device for imrt
|
$980.40 |
$980.40 |
$980.40 |
$1,739.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$35.46 |
$35.46 |
$35.46 |
$93.84
|
|
Desoxycorticosterone
|
$47.60 |
$47.60 |
$47.60 |
$98.80
|
|
Des thora aorta rpr without left sub art 33881
|
$4,386.00 |
$4,386.00 |
$4,386.00 |
$4,937.50
|
|
Destroy cervthor facet jnt 64633
|
$2,555.60 |
$2,555.60 |
$2,555.60 |
$3,018.00
|
|
Destroy cth facet jnt addl 64634
|
$1,303.60 |
$1,303.60 |
$1,303.60 |
$1,441.44
|
|
Destruction benign lesions < 14 lesions
|
$296.00 |
$296.00 |
$296.00 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$2,679.60 |
$2,679.60 |
$2,679.60 |
$1,626.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,754.80 |
$1,754.80 |
$1,754.80 |
$1,618.65
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,825.20 |
$3,825.20 |
$3,825.20 |
$3,295.50
|
|
Destruction vag lesions complex 57065
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$3,762.53
|
|
Destruction vag lesions simple 57061
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$3,815.20
|
|
Detect agent nos dna dir
|
$54.40 |
$54.40 |
$54.40 |
$145.80
|
|
Detect agnt mult dna direc
|
$93.20 |
$93.20 |
$93.20 |
$166.77
|
|
Developmental screen/score/document 96110
|
$218.80 |
$218.80 |
$218.80 |
$143.13
|
|
Devel tst phys/qhp 1st hr
|
$350.40 |
$350.40 |
$350.40 |
$350.40
|
|
Device ablt adv novasure
|
$9,923.60 |
$9,923.60 |
$9,923.60 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,912.00 |
$3,912.00 |
$3,912.00 |
$4,200.00
|
|
Device intraute mirena
|
$1,154.34 |
$1,154.34 |
$1,154.34 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,816.80 |
$1,816.80 |
$1,816.80 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,035.60 |
$2,035.60 |
$2,035.60 |
$2,466.14
|
|
Dexamethasone 4 mg tablet
|
$5.08 |
$5.08 |
$5.08 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$30.20 |
$30.20 |
$30.20 |
$21.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$42.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$26.20 |
$26.20 |
$26.20 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$20.00 |
$20.00 |
$20.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$51.20 |
$51.20 |
$51.20 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$24.00 |
$24.00 |
$24.00 |
$79.20
|
|
Diab manage trn ind/group
|
$32.40 |
$32.40 |
$32.40 |
$54.99
|
|
Diag bronchoscope/catheter
|
$1,735.20 |
$1,735.20 |
$1,735.20 |
$2,360.15
|
|
Diagnostic anoscopy spx 46600
|
$344.40 |
$344.40 |
$344.40 |
$190.68
|
|
Diagnostic digital breast tomosynthesis bil
|
$87.60 |
$87.60 |
$87.60 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$68.40 |
$68.40 |
$68.40 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$469.60 |
$469.60 |
$469.60 |
$334.95
|
|
Diagnostic Mammogram (both breasts)
|
$384.40 |
$384.40 |
$384.40 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$299.60 |
$299.60 |
$299.60 |
$312.72
|
|
Diagnostic radio unlisted proc
|
$37.20 |
$37.20 |
$37.20 |
$243.60
|
|
Dialysis circuit perm vascular embolization 36909
|
$2,101.20 |
$2,101.20 |
$2,101.20 |
$5,663.50
|
|
Dialysis one evaluation
|
$540.80 |
$540.80 |
$540.80 |
$936.00
|
|
Dialysis repeated eval
|
$1,583.60 |
$1,583.60 |
$1,583.60 |
$1,332.80
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.40 |
$0.40 |
$0.40 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$50.00 |
$50.00 |
$50.00 |
$77.25
|
|
Dicyclomine injection
|
$86.42 |
$86.42 |
$86.42 |
$150.91
|
|
Diffusing capacity
|
$232.40 |
$232.40 |
$232.40 |
$335.20
|
|
Digital analysis of eeg
|
$396.40 |
$396.40 |
$396.40 |
$551.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$34.82 |
$34.82 |
$34.82 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$32.40 |
$32.40 |
$32.40 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,073.60 |
$1,073.60 |
$1,073.60 |
$1,729.70
|