|
Colistimethate sodium inj
|
$190.05 |
$190.05 |
$190.05 |
$84.22
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$318.57 |
$318.57 |
$318.57 |
$46.88
|
|
Collar cerv ascend 172 reg
|
$96.01 |
$96.01 |
$96.01 |
$174.01
|
|
Compatibility test each unit electronic
|
$747.25 |
$747.25 |
$747.25 |
$167.17
|
|
Compatibility test each unit immediate spin technique
|
$1,237.30 |
$1,237.30 |
$1,237.30 |
$159.95
|
|
Compatibility test incubate
|
$1,237.30 |
$1,237.30 |
$1,237.30 |
$143.64
|
|
Complement fixation each
|
$114.69 |
$114.69 |
$114.69 |
$25.70
|
|
Conjugated estrogens 25 mg solution for injection
|
$429.45 |
$429.45 |
$429.45 |
$792.24
|
|
Consultation pathology during surgery
|
$295.44 |
$295.44 |
$295.44 |
$112.45
|
|
Consultation pathology during surgery cytological exam initial site
|
$330.18 |
$330.18 |
$330.18 |
$402.05
|
|
Consultation pathology during surgery frozen section each additional block
|
$104.27 |
$104.27 |
$104.27 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$293.69 |
$293.69 |
$293.69 |
$210.80
|
|
Consult comp w/report rfrd material
|
$307.41 |
$307.41 |
$307.41 |
$345.71
|
|
Contrast baths charges
|
$87.21 |
$87.21 |
$87.21 |
$77.98
|
|
Contrast x-ray gallbladder
|
$2,923.64 |
$2,923.64 |
$2,923.64 |
$276.65
|
|
Controler lvad heartmate 3 includes ebb
|
$27,234.90 |
$27,234.90 |
$27,234.90 |
$11,723.40
|
|
Coombs direct
|
$1,379.80 |
$1,379.80 |
$1,379.80 |
$71.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$309.32 |
$309.32 |
$309.32 |
$100.29
|
|
Coombs indirect titer reference
|
$462.24 |
$462.24 |
$462.24 |
$143.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$220.50 |
$220.50 |
$220.50 |
$258.83
|
|
Crbrospnl fld flw imag cistern
|
$7,165.53 |
$7,165.53 |
$7,165.53 |
$1,409.85
|
|
Creatine kinase
|
$561.31 |
$561.31 |
$561.31 |
$58.30
|
|
Creatine kinase isoenzymes
|
$6.00 |
$6.00 |
$6.00 |
$49.40
|
|
Creatine kinase mb
|
$2,679.64 |
$2,679.64 |
$2,679.64 |
$105.95
|
|
Creatinine clearance urine
|
$1,925.45 |
$1,925.45 |
$1,925.45 |
$85.80
|
|
Critical care 30-74 minutes
|
$12,167.72 |
$12,167.72 |
$12,167.72 |
$2,595.34
|
|
Critical care each additional 30 minutes
|
$548.81 |
$548.81 |
$548.81 |
$756.00
|
|
Crotalidae poly immune fab
|
$11,688.60 |
$11,688.60 |
$11,688.60 |
$6,208.33
|
|
Cta abdomen without & /or w/contrast
|
$11,521.64 |
$11,521.64 |
$11,521.64 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$21,031.23 |
$21,031.23 |
$21,031.23 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$11,521.64 |
$11,521.64 |
$11,521.64 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$23,046.37 |
$23,046.37 |
$23,046.37 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$10,081.83 |
$10,081.83 |
$10,081.83 |
$2,017.89
|
|
CT Angiogram of the Head
|
$11,521.64 |
$11,521.64 |
$11,521.64 |
$2,041.78
|
|
CT angio hrt w/3d image
|
$22,897.16 |
$22,897.16 |
$22,897.16 |
$1,601.60
|
|
CT angio pelvis
|
$11,521.64 |
$11,521.64 |
$11,521.64 |
$1,778.40
|
|
CT colonography dx
|
$8,243.59 |
$8,243.59 |
$8,243.59 |
$770.90
|
|
CT colonography dx w/dye
|
$17,148.63 |
$17,148.63 |
$17,148.63 |
$1,009.98
|
|
CT colonography screening
|
$8,243.59 |
$8,243.59 |
$8,243.59 |
$1,084.20
|
|
CT guidance for needle placement
|
$14,632.33 |
$14,632.33 |
$14,632.33 |
$1,506.04
|
|
CT guid parench tis ablat
|
$43,477.68 |
$43,477.68 |
$43,477.68 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$12,033.88 |
$12,033.88 |
$12,033.88 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$17,148.63 |
$17,148.63 |
$17,148.63 |
$1,217.45
|
|
CT hrt w/3d image
|
$24,729.24 |
$24,729.24 |
$24,729.24 |
$1,477.35
|
|
CT limited or localized follow-up study
|
$6,868.38 |
$6,868.38 |
$6,868.38 |
$630.50
|
|
CT neck soft tissue w/contrast
|
$26,292.13 |
$26,292.13 |
$26,292.13 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$25,236.87 |
$25,236.87 |
$25,236.87 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$27,458.12 |
$27,458.12 |
$27,458.12 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$16,437.96 |
$16,437.96 |
$16,437.96 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$12,473.84 |
$12,473.84 |
$12,473.84 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$8,195.89 |
$8,195.89 |
$8,195.89 |
$1,345.05
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$48,392.45 |
$48,392.45 |
$48,392.45 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$42,283.99 |
$42,283.99 |
$42,283.99 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$31,599.17 |
$31,599.17 |
$31,599.17 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$25,236.87 |
$25,236.87 |
$25,236.87 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$14,441.27 |
$14,441.27 |
$14,441.27 |
$1,436.50
|
|
CT t-spine w /wo contrast
|
$39,307.42 |
$39,307.42 |
$39,307.42 |
$2,030.60
|
|
Culture afb any source
|
$3,343.47 |
$3,343.47 |
$3,343.47 |
$107.50
|
|
Culture anaerobic except blood
|
$2,173.95 |
$2,173.95 |
$2,173.95 |
$120.00
|
|
Culture fungi definitive id mold
|
$107.76 |
$107.76 |
$107.76 |
$70.00
|
|
Culture fungi definitive id yeast
|
$324.97 |
$324.97 |
$324.97 |
$79.00
|
|
Culture fungi skin/hair/nail
|
$3,343.47 |
$3,343.47 |
$3,343.47 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$116.42 |
$116.42 |
$116.42 |
$88.14
|
|
Culture quantitative aerobic other source
|
$22.59 |
$22.59 |
$22.59 |
$85.80
|
|
Culture urine each isolate
|
$85.16 |
$85.16 |
$85.16 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$2.10 |
$2.10 |
$2.10 |
$26.73
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,303.05 |
$1,303.05 |
$1,303.05 |
$779.37
|
|
Cyclophosphamide 25 mg capsule
|
$11.55 |
$11.55 |
$11.55 |
$22.51
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$554.18 |
$554.18 |
$554.18 |
$150.79
|
|
Cyclosporine modified 25 mg capsule
|
$9.45 |
$9.45 |
$9.45 |
$9.79
|
|
Cystogram >= 3 views supervision & interpretation
|
$2,909.96 |
$2,909.96 |
$2,909.96 |
$527.50
|
|
Cytarabine 20 mg/ml injection solution
|
$121.80 |
$121.80 |
$121.80 |
$66.95
|
|
Cytopathology cellular enhancement technique non-gyn
|
$281.52 |
$281.52 |
$281.52 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$451.83 |
$451.83 |
$451.83 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$243.30 |
$243.30 |
$243.30 |
$122.40
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$60.84 |
$60.84 |
$60.84 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$149.45 |
$149.45 |
$149.45 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$603.02 |
$603.02 |
$603.02 |
$203.08
|
|
Cytopath smear other source
|
$323.21 |
$323.21 |
$323.21 |
$135.27
|
|
Cytopath tbs c/v manual
|
$14.17 |
$14.17 |
$14.17 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$88.20 |
$88.20 |
$88.20 |
$61.64
|
|
Dactinomycin 0.5 mg intravenous solution
|
$284.55 |
$284.55 |
$284.55 |
$2,281.50
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$663.60 |
$663.60 |
$663.60 |
$194.08
|
|
Dch glucoscan
|
$217.23 |
$217.23 |
$217.23 |
$23.25
|
|
Dch validity tests
|
$184.20 |
$184.20 |
$184.20 |
$25.00
|
|
Debridement (>20 cm) charge pt
|
$157.81 |
$157.81 |
$157.81 |
$262.60
|
|
Decalcification
|
$293.69 |
$293.69 |
$293.69 |
$75.38
|
|
Decitabine 50 mg intravenous solution
|
$8,946.00 |
$8,946.00 |
$8,946.00 |
$1,026.60
|
|
Deferoxamine 500 mg solution for injection
|
$258.30 |
$258.30 |
$258.30 |
$112.87
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$161.61 |
$161.61 |
$161.61 |
$182.40
|
|
Desmopressin 4 mcg/ml injection solution
|
$333.90 |
$333.90 |
$333.90 |
$172.46
|
|
Dextran 40 infusion
|
$103.95 |
$103.95 |
$103.95 |
$173.97
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$60.00 |
$60.00 |
$60.00 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$19.15 |
$19.15 |
$19.15 |
$68.25
|
|
Dextrose 5 % IV bolus
|
$10.00 |
$10.00 |
$10.00 |
$68.25
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$79.80 |
$79.80 |
$79.80 |
$67.89
|
|
Dicyclomine injection
|
$287.70 |
$287.70 |
$287.70 |
$210.00
|
|
Diffusing capacity
|
$513.18 |
$513.18 |
$513.18 |
$357.50
|
|
Digital analysis of eeg
|
$718.38 |
$718.38 |
$718.38 |
$641.56
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$18.90 |
$18.90 |
$18.90 |
$53.00
|