|
CT Angiogram of the Chest (for blood clot)
|
$2,582.50 |
$2,582.50 |
$2,582.50 |
$1,955.80
|
|
CT Angiogram of the Head
|
$2,015.67 |
$2,015.67 |
$2,015.67 |
$2,021.40
|
|
CT angio hrt w/3d image
|
$873.38 |
$873.38 |
$873.38 |
$1,588.60
|
|
CT angio pelvis
|
$1,455.89 |
$1,455.89 |
$1,455.89 |
$1,775.28
|
|
CT bone density axial
|
$338.69 |
$338.69 |
$338.69 |
$326.30
|
|
CT colonography dx
|
$183.46 |
$183.46 |
$183.46 |
$770.90
|
|
CT colonography dx w/dye
|
$430.81 |
$430.81 |
$430.81 |
$1,009.98
|
|
CT colonography screening
|
$441.40 |
$441.40 |
$441.40 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,537.04 |
$1,537.04 |
$1,537.04 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$675.03 |
$675.03 |
$675.03 |
$1,085.05
|
|
CT guid cryo ablat intramuscular
|
$255.59 |
$255.59 |
$255.59 |
$2,136.75
|
|
CT guid parench tis ablat
|
$198.75 |
$198.75 |
$198.75 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$212.47 |
$212.47 |
$212.47 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$873.38 |
$873.38 |
$873.38 |
$1,217.45
|
|
CT hrt w/3d image
|
$873.38 |
$873.38 |
$873.38 |
$1,418.60
|
|
CT neck soft tissue w/contrast
|
$2,431.97 |
$2,431.97 |
$2,431.97 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,733.43 |
$1,733.43 |
$1,733.43 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$2,740.08 |
$2,740.08 |
$2,740.08 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,170.51 |
$2,170.51 |
$2,170.51 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,987.44 |
$1,987.44 |
$1,987.44 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,028.22 |
$1,028.22 |
$1,028.22 |
$1,351.20
|
|
CT scan for therapy guide
|
$716.58 |
$716.58 |
$716.58 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,698.92 |
$3,698.92 |
$3,698.92 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,425.30 |
$3,425.30 |
$3,425.30 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,411.19 |
$3,411.19 |
$3,411.19 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$2,509.20 |
$2,509.20 |
$2,509.20 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$2,426.48 |
$2,426.48 |
$2,426.48 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$307.33 |
$307.33 |
$307.33 |
$400.20
|
|
CT t-spine w /wo contrast
|
$3,032.91 |
$3,032.91 |
$3,032.91 |
$2,030.60
|
|
Culture aerobic additional method definitive id each
|
$63.12 |
$63.12 |
$63.12 |
$63.75
|
|
Culture afb any source
|
$39.20 |
$39.20 |
$39.20 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$21.91 |
$21.91 |
$21.91 |
$77.31
|
|
Culture anaerobic except blood
|
$239.52 |
$239.52 |
$239.52 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$60.37 |
$60.37 |
$60.37 |
$52.80
|
|
Culture body fluid
|
$477.85 |
$477.85 |
$477.85 |
$130.50
|
|
Culture fungi definitive id mold
|
$36.85 |
$36.85 |
$36.85 |
$70.00
|
|
Culture fungi definitive id yeast
|
$43.52 |
$43.52 |
$43.52 |
$80.60
|
|
Culture fungi other (except blood)
|
$165.82 |
$165.82 |
$165.82 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$265.00 |
$265.00 |
$265.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$61.55 |
$61.55 |
$61.55 |
$84.75
|
|
Culture mycoplasma any source
|
$15.14 |
$15.14 |
$15.14 |
$90.37
|
|
Culture screening strep group a
|
$61.94 |
$61.94 |
$61.94 |
$81.60
|
|
Culture typing added method
|
$58.80 |
$58.80 |
$58.80 |
$34.45
|
|
Culture typing immunologic
|
$94.08 |
$94.08 |
$94.08 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$403.76 |
$403.76 |
$403.76 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$72.13 |
$72.13 |
$72.13 |
$124.40
|
|
Culture urine each isolate
|
$87.81 |
$87.81 |
$87.81 |
$46.20
|
|
Cutter lead
|
$5,507.21 |
$5,507.21 |
$5,507.21 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,466.48 |
$1,466.48 |
$1,466.48 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$21.17 |
$21.17 |
$21.17 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$48.81 |
$48.81 |
$48.81 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,190.12 |
$1,190.12 |
$1,190.12 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$60.76 |
$60.76 |
$60.76 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$194.83 |
$194.83 |
$194.83 |
$179.10
|
|
Cyclosporine 2 hour
|
$5.88 |
$5.88 |
$5.88 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$12.55 |
$12.55 |
$12.55 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$1,626.80 |
$1,626.80 |
$1,626.80 |
$39.04
|
|
Cylinder pump set 20cm titan zero angl
|
$20,541.98 |
$20,541.98 |
$20,541.98 |
$22,594.80
|
|
Cyp2c19 gene com variants
|
$50.96 |
$50.96 |
$50.96 |
$567.75
|
|
Cyp2c9 gene com variants
|
$35.08 |
$35.08 |
$35.08 |
$275.10
|
|
Cyp2d6 gene com variants
|
$85.02 |
$85.02 |
$85.02 |
$537.50
|
|
Cyp3a4 gene common variants
|
$35.08 |
$35.08 |
$35.08 |
$230.01
|
|
Cyp3a5 gene common variants
|
$35.08 |
$35.08 |
$35.08 |
$220.50
|
|
Cystatin c
|
$3.92 |
$3.92 |
$3.92 |
$82.26
|
|
Cystic fibrosis cftr
|
$248.27 |
$248.27 |
$248.27 |
$1,041.95
|
|
Cystine urine quantitative
|
$56.35 |
$56.35 |
$56.35 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$739.71 |
$739.71 |
$739.71 |
$539.55
|
|
Cytarabine 20 mg/ml injection solution
|
$31.76 |
$31.76 |
$31.76 |
$89.95
|
|
Cytogenomic neo microra alys
|
$529.52 |
$529.52 |
$529.52 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$31.36 |
$31.36 |
$31.36 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$3.92 |
$3.92 |
$3.92 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$8,264.54 |
$8,264.54 |
$8,264.54 |
$3,113.07
|
|
Cytopathology cellular enhancement technique non-gyn
|
$16.52 |
$16.52 |
$16.52 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$78.40 |
$78.40 |
$78.40 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$121.52 |
$121.52 |
$121.52 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$17.75 |
$17.75 |
$17.75 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$56.84 |
$56.84 |
$56.84 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$617.40 |
$617.40 |
$617.40 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$237.95 |
$237.95 |
$237.95 |
$205.00
|
|
Cytp urine 3-5 probes cmptr
|
$154.20 |
$154.20 |
$154.20 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$54.49 |
$54.49 |
$54.49 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$65.86 |
$65.86 |
$65.86 |
$2,526.62
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2,093.28 |
$2,093.28 |
$2,093.28 |
$315.32
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$580.95 |
$580.95 |
$580.95 |
$5,546.48
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$631.12 |
$631.12 |
$631.12 |
$260.95
|
|
D&c after delivery 59160
|
$3,880.80 |
$3,880.80 |
$3,880.80 |
$3,762.53
|
|
Dch pulmonary stress test
|
$813.80 |
$813.80 |
$813.80 |
$964.41
|
|
Dch validity tests
|
$58.41 |
$58.41 |
$58.41 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$40.17 |
$40.17 |
$40.17 |
$44.16
|
|
Debridement (>20 cm) charge pt
|
$132.89 |
$132.89 |
$132.89 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,059.18 |
$2,059.18 |
$2,059.18 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$184.64 |
$184.64 |
$184.64 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$791.06 |
$791.06 |
$791.06 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$562.13 |
$562.13 |
$562.13 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$184.64 |
$184.64 |
$184.64 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$797.72 |
$797.72 |
$797.72 |
$1,193.40
|
|
Decalcification
|
$3.24 |
$3.24 |
$3.24 |
$73.60
|
|
Decitabine 50 mg intravenous solution
|
$4,468.80 |
$4,468.80 |
$4,468.80 |
$975.45
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$407.68 |
$407.68 |
$407.68 |
$545.90
|
|
Deep muscle biopsy 20205
|
$3,186.96 |
$3,186.96 |
$3,186.96 |
$3,370.52
|