|
CT upper extremity without contrast (both sides)
|
$518.70 |
$518.70 |
$518.70 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$859.56 |
$859.56 |
$859.56 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$29.64 |
$29.64 |
$29.64 |
$63.75
|
|
Culture afb any source
|
$41.04 |
$41.04 |
$41.04 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$58.14 |
$58.14 |
$58.14 |
$77.31
|
|
Culture anaerobic except blood
|
$95.19 |
$95.19 |
$95.19 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$29.07 |
$29.07 |
$29.07 |
$52.80
|
|
Culture body fluid
|
$70.68 |
$70.68 |
$70.68 |
$130.50
|
|
Culture fungi definitive id mold
|
$38.19 |
$38.19 |
$38.19 |
$70.00
|
|
Culture fungi definitive id yeast
|
$38.19 |
$38.19 |
$38.19 |
$80.60
|
|
Culture fungi other (except blood)
|
$28.50 |
$28.50 |
$28.50 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$29.07 |
$29.07 |
$29.07 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$95.76 |
$95.76 |
$95.76 |
$84.75
|
|
Culture mycoplasma any source
|
$92.91 |
$92.91 |
$92.91 |
$90.37
|
|
Culture quantitative aerobic other source
|
$34.77 |
$34.77 |
$34.77 |
$87.02
|
|
Culture screening strep group a
|
$52.44 |
$52.44 |
$52.44 |
$81.60
|
|
Culture typing immunologic
|
$24.51 |
$24.51 |
$24.51 |
$41.60
|
|
Culture urine each isolate
|
$30.78 |
$30.78 |
$30.78 |
$46.20
|
|
Cv stress test i&r only 93018
|
$53.01 |
$53.01 |
$53.01 |
$40.50
|
|
Cv stress test/supervision only 93016
|
$58.71 |
$58.71 |
$58.71 |
$59.25
|
|
Cyanocobalamin unsat binding capacity
|
$24.51 |
$24.51 |
$24.51 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$19.12 |
$19.12 |
$19.12 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$47.88 |
$47.88 |
$47.88 |
$80.05
|
|
Cyclosporine 2 hour
|
$64.41 |
$64.41 |
$64.41 |
$121.80
|
|
Cystatin c
|
$46.17 |
$46.17 |
$46.17 |
$82.26
|
|
Cystine urine quantitative
|
$39.33 |
$39.33 |
$39.33 |
$103.35
|
|
Cysto rx balo cath urtl strx
|
$6,312.18 |
$6,312.18 |
$6,312.18 |
$6,015.75
|
|
Cystoscopy and treatment
|
$1,708.29 |
$1,708.29 |
$1,708.29 |
$4,081.37
|
|
Cystoscopy and treatment
|
$819.66 |
$819.66 |
$819.66 |
$4,081.37
|
|
Cystoscopy and treatment
|
$673.17 |
$673.17 |
$673.17 |
$4,846.99
|
|
Cystoscopy and treatment
|
$816.24 |
$816.24 |
$816.24 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$631.56 |
$631.56 |
$631.56 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$5,115.75 |
$5,115.75 |
$5,115.75 |
$3,970.98
|
|
Cystourethroscop/calib/dilat stric 52281
|
$944.49 |
$944.49 |
$944.49 |
$2,874.36
|
|
Cytarabine 20 mg/ml injection solution
|
$1.14 |
$1.14 |
$1.14 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$42.75 |
$42.75 |
$42.75 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$21.66 |
$21.66 |
$21.66 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$83.22 |
$83.22 |
$83.22 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$138.51 |
$138.51 |
$138.51 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$72.39 |
$72.39 |
$72.39 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$38.19 |
$38.19 |
$38.19 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$57.00 |
$57.00 |
$57.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$71.25 |
$71.25 |
$71.25 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$136.23 |
$136.23 |
$136.23 |
$205.00
|
|
Cytopath smear oth prep screen & interp
|
$38.19 |
$38.19 |
$38.19 |
$95.89
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1.14 |
$1.14 |
$1.14 |
$315.32
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$6.27 |
$6.27 |
$6.27 |
$5,546.48
|
|
Dch validity tests
|
$5.70 |
$5.70 |
$5.70 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$41.04 |
$41.04 |
$41.04 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$149.91 |
$149.91 |
$149.91 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$151.62 |
$151.62 |
$151.62 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$764.94 |
$764.94 |
$764.94 |
$2,553.60
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$630.99 |
$630.99 |
$630.99 |
$810.50
|
|
Debride nail1-5 11720
|
$151.05 |
$151.05 |
$151.05 |
$173.25
|
|
Debride nail6 or more 11721
|
$234.27 |
$234.27 |
$234.27 |
$195.20
|
|
Debride skin bone at fx site
|
$1,918.05 |
$1,918.05 |
$1,918.05 |
$3,278.34
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$2,116.98 |
$2,116.98 |
$2,116.98 |
$2,291.20
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$87.21 |
$87.21 |
$87.21 |
$663.30
|
|
Debrid mastoidectomy cavity simple 69220
|
$188.10 |
$188.10 |
$188.10 |
$235.13
|
|
Debr inf skin add-on 11001
|
$72.39 |
$72.39 |
$72.39 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$531.24 |
$531.24 |
$531.24 |
$1,193.40
|
|
Decalcification
|
$26.79 |
$26.79 |
$26.79 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$4.42 |
$4.42 |
$4.42 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$451.44 |
$451.44 |
$451.44 |
$545.90
|
|
Degarelix 120 mg subcutaneous solution
|
$6.27 |
$6.27 |
$6.27 |
$2,086.82
|
|
Delivery of placenta 59414
|
$4,598.19 |
$4,598.19 |
$4,598.19 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$182.40 |
$182.40 |
$182.40 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$52.48 |
$52.48 |
$52.48 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$305.52 |
$305.52 |
$305.52 |
$460.50
|
|
Depo-estradiol cypionate inj
|
$33.06 |
$33.06 |
$33.06 |
$132.72
|
|
Desmopressin 4 mcg/ml injection solution
|
$37.26 |
$37.26 |
$37.26 |
$102.32
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$334.02 |
$334.02 |
$334.02 |
$275.88
|
|
Dest mal lesion feenlm 0.6-1cm 17281
|
$411.54 |
$411.54 |
$411.54 |
$362.58
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$488.49 |
$488.49 |
$488.49 |
$394.17
|
|
Dest mal lesion snhfg 0.6-1cm 17271
|
$389.88 |
$389.88 |
$389.88 |
$312.00
|
|
Dest mal lesion snhfg 1.1-2cm 17272
|
$445.17 |
$445.17 |
$445.17 |
$278.40
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$342.00 |
$342.00 |
$342.00 |
$269.60
|
|
Dest mal lesion tal 1.1-2.0cm 17262
|
$413.82 |
$413.82 |
$413.82 |
$332.25
|
|
Dest mal lesion tal 2.1-3.0cm 17263
|
$454.29 |
$454.29 |
$454.29 |
$354.00
|
|
Destroy cervthor facet jnt 64633
|
$3,505.50 |
$3,505.50 |
$3,505.50 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$1,472.31 |
$1,472.31 |
$1,472.31 |
$1,441.44
|
|
Destroy premlg lesns;1st lesn 17000
|
$193.23 |
$193.23 |
$193.23 |
$220.12
|
|
Destroy vulva lesion extensive 56515
|
$714.21 |
$714.21 |
$714.21 |
$2,837.09
|
|
Destruct ben lesion 15/> 17111
|
$312.36 |
$312.36 |
$312.36 |
$238.20
|
|
Destruction 2-14 lesions 17003
|
$42.18 |
$42.18 |
$42.18 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$212.61 |
$212.61 |
$212.61 |
$250.60
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,318.98 |
$1,318.98 |
$1,318.98 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$3,439.95 |
$3,439.95 |
$3,439.95 |
$3,375.00
|
|
Destruction mal lsn s/n/h/f/g 2.1-3cm
|
$494.19 |
$494.19 |
$494.19 |
$513.60
|
|
Destruction mal lsn t/a/l >4cm
|
$506.16 |
$506.16 |
$506.16 |
$578.40
|
|
Destruction premal lesions 15/> 17004
|
$413.25 |
$413.25 |
$413.25 |
$470.51
|
|
Destruct penis les/smp/electrodesi 54055
|
$387.60 |
$387.60 |
$387.60 |
$2,236.85
|
|
Developmental screen/score/document 96110
|
$21.66 |
$21.66 |
$21.66 |
$139.10
|
|
Device intraute mirena
|
$898.89 |
$898.89 |
$898.89 |
$2,618.91
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$126.54 |
$126.54 |
$126.54 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$7.08 |
$7.08 |
$7.08 |
$6.01
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$1.26 |
$1.26 |
$1.26 |
$30.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$5.70 |
$5.70 |
$5.70 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$79.23 |
$79.23 |
$79.23 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$50.16 |
$50.16 |
$50.16 |
$78.03
|