|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$61.20 |
$61.20 |
$61.20 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$46.80 |
$46.80 |
$46.80 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$60.80 |
$60.80 |
$60.80 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$60.80 |
$60.80 |
$60.80 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$25.20 |
$25.20 |
$25.20 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$274.40 |
$274.40 |
$274.40 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$90.00 |
$90.00 |
$90.00 |
$209.92
|
|
Cytopath smear other source
|
$39.20 |
$39.20 |
$39.20 |
$91.20
|
|
Cytopath smear other source
|
$90.00 |
$90.00 |
$90.00 |
$140.07
|
|
Cytopath smear oth prep screen & interp
|
$60.80 |
$60.80 |
$60.80 |
$96.20
|
|
Cytopath tbs c/v manual
|
$27.20 |
$27.20 |
$27.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$281.60 |
$281.60 |
$281.60 |
$193.80
|
|
Cytp urine 3-5 probes cmptr
|
$373.60 |
$373.60 |
$373.60 |
$664.80
|
|
Dalbavancin 500 mg intravenous solution
|
$19.39 |
$19.39 |
$19.39 |
$3,480.87
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.34 |
$0.34 |
$0.34 |
$171.19
|
|
D&c after delivery 59160
|
$3,561.20 |
$3,561.20 |
$3,561.20 |
$3,827.25
|
|
Dch glucoscan
|
$8.00 |
$8.00 |
$8.00 |
$29.16
|
|
Dch pulmonary stress test
|
$534.80 |
$534.80 |
$534.80 |
$963.30
|
|
Dch validity tests
|
$6.80 |
$6.80 |
$6.80 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$5,932.80 |
$5,932.80 |
$5,932.80 |
$5,110.00
|
|
Deamidated gliadin antibody iga
|
$7.60 |
$7.60 |
$7.60 |
$42.75
|
|
Debridement (>20 cm) charge pt
|
$147.60 |
$147.60 |
$147.60 |
$278.50
|
|
Debridement bone <= 20 sq cm
|
$2,535.20 |
$2,535.20 |
$2,535.20 |
$2,293.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$784.40 |
$784.40 |
$784.40 |
$687.35
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$255.60 |
$255.60 |
$255.60 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$562.00 |
$562.00 |
$562.00 |
$820.15
|
|
Debride nail1-5 11720
|
$105.60 |
$105.60 |
$105.60 |
$149.04
|
|
Debride nail6 or more 11721
|
$78.40 |
$78.40 |
$78.40 |
$167.63
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$810.80 |
$810.80 |
$810.80 |
$641.52
|
|
Debr musc/fascia 20sq cm/< 11043
|
$882.40 |
$882.40 |
$882.40 |
$1,160.00
|
|
Decalcification
|
$22.40 |
$22.40 |
$22.40 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$538.00 |
$538.00 |
$538.00 |
$546.84
|
|
Deep muscle biopsy 20205
|
$4,416.40 |
$4,416.40 |
$4,416.40 |
$3,370.52
|
|
Delivery of placenta 59414
|
$1,368.40 |
$1,368.40 |
$1,368.40 |
$2,822.68
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$1,899.20 |
$1,899.20 |
$1,899.20 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$400.00 |
$400.00 |
$400.00 |
$182.40
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$13.60 |
$13.60 |
$13.60 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$200.00 |
$200.00 |
$200.00 |
$399.93
|
|
Descend thora aorta rpr/lt sub art 33880
|
$5,267.20 |
$5,267.20 |
$5,267.20 |
$5,958.60
|
|
Design mlc device for imrt
|
$648.00 |
$648.00 |
$648.00 |
$1,739.10
|
|
Desmopressin 4 mcg/ml injection solution
|
$55.10 |
$55.10 |
$55.10 |
$93.84
|
|
Desoxycorticosterone
|
$137.20 |
$137.20 |
$137.20 |
$98.80
|
|
Des thora aorta rpr without left sub art 33881
|
$5,267.20 |
$5,267.20 |
$5,267.20 |
$4,937.50
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$5,267.20 |
$5,267.20 |
$5,267.20 |
$2,906.00
|
|
Destroy cervthor facet jnt 64633
|
$3,431.60 |
$3,431.60 |
$3,431.60 |
$3,018.00
|
|
Destruction benign lesions < 14 lesions
|
$320.80 |
$320.80 |
$320.80 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$1,646.40 |
$1,646.40 |
$1,646.40 |
$1,626.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$738.40 |
$738.40 |
$738.40 |
$1,618.65
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,529.60 |
$1,529.60 |
$1,529.60 |
$3,295.50
|
|
Devel tst phys/qhp 1st hr
|
$262.80 |
$262.80 |
$262.80 |
$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
|
$1,427.54 |
$1,427.54 |
$1,427.54 |
$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
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$139.20 |
$139.20 |
$139.20 |
$199.50
|
|
Dexamethasone 4 mg tablet
|
$3.34 |
$3.34 |
$3.34 |
$6.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$24.86 |
$24.86 |
$24.86 |
$21.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$28.80 |
$28.80 |
$28.80 |
$36.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$28.80 |
$28.80 |
$28.80 |
$42.50
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$28.80 |
$28.80 |
$28.80 |
$46.12
|
|
Dextrose 5 % IV bolus
|
$28.80 |
$28.80 |
$28.80 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$98.00 |
$98.00 |
$98.00 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$43.20 |
$43.20 |
$43.20 |
$79.20
|
|
Diagnostic anoscopy spx 46600
|
$200.00 |
$200.00 |
$200.00 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$286.80 |
$286.80 |
$286.80 |
$334.95
|
|
Diagnostic Mammogram (both breasts)
|
$176.40 |
$176.40 |
$176.40 |
$413.50
|
|
Diagnostic Mammogram (one breast)
|
$265.60 |
$265.60 |
$265.60 |
$312.72
|
|
Dialysis circuit perm vascular embolization 36909
|
$1,139.20 |
$1,139.20 |
$1,139.20 |
$5,663.50
|
|
Dialysis one evaluation
|
$682.00 |
$682.00 |
$682.00 |
$936.00
|
|
Dialysis repeated eval
|
$982.40 |
$982.40 |
$982.40 |
$1,332.80
|
|
Diatrizoate meglumine 18 % urethral solution
|
$0.40 |
$0.40 |
$0.40 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$72.00 |
$72.00 |
$72.00 |
$77.25
|
|
Dicyclomine injection
|
$121.34 |
$121.34 |
$121.34 |
$150.91
|
|
Diffusing capacity
|
$261.60 |
$261.60 |
$261.60 |
$335.20
|
|
Digital analysis of eeg
|
$302.80 |
$302.80 |
$302.80 |
$551.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$54.26 |
$54.26 |
$54.26 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$58.40 |
$58.40 |
$58.40 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$923.20 |
$923.20 |
$923.20 |
$1,729.70
|
|
Dilate ic vasospasm ea add vsl diff territory
|
$3,799.20 |
$3,799.20 |
$3,799.20 |
$3,026.10
|
|
Dilate ic vasospasm ea add vsl same territory
|
$3,799.20 |
$3,799.20 |
$3,799.20 |
$1,895.00
|
|
Dilate ic vasospasm init
|
$7,598.00 |
$7,598.00 |
$7,598.00 |
$4,627.52
|
|
Dilator fascial 10fx20cm
|
$544.40 |
$544.40 |
$544.40 |
$402.10
|
|
Diltiazem 5 mg/ml intravenous solution
|
$4.86 |
$4.86 |
$4.86 |
$46.56
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$57.70 |
$57.70 |
$57.70 |
$18.35
|
|
Disaccharidases
|
$80.00 |
$80.00 |
$80.00 |
$224.31
|
|
Disconnect insert locking wr
|
$48.80 |
$48.80 |
$48.80 |
$75.60
|
|
Disconnect locking wrist uni
|
$133.20 |
$133.20 |
$133.20 |
$207.20
|
|
Dlyd plmt xtn prosth ea addl
|
$1,810.80 |
$1,810.80 |
$1,810.80 |
$1,875.00
|
|
Dna antibody native/double stranded
|
$60.80 |
$60.80 |
$60.80 |
$100.00
|
|
Dna gardnerella
|
$88.40 |
$88.40 |
$88.40 |
$61.80
|
|
Dna probe chlamydia
|
$88.40 |
$88.40 |
$88.40 |
$82.20
|
|
Dna probe gc
|
$96.40 |
$96.40 |
$96.40 |
$84.80
|
|
Dna trichomonas
|
$88.40 |
$88.40 |
$88.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$62.22 |
$62.22 |
$62.22 |
$98.29
|
|
Doppler echo complete
|
$589.60 |
$589.60 |
$589.60 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$925.20 |
$925.20 |
$925.20 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$261.20 |
$261.20 |
$261.20 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$201.20 |
$201.20 |
$201.20 |
$473.76
|
|
Dornase alfa non-comp unit
|
$61.73 |
$61.73 |
$61.73 |
$386.42
|