|
CT thorax low dose for lung screening without contrast
|
$33.30 |
$33.30 |
$33.30 |
$331.50
|
|
CT t-spine w /wo contrast
|
$590.25 |
$590.25 |
$590.25 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$512.55 |
$512.55 |
$512.55 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$463.65 |
$463.65 |
$463.65 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$529.80 |
$529.80 |
$529.80 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$65.25 |
$65.25 |
$65.25 |
$68.64
|
|
Culture afb any source
|
$17.10 |
$17.10 |
$17.10 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$89.40 |
$89.40 |
$89.40 |
$79.00
|
|
Culture anaerobic except blood
|
$89.40 |
$89.40 |
$89.40 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$90.75 |
$90.75 |
$90.75 |
$51.45
|
|
Culture body fluid
|
$89.40 |
$89.40 |
$89.40 |
$126.75
|
|
Culture fungi definitive id mold
|
$14.40 |
$14.40 |
$14.40 |
$77.28
|
|
Culture fungi definitive id yeast
|
$14.40 |
$14.40 |
$14.40 |
$79.10
|
|
Culture fungi other (except blood)
|
$100.65 |
$100.65 |
$100.65 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$4.50 |
$4.50 |
$4.50 |
$74.88
|
|
Culture mycoplasma any source
|
$75.15 |
$75.15 |
$75.15 |
$85.26
|
|
Culture quantitative aerobic other source
|
$119.25 |
$119.25 |
$119.25 |
$90.35
|
|
Culture screening strep group a
|
$105.60 |
$105.60 |
$105.60 |
$81.00
|
|
Culture typing immunologic
|
$5.55 |
$5.55 |
$5.55 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$110.25 |
$110.25 |
$110.25 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$16.50 |
$16.50 |
$16.50 |
$133.90
|
|
Culture urine each isolate
|
$4.05 |
$4.05 |
$4.05 |
$57.00
|
|
Cutter lead
|
$120.45 |
$120.45 |
$120.45 |
$6,092.06
|
|
Cv line/pic reposition
|
$464.10 |
$464.10 |
$464.10 |
$1,720.93
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$111.41 |
$111.41 |
$111.41 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$28.05 |
$28.05 |
$28.05 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$482.74 |
$482.74 |
$482.74 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$2.39 |
$2.39 |
$2.39 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$40.72 |
$40.72 |
$40.72 |
$140.78
|
|
Cyclosporine 2 hour
|
$131.55 |
$131.55 |
$131.55 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$0.73 |
$0.73 |
$0.73 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$22.51 |
$22.51 |
$22.51 |
$34.88
|
|
Cyp2c19 gene com variants
|
$110.40 |
$110.40 |
$110.40 |
$504.00
|
|
Cyp2d6 gene com variants
|
$315.15 |
$315.15 |
$315.15 |
$554.00
|
|
Cystatin c
|
$39.15 |
$39.15 |
$39.15 |
$77.50
|
|
Cystic fibrosis cftr
|
$252.60 |
$252.60 |
$252.60 |
$1,100.00
|
|
Cystine urine quantitative
|
$48.30 |
$48.30 |
$48.30 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$102.15 |
$102.15 |
$102.15 |
$542.10
|
|
Cystometrogram w/up 51727
|
$305.40 |
$305.40 |
$305.40 |
$908.59
|
|
Cystoscopy and treatment
|
$858.15 |
$858.15 |
$858.15 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$241.05 |
$241.05 |
$241.05 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$488.10 |
$488.10 |
$488.10 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$8.33 |
$8.33 |
$8.33 |
$89.94
|
|
Cytogenomic neo microra alys
|
$610.80 |
$610.80 |
$610.80 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$814.05 |
$814.05 |
$814.05 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$60.75 |
$60.75 |
$60.75 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$60.75 |
$60.75 |
$60.75 |
$97.50
|
|
Cytomegalovirus dfa
|
$58.05 |
$58.05 |
$58.05 |
$79.34
|
|
Cytopath fl nongyn filter
|
$9.45 |
$9.45 |
$9.45 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$20.85 |
$20.85 |
$20.85 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$24.30 |
$24.30 |
$24.30 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$16.80 |
$16.80 |
$16.80 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$9.45 |
$9.45 |
$9.45 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$9.45 |
$9.45 |
$9.45 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$1.50 |
$1.50 |
$1.50 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$40.20 |
$40.20 |
$40.20 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$20.85 |
$20.85 |
$20.85 |
$209.23
|
|
Cytopath smear oth prep screen & interp
|
$9.45 |
$9.45 |
$9.45 |
$96.20
|
|
Cytotoxic antibody screening
|
$136.05 |
$136.05 |
$136.05 |
$189.00
|
|
Cytotoxic antibody screening
|
$86.55 |
$86.55 |
$86.55 |
$133.25
|
|
Cytp urine 3-5 probes cmptr
|
$160.95 |
$160.95 |
$160.95 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$5.11 |
$5.11 |
$5.11 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$632.16 |
$632.16 |
$632.16 |
$3,024.59
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$463.62 |
$463.62 |
$463.62 |
$168.53
|
|
Daptomycin (xellia) unrefrig
|
$18.73 |
$18.73 |
$18.73 |
$56.19
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$128.64 |
$128.64 |
$128.64 |
$257.10
|
|
Dch pulmonary stress test
|
$295.05 |
$295.05 |
$295.05 |
$963.30
|
|
Dch validity tests
|
$30.30 |
$30.30 |
$30.30 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$5.70 |
$5.70 |
$5.70 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$118.05 |
$118.05 |
$118.05 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$68.40 |
$68.40 |
$68.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$471.45 |
$471.45 |
$471.45 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$354.60 |
$354.60 |
$354.60 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$354.60 |
$354.60 |
$354.60 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$242.70 |
$242.70 |
$242.70 |
$810.50
|
|
Debride nail1-5 11720
|
$25.20 |
$25.20 |
$25.20 |
$148.80
|
|
Debride nail6 or more 11721
|
$16.80 |
$16.80 |
$16.80 |
$169.60
|
|
Debride skin bone at fx site
|
$568.95 |
$568.95 |
$568.95 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$354.60 |
$354.60 |
$354.60 |
$639.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$259.80 |
$259.80 |
$259.80 |
$1,129.45
|
|
Debr musc/fascia 20sq cm/< 11043
|
$363.75 |
$363.75 |
$363.75 |
$1,160.00
|
|
Decalcification
|
$5.70 |
$5.70 |
$5.70 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$367.54 |
$367.54 |
$367.54 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$169.50 |
$169.50 |
$169.50 |
$543.00
|
|
Deferoxamine 500 mg solution for injection
|
$42.89 |
$42.89 |
$42.89 |
$95.85
|
|
Delivery of placenta 59414
|
$726.60 |
$726.60 |
$726.60 |
$3,070.56
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$39.00 |
$39.00 |
$39.00 |
$408.10
|
|
Design mlc device for imrt
|
$507.30 |
$507.30 |
$507.30 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$334.51 |
$334.51 |
$334.51 |
$89.78
|
|
Desoxycorticosterone
|
$257.25 |
$257.25 |
$257.25 |
$109.28
|
|
Destroy cervthor facet jnt 64633
|
$484.50 |
$484.50 |
$484.50 |
$3,011.50
|
|
Destroy premlg lesns;1st lesn 17000
|
$49.20 |
$49.20 |
$49.20 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$24.60 |
$24.60 |
$24.60 |
$72.60
|
|
Destruction benign lesions < 14 lesions
|
$32.40 |
$32.40 |
$32.40 |
$235.13
|
|
Device ablt adv novasure
|
$1,262.25 |
$1,262.25 |
$1,262.25 |
$6,097.50
|
|
Device sut capio slim opn
|
$15.15 |
$15.15 |
$15.15 |
$1,894.50
|
|
Devlopment test interpt&rep
|
$108.00 |
$108.00 |
$108.00 |
$109.46
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$72.60 |
$72.60 |
$72.60 |
$227.15
|
|
Dexamethasone 4 mg tablet
|
$60.70 |
$60.70 |
$60.70 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$35.34 |
$35.34 |
$35.34 |
$21.17
|