|
Cta lower extremity without & w/contrast (both sides)
|
$4,152.00 |
$4,152.00 |
$4,152.00 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,892.00 |
$2,892.00 |
$2,892.00 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,521.40 |
$3,521.40 |
$3,521.40 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,910.00 |
$2,910.00 |
$2,910.00 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$2,074.80 |
$2,074.80 |
$2,074.80 |
$1,500.38
|
|
CT angio pelvis
|
$2,437.20 |
$2,437.20 |
$2,437.20 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$3,740.40 |
$3,740.40 |
$3,740.40 |
$1,698.00
|
|
CT bone density axial
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$387.62
|
|
CT cerebral perf w cont & prcssng
|
$1,713.00 |
$1,713.00 |
$1,713.00 |
$803.40
|
|
CT colonography dx
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$791.00
|
|
CT colonography dx w/dye
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,037.00
|
|
CT colonography screening
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,178.52
|
|
CT guid cryo ablat intramuscular
|
$3,795.00 |
$3,795.00 |
$3,795.00 |
$1,643.20
|
|
CT guid parench tis ablat
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$117.00 |
$117.00 |
$117.00 |
$171.60
|
|
CT hrt c+ strux cgen hrt ds
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,371.50
|
|
CT hrt w/3d image
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$3,148.20 |
$3,148.20 |
$3,148.20 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$2,822.40 |
$2,822.40 |
$2,822.40 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$4,007.40 |
$4,007.40 |
$4,007.40 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$2,248.80 |
$2,248.80 |
$2,248.80 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,956.60 |
$1,956.60 |
$1,956.60 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,752.80 |
$2,752.80 |
$2,752.80 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,298.00 |
$2,298.00 |
$2,298.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$2,218.20 |
$2,218.20 |
$2,218.20 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$2,187.60 |
$2,187.60 |
$2,187.60 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$592.80 |
$592.80 |
$592.80 |
$437.04
|
|
CT scan for localization
|
$1,881.00 |
$1,881.00 |
$1,881.00 |
$1,205.14
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,355.80 |
$3,355.80 |
$3,355.80 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,136.20 |
$3,136.20 |
$3,136.20 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,695.20 |
$2,695.20 |
$2,695.20 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$2,297.40 |
$2,297.40 |
$2,297.40 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$2,023.80 |
$2,023.80 |
$2,023.80 |
$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
|
$2,644.20 |
$2,644.20 |
$2,644.20 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$3,725.40 |
$3,725.40 |
$3,725.40 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$3,383.40 |
$3,383.40 |
$3,383.40 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$3,526.20 |
$3,526.20 |
$3,526.20 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$74.40 |
$74.40 |
$74.40 |
$68.64
|
|
Culture afb any source
|
$273.00 |
$273.00 |
$273.00 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$176.40 |
$176.40 |
$176.40 |
$79.00
|
|
Culture anaerobic except blood
|
$244.80 |
$244.80 |
$244.80 |
$120.00
|
|
Culture bacteria anaerobic
|
$244.80 |
$244.80 |
$244.80 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$99.00 |
$99.00 |
$99.00 |
$51.45
|
|
Culture body fluid
|
$238.20 |
$238.20 |
$238.20 |
$126.75
|
|
Culture fungi definitive id mold
|
$132.00 |
$132.00 |
$132.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$130.80 |
$130.80 |
$130.80 |
$79.10
|
|
Culture fungi other (except blood)
|
$207.60 |
$207.60 |
$207.60 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$204.60 |
$204.60 |
$204.60 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$282.00 |
$282.00 |
$282.00 |
$89.70
|
|
Culture quantitative aerobic other source
|
$244.80 |
$244.80 |
$244.80 |
$90.35
|
|
Culture screening strep group a
|
$117.60 |
$117.60 |
$117.60 |
$81.00
|
|
Culture type pulse field gel
|
$374.40 |
$374.40 |
$374.40 |
$38.58
|
|
Culture typing immunologic
|
$73.80 |
$73.80 |
$73.80 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$650.40 |
$650.40 |
$650.40 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$496.80 |
$496.80 |
$496.80 |
$133.90
|
|
Culture urine each isolate
|
$118.80 |
$118.80 |
$118.80 |
$57.00
|
|
Cv line/pic reposition
|
$2,747.40 |
$2,747.40 |
$2,747.40 |
$1,720.93
|
|
Cyclic citrullinated peptide antibody
|
$151.20 |
$151.20 |
$151.20 |
$70.72
|
|
Cyclosporine 2 hour
|
$391.80 |
$391.80 |
$391.80 |
$129.48
|
|
Cyp2c19 gene com variants
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$504.00
|
|
Cyp2d6 gene com variants
|
$2,413.80 |
$2,413.80 |
$2,413.80 |
$554.00
|
|
Cystatin c
|
$109.20 |
$109.20 |
$109.20 |
$77.50
|
|
Cystic fibrosis cftr
|
$3,065.40 |
$3,065.40 |
$3,065.40 |
$1,100.00
|
|
Cystine urine quantitative
|
$858.60 |
$858.60 |
$858.60 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$786.60 |
$786.60 |
$786.60 |
$542.10
|
|
Cystometrogram w/up 51727
|
$1,284.00 |
$1,284.00 |
$1,284.00 |
$908.59
|
|
Cystoscopy and treatment
|
$4,543.80 |
$4,543.80 |
$4,543.80 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$3,038.40 |
$3,038.40 |
$3,038.40 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$2,704.80 |
$2,704.80 |
$2,704.80 |
$2,704.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,983.80 |
$2,983.80 |
$2,983.80 |
$3,065.15
|
|
Cytogenetics 25-99
|
$850.80 |
$850.80 |
$850.80 |
$190.00
|
|
Cytogenetics 3-5
|
$327.60 |
$327.60 |
$327.60 |
$170.27
|
|
Cytogenomic neo microra alys
|
$5,365.20 |
$5,365.20 |
$5,365.20 |
$2,020.20
|
|
Cytogenom microarray copy nmbr var
|
$5,398.80 |
$5,398.80 |
$5,398.80 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$195.00 |
$195.00 |
$195.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$205.80 |
$205.80 |
$205.80 |
$97.50
|
|
Cyto/molecular report
|
$202.80 |
$202.80 |
$202.80 |
$133.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$293.40 |
$293.40 |
$293.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$238.20 |
$238.20 |
$238.20 |
$91.84
|
|
Cytopathology concentration technique smears & interpretation
|
$231.60 |
$231.60 |
$231.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$215.40 |
$215.40 |
$215.40 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$135.00 |
$135.00 |
$135.00 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$265.80 |
$265.80 |
$265.80 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$589.80 |
$589.80 |
$589.80 |
$209.23
|
|
Cytopath smear other source
|
$255.00 |
$255.00 |
$255.00 |
$88.13
|
|
Cytopath smear other source
|
$127.20 |
$127.20 |
$127.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$194.40 |
$194.40 |
$194.40 |
$96.20
|
|
Cytopath tbs c/v manual
|
$97.20 |
$97.20 |
$97.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$837.60 |
$837.60 |
$837.60 |
$133.25
|
|
Dch pulmonary stress test
|
$1,479.60 |
$1,479.60 |
$1,479.60 |
$963.30
|
|
Dch validity tests
|
$46.80 |
$46.80 |
$46.80 |
$24.50
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$8,896.20 |
$8,896.20 |
$8,896.20 |
$4,952.36
|
|
Dcmprn plantar digital nerve
|
$477.60 |
$477.60 |
$477.60 |
$2,375.24
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$385.80 |
$385.80 |
$385.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$358.20 |
$358.20 |
$358.20 |
$260.61
|
