|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,501.55 |
$2,501.55 |
$2,501.55 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,127.60 |
$2,127.60 |
$2,127.60 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,536.30 |
$1,536.30 |
$1,536.30 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,398.60 |
$1,398.60 |
$1,398.60 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,004.94 |
$1,004.94 |
$1,004.94 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$99.09 |
$99.09 |
$99.09 |
$331.50
|
|
CT t-spine w /wo contrast
|
$1,794.42 |
$1,794.42 |
$1,794.42 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$921.24 |
$921.24 |
$921.24 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,087.56 |
$1,087.56 |
$1,087.56 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$1,460.43 |
$1,460.43 |
$1,460.43 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$51.57 |
$51.57 |
$51.57 |
$68.64
|
|
Culture afb any source
|
$14.04 |
$14.04 |
$14.04 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$52.65 |
$52.65 |
$52.65 |
$79.00
|
|
Culture anaerobic except blood
|
$63.18 |
$63.18 |
$63.18 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$15.39 |
$15.39 |
$15.39 |
$51.45
|
|
Culture body fluid
|
$109.08 |
$109.08 |
$109.08 |
$126.75
|
|
Culture fungi definitive id mold
|
$9.72 |
$9.72 |
$9.72 |
$77.28
|
|
Culture fungi definitive id yeast
|
$19.98 |
$19.98 |
$19.98 |
$79.10
|
|
Culture fungi other (except blood)
|
$89.91 |
$89.91 |
$89.91 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$6.21 |
$6.21 |
$6.21 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$21.33 |
$21.33 |
$21.33 |
$89.70
|
|
Culture mycoplasma any source
|
$11.85 |
$11.85 |
$11.85 |
$85.26
|
|
Culture screening strep group a
|
$50.76 |
$50.76 |
$50.76 |
$81.00
|
|
Culture typing added method
|
$6.33 |
$6.33 |
$6.33 |
$38.58
|
|
Culture typing immunologic
|
$34.56 |
$34.56 |
$34.56 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$282.42 |
$282.42 |
$282.42 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$73.17 |
$73.17 |
$73.17 |
$133.90
|
|
Culture urine each isolate
|
$20.25 |
$20.25 |
$20.25 |
$57.00
|
|
Curette/treat cornea
|
$65.88 |
$65.88 |
$65.88 |
$1,345.80
|
|
Curette/treat cornea
|
$369.36 |
$369.36 |
$369.36 |
$2,818.14
|
|
Cv line/pic reposition
|
$54.00 |
$54.00 |
$54.00 |
$1,720.93
|
|
Cv stress test i&r only 93018
|
$15.12 |
$15.12 |
$15.12 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$22.14 |
$22.14 |
$22.14 |
$51.20
|
|
Cyanocobalamin unsat binding capacity
|
$3.44 |
$3.44 |
$3.44 |
$64.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$8.91 |
$8.91 |
$8.91 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$5.40 |
$5.40 |
$5.40 |
$70.72
|
|
Cyclosporine 2 hour
|
$4.33 |
$4.33 |
$4.33 |
$129.48
|
|
Cyp2c19 gene com variants
|
$35.10 |
$35.10 |
$35.10 |
$504.00
|
|
Cyp2c9 gene com variants
|
$27.00 |
$27.00 |
$27.00 |
$275.10
|
|
Cyp2d6 gene com variants
|
$48.60 |
$48.60 |
$48.60 |
$554.00
|
|
Cyp3a4 gene common variants
|
$18.90 |
$18.90 |
$18.90 |
$245.31
|
|
Cyp3a5 gene common variants
|
$18.90 |
$18.90 |
$18.90 |
$245.31
|
|
Cystatin c
|
$4.00 |
$4.00 |
$4.00 |
$77.50
|
|
Cystic fibrosis cftr
|
$335.76 |
$335.76 |
$335.76 |
$1,100.00
|
|
Cystine urine quantitative
|
$4.96 |
$4.96 |
$4.96 |
$103.35
|
|
Cysto cgen post urtl valves
|
$439.83 |
$439.83 |
$439.83 |
$4,175.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$15.93 |
$15.93 |
$15.93 |
$542.10
|
|
Cystometrogram w/up 51727
|
$332.10 |
$332.10 |
$332.10 |
$908.59
|
|
Cystorrhaphy wound comp 51865
|
$824.31 |
$824.31 |
$824.31 |
$1,756.80
|
|
Cystorrhaphy wound simple 51860
|
$686.61 |
$686.61 |
$686.61 |
$5,855.00
|
|
Cysto rx balo cath urtl strx
|
$150.12 |
$150.12 |
$150.12 |
$6,015.75
|
|
Cystoscopy and biopsy
|
$152.01 |
$152.01 |
$152.01 |
$4,081.37
|
|
Cystoscopy and treatment
|
$158.22 |
$158.22 |
$158.22 |
$4,081.37
|
|
Cystoscopy and treatment
|
$182.79 |
$182.79 |
$182.79 |
$4,160.10
|
|
Cystoscopy and treatment
|
$223.56 |
$223.56 |
$223.56 |
$5,162.50
|
|
Cystoscopy and treatment
|
$261.90 |
$261.90 |
$261.90 |
$5,995.60
|
|
Cystoscopy and treatment
|
$355.05 |
$355.05 |
$355.05 |
$6,475.26
|
|
Cystoscopy and treatment
|
$191.43 |
$191.43 |
$191.43 |
$3,213.14
|
|
Cystoscopy and treatment
|
$147.96 |
$147.96 |
$147.96 |
$2,424.12
|
|
Cystoscopy and treatment
|
$240.57 |
$240.57 |
$240.57 |
$4,045.60
|
|
Cystoscopy and treatment
|
$293.22 |
$293.22 |
$293.22 |
$4,061.71
|
|
Cystoscopy and treatment
|
$184.41 |
$184.41 |
$184.41 |
$2,424.12
|
|
Cystoscopy and treatment
|
$315.90 |
$315.90 |
$315.90 |
$958.81
|
|
Cystoscopy and treatment
|
$221.94 |
$221.94 |
$221.94 |
$3,587.87
|
|
Cystoscopy and treatment
|
$254.34 |
$254.34 |
$254.34 |
$4,081.37
|
|
Cystoscopy and treatment
|
$289.44 |
$289.44 |
$289.44 |
$2,874.36
|
|
Cystoscopy and treatment
|
$249.21 |
$249.21 |
$249.21 |
$3,203.50
|
|
Cystoscopy and treatment
|
$223.83 |
$223.83 |
$223.83 |
$4,061.71
|
|
Cystoscopy and treatment
|
$238.95 |
$238.95 |
$238.95 |
$3,820.84
|
|
Cystoscopy (Bladder Scope)
|
$213.57 |
$213.57 |
$213.57 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$351.81 |
$351.81 |
$351.81 |
$2,704.80
|
|
Cystoscopy inject material
|
$233.55 |
$233.55 |
$233.55 |
$5,986.78
|
|
Cystoscopy removal of clots
|
$396.90 |
$396.90 |
$396.90 |
$4,081.37
|
|
Cystoscopy & revise urethra
|
$226.26 |
$226.26 |
$226.26 |
$2,874.36
|
|
Cystoscopy stone removal
|
$289.71 |
$289.71 |
$289.71 |
$5,741.00
|
|
Cystoscopy & ureter catheter
|
$122.58 |
$122.58 |
$122.58 |
$3,786.00
|
|
Cystostomy cystotomy w/drainage 51040
|
$276.21 |
$276.21 |
$276.21 |
$3,863.60
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$441.99 |
$441.99 |
$441.99 |
$4,081.37
|
|
Cystouretero & or pyeloscope
|
$274.86 |
$274.86 |
$274.86 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$335.07 |
$335.07 |
$335.07 |
$4,846.99
|
|
Cystouretero w/biopsy
|
$378.00 |
$378.00 |
$378.00 |
$5,986.78
|
|
Cystouretero w/excise tumor
|
$423.36 |
$423.36 |
$423.36 |
$5,584.80
|
|
Cysto/uretero w/lithotripsy
|
$376.38 |
$376.38 |
$376.38 |
$9,002.88
|
|
Cystouretero w/lithotripsy
|
$355.05 |
$355.05 |
$355.05 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$321.57 |
$321.57 |
$321.57 |
$5,110.00
|
|
Cysto/uretero w/up stricture
|
$357.21 |
$357.21 |
$357.21 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$294.57 |
$294.57 |
$294.57 |
$3,065.15
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$129.60 |
$129.60 |
$129.60 |
$4,045.60
|
|
Cystourethro w/addl implant 52442
|
$45.90 |
$45.90 |
$45.90 |
$2,161.60
|
|
Cystourethro w/implant
|
$190.62 |
$190.62 |
$190.62 |
$2,298.40
|
|
Cysto w/up stricture tx
|
$280.80 |
$280.80 |
$280.80 |
$4,081.37
|
|
Cysto w/ureter stricture tx
|
$257.85 |
$257.85 |
$257.85 |
$4,081.37
|
|
Cytogenomic neo microra alys
|
$414.45 |
$414.45 |
$414.45 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$324.00 |
$324.00 |
$324.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$8.10 |
$8.10 |
$8.10 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$3.88 |
$3.88 |
$3.88 |
$97.50
|
|
Cyto/molecular report
|
$37.26 |
$37.26 |
$37.26 |
$133.20
|
|
Cytopath fl nongyn filter
|
$7.83 |
$7.83 |
$7.83 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$28.89 |
$28.89 |
$28.89 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$9.55 |
$9.55 |
$9.55 |
$87.50
|