|
CT colonography screening
|
$3,401.46 |
$3,401.46 |
$3,401.46 |
$1,084.20
|
|
CT guidance for needle placement
|
$5,508.26 |
$5,508.26 |
$13,822.99 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,856.98 |
$2,856.98 |
$2,856.98 |
$1,085.05
|
|
CT guid parench tis ablat
|
$1,469.47 |
$1,961.93 |
$15,576.84 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$1,150.55 |
$1,150.55 |
$27,984.45 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$1,808.35 |
$1,808.35 |
$20,421.05 |
$1,217.45
|
|
CT hrt w/3d image
|
$2,145.30 |
$2,147.56 |
$3,748.49 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$2,572.71 |
$2,572.71 |
$13,822.99 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$7,902.23 |
$7,902.23 |
$7,902.23 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$6,771.08 |
$6,771.08 |
$6,771.08 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$9,027.48 |
$9,027.48 |
$9,027.48 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$8,657.33 |
$8,657.33 |
$15,971.02 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$7,022.49 |
$7,022.49 |
$15,971.02 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$9,292.69 |
$9,292.69 |
$23,944.42 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$9,665.73 |
$9,665.73 |
$16,313.55 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$8,461.54 |
$8,461.54 |
$13,412.43 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$7,225.50 |
$7,225.50 |
$14,366.05 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$2,553.81 |
$2,553.81 |
$2,553.81 |
$456.00
|
|
CT scan for therapy guide
|
$2,103.83 |
$2,103.83 |
$2,103.83 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$15,632.01 |
$15,632.01 |
$40,899.80 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$5,541.51 |
$14,185.64 |
$32,059.84 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$13,573.71 |
$13,573.71 |
$31,255.32 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$8,266.23 |
$8,266.23 |
$16,594.07 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$7,653.92 |
$7,653.92 |
$16,431.37 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,332.34 |
$2,046.32 |
$2,046.32 |
$400.20
|
|
CT t-spine w /wo contrast
|
$8,980.80 |
$8,980.80 |
$23,220.98 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$8,338.78 |
$8,338.78 |
$8,338.78 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$6,646.48 |
$6,646.48 |
$6,646.48 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$8,831.99 |
$8,831.99 |
$8,831.99 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$160.98 |
$160.98 |
$160.98 |
$63.75
|
|
Culture afb any source
|
$261.14 |
$261.14 |
$261.14 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$91.84 |
$91.84 |
$766.84 |
$77.31
|
|
Culture anaerobic except blood
|
$447.53 |
$447.53 |
$1,658.86 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$145.71 |
$145.71 |
$360.81 |
$52.80
|
|
Culture body fluid
|
$270.31 |
$270.31 |
$270.31 |
$130.50
|
|
Culture fungi definitive id mold
|
$78.12 |
$78.12 |
$78.12 |
$70.00
|
|
Culture fungi definitive id yeast
|
$130.96 |
$130.96 |
$130.96 |
$80.60
|
|
Culture fungi other (except blood)
|
$240.94 |
$240.94 |
$240.94 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$119.01 |
$119.01 |
$119.01 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$225.51 |
$225.51 |
$389.57 |
$84.75
|
|
Culture mycoplasma any source
|
$237.54 |
$237.54 |
$237.54 |
$90.37
|
|
Culture quantitative aerobic other source
|
$152.65 |
$152.65 |
$1,284.12 |
$87.02
|
|
Culture screening strep group a
|
$192.83 |
$192.83 |
$192.83 |
$81.60
|
|
Culture typing added method
|
$119.47 |
$119.47 |
$273.98 |
$34.45
|
|
Culture typing immunologic
|
$79.96 |
$167.20 |
$350.88 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$3,365.75 |
$3,365.75 |
$3,365.75 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$541.61 |
$541.61 |
$684.24 |
$124.40
|
|
Culture urine each isolate
|
$124.87 |
$124.87 |
$1,509.35 |
$46.20
|
|
Cv line/pic reposition
|
$3,925.23 |
$3,925.23 |
$3,994.42 |
$1,829.42
|
|
Cv stress test/supervision only 93016
|
$88.07 |
$88.07 |
$88.07 |
$59.25
|
|
Cyanocobalamin unsat binding capacity
|
$71.05 |
$71.05 |
$71.05 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$86.45 |
$91.60 |
$103.00 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$15.43 |
$95.32 |
$95.32 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,525.00 |
$1,525.00 |
$1,525.00 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$61.57 |
$61.57 |
$61.57 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$797.00 |
$797.00 |
$797.00 |
$179.10
|
|
Cyclosporine 2 hour
|
$261.42 |
$261.42 |
$261.42 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$35.66 |
$35.66 |
$44.00 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$48.85 |
$56.10 |
$169.16 |
$39.04
|
|
Cyp2c19 gene com variants
|
$194.00 |
$4,497.14 |
$4,497.14 |
$567.75
|
|
Cyp2c9 gene com variants
|
$2,698.20 |
$2,698.20 |
$2,698.20 |
$275.10
|
|
Cyp2d6 gene com variants
|
$6,959.80 |
$6,959.80 |
$6,959.80 |
$537.50
|
|
Cystatin c
|
$46.00 |
$285.85 |
$285.85 |
$82.26
|
|
Cystine urine quantitative
|
$354.70 |
$354.70 |
$354.70 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,241.87 |
$1,241.87 |
$4,013.10 |
$539.55
|
|
Cystometrogram w/up 51727
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$857.38
|
|
Cystoscopy and treatment
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,174.25
|
|
Cystoscopy and treatment
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,219.80
|
|
Cystoscopy (Bladder Scope)
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$33,050.35 |
$33,050.35 |
$33,050.35 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,416.48
|
|
Cystourethroscop/calib/dilat stric 52281
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$2,874.36
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,970.98
|
|
Cystourethro w/addl implant 52442
|
$1,619.72 |
$1,619.72 |
$1,619.72 |
$1,502.96
|
|
Cystourethro w/implant
|
$3,554.89 |
$3,554.89 |
$3,554.89 |
$3,312.80
|
|
Cytarabine 20 mg/ml injection solution
|
$141.25 |
$145.90 |
$978.55 |
$89.95
|
|
Cytogenetics 25-99
|
$654.14 |
$654.14 |
$654.14 |
$180.32
|
|
Cytogenetics 3-5
|
$628.20 |
$628.20 |
$628.20 |
$127.64
|
|
Cytogenom microarray copy nmbr var
|
$13,891.50 |
$13,891.50 |
$13,891.50 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$222.11 |
$222.11 |
$222.11 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$13.92 |
$260.09 |
$260.09 |
$96.80
|
|
Cyto/molecular report
|
$192.76 |
$192.76 |
$243.97 |
$144.75
|
|
Cytopath c/v index add-on
|
$116.44 |
$116.44 |
$116.44 |
$29.60
|
|
Cytopath fl nongyn filter
|
$35.97 |
$35.97 |
$35.97 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$30.52 |
$612.08 |
$612.08 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$410.73 |
$410.73 |
$410.73 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$312.71 |
$312.71 |
$312.71 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$143.48 |
$143.48 |
$526.12 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$143.48 |
$143.48 |
$526.12 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$116.44 |
$251.51 |
$477.35 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$498.15 |
$526.12 |
$1,402.70 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$194.74 |
$220.71 |
$970.30 |
$205.00
|
|
Cytopath smear other source
|
$26.92 |
$209.49 |
$209.49 |
$85.80
|
|
Cytopath smear other source
|
$582.18 |
$582.18 |
$582.18 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$304.65 |
$304.65 |
$836.11 |
$95.89
|
|
Cytopath tbs c/v manual
|
$63.67 |
$171.06 |
$245.72 |
$57.94
|
|
Cytotoxic antibody screening
|
$1,213.97 |
$1,213.97 |
$1,213.97 |
$157.60
|
|
Cytotoxic antibody screening
|
$112.27 |
$112.27 |
$112.27 |
$75.20
|
|
Cytp urine 3-5 probes cmptr
|
$3,289.10 |
$3,289.10 |
$3,289.10 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$149.90 |
$149.90 |
$152.00 |
$82.91
|