|
Culture afb any source
|
$737.74 |
$737.74 |
$737.74 |
$107.50
|
|
Culture fungi definitive id mold
|
$528.10 |
$528.10 |
$528.10 |
$70.00
|
|
Culture fungi definitive id yeast
|
$200.48 |
$200.48 |
$200.48 |
$79.00
|
|
Culture fungi other (except blood)
|
$1,264.71 |
$1,264.71 |
$1,264.71 |
$94.90
|
|
Culture mycobacteria definitive id each isolate
|
$831.41 |
$831.41 |
$831.41 |
$88.14
|
|
Cyanocobalamin unsat binding capacity
|
$393.24 |
$393.24 |
$393.24 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$22.16 |
$22.16 |
$22.16 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$1,371.30 |
$1,371.30 |
$1,371.30 |
$85.03
|
|
Cyclophosphamide 25 mg capsule
|
$129.00 |
$129.00 |
$129.00 |
$22.51
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$783.66 |
$783.66 |
$783.66 |
$150.79
|
|
Cyclosporine 2 hour
|
$583.42 |
$583.42 |
$583.42 |
$119.40
|
|
Cyclosporine modified 25 mg capsule
|
$52.44 |
$52.44 |
$52.44 |
$9.79
|
|
Cyp2c19 gene com variants
|
$4,117.41 |
$4,117.41 |
$4,117.41 |
$553.00
|
|
Cystatin c
|
$606.25 |
$606.25 |
$606.25 |
$82.50
|
|
Cystine urine quantitative
|
$1,237.97 |
$1,237.97 |
$1,237.97 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$4,066.04 |
$4,066.04 |
$4,066.04 |
$527.50
|
|
Cytarabine 20 mg/ml injection solution
|
$330.62 |
$330.62 |
$330.62 |
$66.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$528.10 |
$528.10 |
$528.10 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$528.10 |
$528.10 |
$528.10 |
$101.94
|
|
Cytopathology cellular enhancement technique non-gyn
|
$575.07 |
$575.07 |
$575.07 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$1,254.43 |
$1,254.43 |
$1,254.43 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$1,132.98 |
$1,132.98 |
$1,132.98 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$68.06 |
$68.06 |
$68.06 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1,420.50 |
$1,420.50 |
$1,420.50 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$1,164.43 |
$1,164.43 |
$1,164.43 |
$203.08
|
|
Cytopath smear oth prep screen & interp
|
$1,023.29 |
$1,023.29 |
$1,023.29 |
$95.00
|
|
Cytopath tbs c/v manual
|
$626.59 |
$626.59 |
$626.59 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$205.77 |
$205.77 |
$205.77 |
$61.64
|
|
Dalbavancin 500 mg intravenous solution
|
$8,536.04 |
$8,536.04 |
$8,536.04 |
$3,753.91
|
|
Dalteparin sodium
|
$674.92 |
$674.92 |
$674.92 |
$124.09
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$1,548.67 |
$1,548.67 |
$1,548.67 |
$194.08
|
|
Debridement (>20 cm) charge pt
|
$404.38 |
$404.38 |
$404.38 |
$262.60
|
|
Decalcification
|
$226.80 |
$226.80 |
$226.80 |
$75.38
|
|
Deferoxamine 500 mg solution for injection
|
$412.38 |
$412.38 |
$412.38 |
$112.87
|
|
Desoxycorticosterone
|
$866.05 |
$866.05 |
$866.05 |
$109.28
|
|
Dextran 40 infusion
|
$910.65 |
$910.65 |
$910.65 |
$173.97
|
|
Dextrose 5 % IV bolus
|
$741.01 |
$741.01 |
$741.01 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$737.74 |
$737.74 |
$737.74 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$848.89 |
$848.89 |
$848.89 |
$78.03
|
|
Diatrizoate meglumine 18 % urethral solution
|
$2,800.77 |
$2,800.77 |
$2,800.77 |
$122.25
|
|
Dicyclomine injection
|
$369.73 |
$369.73 |
$369.73 |
$210.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$24,624.51 |
$24,624.51 |
$24,624.51 |
$9,684.65
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,298.88 |
$1,298.88 |
$1,298.88 |
$308.90
|
|
Dimecaprol injection
|
$386.69 |
$386.69 |
$386.69 |
$147.91
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$163.25 |
$163.25 |
$163.25 |
$22.58
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$785.56 |
$785.56 |
$785.56 |
$100.80
|
|
Disaccharidases
|
$1,127.36 |
$1,127.36 |
$1,127.36 |
$224.58
|
|
Discography cerv/thor spine
|
$6,675.21 |
$6,675.21 |
$6,675.21 |
$2,360.70
|
|
Dna antibody native/double stranded
|
$570.48 |
$570.48 |
$570.48 |
$101.40
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$1,382.80 |
$1,382.80 |
$1,382.80 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$51.51 |
$51.51 |
$51.51 |
$64.77
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$420.95 |
$420.95 |
$420.95 |
$89.34
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$157.00 |
$157.00 |
$157.00 |
$280.18
|
|
Drug assay caffeine
|
$984.80 |
$984.80 |
$984.80 |
$86.45
|
|
Drug assay voriconazole
|
$617.32 |
$617.32 |
$617.32 |
$96.75
|
|
Drug of abuse screen urine
|
$4,294.98 |
$4,294.98 |
$4,294.98 |
$63.75
|
|
Drvvt confirm - quest
|
$1,000.04 |
$1,000.04 |
$1,000.04 |
$102.30
|
|
Ductogram sgl duct
|
$3,053.52 |
$3,053.52 |
$3,053.52 |
$382.80
|
|
Duplex scan bilateral study 93985
|
$5,705.45 |
$5,705.45 |
$5,705.45 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$5,705.45 |
$5,705.45 |
$5,705.45 |
$392.15
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$738.47 |
$738.47 |
$738.47 |
$750.20
|
|
Echo exam of fetal heart
|
$4,736.34 |
$4,736.34 |
$4,736.34 |
$855.38
|
|
Echo exam of fetal heart
|
$958.64 |
$958.64 |
$958.64 |
$431.41
|
|
Echo exam of fetal heart
|
$2,280.97 |
$2,280.97 |
$2,280.97 |
$323.40
|
|
Echo exam uterus 76831-
|
$10,385.35 |
$10,385.35 |
$10,385.35 |
$547.23
|
|
Echo guide for amniocentesis
|
$5,274.51 |
$5,274.51 |
$5,274.51 |
$377.11
|
|
Echo guide for artery repair
|
$11,293.97 |
$11,293.97 |
$11,293.97 |
$676.80
|
|
Echo transthoracic
|
$2,420.00 |
$2,420.00 |
$2,420.00 |
$1,475.25
|
|
Eeg 41-60 minutes 95812-26
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$934.05
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$1,048.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$861.12
|
|
Eeg over 1 hour 95813 - 26
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$1,100.40
|
|
Eeg/record in coma or sleep only 95822
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$911.00
|
|
Eeg recording awake and asleep
|
$7,074.91 |
$7,074.91 |
$7,074.91 |
$1,030.27
|
|
Eeg without vid 2-12 hr unmntr
|
$6,431.74 |
$6,431.74 |
$6,431.74 |
$526.57
|
|
E equine encephalitis igg
|
$438.38 |
$438.38 |
$438.38 |
$48.73
|
|
Egfr gene com variants
|
$4,117.41 |
$4,117.41 |
$4,117.41 |
$646.75
|
|
Electrophysiologic study
|
$27,372.66 |
$27,372.66 |
$27,372.66 |
$6,758.40
|
|
Electrophysiology evaluation
|
$61,986.55 |
$61,986.55 |
$61,986.55 |
$8,979.45
|
|
Electrophysiology evaluation
|
$61,986.55 |
$61,986.55 |
$61,986.55 |
$11,542.01
|
|
Electrophysiology evaluation
|
$4,541.52 |
$4,541.52 |
$4,541.52 |
$2,630.40
|
|
Encephalitis, western equine igg/igm
|
$702.36 |
$702.36 |
$702.36 |
$50.35
|
|
Endo cath bile duct s&i
|
$4,612.15 |
$4,612.15 |
$4,612.15 |
$545.37
|
|
Endo cath panc duct s&i
|
$4,612.15 |
$4,612.15 |
$4,612.15 |
$637.65
|
|
Endoscopy swallow (fees) vid
|
$1,564.05 |
$1,564.05 |
$1,564.05 |
$420.00
|
|
Enzyme histochemistry
|
$413.58 |
$413.58 |
$413.58 |
$460.32
|
|
Ep & ablate supravent arrhyt
|
$166,971.48 |
$166,971.48 |
$166,971.48 |
$29,766.10
|
|
Ep & ablate ventric tachy
|
$166,971.48 |
$166,971.48 |
$166,971.48 |
$30,975.00
|
|
Epoprostenol (arginine) 1 mg in 50 ml ns inhalation syringe - cnr
|
$1,463.58 |
$1,463.58 |
$1,463.58 |
$135.20
|
|
Epstein barr early antigen antibody
|
$693.11 |
$693.11 |
$693.11 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$937.12 |
$937.12 |
$937.12 |
$82.55
|
|
Ercp biliary & pancreas
|
$6,108.55 |
$6,108.55 |
$6,108.55 |
$922.35
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$291.77 |
$291.77 |
$291.77 |
$232.84
|
|
Esophageal recording
|
$18,478.39 |
$18,478.39 |
$18,478.39 |
$1,674.16
|
|
Esophagus motility study
|
$1,747.09 |
$1,747.09 |
$1,747.09 |
$1,274.00
|
|
Estradiol total
|
$879.85 |
$879.85 |
$879.85 |
$147.79
|
|
Estrogens total-sendout
|
$1,869.58 |
$1,869.58 |
$1,869.58 |
$89.25
|
|
Ethanolamine oleate 100 mg
|
$2,912.88 |
$2,912.88 |
$2,912.88 |
$933.59
|
|
Ethylene glycol -sendout
|
$1,082.61 |
$1,082.61 |
$1,082.61 |
$78.00
|
|
Euglobulin lysis
|
$708.03 |
$708.03 |
$708.03 |
$37.70
|
