|
Cta lower extremity without & w/contrast (both sides)
|
$4,268.22 |
$4,268.22 |
$4,268.22 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,845.92 |
$2,845.92 |
$2,845.92 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,587.00 |
$4,587.00 |
$4,587.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,420.88 |
$2,420.88 |
$2,420.88 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,845.92 |
$2,845.92 |
$2,845.92 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$293.04 |
$293.04 |
$293.04 |
$1,500.38
|
|
CT angio pelvis
|
$1,974.72 |
$1,974.72 |
$1,974.72 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$3,116.52 |
$3,116.52 |
$3,116.52 |
$1,698.00
|
|
CT bone density axial
|
$30.36 |
$30.36 |
$30.36 |
$387.62
|
|
CT cerebral perf w cont & prcssng
|
$450.78 |
$450.78 |
$450.78 |
$803.40
|
|
CT colonography screening
|
$295.68 |
$295.68 |
$295.68 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,991.22 |
$1,991.22 |
$1,991.22 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$141.90 |
$141.90 |
$141.90 |
$1,178.52
|
|
CT guid cryo ablat intramuscular
|
$970.86 |
$970.86 |
$970.86 |
$1,643.20
|
|
CT guid parench tis ablat
|
$467.28 |
$467.28 |
$467.28 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$71.28 |
$71.28 |
$71.28 |
$171.60
|
|
CT hrt w/3d image
|
$212.52 |
$212.52 |
$212.52 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$116.16 |
$116.16 |
$116.16 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$2,271.06 |
$2,271.06 |
$2,271.06 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$2,661.12 |
$2,661.12 |
$2,661.12 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$958.32 |
$958.32 |
$958.32 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,057.98 |
$1,057.98 |
$1,057.98 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$912.12 |
$912.12 |
$912.12 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$889.68 |
$889.68 |
$889.68 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,645.08 |
$4,645.08 |
$4,645.08 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,960.00 |
$3,960.00 |
$3,960.00 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,687.42 |
$3,687.42 |
$3,687.42 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,504.14 |
$1,504.14 |
$1,504.14 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,279.08 |
$1,279.08 |
$1,279.08 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$439.56 |
$439.56 |
$439.56 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,209.68 |
$2,209.68 |
$2,209.68 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,421.64 |
$1,421.64 |
$1,421.64 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,918.62 |
$1,918.62 |
$1,918.62 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$73.92 |
$73.92 |
$73.92 |
$68.64
|
|
Culture afb any source
|
$18.92 |
$18.92 |
$18.92 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$123.42 |
$123.42 |
$123.42 |
$79.00
|
|
Culture anaerobic except blood
|
$58.08 |
$58.08 |
$58.08 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$42.90 |
$42.90 |
$42.90 |
$51.45
|
|
Culture body fluid
|
$196.02 |
$196.02 |
$196.02 |
$126.75
|
|
Culture fungi definitive id mold
|
$65.63 |
$65.63 |
$65.63 |
$77.28
|
|
Culture fungi definitive id yeast
|
$63.36 |
$63.36 |
$63.36 |
$79.10
|
|
Culture fungi other (except blood)
|
$51.48 |
$51.48 |
$51.48 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$47.52 |
$47.52 |
$47.52 |
$74.88
|
|
Culture mycoplasma any source
|
$28.96 |
$28.96 |
$28.96 |
$85.26
|
|
Culture screening strep group a
|
$65.34 |
$65.34 |
$65.34 |
$81.00
|
|
Culture typing added method
|
$13.57 |
$13.57 |
$13.57 |
$38.58
|
|
Culture typing immunologic
|
$68.64 |
$68.64 |
$68.64 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$458.04 |
$458.04 |
$458.04 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$128.04 |
$128.04 |
$128.04 |
$133.90
|
|
Culture urine each isolate
|
$73.92 |
$73.92 |
$73.92 |
$57.00
|
|
Curette/treat cornea
|
$161.04 |
$161.04 |
$161.04 |
$1,345.80
|
|
Curette/treat cornea
|
$902.88 |
$902.88 |
$902.88 |
$2,818.14
|
|
Cv line/pic reposition
|
$132.00 |
$132.00 |
$132.00 |
$1,720.93
|
|
Cv stress test i&r only 93018
|
$36.96 |
$36.96 |
$36.96 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$54.12 |
$54.12 |
$54.12 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$20.09 |
$20.09 |
$20.09 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$13.20 |
$13.20 |
$13.20 |
$70.72
|
|
Cyclosporine 2 hour
|
$10.59 |
$10.59 |
$10.59 |
$129.48
|
|
Cyp2c19 gene com variants
|
$85.80 |
$85.80 |
$85.80 |
$504.00
|
|
Cyp2c9 gene com variants
|
$66.00 |
$66.00 |
$66.00 |
$275.10
|
|
Cyp2d6 gene com variants
|
$99.00 |
$99.00 |
$99.00 |
$554.00
|
|
Cyp3a5 gene common variants
|
$46.20 |
$46.20 |
$46.20 |
$245.31
|
|
Cystatin c
|
$6.92 |
$6.92 |
$6.92 |
$77.50
|
|
Cystic fibrosis cftr
|
$462.00 |
$462.00 |
$462.00 |
$1,100.00
|
|
Cysto cgen post urtl valves
|
$1,075.14 |
$1,075.14 |
$1,075.14 |
$4,175.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$260.04 |
$260.04 |
$260.04 |
$542.10
|
|
Cystometrogram w/up 51727
|
$811.80 |
$811.80 |
$811.80 |
$908.59
|
|
Cystorrhaphy wound comp 51865
|
$2,014.98 |
$2,014.98 |
$2,014.98 |
$1,756.80
|
|
Cystorrhaphy wound simple 51860
|
$1,678.38 |
$1,678.38 |
$1,678.38 |
$5,855.00
|
|
Cysto rx balo cath urtl strx
|
$366.96 |
$366.96 |
$366.96 |
$6,015.75
|
|
Cystoscopy and biopsy
|
$371.58 |
$371.58 |
$371.58 |
$4,081.37
|
|
Cystoscopy and treatment
|
$386.76 |
$386.76 |
$386.76 |
$4,081.37
|
|
Cystoscopy and treatment
|
$446.82 |
$446.82 |
$446.82 |
$4,160.10
|
|
Cystoscopy and treatment
|
$546.48 |
$546.48 |
$546.48 |
$5,162.50
|
|
Cystoscopy and treatment
|
$640.20 |
$640.20 |
$640.20 |
$5,995.60
|
|
Cystoscopy and treatment
|
$867.90 |
$867.90 |
$867.90 |
$6,475.26
|
|
Cystoscopy and treatment
|
$467.94 |
$467.94 |
$467.94 |
$3,213.14
|
|
Cystoscopy and treatment
|
$361.68 |
$361.68 |
$361.68 |
$2,424.12
|
|
Cystoscopy and treatment
|
$588.06 |
$588.06 |
$588.06 |
$4,045.60
|
|
Cystoscopy and treatment
|
$716.76 |
$716.76 |
$716.76 |
$4,061.71
|
|
Cystoscopy and treatment
|
$450.78 |
$450.78 |
$450.78 |
$2,424.12
|
|
Cystoscopy and treatment
|
$772.20 |
$772.20 |
$772.20 |
$958.81
|
|
Cystoscopy and treatment
|
$542.52 |
$542.52 |
$542.52 |
$3,587.87
|
|
Cystoscopy and treatment
|
$621.72 |
$621.72 |
$621.72 |
$4,081.37
|
|
Cystoscopy and treatment
|
$707.52 |
$707.52 |
$707.52 |
$2,874.36
|
|
Cystoscopy and treatment
|
$609.18 |
$609.18 |
$609.18 |
$3,203.50
|
|
Cystoscopy and treatment
|
$547.14 |
$547.14 |
$547.14 |
$4,061.71
|
|
Cystoscopy and treatment
|
$584.10 |
$584.10 |
$584.10 |
$3,820.84
|
|
Cystoscopy (Bladder Scope)
|
$522.06 |
$522.06 |
$522.06 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$859.98 |
$859.98 |
$859.98 |
$2,704.80
|
|
Cystoscopy inject material
|
$570.90 |
$570.90 |
$570.90 |
$5,986.78
|
|
Cystoscopy removal of clots
|
$970.20 |
$970.20 |
$970.20 |
$4,081.37
|
|
Cystoscopy & revise urethra
|
$553.08 |
$553.08 |
$553.08 |
$2,874.36
|
|
Cystoscopy stone removal
|
$708.18 |
$708.18 |
$708.18 |
$5,741.00
|
|
Cystoscopy & ureter catheter
|
$299.64 |
$299.64 |
$299.64 |
$3,786.00
|