|
CT angio pelvis
|
$1,615.20 |
$1,615.20 |
$1,615.20 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$2,612.64 |
$2,612.64 |
$2,612.64 |
$1,652.25
|
|
CT cerebral perf w cont & prcssng
|
$2,628.00 |
$2,628.00 |
$2,628.00 |
$803.40
|
|
CT colonography dx
|
$194.40 |
$194.40 |
$194.40 |
$770.90
|
|
CT guidance for needle placement
|
$1,572.96 |
$1,572.96 |
$1,572.96 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,140.00 |
$1,140.00 |
$1,140.00 |
$1,085.05
|
|
CT guid parench tis ablat
|
$1,572.96 |
$1,572.96 |
$1,572.96 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$95.52 |
$95.52 |
$95.52 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$653.28 |
$653.28 |
$653.28 |
$1,217.45
|
|
CT hrt w/3d image
|
$1,028.16 |
$1,028.16 |
$1,028.16 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$565.92 |
$565.92 |
$565.92 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$2,481.12 |
$2,481.12 |
$2,481.12 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$1,757.28 |
$1,757.28 |
$1,757.28 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$2,661.60 |
$2,661.60 |
$2,661.60 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,705.44 |
$1,705.44 |
$1,705.44 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$2,414.40 |
$2,414.40 |
$2,414.40 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,414.40 |
$2,414.40 |
$2,414.40 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,705.44 |
$1,705.44 |
$1,705.44 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$616.80 |
$616.80 |
$616.80 |
$456.00
|
|
CT scan for therapy guide
|
$1,029.12 |
$1,029.12 |
$1,029.12 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,915.04 |
$2,915.04 |
$2,915.04 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,328.00 |
$2,328.00 |
$2,328.00 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,082.72 |
$2,082.72 |
$2,082.72 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$2,160.96 |
$2,160.96 |
$2,160.96 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,773.12 |
$1,773.12 |
$1,773.12 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$190.08 |
$190.08 |
$190.08 |
$400.20
|
|
CT t-spine w /wo contrast
|
$2,848.80 |
$2,848.80 |
$2,848.80 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$2,114.40 |
$2,114.40 |
$2,114.40 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,757.28 |
$1,757.28 |
$1,757.28 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$2,289.12 |
$2,289.12 |
$2,289.12 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$68.64 |
$68.64 |
$68.64 |
$63.75
|
|
Culture afb any source
|
$242.40 |
$242.40 |
$242.40 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$107.04 |
$107.04 |
$107.04 |
$77.31
|
|
Culture anaerobic except blood
|
$92.16 |
$92.16 |
$92.16 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$27.84 |
$27.84 |
$27.84 |
$52.80
|
|
Culture body fluid
|
$136.32 |
$136.32 |
$136.32 |
$130.50
|
|
Culture fungi definitive id mold
|
$101.28 |
$101.28 |
$101.28 |
$70.00
|
|
Culture fungi definitive id yeast
|
$88.32 |
$88.32 |
$88.32 |
$80.60
|
|
Culture fungi other (except blood)
|
$190.08 |
$190.08 |
$190.08 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$216.00 |
$216.00 |
$216.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$176.16 |
$176.16 |
$176.16 |
$84.75
|
|
Culture mycoplasma any source
|
$101.90 |
$101.90 |
$101.90 |
$90.37
|
|
Culture screening strep group a
|
$117.60 |
$117.60 |
$117.60 |
$81.60
|
|
Culture typing immunologic
|
$40.32 |
$40.32 |
$40.32 |
$41.60
|
|
Curette/treat cornea
|
$2,042.40 |
$2,042.40 |
$2,042.40 |
$1,317.39
|
|
Curette/treat cornea
|
$4,632.48 |
$4,632.48 |
$4,632.48 |
$2,818.14
|
|
Cutter lead
|
$22,050.00 |
$22,050.00 |
$22,050.00 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,964.64 |
$1,964.64 |
$1,964.64 |
$1,829.42
|
|
Cyanocobalamin unsat binding capacity
|
$11.62 |
$11.62 |
$11.62 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$43.20 |
$43.20 |
$43.20 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$702.71 |
$702.71 |
$702.71 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$40.49 |
$40.49 |
$40.49 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$227.62 |
$227.62 |
$227.62 |
$179.10
|
|
Cyclosporine 2 hour
|
$162.24 |
$162.24 |
$162.24 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$14.98 |
$14.98 |
$14.98 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$52.63 |
$52.63 |
$52.63 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$35,712.68 |
$35,712.68 |
$35,712.68 |
$22,594.80
|
|
Cystatin c
|
$54.43 |
$54.43 |
$54.43 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$350.40 |
$350.40 |
$350.40 |
$539.55
|
|
Cystoscopy and treatment
|
$1,960.32 |
$1,960.32 |
$1,960.32 |
$4,081.37
|
|
Cystoscopy and treatment
|
$4,153.44 |
$4,153.44 |
$4,153.44 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$1,092.48 |
$1,092.48 |
$1,092.48 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$1,960.32 |
$1,960.32 |
$1,960.32 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$3,945.60 |
$3,945.60 |
$3,945.60 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$7,086.72 |
$7,086.72 |
$7,086.72 |
$3,774.40
|
|
Cystouretero & or pyeloscope
|
$1,960.32 |
$1,960.32 |
$1,960.32 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$1,960.32 |
$1,960.32 |
$1,960.32 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,945.60 |
$3,945.60 |
$3,945.60 |
$2,874.36
|
|
Cytarabine 20 mg/ml injection solution
|
$166.60 |
$166.60 |
$166.60 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$44.54 |
$44.54 |
$44.54 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$43.26 |
$43.26 |
$43.26 |
$96.80
|
|
Cyto/molecular report
|
$10.27 |
$10.27 |
$10.27 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$94.08 |
$94.08 |
$94.08 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$58.08 |
$58.08 |
$58.08 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$54.72 |
$54.72 |
$54.72 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$82.08 |
$82.08 |
$82.08 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$111.36 |
$111.36 |
$111.36 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$66.24 |
$66.24 |
$66.24 |
$205.00
|
|
Cytopath smear other source
|
$71.52 |
$71.52 |
$71.52 |
$85.80
|
|
Cytopath smear other source
|
$94.08 |
$94.08 |
$94.08 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$47.04 |
$47.04 |
$47.04 |
$95.89
|
|
Dacarbazine 100 mg intravenous solution
|
$160.77 |
$160.77 |
$160.77 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$536.90 |
$536.90 |
$536.90 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$2,639.81 |
$2,639.81 |
$2,639.81 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$403.57 |
$403.57 |
$403.57 |
$315.32
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$237.81 |
$237.81 |
$237.81 |
$260.95
|
|
D&c after delivery 59160
|
$4,107.36 |
$4,107.36 |
$4,107.36 |
$3,762.53
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$4,100.64 |
$4,100.64 |
$4,100.64 |
$3,774.81
|
|
Dch validity tests
|
$20.16 |
$20.16 |
$20.16 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$40.80 |
$40.80 |
$40.80 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$934.08 |
$934.08 |
$934.08 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$109.92 |
$109.92 |
$109.92 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,412.48 |
$2,412.48 |
$2,412.48 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$248.64 |
$248.64 |
$248.64 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$248.64 |
$248.64 |
$248.64 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$934.08 |
$934.08 |
$934.08 |
$810.50
|
|
Debride nail1-5 11720
|
$257.76 |
$257.76 |
$257.76 |
$173.25
|