|
Cystatin c
|
$27.00 |
$27.00 |
$27.00 |
$77.50
|
|
Cystoscopy and treatment
|
$250.50 |
$250.50 |
$250.50 |
$5,162.50
|
|
Cystoscopy (Bladder Scope)
|
$571.00 |
$571.00 |
$571.00 |
$1,493.80
|
|
Cystoscopy removal of clots
|
$2,881.00 |
$2,881.00 |
$2,881.00 |
$4,081.37
|
|
Cystostomy cystotomy w/drainage 51040
|
$2,458.00 |
$2,458.00 |
$2,458.00 |
$3,863.60
|
|
Cytomegalovirus (cmv) antibody igg
|
$32.00 |
$32.00 |
$32.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$10.00 |
$10.00 |
$10.00 |
$97.50
|
|
Cyto/molecular report
|
$36.00 |
$36.00 |
$36.00 |
$133.20
|
|
Cytopath fl nongyn filter
|
$19.50 |
$19.50 |
$19.50 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$81.50 |
$81.50 |
$81.50 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$82.00 |
$82.00 |
$82.00 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$50.50 |
$50.50 |
$50.50 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$23.50 |
$23.50 |
$23.50 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$29.50 |
$29.50 |
$29.50 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$22.50 |
$22.50 |
$22.50 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$72.50 |
$72.50 |
$72.50 |
$209.23
|
|
Cytopath smear other source
|
$40.50 |
$40.50 |
$40.50 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$26.50 |
$26.50 |
$26.50 |
$96.20
|
|
Dalbavancin 500 mg intravenous solution
|
$13.50 |
$13.50 |
$13.50 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.50 |
$0.50 |
$0.50 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$11.50 |
$11.50 |
$11.50 |
$6,072.48
|
|
Darbepoetin alfa, esrd use
|
$11.50 |
$11.50 |
$11.50 |
$4.48
|
|
Dch validity tests
|
$13.50 |
$13.50 |
$13.50 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$33.00 |
$33.00 |
$33.00 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$28.00 |
$28.00 |
$28.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$25.50 |
$25.50 |
$25.50 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$234.00 |
$234.00 |
$234.00 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$56.50 |
$56.50 |
$56.50 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$101.00 |
$101.00 |
$101.00 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$389.50 |
$389.50 |
$389.50 |
$810.50
|
|
Debride nail1-5 11720
|
$15.00 |
$15.00 |
$15.00 |
$148.80
|
|
Debride nail6 or more 11721
|
$56.50 |
$56.50 |
$56.50 |
$169.60
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$307.50 |
$307.50 |
$307.50 |
$1,012.80
|
|
Debride skin bone at fx site
|
$422.50 |
$422.50 |
$422.50 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$26.00 |
$26.00 |
$26.00 |
$639.60
|
|
Debrid mastoidectomy cavity simple 69220
|
$51.00 |
$51.00 |
$51.00 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$285.00 |
$285.00 |
$285.00 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$708.00 |
$708.00 |
$708.00 |
$1,160.00
|
|
Decalcification
|
$53.00 |
$53.00 |
$53.00 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$527.50 |
$527.50 |
$527.50 |
$543.00
|
|
Degarelix 120 mg subcutaneous solution
|
$6.00 |
$6.00 |
$6.00 |
$1,807.08
|
|
Delivery of placenta 59414
|
$100.50 |
$100.50 |
$100.50 |
$3,070.56
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$112.50 |
$112.50 |
$112.50 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$45.50 |
$45.50 |
$45.50 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$200.00 |
$200.00 |
$200.00 |
$408.10
|
|
Dermapure 1 square cm
|
$119.50 |
$119.50 |
$119.50 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$5.00 |
$5.00 |
$5.00 |
$89.78
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$192.50 |
$192.50 |
$192.50 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$128.00 |
$128.00 |
$128.00 |
$408.50
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$115.00 |
$115.00 |
$115.00 |
$364.50
|
|
Destroy cervthor facet jnt 64633
|
$1,870.50 |
$1,870.50 |
$1,870.50 |
$3,011.50
|
|
Destroy cth facet jnt addl 64634
|
$961.50 |
$961.50 |
$961.50 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$192.50 |
$192.50 |
$192.50 |
$199.50
|
|
Destroy vulva lesion extensive 56515
|
$215.00 |
$215.00 |
$215.00 |
$2,837.09
|
|
Destroy vulva lesion simple 56501
|
$1,976.50 |
$1,976.50 |
$1,976.50 |
$3,562.00
|
|
Destruct ben lesion 15/> 17111
|
$80.00 |
$80.00 |
$80.00 |
$235.13
|
|
Destruct cut vasl lesions 10-50cm 17107
|
$341.50 |
$341.50 |
$341.50 |
$966.60
|
|
Destruct cut vasl lesions >50cm 17108
|
$507.50 |
$507.50 |
$507.50 |
$2,142.40
|
|
Destruction 2-14 lesions 17003
|
$44.50 |
$44.50 |
$44.50 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$192.50 |
$192.50 |
$192.50 |
$235.13
|
|
Destruction by injection tx of nerve 64630
|
$847.50 |
$847.50 |
$847.50 |
$1,589.38
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$915.50 |
$915.50 |
$915.50 |
$1,616.72
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,870.50 |
$1,870.50 |
$1,870.50 |
$3,202.98
|
|
Destruction penis lesion(s) chem 54050
|
$105.50 |
$105.50 |
$105.50 |
$332.00
|
|
Destruction vag lesions simple 57061
|
$116.00 |
$116.00 |
$116.00 |
$3,815.20
|
|
Destruct penis les/smp/electrodesi 54055
|
$95.50 |
$95.50 |
$95.50 |
$2,837.09
|
|
Detect agent nos dna dir
|
$198.00 |
$198.00 |
$198.00 |
$115.20
|
|
Determine refractive state
|
$18.00 |
$18.00 |
$18.00 |
$19.80
|
|
Developmental screen/score/document 96110
|
$13.50 |
$13.50 |
$13.50 |
$130.65
|
|
Device intraute mirena
|
$1,822.00 |
$1,822.00 |
$1,822.00 |
$2,125.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$10.50 |
$10.50 |
$10.50 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$0.50 |
$0.50 |
$0.50 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.50 |
$0.50 |
$0.50 |
$21.17
|
|
Dexamethasone intra implant
|
$294.50 |
$294.50 |
$294.50 |
$2,538.20
|
|
Dhea-s (dehydroepiand sulfate)
|
$62.00 |
$62.00 |
$62.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$67.00 |
$67.00 |
$67.00 |
$79.20
|
|
Diagnostic anoscopy
|
$97.50 |
$97.50 |
$97.50 |
$391.20
|
|
Diagnostic anoscopy spx 46600
|
$44.50 |
$44.50 |
$44.50 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$191.50 |
$191.50 |
$191.50 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$343.50 |
$343.50 |
$343.50 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$212.00 |
$212.00 |
$212.00 |
$301.55
|
|
Diffusing capacity
|
$177.50 |
$177.50 |
$177.50 |
$332.00
|
|
Digoxin total therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$65.00 |
$65.00 |
$65.00 |
$297.86
|
|
Dilate tear duct opening
|
$76.50 |
$76.50 |
$76.50 |
$472.21
|
|
Dilate urethra stricture
|
$239.50 |
$239.50 |
$239.50 |
$490.00
|
|
Dilate urethra stricture
|
$55.00 |
$55.00 |
$55.00 |
$200.80
|
|
Dilate urethra stricture
|
$239.50 |
$239.50 |
$239.50 |
$343.55
|
|
Dilation/female urethra/initial 53660
|
$42.50 |
$42.50 |
$42.50 |
$235.61
|
|
Dilation of urethra
|
$41.00 |
$41.00 |
$41.00 |
$172.00
|
|
Dilation/urethral strict/male/ini 53620
|
$668.00 |
$668.00 |
$668.00 |
$1,372.80
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,005.50 |
$1,005.50 |
$1,005.50 |
$1,258.20
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.00 |
$1.00 |
$1.00 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$1.50 |
$1.50 |
$1.50 |
$17.75
|
|
Disability dlco
|
$13.50 |
$13.50 |
$13.50 |
$282.40
|
|
Disaccharidases
|
$415.00 |
$415.00 |
$415.00 |
$216.00
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1.00 |
$1.00 |
$1.00 |
$904.81
|
|
Doppler echo complete
|
$19.50 |
$19.50 |
$19.50 |
$540.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$25.00 |
$25.00 |
$25.00 |
$662.35
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$13.50 |
$13.50 |
$13.50 |
$471.17
|