|
Collection blood specimen from completely implantable venous access device
|
$560.35 |
$560.35 |
$560.35 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$236.86 |
$236.86 |
$236.86 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$36.86 |
$36.86 |
$36.86 |
$22.00
|
|
Compatibility test each unit antiglobulin technique
|
$541.47 |
$541.47 |
$541.47 |
$173.25
|
|
Compatibility test each unit immediate spin technique
|
$539.71 |
$539.71 |
$539.71 |
$169.52
|
|
Complement antigen each component c3
|
$456.41 |
$456.41 |
$456.41 |
$111.15
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,653.57 |
$1,653.57 |
$1,653.57 |
$940.00
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$3,620.77 |
$3,620.77 |
$3,620.77 |
$1,206.00
|
|
Complx repair fccmnaxghf 13131
|
$2,824.66 |
$2,824.66 |
$2,824.66 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$3,017.03 |
$3,017.03 |
$3,017.03 |
$1,244.09
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,166.03 |
$2,166.03 |
$2,166.03 |
$576.66
|
|
Concentration infection agents any type
|
$106.12 |
$106.12 |
$106.12 |
$51.32
|
|
Condylomata destruction 56420
|
$1,787.87 |
$1,787.87 |
$1,787.87 |
$509.81
|
|
Control of nosebleedantersmpl 30901
|
$958.56 |
$958.56 |
$958.56 |
$385.45
|
|
Coombs direct
|
$196.26 |
$196.26 |
$196.26 |
$73.26
|
|
Cortisol total am
|
$275.04 |
$275.04 |
$275.04 |
$122.20
|
|
Counseling smoke cess interm >10mins
|
$153.88 |
$153.88 |
$153.88 |
$57.85
|
|
#coxa-coxsackie a serotype a16
|
$134.51 |
$134.51 |
$134.51 |
$65.36
|
|
C-peptide
|
$352.96 |
$352.96 |
$352.96 |
$100.00
|
|
C-reactive protein
|
$300.70 |
$300.70 |
$300.70 |
$63.00
|
|
C-reactive protein high sensitivity
|
$370.95 |
$370.95 |
$370.95 |
$91.65
|
|
Creatine kinase
|
$234.79 |
$234.79 |
$234.79 |
$59.78
|
|
Creatine kinase mb
|
$391.57 |
$391.57 |
$391.57 |
$111.00
|
|
Creatine - sendout
|
$108.53 |
$108.53 |
$108.53 |
$39.00
|
|
Creatinine
|
$152.87 |
$152.87 |
$152.87 |
$44.10
|
|
Creatinine 24 hour urine
|
$219.70 |
$219.70 |
$219.70 |
$59.80
|
|
Creatinine clearance urine
|
$294.93 |
$294.93 |
$294.93 |
$87.50
|
|
Critical care 30-74 minutes
|
$9,199.72 |
$9,199.72 |
$9,199.72 |
$2,745.69
|
|
Critical care each additional 30 minutes
|
$1,627.99 |
$1,627.99 |
$1,627.99 |
$777.00
|
|
Cta abdomen without & /or w/contrast
|
$2,239.28 |
$2,239.28 |
$2,239.28 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,551.38 |
$2,551.38 |
$2,551.38 |
$2,080.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,714.29 |
$3,714.29 |
$3,714.29 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$2,801.09 |
$2,801.09 |
$2,801.09 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,301.91 |
$4,301.91 |
$4,301.91 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,160.09 |
$1,160.09 |
$1,160.09 |
$1,955.80
|
|
CT Angiogram of the Head
|
$2,844.31 |
$2,844.31 |
$2,844.31 |
$2,021.40
|
|
Cta upper extremity w &/or without contrast left
|
$3,410.60 |
$3,410.60 |
$3,410.60 |
$1,652.25
|
|
CT heart w/evaluation of calcium without contrast
|
$124.98 |
$124.98 |
$124.98 |
$192.00
|
|
CT lower extremity w/contrast (both sides)
|
$2,310.39 |
$2,310.39 |
$2,310.39 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$2,737.43 |
$2,737.43 |
$2,737.43 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$3,915.03 |
$3,915.03 |
$3,915.03 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$2,941.22 |
$2,941.22 |
$2,941.22 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,570.10 |
$1,570.10 |
$1,570.10 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$3,253.04 |
$3,253.04 |
$3,253.04 |
$1,959.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$4,169.88 |
$4,169.88 |
$4,169.88 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,734.90 |
$1,734.90 |
$1,734.90 |
$1,351.20
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$7,627.63 |
$7,627.63 |
$7,627.63 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$7,152.05 |
$7,152.05 |
$7,152.05 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,041.18 |
$4,041.18 |
$4,041.18 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,281.81 |
$1,281.81 |
$1,281.81 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$999.42 |
$999.42 |
$999.42 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,381.72 |
$1,381.72 |
$1,381.72 |
$400.20
|
|
CT upper extremity w/contrast (both sides)
|
$2,581.74 |
$2,581.74 |
$2,581.74 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,758.02 |
$1,758.02 |
$1,758.02 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$2,053.24 |
$2,053.24 |
$2,053.24 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$225.49 |
$225.49 |
$225.49 |
$63.75
|
|
Culture afb any source
|
$210.84 |
$210.84 |
$210.84 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$320.02 |
$320.02 |
$320.02 |
$77.31
|
|
Culture anaerobic except blood
|
$148.32 |
$148.32 |
$148.32 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$57.45 |
$57.45 |
$57.45 |
$52.80
|
|
Culture body fluid
|
$120.44 |
$120.44 |
$120.44 |
$130.50
|
|
Culture fungi definitive id yeast
|
$225.23 |
$225.23 |
$225.23 |
$80.60
|
|
Culture fungi other (except blood)
|
$325.79 |
$325.79 |
$325.79 |
$105.60
|
|
Culture screening strep group a
|
$156.75 |
$156.75 |
$156.75 |
$81.60
|
|
Culture typing added method
|
$96.76 |
$96.76 |
$96.76 |
$34.45
|
|
Culture typing immunologic
|
$85.56 |
$85.56 |
$85.56 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,817.22 |
$1,817.22 |
$1,817.22 |
$408.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$159.70 |
$159.70 |
$159.70 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$269.94 |
$269.94 |
$269.94 |
$80.05
|
|
Cyclosporine oral 100 mg
|
$79.32 |
$79.32 |
$79.32 |
$39.04
|
|
Cyp2c19 gene com variants
|
$1,946.15 |
$1,946.15 |
$1,946.15 |
$567.75
|
|
Cystatin c
|
$231.50 |
$231.50 |
$231.50 |
$82.26
|
|
Cytarabine 20 mg/ml injection solution
|
$106.31 |
$106.31 |
$106.31 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$318.55 |
$318.55 |
$318.55 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$210.63 |
$210.63 |
$210.63 |
$96.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$33,315.88 |
$33,315.88 |
$33,315.88 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$30,299.61 |
$30,299.61 |
$30,299.61 |
$5,546.48
|
|
Deamidated gliadin antibody iga
|
$148.96 |
$148.96 |
$148.96 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$2,252.10 |
$2,252.10 |
$2,252.10 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$952.66 |
$952.66 |
$952.66 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$3,697.98 |
$3,697.98 |
$3,697.98 |
$2,553.60
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,373.19 |
$2,373.19 |
$2,373.19 |
$810.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,849.00 |
$1,849.00 |
$1,849.00 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,377.28 |
$2,377.28 |
$2,377.28 |
$1,193.40
|
|
Decalcification
|
$213.60 |
$213.60 |
$213.60 |
$73.60
|
|
Deferoxamine 500 mg solution for injection
|
$2,142.05 |
$2,142.05 |
$2,142.05 |
$110.82
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$365.42 |
$365.42 |
$365.42 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$47,916.80 |
$47,916.80 |
$47,916.80 |
$7,933.81
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,015.73 |
$1,015.73 |
$1,015.73 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$3,370.69 |
$3,370.69 |
$3,370.69 |
$102.32
|
|
Destroy cervthor facet jnt 64633
|
$3,982.40 |
$3,982.40 |
$3,982.40 |
$3,164.80
|
|
Destroy cth facet jnt addl 64634
|
$1,807.82 |
$1,807.82 |
$1,807.82 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$2,769.80 |
$2,769.80 |
$2,769.80 |
$1,879.50
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$4,851.16 |
$4,851.16 |
$4,851.16 |
$3,375.00
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$93.54 |
$93.54 |
$93.54 |
$30.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$441.12 |
$441.12 |
$441.12 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$441.12 |
$441.12 |
$441.12 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$109.94 |
$109.94 |
$109.94 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$441.12 |
$441.12 |
$441.12 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$267.07 |
$267.07 |
$267.07 |
$107.50
|