|
CT bone density axial
|
$310.70 |
$310.70 |
$310.70 |
$321.75
|
|
CT guidance for needle placement
|
$1,522.95 |
$1,522.95 |
$1,522.95 |
$1,425.85
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$620.10 |
$620.10 |
$620.10 |
$1,007.29
|
|
CT heart w/evaluation of calcium without contrast
|
$32.50 |
$32.50 |
$32.50 |
$176.89
|
|
CT limited or localized follow-up study
|
$518.70 |
$518.70 |
$518.70 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$2,453.10 |
$2,453.10 |
$2,453.10 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,163.20 |
$2,163.20 |
$2,163.20 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$1,617.85 |
$1,617.85 |
$1,617.85 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,652.30 |
$1,652.30 |
$1,652.30 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$1,366.30 |
$1,366.30 |
$1,366.30 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,859.65 |
$1,859.65 |
$1,859.65 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,897.35 |
$1,897.35 |
$1,897.35 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,525.55 |
$1,525.55 |
$1,525.55 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,360.45 |
$1,360.45 |
$1,360.45 |
$1,250.00
|
|
Ctrl nosebld postir subsq 30906
|
$481.00 |
$481.00 |
$481.00 |
$449.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,602.30 |
$3,602.30 |
$3,602.30 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,971.80 |
$2,971.80 |
$2,971.80 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,493.40 |
$2,493.40 |
$2,493.40 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,821.95 |
$1,821.95 |
$1,821.95 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,558.05 |
$1,558.05 |
$1,558.05 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$402.35 |
$402.35 |
$402.35 |
$418.50
|
|
CT t-spine w /wo contrast
|
$1,937.00 |
$1,937.00 |
$1,937.00 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$1,321.45 |
$1,321.45 |
$1,321.45 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$1,177.80 |
$1,177.80 |
$1,177.80 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,674.40 |
$1,674.40 |
$1,674.40 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$54.60 |
$54.60 |
$54.60 |
$61.03
|
|
Culture afb any source
|
$131.95 |
$131.95 |
$131.95 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$66.30 |
$66.30 |
$66.30 |
$73.00
|
|
Culture anaerobic except blood
|
$131.30 |
$131.30 |
$131.30 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$57.20 |
$57.20 |
$57.20 |
$49.40
|
|
Culture body fluid
|
$126.75 |
$126.75 |
$126.75 |
$111.15
|
|
Culture fungi definitive id mold
|
$63.70 |
$63.70 |
$63.70 |
$70.00
|
|
Culture fungi definitive id yeast
|
$74.10 |
$74.10 |
$74.10 |
$68.00
|
|
Culture fungi other (except blood)
|
$113.75 |
$113.75 |
$113.75 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$82.55 |
$82.55 |
$82.55 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$49.40 |
$49.40 |
$49.40 |
$79.00
|
|
Culture mycoplasma any source
|
$107.90 |
$107.90 |
$107.90 |
$94.00
|
|
Culture screening strep group a
|
$85.80 |
$85.80 |
$85.80 |
$76.00
|
|
Culture typing immunologic
|
$53.30 |
$53.30 |
$53.30 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$733.20 |
$733.20 |
$733.20 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$31.20 |
$31.20 |
$31.20 |
$100.20
|
|
Culture urine each isolate
|
$54.60 |
$54.60 |
$54.60 |
$44.80
|
|
Cv stress test i&r only 93018
|
$76.70 |
$76.70 |
$76.70 |
$42.00
|
|
Cv stress test/supervision only 93016
|
$83.20 |
$83.20 |
$83.20 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$21.13 |
$21.13 |
$21.13 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$116.35 |
$116.35 |
$116.35 |
$91.20
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$805.31 |
$805.31 |
$805.31 |
$2.42
|
|
Cyclosporine 2 hour
|
$159.25 |
$159.25 |
$159.25 |
$126.10
|
|
Cyp2c19 gene com variants
|
$579.80 |
$579.80 |
$579.80 |
$583.20
|
|
Cyp3a4 gene common variants
|
$422.50 |
$422.50 |
$422.50 |
$245.31
|
|
Cystatin c
|
$87.10 |
$87.10 |
$87.10 |
$83.20
|
|
Cystic fibrosis cftr
|
$1,041.95 |
$1,041.95 |
$1,041.95 |
$1,041.95
|
|
Cystogram >= 3 views supervision & interpretation
|
$542.10 |
$542.10 |
$542.10 |
$487.04
|
|
Cytogenetics 25-99
|
$118.30 |
$118.30 |
$118.30 |
$188.40
|
|
Cytogenom microarray copy nmbr var
|
$1,067.30 |
$1,067.30 |
$1,067.30 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$81.90 |
$81.90 |
$81.90 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$76.05 |
$76.05 |
$76.05 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$105.30 |
$105.30 |
$105.30 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$66.30 |
$66.30 |
$66.30 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$57.85 |
$57.85 |
$57.85 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$105.30 |
$105.30 |
$105.30 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$94.25 |
$94.25 |
$94.25 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$57.85 |
$57.85 |
$57.85 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$96.85 |
$96.85 |
$96.85 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$126.10 |
$126.10 |
$126.10 |
$205.00
|
|
Cytopath smear other source
|
$61.75 |
$61.75 |
$61.75 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$79.30 |
$79.30 |
$79.30 |
$95.00
|
|
Cytopath tbs c/v manual
|
$59.15 |
$59.15 |
$59.15 |
$57.94
|
|
Dalbavancin 500 mg intravenous solution
|
$3,480.61 |
$3,480.61 |
$3,480.61 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$90.67 |
$90.67 |
$90.67 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,542.99 |
$4,542.99 |
$4,542.99 |
$4,542.99
|
|
Dch validity tests
|
$25.35 |
$25.35 |
$25.35 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$91.65 |
$91.65 |
$91.65 |
$53.95
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$99.45 |
$99.45 |
$99.45 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$313.30 |
$313.30 |
$313.30 |
$313.30
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$224.25 |
$224.25 |
$224.25 |
$779.35
|
|
Debr inf skin add-on 11001
|
$40.95 |
$40.95 |
$40.95 |
$106.86
|
|
Decalcification
|
$63.05 |
$63.05 |
$63.05 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$326.30 |
$326.30 |
$326.30 |
$482.35
|
|
Delivery of placenta 59414
|
$382.20 |
$382.20 |
$382.20 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$125.45 |
$125.45 |
$125.45 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,744.96 |
$7,744.96 |
$7,744.96 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$433.55 |
$433.55 |
$433.55 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$11.34 |
$11.34 |
$11.34 |
$37.26
|
|
Desoxycorticosterone
|
$122.20 |
$122.20 |
$122.20 |
$109.28
|
|
Destruction benign lesions < 14 lesions
|
$157.30 |
$157.30 |
$157.30 |
$231.52
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$229.45 |
$229.45 |
$229.45 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$4.87 |
$4.87 |
$4.87 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$9.07 |
$9.07 |
$9.07 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$68.25 |
$68.25 |
$68.25 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$68.25 |
$68.25 |
$68.25 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$68.25 |
$68.25 |
$68.25 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$68.25 |
$68.25 |
$68.25 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$146.90 |
$146.90 |
$146.90 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$74.75 |
$74.75 |
$74.75 |
$70.00
|
|
Diab manage trn ind/group
|
$50.70 |
$50.70 |
$50.70 |
$56.55
|
|
Diagnostic anoscopy spx 46600
|
$159.90 |
$159.90 |
$159.90 |
$252.00
|
|
Diagnostic Mammogram (both breasts)
|
$228.15 |
$228.15 |
$228.15 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$206.70 |
$206.70 |
$206.70 |
$276.60
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$21.68 |
$21.68 |
$21.68 |
$42.12
|
