|
CT Angiogram of Abdomen and Pelvis
|
$2,580.00 |
$2,580.00 |
$2,580.00 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,915.30
|
|
CT Angiogram of the Head
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,881.75
|
|
CT angio hrt w/3d image
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$1,428.68
|
|
CT angio pelvis
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,150.00 |
$2,150.00 |
$2,150.00 |
$1,691.30
|
|
CT guidance for needle placement
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$580.00 |
$580.00 |
$580.00 |
$1,215.06
|
|
CT guid parench tis ablat
|
$945.00 |
$945.00 |
$945.00 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$280.00 |
$280.00 |
$280.00 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$1,395.79
|
|
CT hrt w/3d image
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$605.00 |
$605.00 |
$605.00 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$1,818.96
|
|
CT scan for localization
|
$1,340.00 |
$1,340.00 |
$1,340.00 |
$1,216.80
|
|
CT scan for therapy guide
|
$960.00 |
$960.00 |
$960.00 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,580.00 |
$3,580.00 |
$3,580.00 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,455.00 |
$2,455.00 |
$2,455.00 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,245.00 |
$2,245.00 |
$2,245.00 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,240.00 |
$2,240.00 |
$2,240.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$40.00 |
$40.00 |
$40.00 |
$72.00
|
|
Culture afb any source
|
$107.50 |
$107.50 |
$107.50 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$45.00 |
$45.00 |
$45.00 |
$84.76
|
|
Culture anaerobic except blood
|
$120.00 |
$120.00 |
$120.00 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$52.50 |
$52.50 |
$52.50 |
$52.50
|
|
Culture body fluid
|
$90.00 |
$90.00 |
$90.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$70.00 |
$70.00 |
$70.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$62.50 |
$62.50 |
$62.50 |
$80.00
|
|
Culture fungi other (except blood)
|
$67.50 |
$67.50 |
$67.50 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$92.50 |
$92.50 |
$92.50 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$72.50 |
$72.50 |
$72.50 |
$100.00
|
|
Culture quantitative aerobic other source
|
$97.50 |
$97.50 |
$97.50 |
$87.02
|
|
Culture screening strep group a
|
$142.50 |
$142.50 |
$142.50 |
$84.60
|
|
Culture type pulse field gel
|
$120.00 |
$120.00 |
$120.00 |
$38.58
|
|
Culture typing immunologic
|
$45.00 |
$45.00 |
$45.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$257.50 |
$257.50 |
$257.50 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$187.50 |
$187.50 |
$187.50 |
$140.80
|
|
Culture urine each isolate
|
$47.50 |
$47.50 |
$47.50 |
$55.50
|
|
Cutter lead
|
$1,235.48 |
$1,235.48 |
$1,235.48 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$112.50 |
$112.50 |
$112.50 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$72.50 |
$72.50 |
$72.50 |
$72.36
|
|
Cyclosporine 2 hour
|
$115.00 |
$115.00 |
$115.00 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$28,187.05 |
$28,187.05 |
$28,187.05 |
$24,728.89
|
|
Cystatin c
|
$82.50 |
$82.50 |
$82.50 |
$77.60
|
|
Cystic fibrosis cftr
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,104.40
|
|
Cystine urine quantitative
|
$112.50 |
$112.50 |
$112.50 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$675.00 |
$675.00 |
$675.00 |
$586.95
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$3,245.90
|
|
Cytogenetics 25-99
|
$190.00 |
$190.00 |
$190.00 |
$189.80
|
|
Cytogenetics 3-5
|
$1,105.00 |
$1,105.00 |
$1,105.00 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$85.00 |
$85.00 |
$85.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$95.00 |
$95.00 |
$95.00 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$192.50 |
$192.50 |
$192.50 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$137.50 |
$137.50 |
$137.50 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$110.00 |
$110.00 |
$110.00 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$177.50 |
$177.50 |
$177.50 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$132.50 |
$132.50 |
$132.50 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$147.50 |
$147.50 |
$147.50 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$295.00 |
$295.00 |
$295.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$205.00 |
$205.00 |
$205.00 |
$213.85
|
|
Cytopath smear other source
|
$97.50 |
$97.50 |
$97.50 |
$92.50
|
|
Cytopath smear other source
|
$140.00 |
$140.00 |
$140.00 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$95.00 |
$95.00 |
$95.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$62.50 |
$62.50 |
$62.50 |
$59.28
|
|
Cytp urine 3-5 probes cmptr
|
$855.00 |
$855.00 |
$855.00 |
$664.80
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.26 |
$0.26 |
$0.26 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$135.18 |
$135.18 |
$135.18 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$18.38 |
$18.38 |
$18.38 |
$6,281.29
|
|
Dch validity tests
|
$25.00 |
$25.00 |
$25.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$72.50 |
$72.50 |
$72.50 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$230.00 |
$230.00 |
$230.00 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$2,030.00 |
$2,030.00 |
$2,030.00 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$580.00 |
$580.00 |
$580.00 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,015.00 |
$1,015.00 |
$1,015.00 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$665.00 |
$665.00 |
$665.00 |
$835.20
|
|
Debride nail1-5 11720
|
$90.00 |
$90.00 |
$90.00 |
$149.60
|
|
Debride nail6 or more 11721
|
$105.00 |
$105.00 |
$105.00 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$332.50 |
$332.50 |
$332.50 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,160.00 |
$1,160.00 |
$1,160.00 |
$1,165.50
|
|
Decalcification
|
$67.50 |
$67.50 |
$67.50 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$472.50 |
$472.50 |
$472.50 |
$572.95
|
|
Decomp fasct leg ant+/lat+pst cmprt 27602
|
$3,890.00 |
$3,890.00 |
$3,890.00 |
$4,914.00
|
|
Decompression of lower leg
|
$3,885.00 |
$3,885.00 |
$3,885.00 |
$3,969.00
|
|
Delivery of placenta 59414
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$2,912.46
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$2,705.00 |
$2,705.00 |
$2,705.00 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$127.50 |
$127.50 |
$127.50 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$73.59 |
$73.59 |
$73.59 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$150.00 |
$150.00 |
$150.00 |
$401.60
|
|
Descend thora aorta rpr/lt sub art 33880
|
$2,395.00 |
$2,395.00 |
$2,395.00 |
$6,288.45
|
|
Description not available
|
$41.09 |
$41.09 |
$41.09 |
$19.50
|
|
Des thora aorta rpr without left sub art 33881
|
$2,395.00 |
$2,395.00 |
$2,395.00 |
$5,267.20
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$2,395.00 |
$2,395.00 |
$2,395.00 |
$3,273.55
|
|
Destroy cervthor facet jnt 64633
|
$2,720.00 |
$2,720.00 |
$2,720.00 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$1,652.35
|
