|
Crotalidae poly immune fab
|
$8,873.49 |
$8,873.49 |
$8,873.49 |
$6,208.33
|
|
Cryofibrinogen qualitative - sendout
|
$13.22 |
$13.22 |
$13.22 |
$50.88
|
|
Crystal identification light microscopy
|
$652.60 |
$652.60 |
$652.60 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$18,746.73 |
$18,746.73 |
$18,746.73 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$24,987.34 |
$24,987.34 |
$24,987.34 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$22,103.43 |
$22,103.43 |
$22,103.43 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$24,412.23 |
$24,412.23 |
$24,412.23 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$16,435.18 |
$16,435.18 |
$16,435.18 |
$2,017.89
|
|
CT Angiogram of the Head
|
$22,103.43 |
$22,103.43 |
$22,103.43 |
$2,041.78
|
|
CT angio pelvis
|
$18,287.76 |
$18,287.76 |
$18,287.76 |
$1,778.40
|
|
CT limited or localized follow-up study
|
$6,105.12 |
$6,105.12 |
$6,105.12 |
$630.50
|
|
CT neck soft tissue w/contrast
|
$12,437.00 |
$12,437.00 |
$12,437.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$12,492.29 |
$12,492.29 |
$12,492.29 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$19,899.75 |
$19,899.75 |
$19,899.75 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$13,512.60 |
$13,512.60 |
$13,512.60 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$11,176.14 |
$11,176.14 |
$11,176.14 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$10,454.50 |
$10,454.50 |
$10,454.50 |
$1,345.05
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$27,318.23 |
$27,318.23 |
$27,318.23 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$24,033.42 |
$24,033.42 |
$24,033.42 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$20,754.14 |
$20,754.14 |
$20,754.14 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$11,563.23 |
$11,563.23 |
$11,563.23 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$11,563.23 |
$11,563.23 |
$11,563.23 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$13,388.23 |
$13,388.23 |
$13,388.23 |
$420.60
|
|
CT t-spine w /wo contrast
|
$8,922.66 |
$8,922.66 |
$8,922.66 |
$2,030.60
|
|
Culture aerobic additional method definitive id each
|
$975.25 |
$975.25 |
$975.25 |
$62.65
|
|
Culture afb any source
|
$2.86 |
$2.86 |
$2.86 |
$107.50
|
|
Culture anaerobic except blood
|
$2,435.41 |
$2,435.41 |
$2,435.41 |
$120.00
|
|
Culture fungi other (except blood)
|
$3.58 |
$3.58 |
$3.58 |
$94.90
|
|
Culture mycobacteria definitive id each isolate
|
$16.66 |
$16.66 |
$16.66 |
$88.14
|
|
Culture urine each isolate
|
$975.25 |
$975.25 |
$975.25 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$19.50 |
$19.50 |
$19.50 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$140.36 |
$140.36 |
$140.36 |
$85.03
|
|
Cyclosporine modified 25 mg capsule
|
$33.99 |
$33.99 |
$33.99 |
$9.79
|
|
Cystine urine quantitative
|
$13.48 |
$13.48 |
$13.48 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,631.53 |
$1,631.53 |
$1,631.53 |
$527.50
|
|
Cytomegalovirus (cmv) antibody igg
|
$153.62 |
$153.62 |
$153.62 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$175.97 |
$175.97 |
$175.97 |
$101.94
|
|
Cytopath c/v index add-on
|
$19.28 |
$19.28 |
$19.28 |
$29.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$120.55 |
$120.55 |
$120.55 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$1,137.84 |
$1,137.84 |
$1,137.84 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$1,779.81 |
$1,779.81 |
$1,779.81 |
$122.40
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$1,061.91 |
$1,061.91 |
$1,061.91 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$4,245.01 |
$4,245.01 |
$4,245.01 |
$203.08
|
|
Cytopath smear other source
|
$120.55 |
$120.55 |
$120.55 |
$135.27
|
|
Cytopath smear oth prep screen & interp
|
$1,024.01 |
$1,024.01 |
$1,024.01 |
$95.00
|
|
Cytotoxic antibody screening
|
$88.00 |
$88.00 |
$88.00 |
$157.60
|
|
Deferoxamine 500 mg solution for injection
|
$131.78 |
$131.78 |
$131.78 |
$112.87
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$596.62 |
$596.62 |
$596.62 |
$182.40
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$494.65 |
$494.65 |
$494.65 |
$222.30
|
|
Dextran 40 infusion
|
$332.30 |
$332.30 |
$332.30 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$14.78 |
$14.78 |
$14.78 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$19.50 |
$19.50 |
$19.50 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$129.59 |
$129.59 |
$129.59 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$225.13 |
$225.13 |
$225.13 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$397.51 |
$397.51 |
$397.51 |
$78.03
|
|
Diatrizoate meglumine 18 % urethral solution
|
$97.91 |
$97.91 |
$97.91 |
$122.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$75.95 |
$75.95 |
$75.95 |
$67.89
|
|
Dicyclomine injection
|
$97.34 |
$97.34 |
$97.34 |
$210.00
|
|
Diffusing capacity
|
$1,816.55 |
$1,816.55 |
$1,816.55 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$19.50 |
$19.50 |
$19.50 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$14,258.85 |
$14,258.85 |
$14,258.85 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$861.19 |
$861.19 |
$861.19 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$304.16 |
$304.16 |
$304.16 |
$308.90
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$19.50 |
$19.50 |
$19.50 |
$22.58
|
|
Disability dlco
|
$4,384.83 |
$4,384.83 |
$4,384.83 |
$302.40
|
|
Dna antibody native/double stranded
|
$147.58 |
$147.58 |
$147.58 |
$101.40
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$482.03 |
$482.03 |
$482.03 |
$490.82
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$50.96 |
$50.96 |
$50.96 |
$89.34
|
|
Dronabinol 2.5mg oral
|
$98.46 |
$98.46 |
$98.46 |
$10.17
|
|
Droperidol 2.5 mg/ml injection solution
|
$81.89 |
$81.89 |
$81.89 |
$33.99
|
|
Drsg oasis ultr ster 3lyr 7x10 70sqcm -cost per sq cm
|
$6,179.60 |
$6,179.60 |
$6,179.60 |
$327.39
|
|
Drug assay caffeine
|
$151.34 |
$151.34 |
$151.34 |
$86.45
|
|
Drug test def 8-14 classes
|
$29.00 |
$29.00 |
$29.00 |
$172.25
|
|
Duplex scan bilateral study 93985
|
$3,659.89 |
$3,659.89 |
$3,659.89 |
$690.95
|
|
Duplex scan unilateral study 93986
|
$7,286.24 |
$7,286.24 |
$7,286.24 |
$392.15
|
|
Dup scan/lwr xtr vasc stdy bilat 93924
|
$7,504.82 |
$7,504.82 |
$7,504.82 |
$750.20
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,952.83 |
$1,952.83 |
$1,952.83 |
$885.60
|
|
Echocardiogram (Heart Ultrasound)
|
$19,227.92 |
$19,227.92 |
$19,227.92 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$4,248.56 |
$4,248.56 |
$4,248.56 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$2,739.97 |
$2,739.97 |
$2,739.97 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$2,739.97 |
$2,739.97 |
$2,739.97 |
$354.90
|
|
Echo guide for artery repair
|
$4,502.58 |
$4,502.58 |
$4,502.58 |
$676.80
|
|
Echo stress
|
$9,184.02 |
$9,184.02 |
$9,184.02 |
$1,607.45
|
|
Echo transesophageal intraop
|
$18,928.57 |
$18,928.57 |
$18,928.57 |
$1,571.70
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$3,779.00 |
$3,779.00 |
$3,779.00 |
$1,048.30
|
|
Eeg monitor/record/awake/drowsy 95816
|
$5,355.97 |
$5,355.97 |
$5,355.97 |
$861.12
|
|
Eeg recording awake and asleep
|
$5,445.61 |
$5,445.61 |
$5,445.61 |
$1,030.27
|
|
Electrolyte panel
|
$2,172.34 |
$2,172.34 |
$2,172.34 |
$86.33
|
|
Electron microscopy diagnostic
|
$1,420.18 |
$1,420.18 |
$1,420.18 |
$1,006.20
|
|
Electrophysiology evaluation
|
$11,458.39 |
$11,458.39 |
$11,458.39 |
$2,845.10
|
|
Epoetin alfa, 100 units esrd
|
$2,129.36 |
$2,129.36 |
$2,129.36 |
$41.32
|
|
Epstein barr early antigen antibody
|
$14.95 |
$14.95 |
$14.95 |
$72.50
|
|
Epstein barr nuclear antigen antibody
|
$1.39 |
$1.39 |
$1.39 |
$82.55
|
|
Ercp biliary & pancreas
|
$6,412.11 |
$6,412.11 |
$6,412.11 |
$922.35
|
|
Ertapenem 1000 mg/10 ml IV (dilution #1) desensitization - cnr
|
$172.87 |
$172.87 |
$172.87 |
$364.08
|
|
Erythromycin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$250.66 |
$250.66 |
$250.66 |
$232.84
|
|
Estradiol total
|
$277.11 |
$277.11 |
$277.11 |
$147.79
|
|
Estrogens total-sendout
|
$7.00 |
$7.00 |
$7.00 |
$89.25
|
|
Ethylene glycol -sendout
|
$26.06 |
$26.06 |
$26.06 |
$78.00
|
|
Evaluation of speech fluency 92521
|
$1,216.85 |
$1,216.85 |
$1,216.85 |
$347.75
|