|
CT guidance for needle placement
|
$270.40 |
$270.40 |
$270.40 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$383.98 |
$383.98 |
$383.98 |
$1,215.06
|
|
CT guid parench tis ablat
|
$230.44 |
$230.44 |
$230.44 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$383.02 |
$383.02 |
$383.02 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$353.57 |
$353.57 |
$353.57 |
$1,395.79
|
|
CT hrt w/3d image
|
$337.88 |
$337.88 |
$337.88 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$86.73 |
$86.73 |
$86.73 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$428.40 |
$428.40 |
$428.40 |
$1,818.96
|
|
CT scan for localization
|
$298.96 |
$298.96 |
$298.96 |
$1,216.80
|
|
CT scan for therapy guide
|
$114.11 |
$114.11 |
$114.11 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$665.00 |
$665.00 |
$665.00 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$554.22 |
$554.22 |
$554.22 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$443.28 |
$443.28 |
$443.28 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$690.72 |
$690.72 |
$690.72 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$452.02 |
$452.02 |
$452.02 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$20.70 |
$20.70 |
$20.70 |
$72.00
|
|
Culture afb any source
|
$69.95 |
$69.95 |
$69.95 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$23.72 |
$23.72 |
$23.72 |
$84.76
|
|
Culture anaerobic except blood
|
$74.57 |
$74.57 |
$74.57 |
$121.22
|
|
Culture bacteria anaerobic
|
$5.83 |
$5.83 |
$5.83 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$12.66 |
$12.66 |
$12.66 |
$52.50
|
|
Culture body fluid
|
$54.87 |
$54.87 |
$54.87 |
$126.75
|
|
Culture fungi definitive id mold
|
$27.74 |
$27.74 |
$27.74 |
$80.00
|
|
Culture fungi definitive id yeast
|
$12.46 |
$12.46 |
$12.46 |
$80.00
|
|
Culture fungi other (except blood)
|
$15.68 |
$15.68 |
$15.68 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$11.86 |
$11.86 |
$11.86 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$12.86 |
$12.86 |
$12.86 |
$100.00
|
|
Culture mycoplasma any source
|
$12.66 |
$12.66 |
$12.66 |
$83.21
|
|
Culture quantitative aerobic other source
|
$12.26 |
$12.26 |
$12.26 |
$87.02
|
|
Culture screening strep group a
|
$26.33 |
$26.33 |
$26.33 |
$84.60
|
|
Culture typing glc/hplc
|
$7.64 |
$7.64 |
$7.64 |
$53.75
|
|
Culture typing immunologic
|
$17.09 |
$17.09 |
$17.09 |
$44.00
|
|
Culture urine each isolate
|
$5.03 |
$5.03 |
$5.03 |
$55.50
|
|
Cutter lead
|
$5,601.54 |
$5,601.54 |
$5,601.54 |
$6,581.45
|
|
Cv line/pic reposition
|
$630.34 |
$630.34 |
$630.34 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$10.16 |
$10.16 |
$10.16 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$7.73 |
$7.73 |
$7.73 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$0.36 |
$0.36 |
$0.36 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$8.93 |
$8.93 |
$8.93 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$17,083.04 |
$17,083.04 |
$17,083.04 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$249.91 |
$249.91 |
$249.91 |
$524.00
|
|
Cyp2c9 gene com variants
|
$93.45 |
$93.45 |
$93.45 |
$275.10
|
|
Cyp2d6 gene com variants
|
$240.83 |
$240.83 |
$240.83 |
$570.70
|
|
Cyp3a4 gene common variants
|
$93.45 |
$93.45 |
$93.45 |
$241.24
|
|
Cyp3a5 gene common variants
|
$93.45 |
$93.45 |
$93.45 |
$245.31
|
|
Cystatin c
|
$8.62 |
$8.62 |
$8.62 |
$77.60
|
|
Cystic fibrosis cftr
|
$428.09 |
$428.09 |
$428.09 |
$1,104.40
|
|
Cystine urine quantitative
|
$14.01 |
$14.01 |
$14.01 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$237.19 |
$237.19 |
$237.19 |
$586.95
|
|
Cytogenetics 25-99
|
$42.23 |
$42.23 |
$42.23 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$7.86 |
$7.86 |
$7.86 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$7.99 |
$7.99 |
$7.99 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$38.32 |
$38.32 |
$38.32 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$31.52 |
$31.52 |
$31.52 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$24.10 |
$24.10 |
$24.10 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$64.89 |
$64.89 |
$64.89 |
$135.20
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$9.68 |
$9.68 |
$9.68 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$75.19 |
$75.19 |
$75.19 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$84.25 |
$84.25 |
$84.25 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$44.91 |
$44.91 |
$44.91 |
$96.20
|
|
Cytotoxic antibody screening
|
$11.79 |
$11.79 |
$11.79 |
$133.25
|
|
Darbepoetin alfa, esrd use
|
$2.26 |
$2.26 |
$2.26 |
$7.20
|
|
Dch validity tests
|
$2.85 |
$2.85 |
$2.85 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$7.73 |
$7.73 |
$7.73 |
$43.35
|
|
Decalcification
|
$9.68 |
$9.68 |
$9.68 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$167.79 |
$167.79 |
$167.79 |
$572.95
|
|
Delivery of placenta 59414
|
$3,772.26 |
$3,772.26 |
$3,772.26 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,109.23 |
$2,109.23 |
$2,109.23 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$70.00 |
$70.00 |
$70.00 |
$185.17
|
|
Descend thora aorta rpr/lt sub art 33880
|
$3,803.44 |
$3,803.44 |
$3,803.44 |
$6,288.45
|
|
Desoxycorticosterone
|
$14.32 |
$14.32 |
$14.32 |
$109.28
|
|
Des thora aorta rpr without left sub art 33881
|
$4,834.44 |
$4,834.44 |
$4,834.44 |
$5,267.20
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$6,445.71 |
$6,445.71 |
$6,445.71 |
$3,273.55
|
|
Device ablt adv novasure
|
$3,395.12 |
$3,395.12 |
$3,395.12 |
$6,237.48
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$2,153.72 |
$2,153.72 |
$2,153.72 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,010.80 |
$3,010.80 |
$3,010.80 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$2,153.72 |
$2,153.72 |
$2,153.72 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$62.91 |
$62.91 |
$62.91 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$10.32 |
$10.32 |
$10.32 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$27.26 |
$27.26 |
$27.26 |
$79.30
|
|
Diagnostic laryngoscopy 31575
|
$147.70 |
$147.70 |
$147.70 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$199.26 |
$199.26 |
$199.26 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$131.54 |
$131.54 |
$131.54 |
$314.00
|
|
Dialysis circuit perm vascular embolization 36909
|
$3,244.87 |
$3,244.87 |
$3,244.87 |
$5,741.00
|
|
Diffusing capacity
|
$50.23 |
$50.23 |
$50.23 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$8.16 |
$8.16 |
$8.16 |
$102.07
|
|
Dilate biliary duct/ampulla
|
$1,523.86 |
$1,523.86 |
$1,523.86 |
$1,866.73
|
|
Dilator fascial 10fx20cm
|
$334.34 |
$334.34 |
$334.34 |
$402.10
|
|
Dilat xst trc ndurlgc px
|
$1,116.82 |
$1,116.82 |
$1,116.82 |
$3,900.60
|
|
Dilat xst trc new access rcs
|
$1,892.95 |
$1,892.95 |
$1,892.95 |
$4,258.20
|
|
Disability dlco
|
$29.95 |
$29.95 |
$29.95 |
$293.76
|
|
Disaccharidases
|
$55.75 |
$55.75 |
$55.75 |
$230.40
|
|
Dissolve clot heart vessel
|
$1,446.35 |
$1,446.35 |
$1,446.35 |
$1,579.93
|
|
Dlyd plmt xtn prosth ea addl
|
$2,213.22 |
$2,213.22 |
$2,213.22 |
$1,810.80
|
|
Dna antibody native/double stranded
|
$8.12 |
$8.12 |
$8.12 |
$100.00
|
|
Dna gardnerella
|
$12.26 |
$12.26 |
$12.26 |
$61.83
|
|
Dna trichomonas
|
$12.26 |
$12.26 |
$12.26 |
$63.00
|
|
Doppler echo complete
|
$239.93 |
$239.93 |
$239.93 |
$558.00
|
|
Doppler intravascular pressure flow initial vessel
|
$880.60 |
$880.60 |
$880.60 |
$2,777.60
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$193.07 |
$193.07 |
$193.07 |
$679.64
|
