|
CT Angiogram of the Chest (for blood clot)
|
$5,752.29 |
$5,752.29 |
$5,752.29 |
$1,955.80
|
|
CT Angiogram of the Head
|
$9,036.69 |
$9,036.69 |
$9,036.69 |
$2,021.40
|
|
CT angio pelvis
|
$3,091.62 |
$3,091.62 |
$3,091.62 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$11,077.71 |
$11,077.71 |
$11,077.71 |
$1,652.25
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,287.24 |
$1,287.24 |
$1,287.24 |
$1,085.05
|
|
CT limited or localized follow-up study
|
$2,248.08 |
$2,248.08 |
$2,248.08 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$3,970.35 |
$3,970.35 |
$3,970.35 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$3,734.22 |
$3,734.22 |
$3,734.22 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$3,970.35 |
$3,970.35 |
$3,970.35 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$3,933.12 |
$3,933.12 |
$3,933.12 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$3,196.17 |
$3,196.17 |
$3,196.17 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$4,325.82 |
$4,325.82 |
$4,325.82 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$3,811.23 |
$3,811.23 |
$3,811.23 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$3,650.07 |
$3,650.07 |
$3,650.07 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$3,002.88 |
$3,002.88 |
$3,002.88 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$420.75 |
$420.75 |
$420.75 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$12,408.81 |
$12,408.81 |
$12,408.81 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$10,290.27 |
$10,290.27 |
$10,290.27 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$9,501.81 |
$9,501.81 |
$9,501.81 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$5,563.08 |
$5,563.08 |
$5,563.08 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$5,058.18 |
$5,058.18 |
$5,058.18 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$685.95 |
$685.95 |
$685.95 |
$400.20
|
|
CT t-spine w /wo contrast
|
$6,113.88 |
$6,113.88 |
$6,113.88 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$4,650.69 |
$4,650.69 |
$4,650.69 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$4,227.90 |
$4,227.90 |
$4,227.90 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$5,116.32 |
$5,116.32 |
$5,116.32 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$308.04 |
$308.04 |
$308.04 |
$63.75
|
|
Culture afb any source
|
$174.42 |
$174.42 |
$174.42 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$358.02 |
$358.02 |
$358.02 |
$77.31
|
|
Culture anaerobic except blood
|
$419.22 |
$419.22 |
$419.22 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$159.12 |
$159.12 |
$159.12 |
$52.80
|
|
Culture body fluid
|
$382.50 |
$382.50 |
$382.50 |
$130.50
|
|
Culture fungi definitive id mold
|
$159.12 |
$159.12 |
$159.12 |
$70.00
|
|
Culture fungi definitive id yeast
|
$233.58 |
$233.58 |
$233.58 |
$80.60
|
|
Culture fungi other (except blood)
|
$29.58 |
$29.58 |
$29.58 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$109.14 |
$109.14 |
$109.14 |
$77.40
|
|
Culture mycoplasma any source
|
$108.27 |
$108.27 |
$108.27 |
$90.37
|
|
Culture screening strep group a
|
$149.43 |
$149.43 |
$149.43 |
$81.60
|
|
Culture typing immunologic
|
$288.66 |
$288.66 |
$288.66 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$280.50 |
$280.50 |
$280.50 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$224.91 |
$224.91 |
$224.91 |
$124.40
|
|
Curette/treat cornea
|
$1,687.08 |
$1,687.08 |
$1,687.08 |
$1,317.39
|
|
Curette/treat cornea
|
$4,086.12 |
$4,086.12 |
$4,086.12 |
$2,818.14
|
|
Cutter lead
|
$28,974.38 |
$28,974.38 |
$28,974.38 |
$5,538.98
|
|
Cyanocobalamin unsat binding capacity
|
$12.34 |
$12.34 |
$12.34 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$45.90 |
$45.90 |
$45.90 |
$80.05
|
|
Cyclosporine 2 hour
|
$279.48 |
$279.48 |
$279.48 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$5.61 |
$5.61 |
$5.61 |
$9.79
|
|
Cylinder pump set 20cm titan zero angl
|
$47,254.88 |
$47,254.88 |
$47,254.88 |
$22,594.80
|
|
Cystatin c
|
$57.83 |
$57.83 |
$57.83 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,339.77 |
$1,339.77 |
$1,339.77 |
$539.55
|
|
Cystoscopy and treatment
|
$7,432.74 |
$7,432.74 |
$7,432.74 |
$4,081.37
|
|
Cystoscopy and treatment
|
$4,301.85 |
$4,301.85 |
$4,301.85 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$1,450.44 |
$1,450.44 |
$1,450.44 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$7,432.74 |
$7,432.74 |
$7,432.74 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$4,301.85 |
$4,301.85 |
$4,301.85 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,776.04 |
$3,776.04 |
$3,776.04 |
$3,774.40
|
|
Cystouretero & or pyeloscope
|
$7,432.74 |
$7,432.74 |
$7,432.74 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$7,432.74 |
$7,432.74 |
$7,432.74 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$4,301.85 |
$4,301.85 |
$4,301.85 |
$2,874.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$197.88 |
$197.88 |
$197.88 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$45.97 |
$45.97 |
$45.97 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$282.54 |
$282.54 |
$282.54 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$136.68 |
$136.68 |
$136.68 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$108.63 |
$108.63 |
$108.63 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$206.04 |
$206.04 |
$206.04 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$45.90 |
$45.90 |
$45.90 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$290.19 |
$290.19 |
$290.19 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$172.38 |
$172.38 |
$172.38 |
$205.00
|
|
Cytopath smear other source
|
$146.37 |
$146.37 |
$146.37 |
$85.80
|
|
Cytopath smear other source
|
$102.51 |
$102.51 |
$102.51 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$51.00 |
$51.00 |
$51.00 |
$95.89
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$156.56 |
$156.56 |
$156.56 |
$315.32
|
|
D&c after delivery 59160
|
$5,755.86 |
$5,755.86 |
$5,755.86 |
$3,762.53
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$5,724.24 |
$5,724.24 |
$5,724.24 |
$3,774.81
|
|
Dch validity tests
|
$49.47 |
$49.47 |
$49.47 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$43.35 |
$43.35 |
$43.35 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,176.57 |
$1,176.57 |
$1,176.57 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$340.68 |
$340.68 |
$340.68 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$3,014.10 |
$3,014.10 |
$3,014.10 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$892.50 |
$892.50 |
$892.50 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,339.77 |
$1,339.77 |
$1,339.77 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$595.68 |
$595.68 |
$595.68 |
$810.50
|
|
Debride nail1-5 11720
|
$116.79 |
$116.79 |
$116.79 |
$173.25
|
|
Debride nail6 or more 11721
|
$116.79 |
$116.79 |
$116.79 |
$195.20
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$1,265.16
|
|
Debride skin bone at fx site
|
$3,904.56 |
$3,904.56 |
$3,904.56 |
$3,278.34
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$943.50 |
$943.50 |
$943.50 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,313.76 |
$1,313.76 |
$1,313.76 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$274.89 |
$274.89 |
$274.89 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,176.57 |
$1,176.57 |
$1,176.57 |
$1,193.40
|
|
Decalcification
|
$51.51 |
$51.51 |
$51.51 |
$73.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$673.71 |
$673.71 |
$673.71 |
$545.90
|
|
Decompress fasciotomyhand 26037
|
$6,059.82 |
$6,059.82 |
$6,059.82 |
$3,594.44
|
|
Decompression of lower leg
|
$6,026.16 |
$6,026.16 |
$6,026.16 |
$3,839.54
|
|
Decompression of thigh/knee
|
$6,026.16 |
$6,026.16 |
$6,026.16 |
$3,839.54
|
|
Delivery of placenta 59414
|
$5,724.24 |
$5,724.24 |
$5,724.24 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$477.36 |
$477.36 |
$477.36 |
$196.26
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$851.19 |
$851.19 |
$851.19 |
$460.50
|