|
C-reactive protein high sensitivity
|
$390.00 |
$390.00 |
$390.00 |
$91.20
|
|
C-reactive protein, quantitative
|
$327.25 |
$327.25 |
$327.25 |
$63.07
|
|
Creatine kinase mb
|
$929.75 |
$929.75 |
$929.75 |
$105.95
|
|
Creatinine
|
$417.00 |
$417.00 |
$417.00 |
$42.50
|
|
Creatinine clearance urine
|
$1,926.75 |
$1,926.75 |
$1,926.75 |
$85.80
|
|
Critical care 30-74 minutes
|
$10,596.00 |
$10,596.00 |
$10,596.00 |
$2,595.34
|
|
Critical care each additional 30 minutes
|
$3,402.75 |
$3,402.75 |
$3,402.75 |
$756.00
|
|
Cryofibrinogen qualitative - sendout
|
$261.50 |
$261.50 |
$261.50 |
$50.88
|
|
Cryptosporidium antigen
|
$362.25 |
$362.25 |
$362.25 |
$58.94
|
|
Crystal identification light microscopy
|
$647.75 |
$647.75 |
$647.75 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,732.75 |
$2,732.75 |
$2,732.75 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$2,017.89
|
|
CT Angiogram of the Head
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$2,041.78
|
|
CT angio pelvis
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$1,778.40
|
|
CT guidance for needle placement
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,192.75 |
$2,192.75 |
$2,192.75 |
$1,058.40
|
|
CT neck soft tissue w/contrast
|
$11,792.50 |
$11,792.50 |
$11,792.50 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$12,459.75 |
$12,459.75 |
$12,459.75 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$11,792.50 |
$11,792.50 |
$11,792.50 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$1,345.05
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,732.75 |
$2,732.75 |
$2,732.75 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$23,577.75 |
$23,577.75 |
$23,577.75 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$22,248.00 |
$22,248.00 |
$22,248.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$11,792.50 |
$11,792.50 |
$11,792.50 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$11,125.50 |
$11,125.50 |
$11,125.50 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$356.50 |
$356.50 |
$356.50 |
$420.60
|
|
CT t-spine w /wo contrast
|
$24,245.00 |
$24,245.00 |
$24,245.00 |
$2,030.60
|
|
Culture anaerobic additional method definitive id each
|
$250.75 |
$250.75 |
$250.75 |
$75.29
|
|
Culture fungi definitive id mold
|
$227.25 |
$227.25 |
$227.25 |
$70.00
|
|
Culture fungi definitive id yeast
|
$318.75 |
$318.75 |
$318.75 |
$79.00
|
|
Culture fungi skin/hair/nail
|
$236.25 |
$236.25 |
$236.25 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$337.25 |
$337.25 |
$337.25 |
$88.14
|
|
Culture typing added method
|
$155.50 |
$155.50 |
$155.50 |
$34.45
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$162.00 |
$162.00 |
$162.00 |
$101.45
|
|
Culture urine each isolate
|
$250.75 |
$250.75 |
$250.75 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$33.00 |
$33.00 |
$33.00 |
$26.73
|
|
Cyclophosphamide 25 mg capsule
|
$16.00 |
$16.00 |
$16.00 |
$22.51
|
|
Cyclosporine modified 25 mg capsule
|
$12.00 |
$12.00 |
$12.00 |
$9.79
|
|
Cyp2c19 gene com variants
|
$187.75 |
$187.75 |
$187.75 |
$553.00
|
|
Cystatin c
|
$1,509.75 |
$1,509.75 |
$1,509.75 |
$82.50
|
|
Cytogenetics 3-5
|
$213.75 |
$213.75 |
$213.75 |
$127.64
|
|
Cytomegalovirus dfa
|
$362.25 |
$362.25 |
$362.25 |
$51.20
|
|
Cytopath c/v index add-on
|
$22.25 |
$22.25 |
$22.25 |
$29.60
|
|
Cytopath fl nongyn filter
|
$347.25 |
$347.25 |
$347.25 |
$66.61
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$127.00 |
$127.00 |
$127.00 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$327.25 |
$327.25 |
$327.25 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$154.00 |
$154.00 |
$154.00 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$119.00 |
$119.00 |
$119.00 |
$75.60
|
|
Cytopath smear other source
|
$238.00 |
$238.00 |
$238.00 |
$85.80
|
|
Cytopath smear other source
|
$386.50 |
$386.50 |
$386.50 |
$135.27
|
|
Cytotoxic antibody screening
|
$1,191.25 |
$1,191.25 |
$1,191.25 |
$157.60
|
|
Cytotoxic antibody screening
|
$890.00 |
$890.00 |
$890.00 |
$75.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$240.00 |
$240.00 |
$240.00 |
$182.40
|
|
Desmopressin 4 mcg/ml injection solution
|
$168.50 |
$168.50 |
$168.50 |
$172.46
|
|
Desoxycorticosterone
|
$931.75 |
$931.75 |
$931.75 |
$109.28
|
|
Detect agent nos dna dir
|
$399.25 |
$399.25 |
$399.25 |
$67.15
|
|
Developmental screen/score/document 96110
|
$729.50 |
$729.50 |
$729.50 |
$136.64
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$379.00 |
$379.00 |
$379.00 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$73.00 |
$73.00 |
$73.00 |
$68.25
|
|
Diagnostic Mammogram (both breasts)
|
$929.25 |
$929.25 |
$929.25 |
$403.32
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$91.00 |
$91.00 |
$91.00 |
$67.89
|
|
Dicyclomine injection
|
$222.00 |
$222.00 |
$222.00 |
$210.00
|
|
Diffusing capacity
|
$1,695.25 |
$1,695.25 |
$1,695.25 |
$357.50
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$108.00 |
$108.00 |
$108.00 |
$53.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$7,068.00 |
$7,068.00 |
$7,068.00 |
$9,684.65
|
|
Digoxin total therapeutic drug level
|
$320.50 |
$320.50 |
$320.50 |
$99.35
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$33.00 |
$33.00 |
$33.00 |
$22.58
|
|
Disability dlco
|
$1,510.75 |
$1,510.75 |
$1,510.75 |
$302.40
|
|
Dna gardnerella
|
$92.50 |
$92.50 |
$92.50 |
$66.05
|
|
Dna probe chlamydia
|
$525.25 |
$525.25 |
$525.25 |
$82.20
|
|
Dna probe gc
|
$399.25 |
$399.25 |
$399.25 |
$88.67
|
|
Dna trichomonas
|
$92.50 |
$92.50 |
$92.50 |
$68.50
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$168.00 |
$168.00 |
$168.00 |
$64.77
|
|
Doppler echo complete
|
$2,977.25 |
$2,977.25 |
$2,977.25 |
$644.00
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$2,493.50 |
$2,493.50 |
$2,493.50 |
$490.82
|
|
Dornase alfa non-comp unit
|
$128.00 |
$128.00 |
$128.00 |
$500.29
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$238.00 |
$238.00 |
$238.00 |
$89.34
|
|
Drug assay caffeine
|
$411.75 |
$411.75 |
$411.75 |
$86.45
|
|
Drug assay posaconazole
|
$125.25 |
$125.25 |
$125.25 |
$96.39
|
|
Drug assay vedolizumab
|
$183.50 |
$183.50 |
$183.50 |
$169.26
|
|
Drug assay voriconazole
|
$73.75 |
$73.75 |
$73.75 |
$96.75
|
|
Drug of abuse screen urine
|
$276.75 |
$276.75 |
$276.75 |
$63.75
|
|
Drug screen quant tiagabine
|
$411.75 |
$411.75 |
$411.75 |
$90.75
|
|
Drug test def 1-7 classes
|
$457.50 |
$457.50 |
$457.50 |
$263.86
|
|
Dup scan/hemodialysis access 93990
|
$1,116.75 |
$1,116.75 |
$1,116.75 |
$499.38
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$3,058.75 |
$3,058.75 |
$3,058.75 |
$885.60
|
|
Ecg 12 lead tracing only
|
$115.75 |
$115.75 |
$115.75 |
$243.61
|
|
Ecg external < 48 hours recording
|
$4,624.00 |
$4,624.00 |
$4,624.00 |
$461.76
|
|
Echocardiogram (Heart Ultrasound)
|
$3,759.00 |
$3,759.00 |
$3,759.00 |
$2,049.45
|
|
Echocardiography doppler color flow mapping
|
$2,204.25 |
$2,204.25 |
$2,204.25 |
$461.61
|
|
Echocardiography transthoracic 2d followup/limited
|
$2,707.50 |
$2,707.50 |
$2,707.50 |
$773.30
|
|
Echocardiograpy doppler follow up/limited study
|
$1,873.00 |
$1,873.00 |
$1,873.00 |
$354.90
|
|
Echo stress
|
$5,575.00 |
$5,575.00 |
$5,575.00 |
$1,607.45
|
|
E coli 0157 ag ia
|
$381.25 |
$381.25 |
$381.25 |
$32.00
|
|
Eeg 41-60 minutes 95812-26
|
$2,508.75 |
$2,508.75 |
$2,508.75 |
$934.05
|
