|
Chromosome count additional
|
$21.75 |
$21.75 |
$21.75 |
$110.00
|
|
Chromosome karyotype study
|
$201.25 |
$201.25 |
$201.25 |
$102.72
|
|
Chromosome study additional
|
$260.75 |
$260.75 |
$260.75 |
$147.03
|
|
Chronic urticaria - sendout
|
$121.50 |
$121.50 |
$121.50 |
$89.70
|
|
Chylomicron screen, bf - sendout
|
$17.00 |
$17.00 |
$17.00 |
$123.20
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$2,097.00 |
$2,097.00 |
$2,097.00 |
$576.60
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$197.50 |
$197.50 |
$197.50 |
$81.02
|
|
Clot factor xii hageman
|
$148.75 |
$148.75 |
$148.75 |
$125.00
|
|
Clot factor xiii fibrin scrn
|
$51.50 |
$51.50 |
$51.50 |
$47.30
|
|
Clotting assay whole blood
|
$894.25 |
$894.25 |
$894.25 |
$105.95
|
|
#cmvcul-virus inoculation shell
|
$85.75 |
$85.75 |
$85.75 |
$102.57
|
|
Cmv pcr-sendout
|
$114.25 |
$114.25 |
$114.25 |
$172.25
|
|
Colistimethate sodium inj
|
$459.00 |
$459.00 |
$459.00 |
$84.22
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$67.20 |
$67.20 |
$67.20 |
$46.88
|
|
Collar cerv ascend 172 reg
|
$90.54 |
$90.54 |
$90.54 |
$174.01
|
|
Compatibility test each unit immediate spin technique
|
$295.00 |
$295.00 |
$295.00 |
$159.95
|
|
Conjugated estrogens 25 mg solution for injection
|
$669.25 |
$669.25 |
$669.25 |
$792.24
|
|
Connect omega .5mm
|
$1,616.48 |
$1,616.48 |
$1,616.48 |
$747.50
|
|
Consultation pathology during surgery
|
$462.50 |
$462.50 |
$462.50 |
$112.45
|
|
Consultation pathology during surgery frozen section first tissue block
|
$20.00 |
$20.00 |
$20.00 |
$210.80
|
|
Consultation/report referred slides prepared elsewhere
|
$744.50 |
$744.50 |
$744.50 |
$176.15
|
|
Consult comp w/report rfrd material
|
$432.00 |
$432.00 |
$432.00 |
$345.71
|
|
Contrast x-ray gallbladder
|
$4,775.00 |
$4,775.00 |
$4,775.00 |
$276.65
|
|
Contrast x-ray of ankle
|
$1,405.25 |
$1,405.25 |
$1,405.25 |
$566.28
|
|
Contrast x-ray of brain
|
$12,419.75 |
$12,419.75 |
$12,419.75 |
$900.00
|
|
Coombs indirect titer reference
|
$488.50 |
$488.50 |
$488.50 |
$143.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$935.00 |
$935.00 |
$935.00 |
$258.83
|
|
Co-treatment - group 15 mins, st
|
$257.25 |
$257.25 |
$257.25 |
$110.00
|
|
Cover wrist
|
$1,267.12 |
$1,267.12 |
$1,267.12 |
$308.82
|
|
C-peptide
|
$92.00 |
$92.00 |
$92.00 |
$100.26
|
|
Crbrospnl fld flw imag cistern
|
$2,854.00 |
$2,854.00 |
$2,854.00 |
$1,409.85
|
|
C-reactive protein
|
$218.00 |
$218.00 |
$218.00 |
$61.10
|
|
C-reactive protein high sensitivity
|
$218.00 |
$218.00 |
$218.00 |
$91.20
|
|
Creatine kinase
|
$462.50 |
$462.50 |
$462.50 |
$58.30
|
|
Creatine kinase isoenzymes
|
$7.00 |
$7.00 |
$7.00 |
$49.40
|
|
Creatine kinase mb
|
$462.50 |
$462.50 |
$462.50 |
$105.95
|
|
Creatinine
|
$255.50 |
$255.50 |
$255.50 |
$42.50
|
|
Creatinine clearance urine
|
$462.50 |
$462.50 |
$462.50 |
$85.80
|
|
Crotalidae poly immune fab
|
$9,398.00 |
$9,398.00 |
$9,398.00 |
$6,208.33
|
|
Cryofibrinogen qualitative - sendout
|
$7.25 |
$7.25 |
$7.25 |
$50.88
|
|
Cryptosporidium antigen
|
$6.75 |
$6.75 |
$6.75 |
$58.94
|
|
Crystal identification light microscopy
|
$176.50 |
$176.50 |
$176.50 |
$58.50
|
|
Csf leakage imaging
|
$8,693.25 |
$8,693.25 |
$8,693.25 |
$1,433.25
|
|
Csf ventriculography
|
$3,602.00 |
$3,602.00 |
$3,602.00 |
$714.87
|
|
Cta abdomen without & /or w/contrast
|
$18,386.00 |
$18,386.00 |
$18,386.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$18,386.00 |
$18,386.00 |
$18,386.00 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$16,806.75 |
$16,806.75 |
$16,806.75 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$29,550.50 |
$29,550.50 |
$29,550.50 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$18,386.00 |
$18,386.00 |
$18,386.00 |
$2,017.89
|
|
CT angio hrt w/3d image
|
$17,724.50 |
$17,724.50 |
$17,724.50 |
$1,601.60
|
|
CT angio pelvis
|
$18,386.00 |
$18,386.00 |
$18,386.00 |
$1,778.40
|
|
CT guidance for needle placement
|
$3,546.25 |
$3,546.25 |
$3,546.25 |
$1,506.04
|
|
CT guid parench tis ablat
|
$6,447.75 |
$6,447.75 |
$6,447.75 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$1,272.25 |
$1,272.25 |
$1,272.25 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$17,724.50 |
$17,724.50 |
$17,724.50 |
$1,217.45
|
|
CT hrt w/3d image
|
$22,156.50 |
$22,156.50 |
$22,156.50 |
$1,477.35
|
|
CT limited or localized follow-up study
|
$3,618.25 |
$3,618.25 |
$3,618.25 |
$630.50
|
|
CT neck soft tissue w/contrast
|
$12,708.00 |
$12,708.00 |
$12,708.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$12,152.50 |
$12,152.50 |
$12,152.50 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$16,459.50 |
$16,459.50 |
$16,459.50 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$16,459.50 |
$16,459.50 |
$16,459.50 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$12,708.00 |
$12,708.00 |
$12,708.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$12,152.50 |
$12,152.50 |
$12,152.50 |
$1,345.05
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$29,550.50 |
$29,550.50 |
$29,550.50 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$29,550.50 |
$29,550.50 |
$29,550.50 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$29,550.50 |
$29,550.50 |
$29,550.50 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$14,431.75 |
$14,431.75 |
$14,431.75 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$13,879.50 |
$13,879.50 |
$13,879.50 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$1,272.25 |
$1,272.25 |
$1,272.25 |
$420.60
|
|
CT t-spine w /wo contrast
|
$17,790.00 |
$17,790.00 |
$17,790.00 |
$2,030.60
|
|
Culture anaerobic additional method definitive id each
|
$160.00 |
$160.00 |
$160.00 |
$75.29
|
|
Culture fungi definitive id mold
|
$134.00 |
$134.00 |
$134.00 |
$70.00
|
|
Culture fungi other (except blood)
|
$176.50 |
$176.50 |
$176.50 |
$94.90
|
|
Culture mycobacteria definitive id each isolate
|
$10.50 |
$10.50 |
$10.50 |
$88.14
|
|
Cyanocobalamin unsat binding capacity
|
$11.50 |
$11.50 |
$11.50 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$26.73
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$42.00 |
$42.00 |
$42.00 |
$150.79
|
|
Cyclosporine modified 25 mg capsule
|
$13.00 |
$13.00 |
$13.00 |
$9.79
|
|
Cyp2c19 gene com variants
|
$176.00 |
$176.00 |
$176.00 |
$553.00
|
|
Cystatin c
|
$44.75 |
$44.75 |
$44.75 |
$82.50
|
|
Cytarabine 20 mg/ml injection solution
|
$50.00 |
$50.00 |
$50.00 |
$66.95
|
|
Cytogenetics 25-99
|
$40.25 |
$40.25 |
$40.25 |
$180.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$120.50 |
$120.50 |
$120.50 |
$101.94
|
|
Cytomegalovirus dfa
|
$59.25 |
$59.25 |
$59.25 |
$51.20
|
|
Cytopath c/v index add-on
|
$66.25 |
$66.25 |
$66.25 |
$29.60
|
|
Cytopath fl nongyn filter
|
$32.25 |
$32.25 |
$32.25 |
$66.61
|
|
Cytopathology cellular enhancement technique non-gyn
|
$27.50 |
$27.50 |
$27.50 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$249.00 |
$249.00 |
$249.00 |
$84.50
|
|
Cytopath smear other source
|
$19.00 |
$19.00 |
$19.00 |
$85.80
|
|
Cytopath tbs c/v manual
|
$115.25 |
$115.25 |
$115.25 |
$57.94
|
|
Cytotoxic antibody screening
|
$83.50 |
$83.50 |
$83.50 |
$157.60
|
|
Cytp urine 3-5 probes cmptr
|
$215.00 |
$215.00 |
$215.00 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$314.50 |
$314.50 |
$314.50 |
$61.64
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,652.00 |
$2,652.00 |
$2,652.00 |
$5,500.25
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$332.00 |
$332.00 |
$332.00 |
$194.08
|
|
Dch pulmonary stress test
|
$4,274.75 |
$4,274.75 |
$4,274.75 |
$964.41
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$241.00 |
$241.00 |
$241.00 |
$182.40
|
|
Desoxycorticosterone
|
$112.75 |
$112.75 |
$112.75 |
$109.28
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$1,083.50 |
$1,083.50 |
$1,083.50 |
$222.30
|
|
Dextran 40 infusion
|
$179.00 |
$179.00 |
$179.00 |
$173.97
|
