|
Cystic fibrosis cftr
|
$1,207.83 |
$1,207.83 |
$1,207.83 |
$1,104.40
|
|
Cystine urine quantitative
|
$40.06 |
$40.06 |
$40.06 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$272.24 |
$272.24 |
$272.24 |
$586.95
|
|
Cytogenetics 25-99
|
$18.64 |
$18.64 |
$18.64 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$3.82 |
$3.82 |
$3.82 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$3.18 |
$3.18 |
$3.18 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$27.96 |
$27.96 |
$27.96 |
$159.90
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$20.50 |
$20.50 |
$20.50 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$27.96 |
$27.96 |
$27.96 |
$213.85
|
|
Dch validity tests
|
$21.79 |
$21.79 |
$21.79 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$37.58 |
$37.58 |
$37.58 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$43.28 |
$43.28 |
$43.28 |
$284.00
|
|
Decalcification
|
$3.80 |
$3.80 |
$3.80 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$354.58 |
$354.58 |
$354.58 |
$572.95
|
|
Delivery of placenta 59414
|
$2,192.20 |
$2,192.20 |
$2,192.20 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$110.10 |
$110.10 |
$110.10 |
$185.17
|
|
Desoxycorticosterone
|
$9.39 |
$9.39 |
$9.39 |
$109.28
|
|
Device sut capio slim opn
|
$7,029.06 |
$7,029.06 |
$7,029.06 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$6,475.07 |
$6,475.07 |
$6,475.07 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$271.58 |
$271.58 |
$271.58 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$4.38 |
$4.38 |
$4.38 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$18.78 |
$18.78 |
$18.78 |
$79.30
|
|
Diagnostic Mammogram (both breasts)
|
$388.22 |
$388.22 |
$388.22 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$256.89 |
$256.89 |
$256.89 |
$314.00
|
|
Diffusing capacity
|
$330.75 |
$330.75 |
$330.75 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$25.04 |
$25.04 |
$25.04 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$1,005.16 |
$1,005.16 |
$1,005.16 |
$402.10
|
|
Disability dlco
|
$272.00 |
$272.00 |
$272.00 |
$293.76
|
|
Disaccharidases
|
$195.31 |
$195.31 |
$195.31 |
$230.40
|
|
#d/lmeth-l-methamphetamine
|
$10.64 |
$10.64 |
$10.64 |
$72.14
|
|
Dna antibody native/double stranded
|
$3.18 |
$3.18 |
$3.18 |
$100.00
|
|
Dna trichomonas
|
$72.54 |
$72.54 |
$72.54 |
$63.00
|
|
Doppler echo complete
|
$395.30 |
$395.30 |
$395.30 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$402.99 |
$402.99 |
$402.99 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$244.22 |
$244.22 |
$244.22 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$132,935.43 |
$132,935.43 |
$132,935.43 |
$34,278.00
|
|
Dpyd gene common variants
|
$154.28 |
$154.28 |
$154.28 |
$423.60
|
|
Drainage of kidney lesion
|
$1,440.20 |
$1,440.20 |
$1,440.20 |
$1,506.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$5,623.85 |
$5,623.85 |
$5,623.85 |
$1,818.32
|
|
Drug assay caffeine
|
$17.53 |
$17.53 |
$17.53 |
$80.00
|
|
Drug assay posaconazole
|
$42.57 |
$42.57 |
$42.57 |
$96.75
|
|
Drug assay vedolizumab
|
$167.14 |
$167.14 |
$167.14 |
$154.00
|
|
Drug assay voriconazole
|
$47.58 |
$47.58 |
$47.58 |
$96.75
|
|
Drug asy hydroxychloroquine
|
$150.87 |
$150.87 |
$150.87 |
$66.43
|
|
Drug of abuse screen urine
|
$23.79 |
$23.79 |
$23.79 |
$67.89
|
|
Drug screening tapentadol
|
$3.76 |
$3.76 |
$3.76 |
$47.03
|
|
Drug test prsmv instrmnt
|
$32.55 |
$32.55 |
$32.55 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$191.56 |
$191.56 |
$191.56 |
$278.85
|
|
Drvvt confirm - quest
|
$71.52 |
$71.52 |
$71.52 |
$109.20
|
|
Dup scan/hemodialysis access 93990
|
$472.68 |
$472.68 |
$472.68 |
$489.72
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$765.38 |
$765.38 |
$765.38 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$503.81 |
$503.81 |
$503.81 |
$401.20
|
|
Ecg external < 48 hours recording
|
$347.04 |
$347.04 |
$347.04 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$550.93 |
$550.93 |
$550.93 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$1,141.65 |
$1,141.65 |
$1,141.65 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$388.22 |
$388.22 |
$388.22 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$311.52 |
$311.52 |
$311.52 |
$511.55
|
|
Echocardiograpy doppler follow up/limited study
|
$198.83 |
$198.83 |
$198.83 |
$371.25
|
|
Echo guide for amniocentesis
|
$522.81 |
$522.81 |
$522.81 |
$455.57
|
|
Echo stress
|
$739.27 |
$739.27 |
$739.27 |
$1,609.44
|
|
Echo transthoracic
|
$626.58 |
$626.58 |
$626.58 |
$1,052.40
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$627.76 |
$627.76 |
$627.76 |
$1,033.00
|
|
Eeg monitor/record/awake/drowsy 95816
|
$455.09 |
$455.09 |
$455.09 |
$835.00
|
|
Eeg recording awake and asleep
|
$542.52 |
$542.52 |
$542.52 |
$931.20
|
|
E equine encephalitis igg
|
$8.92 |
$8.92 |
$8.92 |
$51.84
|
|
Egfr gene com variants
|
$126.79 |
$126.79 |
$126.79 |
$672.88
|
|
EKG (Tracing Only)
|
$290.85 |
$290.85 |
$290.85 |
$226.50
|
|
Elbow X-ray (2 views, both sides)
|
$149.57 |
$149.57 |
$149.57 |
$291.94
|
|
Elbow X-ray (3 or more views, both sides)
|
$186.30 |
$186.30 |
$186.30 |
$364.20
|
|
Electrd sq emblem s-icd
|
$7,029.06 |
$7,029.06 |
$7,029.06 |
$10,243.24
|
|
Electrical Stimulation Therapy (each 15 minutes)
|
$83.14 |
$83.14 |
$83.14 |
$87.49
|
|
Electrical stimulation/unattended 97014
|
$67.24 |
$67.24 |
$67.24 |
$81.75
|
|
Electrolyte panel
|
$48.83 |
$48.83 |
$48.83 |
$79.30
|
|
Electron microscopy diagnostic
|
$295.40 |
$295.40 |
$295.40 |
$1,011.98
|
|
Encephalitis, california igg/igm
|
$8.92 |
$8.92 |
$8.92 |
$56.50
|
|
Encephalitis, st louis igg/igm
|
$8.92 |
$8.92 |
$8.92 |
$51.84
|
|
Encephalitis, western equine igg/igm
|
$8.92 |
$8.92 |
$8.92 |
$54.99
|
|
Entamoeba histolytica ag eia - sendout
|
$12.83 |
$12.83 |
$12.83 |
$56.89
|
|
Epoetin alfa, 100 units esrd
|
$18.54 |
$18.54 |
$18.54 |
$6.00
|
|
Epstein barr early antigen antibody
|
$2.55 |
$2.55 |
$2.55 |
$60.00
|
|
Epstein barr nuclear antigen antibody
|
$63.06 |
$63.06 |
$63.06 |
$76.86
|
|
Epstein barr viral capsid antigen antibody igm
|
$81.54 |
$81.54 |
$81.54 |
$85.50
|
|
ER Visit (level 1, minor)
|
$311.68 |
$311.68 |
$311.68 |
$252.60
|
|
ER Visit (level 2)
|
$502.82 |
$502.82 |
$502.82 |
$463.00
|
|
ER Visit (level 3)
|
$1,059.08 |
$1,059.08 |
$1,059.08 |
$812.18
|
|
ER Visit (level 4)
|
$2,826.36 |
$2,826.36 |
$2,826.36 |
$1,291.00
|
|
ER Visit (level 5, high severity)
|
$3,441.94 |
$3,441.94 |
$3,441.94 |
$1,871.60
|
|
Esophageal motility
|
$650.87 |
$650.87 |
$650.87 |
$655.45
|
|
Established Patient Office Visit (level 1)
|
$290.87 |
$290.87 |
$290.87 |
$122.20
|
|
Established Patient Office Visit (level 2)
|
$737.20 |
$737.20 |
$737.20 |
$139.20
|
|
Established Patient Office Visit (level 3)
|
$1,479.42 |
$1,479.42 |
$1,479.42 |
$186.94
|
|
Established Patient Office Visit (level 4)
|
$2,281.82 |
$2,281.82 |
$2,281.82 |
$239.25
|
|
Established Patient Office Visit (level 5)
|
$3,214.61 |
$3,214.61 |
$3,214.61 |
$290.68
|
|
Estradiol total
|
$8.76 |
$8.76 |
$8.76 |
$152.10
|
|
Estrogens total-sendout
|
$41.32 |
$41.32 |
$41.32 |
$97.50
|
|
Ethylene glycol -sendout
|
$27.54 |
$27.54 |
$27.54 |
$86.04
|
|
Evaluation cervicovaginal fluid for specific amniotic fluid proteins qualitative each specimen
|
$184.67 |
$184.67 |
$184.67 |
$213.15
|
|
Evoked potentials auditory screening automated analysis
|
$207.04 |
$207.04 |
$207.04 |
$261.30
|
|
Expander tiss 133s-mv-12-t 300ml natrelle smth
|
$5,623.85 |
$5,623.85 |
$5,623.85 |
$4,101.67
|
|
External newborn metabolic screening panel
|
$122.48 |
$122.48 |
$122.48 |
$109.76
|
