|
CT colonography dx w/dye
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,016.80
|
|
CT guidance for needle placement
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,498.20
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$4,113.60 |
$4,113.60 |
$4,113.60 |
$1,113.84
|
|
CT guid parench tis ablat
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$117.00 |
$117.00 |
$117.00 |
$187.72
|
|
CT hrt c+ strux cgen hrt ds
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,400.00
|
|
CT hrt w/3d image
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,373.40
|
|
CT limited or localized follow-up study
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,619.20
|
|
CT lower extremity without contrast (both sides)
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,851.60
|
|
CT neck soft tissue w/contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,630.23
|
|
CT neck soft tissue without contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,318.20
|
|
CT neck soft tissue without & w/contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$3,491.40 |
$3,491.40 |
$3,491.40 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$331.80 |
$331.80 |
$331.80 |
$425.60
|
|
CT scan for localization
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,202.37
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,688.80 |
$3,688.80 |
$3,688.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,688.80 |
$3,688.80 |
$3,688.80 |
$2,855.63
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,633.00 |
$3,633.00 |
$3,633.00 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,688.40
|
|
CT thoracic spine without contrast
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$176.40 |
$176.40 |
$176.40 |
$331.50
|
|
CT t-spine w /wo contrast
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,421.20
|
|
CT uppr extremity w/o&w/dye
|
$5,365.80 |
$5,365.80 |
$5,365.80 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$64.20 |
$64.20 |
$64.20 |
$68.80
|
|
Culture afb any source
|
$226.20 |
$226.20 |
$226.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$172.20 |
$172.20 |
$172.20 |
$78.60
|
|
Culture anaerobic except blood
|
$228.60 |
$228.60 |
$228.60 |
$117.45
|
|
Culture bacteria anaerobic
|
$228.60 |
$228.60 |
$228.60 |
$64.13
|
|
Culture bact stool aero addl path ea
|
$122.40 |
$122.40 |
$122.40 |
$51.60
|
|
Culture body fluid
|
$247.80 |
$247.80 |
$247.80 |
$121.80
|
|
Culture fungi definitive id mold
|
$135.60 |
$135.60 |
$135.60 |
$74.83
|
|
Culture fungi definitive id yeast
|
$124.20 |
$124.20 |
$124.20 |
$79.10
|
|
Culture fungi other (except blood)
|
$169.80 |
$169.80 |
$169.80 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$47.40 |
$47.40 |
$47.40 |
$75.40
|
|
Culture mycobacteria definitive id each isolate
|
$528.60 |
$528.60 |
$528.60 |
$88.40
|
|
Culture mycoplasma any source
|
$165.00 |
$165.00 |
$165.00 |
$86.40
|
|
Culture quantitative aerobic other source
|
$228.60 |
$228.60 |
$228.60 |
$89.10
|
|
Culture screening strep group a
|
$115.80 |
$115.80 |
$115.80 |
$81.25
|
|
Culture type pulse field gel
|
$408.00 |
$408.00 |
$408.00 |
$38.58
|
|
Culture typing immunologic
|
$89.40 |
$89.40 |
$89.40 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$591.00 |
$591.00 |
$591.00 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$541.20 |
$541.20 |
$541.20 |
$130.38
|
|
Culture urine each isolate
|
$105.00 |
$105.00 |
$105.00 |
$52.65
|
|
Cv line/pic reposition
|
$3,507.00 |
$3,507.00 |
$3,507.00 |
$1,719.44
|
|
Cyanocobalamin unsat binding capacity
|
$168.60 |
$168.60 |
$168.60 |
$64.28
|
|
Cyclic citrullinated peptide antibody
|
$48.00 |
$48.00 |
$48.00 |
$72.00
|
|
Cyclosporine 2 hour
|
$236.40 |
$236.40 |
$236.40 |
$126.10
|
|
Cyp2c19 gene com variants
|
$1,686.00 |
$1,686.00 |
$1,686.00 |
$433.00
|
|
Cyp2d6 gene com variants
|
$2,203.80 |
$2,203.80 |
$2,203.80 |
$525.95
|
|
Cystatin c
|
$342.00 |
$342.00 |
$342.00 |
$76.41
|
|
Cystic fibrosis cftr
|
$3,204.60 |
$3,204.60 |
$3,204.60 |
$1,060.00
|
|
Cystine urine quantitative
|
$744.00 |
$744.00 |
$744.00 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$493.80 |
$493.80 |
$493.80 |
$539.55
|
|
Cystoscopy and treatment
|
$1,759.80 |
$1,759.80 |
$1,759.80 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$3,148.20 |
$3,148.20 |
$3,148.20 |
$1,510.30
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,865.80 |
$3,865.80 |
$3,865.80 |
$3,015.50
|
|
Cytogenetics 25-99
|
$624.60 |
$624.60 |
$624.60 |
$189.80
|
|
Cytogenetics 3-5
|
$252.00 |
$252.00 |
$252.00 |
$147.36
|
|
Cytogenomic neo microra alys
|
$5,667.60 |
$5,667.60 |
$5,667.60 |
$1,911.78
|
|
Cytogenom microarray copy nmbr var
|
$4,304.40 |
$4,304.40 |
$4,304.40 |
$1,341.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$186.60 |
$186.60 |
$186.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$136.20 |
$136.20 |
$136.20 |
$95.55
|
|
Cytomegalovirus dfa
|
$229.20 |
$229.20 |
$229.20 |
$74.88
|
|
Cyto/molecular report
|
$157.80 |
$157.80 |
$157.80 |
$127.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$233.40 |
$233.40 |
$233.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$232.80 |
$232.80 |
$232.80 |
$91.84
|
|
Cytopathology concentration technique smears & interpretation
|
$182.40 |
$182.40 |
$182.40 |
$134.70
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$233.40 |
$233.40 |
$233.40 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$197.40 |
$197.40 |
$197.40 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$234.00 |
$234.00 |
$234.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$661.80 |
$661.80 |
$661.80 |
$207.50
|
|
Cytopath smear other source
|
$183.60 |
$183.60 |
$183.60 |
$88.13
|
|
Cytopath smear other source
|
$145.20 |
$145.20 |
$145.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$87.00 |
$87.00 |
$87.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$109.80 |
$109.80 |
$109.80 |
$59.15
|
|
Cytotoxic antibody screening
|
$982.80 |
$982.80 |
$982.80 |
$75.20
|
|
Cytp urine 3-5 probes cmptr
|
$734.40 |
$734.40 |
$734.40 |
$690.00
|
|
D&c after delivery 59160
|
$5,782.80 |
$5,782.80 |
$5,782.80 |
$3,827.25
|
|
Dch glucoscan
|
$39.60 |
$39.60 |
$39.60 |
$27.50
|
|
Dch pulmonary stress test
|
$1,215.00 |
$1,215.00 |
$1,215.00 |
$963.30
|
|
Dch validity tests
|
$49.20 |
$49.20 |
$49.20 |
$24.05
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$686.40 |
$686.40 |
$686.40 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$160.80 |
$160.80 |
$160.80 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,321.40 |
$2,321.40 |
$2,321.40 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$337.80 |
$337.80 |
$337.80 |
$661.09
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,907.40 |
$1,907.40 |
$1,907.40 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$755.40 |
$755.40 |
$755.40 |
$814.80
|
|
Debride nail1-5 11720
|
$118.20 |
$118.20 |
$118.20 |
$148.80
|
|
Debride nail6 or more 11721
|
$266.40 |
$266.40 |
$266.40 |
$166.40
|
|
Debride skin bone at fx site
|
$1,049.40 |
$1,049.40 |
$1,049.40 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$252.60 |
$252.60 |
$252.60 |
$639.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,088.40 |
$1,088.40 |
$1,088.40 |
$1,176.57
|
|
Decalcification
|
$90.60 |
$90.60 |
$90.60 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,434.00 |
$1,434.00 |
$1,434.00 |
$540.00
|