|
CT Angiogram of the Head
|
$1,305.07 |
$1,305.07 |
$1,305.07 |
$2,021.40
|
|
CT angio hrt w/3d image
|
$862.55 |
$862.55 |
$862.55 |
$1,588.60
|
|
CT angio pelvis
|
$1,054.06 |
$1,054.06 |
$1,054.06 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$1,162.40 |
$1,162.40 |
$1,162.40 |
$1,652.25
|
|
CT colonography dx
|
$368.82 |
$368.82 |
$368.82 |
$770.90
|
|
CT guidance for needle placement
|
$109.52 |
$109.52 |
$109.52 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$207.80 |
$207.80 |
$207.80 |
$1,085.05
|
|
CT guid parench tis ablat
|
$907.24 |
$907.24 |
$907.24 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$20.43 |
$20.43 |
$20.43 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$483.08 |
$483.08 |
$483.08 |
$1,217.45
|
|
CT hrt w/3d image
|
$586.68 |
$586.68 |
$586.68 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$271.14 |
$271.14 |
$271.14 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$993.38 |
$993.38 |
$993.38 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$694.72 |
$694.72 |
$694.72 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$896.00 |
$896.00 |
$896.00 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,220.41 |
$1,220.41 |
$1,220.41 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,012.92 |
$1,012.92 |
$1,012.92 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$1,281.39 |
$1,281.39 |
$1,281.39 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,044.29 |
$1,044.29 |
$1,044.29 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$856.33 |
$856.33 |
$856.33 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$751.25 |
$751.25 |
$751.25 |
$1,351.20
|
|
CT scan for therapy guide
|
$330.64 |
$330.64 |
$330.64 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$807.20 |
$807.20 |
$807.20 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$714.55 |
$714.55 |
$714.55 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$607.40 |
$607.40 |
$607.40 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,390.91 |
$1,390.91 |
$1,390.91 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,061.76 |
$1,061.76 |
$1,061.76 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$177.60 |
$177.60 |
$177.60 |
$400.20
|
|
CT t-spine w /wo contrast
|
$1,507.83 |
$1,507.83 |
$1,507.83 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$1,028.01 |
$1,028.01 |
$1,028.01 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$694.72 |
$694.72 |
$694.72 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$1,028.01 |
$1,028.01 |
$1,028.01 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$112.48 |
$112.48 |
$112.48 |
$63.75
|
|
Culture afb any source
|
$137.64 |
$137.64 |
$137.64 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$93.54 |
$93.54 |
$93.54 |
$77.31
|
|
Culture anaerobic except blood
|
$24.57 |
$24.57 |
$24.57 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$33.45 |
$33.45 |
$33.45 |
$52.80
|
|
Culture body fluid
|
$21.91 |
$21.91 |
$21.91 |
$130.50
|
|
Culture fungi definitive id mold
|
$31.68 |
$31.68 |
$31.68 |
$70.00
|
|
Culture fungi definitive id yeast
|
$112.78 |
$112.78 |
$112.78 |
$80.60
|
|
Culture fungi other (except blood)
|
$21.91 |
$21.91 |
$21.91 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$19.24 |
$19.24 |
$19.24 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$76.37 |
$76.37 |
$76.37 |
$84.75
|
|
Culture mycoplasma any source
|
$116.33 |
$116.33 |
$116.33 |
$90.37
|
|
Culture quantitative aerobic other source
|
$14.80 |
$14.80 |
$14.80 |
$87.02
|
|
Culture screening strep group a
|
$21.61 |
$21.61 |
$21.61 |
$81.60
|
|
Culture typing added method
|
$76.37 |
$76.37 |
$76.37 |
$34.45
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$87.03 |
$87.03 |
$87.03 |
$124.40
|
|
Culture urine each isolate
|
$18.36 |
$18.36 |
$18.36 |
$46.20
|
|
Cutter lead
|
$534.28 |
$534.28 |
$534.28 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,898.55 |
$1,898.55 |
$1,898.55 |
$1,829.42
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$18.96 |
$18.96 |
$18.96 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$167.24 |
$167.24 |
$167.24 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$553.10 |
$553.10 |
$553.10 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$268.13 |
$268.13 |
$268.13 |
$23.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$86.17 |
$86.17 |
$86.17 |
$179.10
|
|
Cyclosporine 2 hour
|
$43.81 |
$43.81 |
$43.81 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$25.22 |
$25.22 |
$25.22 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$226.38 |
$226.38 |
$226.38 |
$39.04
|
|
Cyp2d6 gene com variants
|
$264.63 |
$264.63 |
$264.63 |
$537.50
|
|
Cystatin c
|
$46.18 |
$46.18 |
$46.18 |
$82.26
|
|
Cystine urine quantitative
|
$58.61 |
$58.61 |
$58.61 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$265.22 |
$265.22 |
$265.22 |
$539.55
|
|
Cystometrogram w/up 51727
|
$271.73 |
$271.73 |
$271.73 |
$857.38
|
|
Cystoscopy and treatment
|
$1,381.73 |
$1,381.73 |
$1,381.73 |
$4,081.37
|
|
Cystoscopy (Bladder Scope)
|
$520.37 |
$520.37 |
$520.37 |
$1,610.20
|
|
Cystoscopy chemodenervation
|
$1,482.67 |
$1,482.67 |
$1,482.67 |
$2,412.45
|
|
Cystoscopy & ureter catheter
|
$1,421.40 |
$1,421.40 |
$1,421.40 |
$3,416.48
|
|
Cysto/uretero w/lithotripsy
|
$3,176.08 |
$3,176.08 |
$3,176.08 |
$5,844.61
|
|
Cystouretero w/lithotripsy
|
$1,437.38 |
$1,437.38 |
$1,437.38 |
$6,015.75
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,419.62 |
$1,419.62 |
$1,419.62 |
$2,874.36
|
|
Cytarabine 20 mg/ml injection solution
|
$145.36 |
$145.36 |
$145.36 |
$89.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$25.76 |
$25.76 |
$25.76 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$25.76 |
$25.76 |
$25.76 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$46.77 |
$46.77 |
$46.77 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$58.91 |
$58.91 |
$58.91 |
$84.50
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$80.81 |
$80.81 |
$80.81 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$24.28 |
$24.28 |
$24.28 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$174.64 |
$174.64 |
$174.64 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$51.21 |
$51.21 |
$51.21 |
$205.00
|
|
Cytopath tbs c/v manual
|
$42.04 |
$42.04 |
$42.04 |
$57.94
|
|
Dacarbazine 100 mg intravenous solution
|
$130.69 |
$130.69 |
$130.69 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$5,000.58 |
$5,000.58 |
$5,000.58 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$3,401.41 |
$3,401.41 |
$3,401.41 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$973.35 |
$973.35 |
$973.35 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$22,977.61 |
$22,977.61 |
$22,977.61 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$8,097.13 |
$8,097.13 |
$8,097.13 |
$5,546.48
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$22,284.19 |
$22,284.19 |
$22,284.19 |
$26,349.55
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$354.45 |
$354.45 |
$354.45 |
$260.95
|
|
Dch glucoscan
|
$5.92 |
$5.92 |
$5.92 |
$24.85
|
|
Dch pulmonary stress test
|
$305.77 |
$305.77 |
$305.77 |
$964.41
|
|
Dch validity tests
|
$10.36 |
$10.36 |
$10.36 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$15.40 |
$15.40 |
$15.40 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$353.13 |
$353.13 |
$353.13 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$116.04 |
$116.04 |
$116.04 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,228.70 |
$1,228.70 |
$1,228.70 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$185.30 |
$185.30 |
$185.30 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$823.48 |
$823.48 |
$823.48 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$686.43 |
$686.43 |
$686.43 |
$810.50
|
|
Debride nail1-5 11720
|
$37.30 |
$37.30 |
$37.30 |
$173.25
|