|
Consultation pathology during surgery cytological exam initial site
|
$1,604.26 |
$1,604.26 |
$1,604.26 |
$402.05
|
|
Consultation pathology during surgery frozen section each additional block
|
$1,081.70 |
$1,081.70 |
$1,081.70 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,081.70 |
$1,081.70 |
$1,081.70 |
$210.80
|
|
Consultation/report referred material w/preparation of slides
|
$1,081.70 |
$1,081.70 |
$1,081.70 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$183.44 |
$183.44 |
$183.44 |
$176.15
|
|
Consult comp w/report rfrd material
|
$6,642.43 |
$6,642.43 |
$6,642.43 |
$345.71
|
|
Contrast exam thoracic aorta
|
$31,637.78 |
$31,637.78 |
$31,637.78 |
$3,648.84
|
|
Contrast exam thoracic aorta 75605-26
|
$40,455.05 |
$40,455.05 |
$40,455.05 |
$3,780.00
|
|
Contrast x-ray gallbladder
|
$4,241.51 |
$4,241.51 |
$4,241.51 |
$276.65
|
|
Coombs indirect titer reference
|
$106.00 |
$106.00 |
$106.00 |
$143.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$774.39 |
$774.39 |
$774.39 |
$258.83
|
|
Counseling smoke cess interm >10mins
|
$470.76 |
$470.76 |
$470.76 |
$57.60
|
|
Covid-19 lab test non-cdc
|
$51.31 |
$51.31 |
$51.31 |
$56.44
|
|
#covid19rsv-rsv
|
$250.00 |
$250.00 |
$250.00 |
$140.80
|
|
C-peptide
|
$156.28 |
$156.28 |
$156.28 |
$100.26
|
|
Crbrospnl fld flw imag cistern
|
$5,700.07 |
$5,700.07 |
$5,700.07 |
$1,409.85
|
|
C-reactive protein
|
$340.02 |
$340.02 |
$340.02 |
$61.10
|
|
C-reactive protein high sensitivity
|
$7.61 |
$7.61 |
$7.61 |
$91.20
|
|
Creatine kinase
|
$2,003.56 |
$2,003.56 |
$2,003.56 |
$58.30
|
|
Creatine kinase isoenzymes
|
$5.64 |
$5.64 |
$5.64 |
$49.40
|
|
Creatine kinase mb
|
$1,603.93 |
$1,603.93 |
$1,603.93 |
$105.95
|
|
Creatinine
|
$464.41 |
$464.41 |
$464.41 |
$42.50
|
|
Creatinine clearance urine
|
$1,301.52 |
$1,301.52 |
$1,301.52 |
$85.80
|
|
Crotalidae poly immune fab
|
$13,042.00 |
$13,042.00 |
$13,042.00 |
$6,208.33
|
|
Cryofibrinogen qualitative - sendout
|
$1.88 |
$1.88 |
$1.88 |
$50.88
|
|
Crystal identification light microscopy
|
$712.89 |
$712.89 |
$712.89 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$25,709.17 |
$25,709.17 |
$25,709.17 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$2,017.89
|
|
CT Angiogram of the Head
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$2,041.78
|
|
CT angio hrt w/3d image
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$1,601.60
|
|
CT angio pelvis
|
$23,024.94 |
$23,024.94 |
$23,024.94 |
$1,778.40
|
|
CT guidance for needle placement
|
$13,810.56 |
$13,810.56 |
$13,810.56 |
$1,506.04
|
|
CT guid parench tis ablat
|
$9,652.21 |
$9,652.21 |
$9,652.21 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$17,650.89 |
$17,650.89 |
$17,650.89 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$18,760.49 |
$18,760.49 |
$18,760.49 |
$1,217.45
|
|
CT hrt w/3d image
|
$18,233.11 |
$18,233.11 |
$18,233.11 |
$1,477.35
|
|
CT limited or localized follow-up study
|
$5,875.49 |
$5,875.49 |
$5,875.49 |
$630.50
|
|
CT neck soft tissue w/contrast
|
$14,617.78 |
$14,617.78 |
$14,617.78 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$19,015.79 |
$19,015.79 |
$19,015.79 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$25,801.59 |
$25,801.59 |
$25,801.59 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$13,053.29 |
$13,053.29 |
$13,053.29 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$12,905.54 |
$12,905.54 |
$12,905.54 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$12,866.41 |
$12,866.41 |
$12,866.41 |
$1,345.05
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$35,649.33 |
$35,649.33 |
$35,649.33 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$34,634.24 |
$34,634.24 |
$34,634.24 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$32,369.83 |
$32,369.83 |
$32,369.83 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$19,749.62 |
$19,749.62 |
$19,749.62 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$16,031.57 |
$16,031.57 |
$16,031.57 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$2,614.11 |
$2,614.11 |
$2,614.11 |
$420.60
|
|
CT t-spine w /wo contrast
|
$24,288.67 |
$24,288.67 |
$24,288.67 |
$2,030.60
|
|
Culture anaerobic additional method definitive id each
|
$475.11 |
$475.11 |
$475.11 |
$75.29
|
|
Culture anaerobic except blood
|
$1,770.13 |
$1,770.13 |
$1,770.13 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$92.00 |
$92.00 |
$92.00 |
$52.50
|
|
Culture fungi skin/hair/nail
|
$85.33 |
$85.33 |
$85.33 |
$76.05
|
|
Culture urine each isolate
|
$1,940.19 |
$1,940.19 |
$1,940.19 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$32.85 |
$32.85 |
$32.85 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$105.37 |
$105.37 |
$105.37 |
$85.03
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$177.59 |
$177.59 |
$177.59 |
$150.79
|
|
Cystatin c
|
$10.00 |
$10.00 |
$10.00 |
$82.50
|
|
Cystine urine quantitative
|
$15.00 |
$15.00 |
$15.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,578.93 |
$1,578.93 |
$1,578.93 |
$527.50
|
|
Cytomegalovirus (cmv) antibody igm
|
$137.14 |
$137.14 |
$137.14 |
$101.94
|
|
Cytopath c/v index add-on
|
$47.34 |
$47.34 |
$47.34 |
$29.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$295.96 |
$295.96 |
$295.96 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$17.10 |
$17.10 |
$17.10 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$159.39 |
$159.39 |
$159.39 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$159.39 |
$159.39 |
$159.39 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$295.96 |
$295.96 |
$295.96 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$295.96 |
$295.96 |
$295.96 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$295.96 |
$295.96 |
$295.96 |
$203.08
|
|
Cytopath smear other source
|
$295.96 |
$295.96 |
$295.96 |
$135.27
|
|
Cytopath smear oth prep screen & interp
|
$159.39 |
$159.39 |
$159.39 |
$95.00
|
|
Cytopath tbs c/v manual
|
$83.56 |
$83.56 |
$83.56 |
$57.94
|
|
Cytotoxic antibody screening
|
$125.00 |
$125.00 |
$125.00 |
$157.60
|
|
Dacarbazine 100 mg intravenous solution
|
$152.59 |
$152.59 |
$152.59 |
$61.64
|
|
Dactinomycin 0.5 mg intravenous solution
|
$4,435.26 |
$4,435.26 |
$4,435.26 |
$2,281.50
|
|
Dalbavancin 500 mg intravenous solution
|
$5,092.00 |
$5,092.00 |
$5,092.00 |
$3,753.91
|
|
Decitabine 50 mg intravenous solution
|
$10,332.68 |
$10,332.68 |
$10,332.68 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$179.40 |
$179.40 |
$179.40 |
$112.87
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$284.10 |
$284.10 |
$284.10 |
$182.40
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$1,915.02 |
$1,915.02 |
$1,915.02 |
$222.30
|
|
Dextran 40 infusion
|
$142.81 |
$142.81 |
$142.81 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$109.31 |
$109.31 |
$109.31 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$67.50 |
$67.50 |
$67.50 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$135.00 |
$135.00 |
$135.00 |
$68.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$181.01 |
$181.01 |
$181.01 |
$107.50
|
|
Diagnostic Mammogram (both breasts)
|
$1,525.10 |
$1,525.10 |
$1,525.10 |
$403.32
|
|
Diatrizoate meglumine 18 % urethral solution
|
$55.19 |
$55.19 |
$55.19 |
$122.25
|
|
Dicyclomine injection
|
$274.92 |
$274.92 |
$274.92 |
$210.00
|
|
Diffusing capacity
|
$1,900.23 |
$1,900.23 |
$1,900.23 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$40.80 |
$40.80 |
$40.80 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$3,874.85 |
$3,874.85 |
$3,874.85 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$1,053.11 |
$1,053.11 |
$1,053.11 |
$99.35
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$774.39 |
$774.39 |
$774.39 |
$308.90
|
|
Dimenhydrinate injection
|
$73.65 |
$73.65 |
$73.65 |
$24.68
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$0.82 |
$0.82 |
$0.82 |
$1.62
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$32.85 |
$32.85 |
$32.85 |
$22.58
|