|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,351.20 |
$4,351.20 |
$4,351.20 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$3,948.00 |
$3,948.00 |
$3,948.00 |
$1,655.85
|
|
CT thoracic spine without contrast
|
$3,231.20 |
$3,231.20 |
$3,231.20 |
$1,430.20
|
|
CT thorax low dose for lung screening without contrast
|
$397.60 |
$397.60 |
$397.60 |
$332.00
|
|
CT t-spine w /wo contrast
|
$4,306.40 |
$4,306.40 |
$4,306.40 |
$1,968.47
|
|
CT upper extremity w/contrast (both sides)
|
$2,872.80 |
$2,872.80 |
$2,872.80 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$2,514.40 |
$2,514.40 |
$2,514.40 |
$1,404.36
|
|
CT uppr extremity w/o&w/dye
|
$3,589.60 |
$3,589.60 |
$3,589.60 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$1,472.80 |
$1,472.80 |
$1,472.80 |
$1,472.80
|
|
Cultr oocyte/embryo <4 days
|
$2,094.40 |
$2,094.40 |
$2,094.40 |
$1,291.35
|
|
Cultr oocyte/embryo <4 days
|
$2,178.40 |
$2,178.40 |
$2,178.40 |
$441.00
|
|
Cult skin graft fnhfg 15155
|
$11,300.80 |
$11,300.80 |
$11,300.80 |
$4,052.18
|
|
Cult skin grft t/arm/leg
|
$11,300.80 |
$11,300.80 |
$11,300.80 |
$2,441.40
|
|
Culture aerobic additional method definitive id each
|
$100.80 |
$100.80 |
$100.80 |
$71.40
|
|
Culture afb any source
|
$94.64 |
$94.64 |
$94.64 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$118.16 |
$118.16 |
$118.16 |
$84.76
|
|
Culture anaerobic except blood
|
$147.28 |
$147.28 |
$147.28 |
$120.54
|
|
Culture bacteria anaerobic
|
$154.00 |
$154.00 |
$154.00 |
$84.24
|
|
Culture bacterial urine
|
$29.12 |
$29.12 |
$29.12 |
$29.12
|
|
Culture bact stool aero addl path ea
|
$63.84 |
$63.84 |
$63.84 |
$52.50
|
|
Culture body fluid
|
$254.80 |
$254.80 |
$254.80 |
$126.00
|
|
Culture fungi definitive id mold
|
$161.84 |
$161.84 |
$161.84 |
$80.00
|
|
Culture fungi definitive id yeast
|
$129.36 |
$129.36 |
$129.36 |
$79.50
|
|
Culture fungi other (except blood)
|
$174.16 |
$174.16 |
$174.16 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$70.00 |
$70.00 |
$70.00 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$134.40 |
$134.40 |
$134.40 |
$100.00
|
|
Culture mycoplasma any source
|
$42.00 |
$42.00 |
$42.00 |
$81.62
|
|
Culture of specimen by kit
|
$89.04 |
$89.04 |
$89.04 |
$49.00
|
|
Culture quantitative aerobic other source
|
$173.60 |
$173.60 |
$173.60 |
$90.35
|
|
Culture screening strep group a
|
$104.72 |
$104.72 |
$104.72 |
$83.16
|
|
Culture type pulse field gel
|
$53.76 |
$53.76 |
$53.76 |
$38.58
|
|
Culture typing added method
|
$49.28 |
$49.28 |
$49.28 |
$38.70
|
|
Culture typing glc/hplc
|
$152.32 |
$152.32 |
$152.32 |
$53.75
|
|
Culture typing immunologic
|
$56.56 |
$56.56 |
$56.56 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$565.60 |
$565.60 |
$565.60 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$308.00 |
$308.00 |
$308.00 |
$138.40
|
|
Culture urine each isolate
|
$96.88 |
$96.88 |
$96.88 |
$54.78
|
|
Culture virus isolation
|
$239.12 |
$239.12 |
$239.12 |
$162.00
|
|
Curette/treat cornea
|
$3,108.00 |
$3,108.00 |
$3,108.00 |
$1,345.80
|
|
Curette/treat cornea
|
$6,736.80 |
$6,736.80 |
$6,736.80 |
$2,818.14
|
|
Cus elbo skt in for con/atyp
|
$1,453.20 |
$1,453.20 |
$1,453.20 |
$1,453.20
|
|
Cus elbo skt in not con/atyp
|
$1,453.20 |
$1,453.20 |
$1,453.20 |
$1,453.20
|
|
Custom glove for term device
|
$630.00 |
$630.00 |
$630.00 |
$630.00
|
|
Custom shape cover ak
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$1,125.60
|
|
Custom shape cover bk
|
$686.00 |
$686.00 |
$686.00 |
$686.00
|
|
Custom shape cvr hip disart
|
$1,587.60 |
$1,587.60 |
$1,587.60 |
$1,587.60
|
|
Custom shape cvr knee disart
|
$1,117.20 |
$1,117.20 |
$1,117.20 |
$1,117.20
|
|
Cutter lead
|
$48,300.00 |
$48,300.00 |
$48,300.00 |
$6,685.72
|
|
Cv line/pic reposition
|
$3,623.20 |
$3,623.20 |
$3,623.20 |
$1,608.00
|
|
Cyanocobalamin unsat binding capacity
|
$38.08 |
$38.08 |
$38.08 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$10.57 |
$10.57 |
$10.57 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$54.32 |
$54.32 |
$54.32 |
$72.15
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,305.02 |
$1,305.02 |
$1,305.02 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$881.79 |
$881.79 |
$881.79 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$146.29 |
$146.29 |
$146.29 |
$140.78
|
|
Cyclosporine 2 hour
|
$176.40 |
$176.40 |
$176.40 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$11.58 |
$11.58 |
$11.58 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$1,460.91 |
$1,460.91 |
$1,460.91 |
$35.57
|
|
Cygnus matrix, per sq cm
|
$44.80 |
$44.80 |
$44.80 |
$295.20
|
|
Cygnus, per sq cm
|
$0.56 |
$0.56 |
$0.56 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$16,938.18 |
$16,938.18 |
$16,938.18 |
$24,372.98
|
|
Cymetra injectable
|
$728.56 |
$728.56 |
$728.56 |
$578.24
|
|
Cyp2c19 gene com variants
|
$666.40 |
$666.40 |
$666.40 |
$502.45
|
|
Cyp2c9 gene com variants
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$266.50
|
|
Cyp2d6 gene com variants
|
$3,063.20 |
$3,063.20 |
$3,063.20 |
$573.65
|
|
Cyp3a4 gene common variants
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$241.24
|
|
Cyp3a5 gene common variants
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$245.31
|
|
Cystatin c
|
$68.32 |
$68.32 |
$68.32 |
$76.48
|
|
Cystic fibrosis cftr
|
$3,326.40 |
$3,326.40 |
$3,326.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$63.28 |
$63.28 |
$63.28 |
$100.70
|
|
Cysto cgen post urtl valves
|
$6,848.80 |
$6,848.80 |
$6,848.80 |
$4,175.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,428.00 |
$1,428.00 |
$1,428.00 |
$564.85
|
|
Cysto impl 4 or more
|
$5,700.80 |
$5,700.80 |
$5,700.80 |
$6,860.21
|
|
Cysto insj dev ischmc rmdlg
|
$16,469.60 |
$16,469.60 |
$16,469.60 |
$10,942.71
|
|
Cystometrogram w/up 51727
|
$2,072.00 |
$2,072.00 |
$2,072.00 |
$908.59
|
|
Cystorrhaphy wound simple 51860
|
$9,441.60 |
$9,441.60 |
$9,441.60 |
$6,297.20
|
|
Cysto rx balo cath urtl strx
|
$9,144.80 |
$9,144.80 |
$9,144.80 |
$6,853.60
|
|
Cystoscopy and biopsy
|
$8,439.20 |
$8,439.20 |
$8,439.20 |
$4,081.37
|
|
Cystoscopy and radiotracer
|
$9,643.20 |
$9,643.20 |
$9,643.20 |
$4,846.99
|
|
Cystoscopy and treatment
|
$7,033.60 |
$7,033.60 |
$7,033.60 |
$4,081.37
|
|
Cystoscopy and treatment
|
$9,262.40 |
$9,262.40 |
$9,262.40 |
$4,350.00
|
|
Cystoscopy and treatment
|
$10,908.80 |
$10,908.80 |
$10,908.80 |
$5,304.00
|
|
Cystoscopy and treatment
|
$12,376.00 |
$12,376.00 |
$12,376.00 |
$5,995.60
|
|
Cystoscopy and treatment
|
$17,578.40 |
$17,578.40 |
$17,578.40 |
$6,593.60
|
|
Cystoscopy and treatment
|
$8,948.80 |
$8,948.80 |
$8,948.80 |
$3,213.14
|
|
Cystoscopy and treatment
|
$3,505.60 |
$3,505.60 |
$3,505.60 |
$2,424.12
|
|
Cystoscopy and treatment
|
$5,807.20 |
$5,807.20 |
$5,807.20 |
$4,045.60
|
|
Cystoscopy and treatment
|
$8,439.20 |
$8,439.20 |
$8,439.20 |
$4,055.01
|
|
Cystoscopy and treatment
|
$6,669.60 |
$6,669.60 |
$6,669.60 |
$2,424.12
|
|
Cystoscopy and treatment
|
$6,882.40 |
$6,882.40 |
$6,882.40 |
$958.81
|
|
Cystoscopy and treatment
|
$6,540.80 |
$6,540.80 |
$6,540.80 |
$2,874.36
|
|
Cystoscopy and treatment
|
$6,540.80 |
$6,540.80 |
$6,540.80 |
$4,081.37
|
|
Cystoscopy and treatment
|
$7,672.00 |
$7,672.00 |
$7,672.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$6,015.75
|
|
Cystoscopy and treatment
|
$8,489.60 |
$8,489.60 |
$8,489.60 |
$2,850.95
|
|
Cystoscopy and treatment
|
$8,680.00 |
$8,680.00 |
$8,680.00 |
$3,203.50
|
|
Cystoscopy and treatment
|
$8,439.20 |
$8,439.20 |
$8,439.20 |
$4,081.37
|
|
Cystoscopy and treatment
|
$9,038.40 |
$9,038.40 |
$9,038.40 |
$3,817.53
|
|
Cystoscopy (Bladder Scope)
|
$2,884.00 |
$2,884.00 |
$2,884.00 |
$1,445.41
|
|
Cystoscopy chemodenervation
|
$5,924.80 |
$5,924.80 |
$5,924.80 |
$2,831.92
|