|
Cystatin c
|
$23.52 |
$23.52 |
$23.52 |
$77.60
|
|
Cystic fibrosis cftr
|
$628.74 |
$628.74 |
$628.74 |
$1,104.40
|
|
Cystine urine quantitative
|
$38.22 |
$38.22 |
$38.22 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$315.42 |
$315.42 |
$315.42 |
$586.95
|
|
Cytogenetics 25-99
|
$53.76 |
$53.76 |
$53.76 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$25.62 |
$25.62 |
$25.62 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$44.94 |
$44.94 |
$44.94 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$68.04 |
$68.04 |
$68.04 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$25.62 |
$25.62 |
$25.62 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$33.18 |
$33.18 |
$33.18 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$33.18 |
$33.18 |
$33.18 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$37.80 |
$37.80 |
$37.80 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$143.64 |
$143.64 |
$143.64 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$44.94 |
$44.94 |
$44.94 |
$213.85
|
|
Cytopath smear other source
|
$29.82 |
$29.82 |
$29.82 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$28.56 |
$28.56 |
$28.56 |
$96.20
|
|
Cytotoxic antibody screening
|
$37.80 |
$37.80 |
$37.80 |
$133.25
|
|
Dch glucoscan
|
$6.72 |
$6.72 |
$6.72 |
$29.16
|
|
Dch pulmonary stress test
|
$627.90 |
$627.90 |
$627.90 |
$963.30
|
|
Dch validity tests
|
$4.62 |
$4.62 |
$4.62 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$24.78 |
$24.78 |
$24.78 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$90.30 |
$90.30 |
$90.30 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$994.98 |
$994.98 |
$994.98 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$260.82 |
$260.82 |
$260.82 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$620.34 |
$620.34 |
$620.34 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$356.16 |
$356.16 |
$356.16 |
$835.20
|
|
Debride nail1-5 11720
|
$43.68 |
$43.68 |
$43.68 |
$149.60
|
|
Debride nail6 or more 11721
|
$58.80 |
$58.80 |
$58.80 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$129.78 |
$129.78 |
$129.78 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$475.44 |
$475.44 |
$475.44 |
$1,165.50
|
|
Decalcification
|
$17.64 |
$17.64 |
$17.64 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$152.88 |
$152.88 |
$152.88 |
$572.95
|
|
Delivery of placenta 59414
|
$1,136.10 |
$1,136.10 |
$1,136.10 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$85.68 |
$85.68 |
$85.68 |
$185.17
|
|
Descend thora aorta rpr/lt sub art 33880
|
$9,879.24 |
$9,879.24 |
$9,879.24 |
$6,288.45
|
|
Design mlc device for imrt
|
$459.48 |
$459.48 |
$459.48 |
$1,753.00
|
|
Desoxycorticosterone
|
$39.06 |
$39.06 |
$39.06 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$8,486.52 |
$8,486.52 |
$8,486.52 |
$5,267.20
|
|
Destroy cervthor facet jnt 64633
|
$1,825.74 |
$1,825.74 |
$1,825.74 |
$3,138.15
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$708.96 |
$708.96 |
$708.96 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$1,940.40 |
$1,940.40 |
$1,940.40 |
$3,296.80
|
|
Device ablt adv novasure
|
$4,863.60 |
$4,863.60 |
$4,863.60 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,564.10 |
$2,564.10 |
$2,564.10 |
$4,200.00
|
|
Device sut capio slim opn
|
$4,863.60 |
$4,863.60 |
$4,863.60 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$5,835.90 |
$5,835.90 |
$5,835.90 |
$2,515.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$28.14 |
$28.14 |
$28.14 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$12.60 |
$12.60 |
$12.60 |
$79.30
|
|
Diab manage trn ind/group
|
$15.96 |
$15.96 |
$15.96 |
$54.99
|
|
Diagnostic laryngoscopy 31575
|
$145.74 |
$145.74 |
$145.74 |
$338.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$4,114.32 |
$4,114.32 |
$4,114.32 |
$5,741.00
|
|
Diffusing capacity
|
$199.92 |
$199.92 |
$199.92 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$22.26 |
$22.26 |
$22.26 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$2,714.88 |
$2,714.88 |
$2,714.88 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$905.94 |
$905.94 |
$905.94 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$3,005.10 |
$3,005.10 |
$3,005.10 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$3,057.60 |
$3,057.60 |
$3,057.60 |
$4,258.20
|
|
Disability dlco
|
$157.08 |
$157.08 |
$157.08 |
$293.76
|
|
Disaccharidases
|
$152.04 |
$152.04 |
$152.04 |
$230.40
|
|
Discography cerv/thor spine
|
$2,344.44 |
$2,344.44 |
$2,344.44 |
$2,565.00
|
|
Dissolve clot heart vessel
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$1,579.93
|
|
Dlyd plmt xtn prosth ea addl
|
$274.26 |
$274.26 |
$274.26 |
$1,810.80
|
|
Dna antibody native/double stranded
|
$26.04 |
$26.04 |
$26.04 |
$100.00
|
|
Dna gardnerella
|
$37.80 |
$37.80 |
$37.80 |
$61.83
|
|
Dna trichomonas
|
$25.62 |
$25.62 |
$25.62 |
$63.00
|
|
Doppler echo complete
|
$401.52 |
$401.52 |
$401.52 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$1,960.14 |
$1,960.14 |
$1,960.14 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$563.22 |
$563.22 |
$563.22 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$364.14 |
$364.14 |
$364.14 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$91,981.68 |
$91,981.68 |
$91,981.68 |
$34,278.00
|
|
Dpyd gene common variants
|
$220.50 |
$220.50 |
$220.50 |
$423.60
|
|
Drainage of bladder abscess
|
$1,796.76 |
$1,796.76 |
$1,796.76 |
$3,127.88
|
|
Drainage of kidney lesion
|
$1,271.34 |
$1,271.34 |
$1,271.34 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$67.20 |
$67.20 |
$67.20 |
$182.40
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$1,061.76 |
$1,061.76 |
$1,061.76 |
$2,540.00
|
|
Drain cath image guided visceral pq
|
$1,064.70 |
$1,064.70 |
$1,064.70 |
$2,903.44
|
|
Drain cerebro spinal fluid 62272
|
$435.54 |
$435.54 |
$435.54 |
$1,044.00
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$218.40 |
$218.40 |
$218.40 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$182.70 |
$182.70 |
$182.70 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$506.10 |
$506.10 |
$506.10 |
$541.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$3,891.30 |
$3,891.30 |
$3,891.30 |
$1,818.32
|
|
Drsg wnd mesh bovine bilayer 4x10in matrix-q4104-cost per sq cm
|
$49.81 |
$49.81 |
$49.81 |
$7,465.97
|
|
Drsg wound matrix sheet 2.5x2.5cm-7 sq cm-cost per sq cm
|
$204.04 |
$204.04 |
$204.04 |
$376.50
|
|
Drug admin & hemodynmic meas
|
$1,882.02 |
$1,882.02 |
$1,882.02 |
$569.75
|
|
Drug assay caffeine
|
$48.72 |
$48.72 |
$48.72 |
$80.00
|
|
Drug assay posaconazole
|
$49.56 |
$49.56 |
$49.56 |
$96.75
|
|
Drug assay vedolizumab
|
$133.14 |
$133.14 |
$133.14 |
$154.00
|
|
Drug assay voriconazole
|
$53.34 |
$53.34 |
$53.34 |
$96.75
|
|
Drug of abuse screen urine
|
$15.96 |
$15.96 |
$15.96 |
$67.89
|
|
Drug screening tapentadol
|
$23.52 |
$23.52 |
$23.52 |
$47.03
|
|
Drug test prsmv instrmnt
|
$21.84 |
$21.84 |
$21.84 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$188.58 |
$188.58 |
$188.58 |
$278.85
|
|
Drvvt confirm - quest
|
$22.68 |
$22.68 |
$22.68 |
$109.20
|
|
Ductogram sgl duct
|
$175.98 |
$175.98 |
$175.98 |
$469.80
|
|
Duplex scan bilateral study 93985
|
$370.44 |
$370.44 |
$370.44 |
$691.08
|
|
Duplex scan unilateral study 93986
|
$281.82 |
$281.82 |
$281.82 |
$369.20
|
|
Dup scan/hemodialysis access 93990
|
$296.94 |
$296.94 |
$296.94 |
$489.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,024.80 |
$1,024.80 |
$1,024.80 |
$904.78
|
|
Ecg/1-3 leads/tracing only 93041
|
$58.80 |
$58.80 |
$58.80 |
$132.08
|
|
Echocardiogram (Heart Ultrasound)
|
$1,123.92 |
$1,123.92 |
$1,123.92 |
$2,024.64
|
