|
Cystatin c
|
$49.00 |
$49.00 |
$49.00 |
$77.50
|
|
Cystine urine quantitative
|
$81.00 |
$81.00 |
$81.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$660.50 |
$660.50 |
$660.50 |
$542.10
|
|
Cysto, litho, vacuum kidney
|
$3,974.50 |
$3,974.50 |
$3,974.50 |
$10,942.71
|
|
Cystoscopy and treatment
|
$4,234.00 |
$4,234.00 |
$4,234.00 |
$5,162.50
|
|
Cystoscopy and treatment
|
$2,482.00 |
$2,482.00 |
$2,482.00 |
$5,995.60
|
|
Cystoscopy and treatment
|
$7,008.00 |
$7,008.00 |
$7,008.00 |
$6,475.26
|
|
Cystoscopy and treatment
|
$5,833.63 |
$5,833.63 |
$5,833.63 |
$3,213.14
|
|
Cystoscopy and treatment
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$801.50 |
$801.50 |
$801.50 |
$958.81
|
|
Cystoscopy and treatment
|
$1,387.00 |
$1,387.00 |
$1,387.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$2,874.36
|
|
Cystoscopy and treatment
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$3,203.50
|
|
Cystoscopy and treatment
|
$8,715.00 |
$8,715.00 |
$8,715.00 |
$4,061.71
|
|
Cystoscopy (Bladder Scope)
|
$3,392.42 |
$3,392.42 |
$3,392.42 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$335.00 |
$335.00 |
$335.00 |
$2,704.80
|
|
Cystoscopy removal of clots
|
$4,051.50 |
$4,051.50 |
$4,051.50 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$7,811.00 |
$7,811.00 |
$7,811.00 |
$3,786.00
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,501.00 |
$3,501.00 |
$3,501.00 |
$3,863.60
|
|
Cystouretero & or pyeloscope
|
$3,800.00 |
$3,800.00 |
$3,800.00 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$3,650.00 |
$3,650.00 |
$3,650.00 |
$4,846.99
|
|
Cystouretero w/biopsy
|
$8,511.67 |
$8,511.67 |
$8,511.67 |
$5,986.78
|
|
Cystouretero w/excise tumor
|
$3,696.00 |
$3,696.00 |
$3,696.00 |
$5,584.80
|
|
Cysto/uretero w/lithotripsy
|
$13,189.50 |
$13,189.50 |
$13,189.50 |
$9,002.88
|
|
Cystouretero w/lithotripsy
|
$9,602.50 |
$9,602.50 |
$9,602.50 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$10,832.67 |
$10,832.67 |
$10,832.67 |
$5,110.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$3,065.15
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$0.28 |
$0.28 |
$0.28 |
$89.94
|
|
Cytogenetics 25-99
|
$241.00 |
$241.00 |
$241.00 |
$190.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$63.00 |
$63.00 |
$63.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$10.00 |
$10.00 |
$10.00 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$501.19 |
$501.19 |
$501.19 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$86.50 |
$86.50 |
$86.50 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$105.50 |
$105.50 |
$105.50 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$102.50 |
$102.50 |
$102.50 |
$129.60
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$133.00 |
$133.00 |
$133.00 |
$209.23
|
|
Dacarbazine 100 mg intravenous solution
|
$40.52 |
$40.52 |
$40.52 |
$58.22
|
|
Dalbavancin 500 mg intravenous solution
|
$6,201.23 |
$6,201.23 |
$6,201.23 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$916.36 |
$916.36 |
$916.36 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$99.22 |
$99.22 |
$99.22 |
$56.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$19,945.05 |
$19,945.05 |
$19,945.05 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$8,394.35 |
$8,394.35 |
$8,394.35 |
$6,072.48
|
|
Darbepoetin alfa, esrd use
|
$17.00 |
$17.00 |
$17.00 |
$4.48
|
|
D&c after delivery 59160
|
$4,617.00 |
$4,617.00 |
$4,617.00 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$6,570.00 |
$6,570.00 |
$6,570.00 |
$3,774.81
|
|
Dch validity tests
|
$14.00 |
$14.00 |
$14.00 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$35.00 |
$35.00 |
$35.00 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$467.00 |
$467.00 |
$467.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$952.00 |
$952.00 |
$952.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$4,088.00 |
$4,088.00 |
$4,088.00 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,654.00 |
$1,654.00 |
$1,654.00 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$4,572.00 |
$4,572.00 |
$4,572.00 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,336.00 |
$2,336.00 |
$2,336.00 |
$810.50
|
|
Debride nail1-5 11720
|
$129.00 |
$129.00 |
$129.00 |
$148.80
|
|
Debride nail6 or more 11721
|
$111.50 |
$111.50 |
$111.50 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$814.00 |
$814.00 |
$814.00 |
$1,012.80
|
|
Debride skin bone at fx site
|
$3,926.00 |
$3,926.00 |
$3,926.00 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,168.00 |
$1,168.00 |
$1,168.00 |
$639.60
|
|
Debrid mastoidectomy cavity simple 69220
|
$274.00 |
$274.00 |
$274.00 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$4,190.00 |
$4,190.00 |
$4,190.00 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$1,160.00
|
|
Decalcification
|
$106.00 |
$106.00 |
$106.00 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$66.11 |
$66.11 |
$66.11 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$380.00 |
$380.00 |
$380.00 |
$543.00
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$4,575.00 |
$4,575.00 |
$4,575.00 |
$4,914.00
|
|
Decompression of tibia nerve
|
$4,032.00 |
$4,032.00 |
$4,032.00 |
$2,625.60
|
|
Degarelix 120 mg subcutaneous solution
|
$2,151.09 |
$2,151.09 |
$2,151.09 |
$1,807.08
|
|
Delayed breast prosthesis 19342
|
$15,198.08 |
$15,198.08 |
$15,198.08 |
$10,457.82
|
|
Delay flap eye/nos/ear/lip
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,190.24
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$184.00 |
$184.00 |
$184.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,489.51 |
$7,489.51 |
$7,489.51 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$160.00 |
$160.00 |
$160.00 |
$408.10
|
|
Dermabrasion segmental face 15781
|
$4,368.00 |
$4,368.00 |
$4,368.00 |
$1,290.07
|
|
Dermapure 1 square cm
|
$47.00 |
$47.00 |
$47.00 |
$3,822.00
|
|
Design mlc device for imrt
|
$477.50 |
$477.50 |
$477.50 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$478.25 |
$478.25 |
$478.25 |
$89.78
|
|
Desoxycorticosterone
|
$44.00 |
$44.00 |
$44.00 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$5,528.50 |
$5,528.50 |
$5,528.50 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$1,243.50 |
$1,243.50 |
$1,243.50 |
$1,441.44
|
|
Destroy internal hemorrhoids destroy 46930
|
$1,388.00 |
$1,388.00 |
$1,388.00 |
$1,344.85
|
|
Destroy premlg lesns;1st lesn 17000
|
$248.50 |
$248.50 |
$248.50 |
$199.50
|
|
Destroy vulva lesion simple 56501
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$231.00 |
$231.00 |
$231.00 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$849.50 |
$849.50 |
$849.50 |
$966.60
|
|
Destruct cut vasl lesions >50cm 17108
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$36.00 |
$36.00 |
$36.00 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$248.50 |
$248.50 |
$248.50 |
$235.13
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$883.17 |
$883.17 |
$883.17 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,163.50 |
$2,163.50 |
$2,163.50 |
$3,202.98
|
|
Destruction penis lesion(s) chem 54050
|
$467.00 |
$467.00 |
$467.00 |
$332.00
|
|
Destruction vag lesions simple 57061
|
$3,720.50 |
$3,720.50 |
$3,720.50 |
$3,815.20
|
|
Detect agent nos dna dir
|
$198.00 |
$198.00 |
$198.00 |
$115.20
|
|
Developmental screen/score/document 96110
|
$25.00 |
$25.00 |
$25.00 |
$130.65
|
|
Devel tst phys/qhp 1st hr
|
$202.00 |
$202.00 |
$202.00 |
$337.50
|
|
Device ablt adv novasure
|
$2,597.50 |
$2,597.50 |
$2,597.50 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$396.21 |
$396.21 |
$396.21 |
$4,200.00
|
|
Device intraute mirena
|
$2,785.50 |
$2,785.50 |
$2,785.50 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,211.77 |
$1,211.77 |
$1,211.77 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$1,278.75 |
$1,278.75 |
$1,278.75 |
$2,541.00
|
