|
CT guid parench tis ablat
|
$2,307.90 |
$2,307.90 |
$2,307.90 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$539.70 |
$539.70 |
$539.70 |
$156.00
|
|
CT hrt w/3d image
|
$3,439.10 |
$3,439.10 |
$3,439.10 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$1,053.50 |
$1,053.50 |
$1,053.50 |
$633.60
|
|
CT lower extremity w/contrast (both sides)
|
$2,975.70 |
$2,975.70 |
$2,975.70 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,622.90 |
$2,622.90 |
$2,622.90 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$3,378.90 |
$3,378.90 |
$3,378.90 |
$1,818.96
|
|
CT neck soft tissue w/contrast
|
$3,250.80 |
$3,250.80 |
$3,250.80 |
$1,603.55
|
|
CT neck soft tissue without contrast
|
$2,566.20 |
$2,566.20 |
$2,566.20 |
$1,312.00
|
|
CT neck soft tissue without & w/contrast
|
$3,704.40 |
$3,704.40 |
$3,704.40 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$3,813.60 |
$3,813.60 |
$3,813.60 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$3,572.10 |
$3,572.10 |
$3,572.10 |
$1,543.00
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$3,287.90 |
$3,287.90 |
$3,287.90 |
$1,345.05
|
|
Ctrl nosebld postir subsq 30906
|
$573.30 |
$573.30 |
$573.30 |
$444.50
|
|
CT scan for localization
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$1,205.14
|
|
CT scan for therapy guide
|
$1,496.60 |
$1,496.60 |
$1,496.60 |
$656.13
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$7,105.70 |
$7,105.70 |
$7,105.70 |
$3,408.50
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$6,049.40 |
$6,049.40 |
$6,049.40 |
$2,871.05
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,802.00 |
$4,802.00 |
$4,802.00 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$2,947.00 |
$2,947.00 |
$2,947.00 |
$1,655.85
|
|
CT thoracic spine without contrast
|
$2,811.90 |
$2,811.90 |
$2,811.90 |
$1,430.20
|
|
CT thorax low dose for lung screening without contrast
|
$781.20 |
$781.20 |
$781.20 |
$332.00
|
|
CT t-spine w /wo contrast
|
$3,208.80 |
$3,208.80 |
$3,208.80 |
$1,968.47
|
|
CT upper extremity w/contrast (both sides)
|
$2,812.60 |
$2,812.60 |
$2,812.60 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$2,563.40 |
$2,563.40 |
$2,563.40 |
$1,404.36
|
|
CT uppr extremity w/o&w/dye
|
$3,768.10 |
$3,768.10 |
$3,768.10 |
$1,845.36
|
|
Cultr oocyte/embryo <4 days
|
$441.00 |
$441.00 |
$441.00 |
$441.00
|
|
Culture aerobic additional method definitive id each
|
$128.10 |
$128.10 |
$128.10 |
$71.40
|
|
Culture afb any source
|
$323.40 |
$323.40 |
$323.40 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$112.70 |
$112.70 |
$112.70 |
$84.76
|
|
Culture anaerobic except blood
|
$356.30 |
$356.30 |
$356.30 |
$120.54
|
|
Culture bact stool aero addl path ea
|
$154.00 |
$154.00 |
$154.00 |
$52.50
|
|
Culture body fluid
|
$380.10 |
$380.10 |
$380.10 |
$126.00
|
|
Culture fungi definitive id mold
|
$415.10 |
$415.10 |
$415.10 |
$80.00
|
|
Culture fungi definitive id yeast
|
$238.70 |
$238.70 |
$238.70 |
$79.50
|
|
Culture fungi other (except blood)
|
$257.60 |
$257.60 |
$257.60 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$233.80 |
$233.80 |
$233.80 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$112.70 |
$112.70 |
$112.70 |
$100.00
|
|
Culture mycoplasma any source
|
$162.40 |
$162.40 |
$162.40 |
$81.62
|
|
Culture quantitative aerobic other source
|
$343.00 |
$343.00 |
$343.00 |
$90.35
|
|
Culture screening strep group a
|
$170.80 |
$170.80 |
$170.80 |
$83.16
|
|
Culture typing added method
|
$75.60 |
$75.60 |
$75.60 |
$38.70
|
|
Culture typing glc/hplc
|
$42.00 |
$42.00 |
$42.00 |
$53.75
|
|
Culture typing immunologic
|
$56.70 |
$56.70 |
$56.70 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$529.20 |
$529.20 |
$529.20 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$135.80 |
$135.80 |
$135.80 |
$138.40
|
|
Culture urine each isolate
|
$98.00 |
$98.00 |
$98.00 |
$54.78
|
|
Cutter lead
|
$14,419.36 |
$14,419.36 |
$14,419.36 |
$6,685.72
|
|
Cv line/pic reposition
|
$2,673.30 |
$2,673.30 |
$2,673.30 |
$1,608.00
|
|
Cyanocobalamin unsat binding capacity
|
$84.70 |
$84.70 |
$84.70 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$79.10 |
$79.10 |
$79.10 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$198.10 |
$198.10 |
$198.10 |
$72.15
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$3,795.22 |
$3,795.22 |
$3,795.22 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$152.60 |
$152.60 |
$152.60 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$2,114.87 |
$2,114.87 |
$2,114.87 |
$140.78
|
|
Cyclosporine 2 hour
|
$205.10 |
$205.10 |
$205.10 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$70.70 |
$70.70 |
$70.70 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$281.57 |
$281.57 |
$281.57 |
$35.57
|
|
Cylinder pump set 20cm titan zero angl
|
$45,173.35 |
$45,173.35 |
$45,173.35 |
$24,372.98
|
|
Cyp2c19 gene com variants
|
$1,333.50 |
$1,333.50 |
$1,333.50 |
$502.45
|
|
Cyp2c9 gene com variants
|
$725.20 |
$725.20 |
$725.20 |
$266.50
|
|
Cyp2d6 gene com variants
|
$1,073.80 |
$1,073.80 |
$1,073.80 |
$573.65
|
|
Cyp3a5 gene common variants
|
$403.20 |
$403.20 |
$403.20 |
$245.31
|
|
Cystatin c
|
$167.30 |
$167.30 |
$167.30 |
$76.48
|
|
Cystic fibrosis cftr
|
$1,877.40 |
$1,877.40 |
$1,877.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$131.60 |
$131.60 |
$131.60 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$921.20 |
$921.20 |
$921.20 |
$564.85
|
|
Cysto rx balo cath urtl strx
|
$26,555.73 |
$26,555.73 |
$26,555.73 |
$6,853.60
|
|
Cystoscopy and treatment
|
$11,752.69 |
$11,752.69 |
$11,752.69 |
$4,081.37
|
|
Cystoscopy and treatment
|
$16,745.39 |
$16,745.39 |
$16,745.39 |
$4,350.00
|
|
Cystoscopy and treatment
|
$19,840.09 |
$19,840.09 |
$19,840.09 |
$5,304.00
|
|
Cystoscopy and treatment
|
$24,111.40 |
$24,111.40 |
$24,111.40 |
$5,995.60
|
|
Cystoscopy and treatment
|
$27,552.24 |
$27,552.24 |
$27,552.24 |
$6,593.60
|
|
Cystoscopy and treatment
|
$17,456.14 |
$17,456.14 |
$17,456.14 |
$3,213.14
|
|
Cystoscopy and treatment
|
$29,796.75 |
$29,796.75 |
$29,796.75 |
$4,045.60
|
|
Cystoscopy and treatment
|
$22,151.24 |
$22,151.24 |
$22,151.24 |
$4,081.37
|
|
Cystoscopy and treatment
|
$14,134.15 |
$14,134.15 |
$14,134.15 |
$2,850.95
|
|
Cystoscopy and treatment
|
$19,758.34 |
$19,758.34 |
$19,758.34 |
$4,081.37
|
|
Cystoscopy (Bladder Scope)
|
$12,287.83 |
$12,287.83 |
$12,287.83 |
$1,445.41
|
|
Cystoscopy chemodenervation
|
$21,086.92 |
$21,086.92 |
$21,086.92 |
$2,831.92
|
|
Cystoscopy removal of clots
|
$59,816.74 |
$59,816.74 |
$59,816.74 |
$4,051.50
|
|
Cystoscopy stone removal
|
$39,920.26 |
$39,920.26 |
$39,920.26 |
$5,741.00
|
|
Cystoscopy & ureter catheter
|
$59,567.99 |
$59,567.99 |
$59,567.99 |
$3,688.80
|
|
Cystouretero & or pyeloscope
|
$18,918.09 |
$18,918.09 |
$18,918.09 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$20,283.05 |
$20,283.05 |
$20,283.05 |
$4,865.91
|
|
Cystouretero w/biopsy
|
$27,343.21 |
$27,343.21 |
$27,343.21 |
$6,015.75
|
|
Cysto/uretero w/lithotripsy
|
$29,129.81 |
$29,129.81 |
$29,129.81 |
$7,573.50
|
|
Cystouretero w/lithotripsy
|
$26,245.81 |
$26,245.81 |
$26,245.81 |
$7,061.60
|
|
Cystouretero w/renal strict
|
$31,309.64 |
$31,309.64 |
$31,309.64 |
$5,741.00
|
|
Cystouretero w/stone remove
|
$22,054.49 |
$22,054.49 |
$22,054.49 |
$5,339.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$15,295.65 |
$15,295.65 |
$15,295.65 |
$3,131.20
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$23,083.19 |
$23,083.19 |
$23,083.19 |
$4,045.60
|
|
Cystourethro w/addl implant 52442
|
$48,048.69 |
$48,048.69 |
$48,048.69 |
$2,161.60
|
|
Cystourethro w/implant
|
$48,048.69 |
$48,048.69 |
$48,048.69 |
$2,777.60
|
|
Cytarabine 20 mg/ml injection solution
|
$161.17 |
$161.17 |
$161.17 |
$90.00
|
|
Cytogenetics 25-99
|
$423.50 |
$423.50 |
$423.50 |
$189.80
|
|
Cytogenomic neo microra alys
|
$6,578.60 |
$6,578.60 |
$6,578.60 |
$2,156.05
|
|
Cytomegalovirus (cmv) antibody igg
|
$259.00 |
$259.00 |
$259.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$254.80 |
$254.80 |
$254.80 |
$100.00
|
|
Cyto/molecular report
|
$427.00 |
$427.00 |
$427.00 |
$144.75
|
