|
CT heart w/evaluation of calcium without contrast
|
$10,817.00 |
$10,817.00 |
$22,141.42 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$10,538.00 |
$10,538.00 |
$10,538.00 |
$1,217.45
|
|
CT hrt w/3d image
|
$9,014.00 |
$9,014.00 |
$9,014.00 |
$1,424.40
|
|
CT limited or localized follow-up study
|
$2,470.00 |
$2,470.00 |
$2,470.00 |
$626.07
|
|
CT lower extremity w/contrast (both sides)
|
$5,290.00 |
$5,290.00 |
$5,290.00 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$3,798.00 |
$3,798.00 |
$3,798.00 |
$1,400.00
|
|
CT lwr extremity w/o&w/dye
|
$6,378.00 |
$6,378.00 |
$6,378.00 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$9,740.00 |
$9,740.00 |
$22,141.42 |
$1,669.00
|
|
CT neck soft tissue without contrast
|
$5,772.00 |
$5,772.00 |
$22,141.42 |
$1,357.54
|
|
CT neck soft tissue without & w/contrast
|
$9,740.00 |
$9,740.00 |
$22,141.42 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$9,729.00 |
$9,729.00 |
$22,141.42 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$7,865.00 |
$7,865.00 |
$22,141.42 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$7,621.00 |
$7,621.00 |
$22,141.42 |
$1,370.85
|
|
Ctrl nosebld postir subsq 30906
|
$799.00 |
$799.00 |
$799.00 |
$470.73
|
|
CT scan for therapy guide
|
$4,681.00 |
$4,681.00 |
$4,681.00 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$19,992.00 |
$19,992.00 |
$26,274.09 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$15,082.00 |
$15,082.00 |
$26,274.09 |
$2,855.63
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$9,883.00 |
$9,883.00 |
$26,274.09 |
$2,299.15
|
|
CT thoracic spine w/contrast
|
$7,022.00 |
$7,022.00 |
$22,141.42 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$6,540.00 |
$6,540.00 |
$22,141.42 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$571.38 |
$571.38 |
$986.00 |
$420.60
|
|
CT t-spine w /wo contrast
|
$7,090.00 |
$7,090.00 |
$22,141.42 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$5,146.00 |
$5,146.00 |
$5,146.00 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$3,798.00 |
$3,798.00 |
$3,798.00 |
$1,473.75
|
|
CT uppr extremity w/o&w/dye
|
$6,378.00 |
$6,378.00 |
$6,378.00 |
$1,841.10
|
|
Culture aerobic additional method definitive id each
|
$166.00 |
$166.00 |
$994.05 |
$63.60
|
|
Culture afb any source
|
$142.56 |
$142.56 |
$700.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$64.35 |
$151.12 |
$253.00 |
$77.31
|
|
Culture anaerobic except blood
|
$466.00 |
$466.00 |
$2,480.80 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$169.00 |
$169.00 |
$169.00 |
$52.80
|
|
Culture body fluid
|
$664.00 |
$664.00 |
$664.00 |
$130.50
|
|
Culture fungi definitive id mold
|
$119.00 |
$972.17 |
$994.05 |
$70.00
|
|
Culture fungi definitive id yeast
|
$145.00 |
$145.00 |
$972.17 |
$79.10
|
|
Culture fungi other (except blood)
|
$164.97 |
$164.97 |
$672.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$36.64 |
$36.64 |
$501.00 |
$77.37
|
|
Culture mycobacteria definitive id each isolate
|
$10.73 |
$10.73 |
$308.00 |
$84.80
|
|
Culture mycoplasma any source
|
$19.40 |
$19.40 |
$152.00 |
$90.37
|
|
Culture quantitative aerobic other source
|
$546.00 |
$546.00 |
$2,100.65 |
$87.02
|
|
Culture screening strep group a
|
$789.00 |
$789.00 |
$789.00 |
$79.20
|
|
Culture typing added method
|
$36.78 |
$36.78 |
$126.00 |
$34.45
|
|
Culture typing immunologic
|
$534.00 |
$534.00 |
$534.00 |
$42.12
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$1,081.00 |
$1,081.00 |
$1,081.00 |
$124.02
|
|
Culture urine each isolate
|
$35.60 |
$397.00 |
$948.00 |
$46.20
|
|
Cv line/pic reposition
|
$4,195.00 |
$4,195.00 |
$4,195.00 |
$1,801.20
|
|
Cv stress test/supervision only 93016
|
$165.00 |
$165.00 |
$165.00 |
$59.25
|
|
Cyanocobalamin unsat binding capacity
|
$11.88 |
$11.88 |
$101.00 |
$58.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$25.00 |
$26.75 |
$120.43 |
$28.08
|
|
Cyclic citrullinated peptide antibody
|
$118.37 |
$118.37 |
$493.00 |
$81.60
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$928.50 |
$928.50 |
$928.50 |
$834.30
|
|
Cyclophosphamide 25 mg capsule
|
$17.00 |
$17.00 |
$17.00 |
$25.00
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$1,747.00 |
$1,747.00 |
$1,886.25 |
$179.10
|
|
Cyclosporine 2 hour
|
$585.00 |
$585.00 |
$585.00 |
$120.20
|
|
Cyclosporine modified 25 mg capsule
|
$2.63 |
$2.63 |
$26.75 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$42.97 |
$150.00 |
$2,547.00 |
$43.04
|
|
Cyp2c19 gene com variants
|
$193.55 |
$193.55 |
$546.00 |
$553.00
|
|
Cyp2c9 gene com variants
|
$205.00 |
$205.00 |
$205.00 |
$275.10
|
|
Cyp2d6 gene com variants
|
$428.00 |
$428.00 |
$428.00 |
$537.50
|
|
Cystatin c
|
$11.95 |
$11.95 |
$563.00 |
$81.00
|
|
Cystine urine quantitative
|
$221.10 |
$221.10 |
$286.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,061.00 |
$4,498.42 |
$5,109.80 |
$527.50
|
|
Cystometrogram w/up 51727
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$857.38
|
|
Cystoscopy and treatment
|
$7,480.00 |
$7,480.00 |
$7,480.00 |
$3,070.20
|
|
Cystoscopy and treatment
|
$12,629.00 |
$12,629.00 |
$12,629.00 |
$3,219.80
|
|
Cystoscopy (Bladder Scope)
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$9,742.00 |
$9,742.00 |
$9,742.00 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$6,759.00 |
$6,759.00 |
$6,759.00 |
$3,416.48
|
|
Cystourethroscop/calib/dilat stric 52281
|
$6,759.00 |
$6,759.00 |
$6,759.00 |
$2,849.55
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$13,051.00 |
$13,051.00 |
$13,051.00 |
$3,970.98
|
|
Cystourethro w/addl implant 52442
|
$2,828.00 |
$2,828.00 |
$2,828.00 |
$1,502.96
|
|
Cystourethro w/implant
|
$5,841.00 |
$5,841.00 |
$5,841.00 |
$3,312.80
|
|
Cytarabine 20 mg/ml injection solution
|
$19.00 |
$19.75 |
$175.16 |
$80.18
|
|
Cytogenetics 25-99
|
$41.01 |
$41.01 |
$145.00 |
$177.45
|
|
Cytogenetics 3-5
|
$216.00 |
$216.00 |
$216.00 |
$127.64
|
|
Cytogenom microarray copy nmbr var
|
$9,221.00 |
$9,221.00 |
$9,221.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$275.00 |
$275.00 |
$275.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$128.45 |
$128.45 |
$310.00 |
$96.80
|
|
Cytomegalovirus dfa
|
$21.45 |
$21.45 |
$21.45 |
$51.20
|
|
Cyto/molecular report
|
$95.00 |
$95.00 |
$95.00 |
$144.75
|
|
Cytopath c/v index add-on
|
$62.10 |
$62.10 |
$62.10 |
$29.60
|
|
Cytopath fl nongyn filter
|
$32.80 |
$32.80 |
$32.80 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$95.06 |
$95.35 |
$1,118.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$537.00 |
$537.00 |
$537.00 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$20.40 |
$20.40 |
$180.00 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$1,309.00 |
$1,565.29 |
$1,599.60 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$469.00 |
$707.72 |
$723.10 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$0.30 |
$11.33 |
$1,094.00 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$923.05 |
$923.05 |
$1,094.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$827.34 |
$845.40 |
$1,239.00 |
$205.00
|
|
Cytopath smear other source
|
$515.00 |
$515.00 |
$515.00 |
$85.80
|
|
Cytopath smear other source
|
$157.10 |
$157.10 |
$157.65 |
$135.01
|
|
Cytopath smear oth prep screen & interp
|
$486.08 |
$496.55 |
$617.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$46.00 |
$46.00 |
$108.75 |
$57.94
|
|
Cytotoxic antibody screening
|
$1,467.00 |
$1,467.00 |
$1,467.00 |
$157.60
|
|
Cytp urine 3-5 probes cmptr
|
$218.77 |
$218.77 |
$849.00 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$56.00 |
$56.00 |
$315.00 |
$76.80
|
|
Dactinomycin 0.5 mg intravenous solution
|
$2,914.75 |
$2,914.75 |
$2,914.75 |
$2,157.32
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$169.00 |
$169.00 |
$169.00 |
$403.57
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$51,807.49 |
$51,807.49 |
$51,807.49 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,652.00 |
$2,652.00 |
$22,008.63 |
$5,546.48
|
