|
CT Angiogram of the Head
|
$350.86 |
$350.86 |
$350.86 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$320.58 |
$320.58 |
$320.58 |
$1,881.75
|
|
CT angio hrt w/3d image
|
$373.84 |
$373.84 |
$373.84 |
$1,428.68
|
|
CT angio pelvis
|
$508.70 |
$508.70 |
$508.70 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$447.65 |
$447.65 |
$447.65 |
$1,691.30
|
|
CT colonography dx
|
$193.40 |
$193.40 |
$193.40 |
$811.41
|
|
CT colonography screening
|
$558.15 |
$558.15 |
$558.15 |
$1,084.20
|
|
CT guidance for needle placement
|
$272.22 |
$272.22 |
$272.22 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$303.85 |
$303.85 |
$303.85 |
$1,215.06
|
|
CT guid parench tis ablat
|
$231.99 |
$231.99 |
$231.99 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$385.61 |
$385.61 |
$385.61 |
$150.00
|
|
CT limited or localized follow-up study
|
$87.31 |
$87.31 |
$87.31 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$403.92 |
$403.92 |
$403.92 |
$1,818.96
|
|
CT scan for therapy guide
|
$114.88 |
$114.88 |
$114.88 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$627.00 |
$627.00 |
$627.00 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$522.56 |
$522.56 |
$522.56 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$417.94 |
$417.94 |
$417.94 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$651.26 |
$651.26 |
$651.26 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$426.20 |
$426.20 |
$426.20 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$21.32 |
$21.32 |
$21.32 |
$72.00
|
|
Culture afb any source
|
$72.04 |
$72.04 |
$72.04 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$24.43 |
$24.43 |
$24.43 |
$84.76
|
|
Culture anaerobic except blood
|
$76.80 |
$76.80 |
$76.80 |
$121.22
|
|
Culture bacteria anaerobic
|
$6.00 |
$6.00 |
$6.00 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$13.04 |
$13.04 |
$13.04 |
$52.50
|
|
Culture body fluid
|
$56.51 |
$56.51 |
$56.51 |
$126.75
|
|
Culture fungi definitive id mold
|
$28.57 |
$28.57 |
$28.57 |
$80.00
|
|
Culture fungi definitive id yeast
|
$28.15 |
$28.15 |
$28.15 |
$80.00
|
|
Culture fungi other (except blood)
|
$16.15 |
$16.15 |
$16.15 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$12.21 |
$12.21 |
$12.21 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$13.25 |
$13.25 |
$13.25 |
$100.00
|
|
Culture mycoplasma any source
|
$13.04 |
$13.04 |
$13.04 |
$83.21
|
|
Culture quantitative aerobic other source
|
$12.63 |
$12.63 |
$12.63 |
$87.02
|
|
Culture screening strep group a
|
$27.12 |
$27.12 |
$27.12 |
$84.60
|
|
Culture typing glc/hplc
|
$7.87 |
$7.87 |
$7.87 |
$53.75
|
|
Culture typing immunologic
|
$17.59 |
$17.59 |
$17.59 |
$44.00
|
|
Culture urine each isolate
|
$5.18 |
$5.18 |
$5.18 |
$55.50
|
|
Cutter lead
|
$11,244.69 |
$11,244.69 |
$11,244.69 |
$6,581.45
|
|
Cv line/pic reposition
|
$547.35 |
$547.35 |
$547.35 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$7.46 |
$7.46 |
$7.46 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$10.03 |
$10.03 |
$10.03 |
$72.36
|
|
Cyclosporine 2 hour
|
$6.55 |
$6.55 |
$6.55 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$18,243.68 |
$18,243.68 |
$18,243.68 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$221.83 |
$221.83 |
$221.83 |
$524.00
|
|
Cyp2c9 gene com variants
|
$82.95 |
$82.95 |
$82.95 |
$275.10
|
|
Cyp2d6 gene com variants
|
$213.77 |
$213.77 |
$213.77 |
$570.70
|
|
Cyp3a4 gene common variants
|
$82.95 |
$82.95 |
$82.95 |
$241.24
|
|
Cyp3a5 gene common variants
|
$82.95 |
$82.95 |
$82.95 |
$245.31
|
|
Cystatin c
|
$6.33 |
$6.33 |
$6.33 |
$77.60
|
|
Cystic fibrosis cftr
|
$379.99 |
$379.99 |
$379.99 |
$1,104.40
|
|
Cystine urine quantitative
|
$10.28 |
$10.28 |
$10.28 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$218.87 |
$218.87 |
$218.87 |
$586.95
|
|
Cytogenetics 25-99
|
$36.90 |
$36.90 |
$36.90 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$10.20 |
$10.20 |
$10.20 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$10.37 |
$10.37 |
$10.37 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$33.48 |
$33.48 |
$33.48 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$27.54 |
$27.54 |
$27.54 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$21.06 |
$21.06 |
$21.06 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$56.70 |
$56.70 |
$56.70 |
$135.20
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$8.46 |
$8.46 |
$8.46 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$65.70 |
$65.70 |
$65.70 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$73.62 |
$73.62 |
$73.62 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$39.24 |
$39.24 |
$39.24 |
$96.20
|
|
Cytotoxic antibody screening
|
$15.30 |
$15.30 |
$15.30 |
$133.25
|
|
Dacarbazine 100 mg intravenous solution
|
$2.97 |
$2.97 |
$2.97 |
$62.41
|
|
Dch validity tests
|
$2.43 |
$2.43 |
$2.43 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$10.03 |
$10.03 |
$10.03 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$440.10 |
$440.10 |
$440.10 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$118.35 |
$118.35 |
$118.35 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$1,870.65 |
$1,870.65 |
$1,870.65 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$357.30 |
$357.30 |
$357.30 |
$702.28
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$501.75 |
$501.75 |
$501.75 |
$835.20
|
|
Debride nail1-5 11720
|
$93.15 |
$93.15 |
$93.15 |
$149.60
|
|
Debride nail6 or more 11721
|
$125.55 |
$125.55 |
$125.55 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$216.00 |
$216.00 |
$216.00 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,274.85 |
$1,274.85 |
$1,274.85 |
$1,165.50
|
|
Decalcification
|
$9.85 |
$9.85 |
$9.85 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$236.70 |
$236.70 |
$236.70 |
$572.95
|
|
Delivery of placenta 59414
|
$840.74 |
$840.74 |
$840.74 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$64.40 |
$64.40 |
$64.40 |
$185.17
|
|
Desoxycorticosterone
|
$10.51 |
$10.51 |
$10.51 |
$109.28
|
|
Device ablt adv novasure
|
$2,304.42 |
$2,304.42 |
$2,304.42 |
$6,237.48
|
|
Device sut capio slim opn
|
$2,837.10 |
$2,837.10 |
$2,837.10 |
$1,860.95
|
|
Dhea-s (dehydroepiand sulfate)
|
$7.57 |
$7.57 |
$7.57 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$20.00 |
$20.00 |
$20.00 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$128.25 |
$128.25 |
$128.25 |
$338.00
|
|
Diffusing capacity
|
$75.99 |
$75.99 |
$75.99 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$5.99 |
$5.99 |
$5.99 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,323.23 |
$1,323.23 |
$1,323.23 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$429.24 |
$429.24 |
$429.24 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$969.78 |
$969.78 |
$969.78 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$1,643.72 |
$1,643.72 |
$1,643.72 |
$4,258.20
|
|
Disability dlco
|
$45.31 |
$45.31 |
$45.31 |
$293.76
|
|
Disaccharidases
|
$40.91 |
$40.91 |
$40.91 |
$230.40
|
|
Dissolve clot heart vessel
|
$1,255.92 |
$1,255.92 |
$1,255.92 |
$1,579.93
|
|
Dna antibody native/double stranded
|
$10.54 |
$10.54 |
$10.54 |
$100.00
|
|
Dna gardnerella
|
$12.63 |
$12.63 |
$12.63 |
$61.83
|
|
Dna trichomonas
|
$12.63 |
$12.63 |
$12.63 |
$63.00
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$0.18 |
$0.18 |
$0.18 |
$65.40
|
|
Doppler echo complete
|
$202.05 |
$202.05 |
$202.05 |
$558.00
|
