|
C-section delivery incl p/p care 59515
|
$2,577.60 |
$2,577.60 |
$2,577.60 |
$2,884.20
|
|
Csf shunt reprogram 62252
|
$167.40 |
$167.40 |
$167.40 |
$535.00
|
|
CT 3d report other modality w/workstation
|
$327.00 |
$327.00 |
$327.00 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,868.00 |
$2,868.00 |
$2,868.00 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,978.20 |
$1,978.20 |
$1,978.20 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$1,745.40 |
$1,745.40 |
$1,745.40 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$1,914.00 |
$1,914.00 |
$1,914.00 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,627.20 |
$1,627.20 |
$1,627.20 |
$1,915.30
|
|
CT Angiogram of the Head
|
$1,656.60 |
$1,656.60 |
$1,656.60 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$1,656.60 |
$1,656.60 |
$1,656.60 |
$1,881.75
|
|
CT angio pelvis
|
$1,837.80 |
$1,837.80 |
$1,837.80 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,147.40 |
$2,147.40 |
$2,147.40 |
$1,691.30
|
|
CT guidance for needle placement
|
$1,158.60 |
$1,158.60 |
$1,158.60 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$157.80 |
$157.80 |
$157.80 |
$2,039.76
|
|
CT limited or localized follow-up study
|
$483.00 |
$483.00 |
$483.00 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$1,963.20 |
$1,963.20 |
$1,963.20 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$543.00 |
$543.00 |
$543.00 |
$422.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,022.80 |
$3,022.80 |
$3,022.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,676.00 |
$2,676.00 |
$2,676.00 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,240.40 |
$2,240.40 |
$2,240.40 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$1,612.20 |
$1,612.20 |
$1,612.20 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$1,672.20 |
$1,672.20 |
$1,672.20 |
$1,845.36
|
|
Cult skin graft fnhfg 15155
|
$1,345.80 |
$1,345.80 |
$1,345.80 |
$4,052.18
|
|
Culture aerobic additional method definitive id each
|
$31.20 |
$31.20 |
$31.20 |
$72.00
|
|
Culture afb any source
|
$106.20 |
$106.20 |
$106.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$54.60 |
$54.60 |
$54.60 |
$84.76
|
|
Culture anaerobic except blood
|
$85.20 |
$85.20 |
$85.20 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$36.60 |
$36.60 |
$36.60 |
$52.50
|
|
Culture body fluid
|
$67.20 |
$67.20 |
$67.20 |
$126.75
|
|
Culture fungi definitive id mold
|
$45.60 |
$45.60 |
$45.60 |
$80.00
|
|
Culture fungi definitive id yeast
|
$90.60 |
$90.60 |
$90.60 |
$80.00
|
|
Culture fungi other (except blood)
|
$105.60 |
$105.60 |
$105.60 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$99.60 |
$99.60 |
$99.60 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$130.20 |
$130.20 |
$130.20 |
$100.00
|
|
Culture mycoplasma any source
|
$112.20 |
$112.20 |
$112.20 |
$83.21
|
|
Culture screening strep group a
|
$54.60 |
$54.60 |
$54.60 |
$84.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$550.20 |
$550.20 |
$550.20 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$100.20 |
$100.20 |
$100.20 |
$140.80
|
|
Culture urine each isolate
|
$46.20 |
$46.20 |
$46.20 |
$55.50
|
|
Culture virus isolation
|
$246.60 |
$246.60 |
$246.60 |
$162.00
|
|
Cutter lead
|
$1,421.40 |
$1,421.40 |
$1,421.40 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,078.80 |
$1,078.80 |
$1,078.80 |
$1,681.20
|
|
Cv stress test i&r only 93018
|
$42.00 |
$42.00 |
$42.00 |
$36.40
|
|
Cv stress test/supervision only 93016
|
$51.00 |
$51.00 |
$51.00 |
$51.20
|
|
Cyanocobalamin unsat binding capacity
|
$67.20 |
$67.20 |
$67.20 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$25.32 |
$25.32 |
$25.32 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$60.60 |
$60.60 |
$60.60 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,636.21 |
$2,636.21 |
$2,636.21 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$66.76 |
$66.76 |
$66.76 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$136.01 |
$136.01 |
$136.01 |
$140.78
|
|
Cyclosporine 2 hour
|
$204.00 |
$204.00 |
$204.00 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$9.62 |
$9.62 |
$9.62 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$1,489.72 |
$1,489.72 |
$1,489.72 |
$37.31
|
|
Cygnus matrix, per sq cm
|
$1,252.80 |
$1,252.80 |
$1,252.80 |
$295.20
|
|
Cystatin c
|
$118.80 |
$118.80 |
$118.80 |
$77.60
|
|
Cystic fibrosis cftr
|
$1,788.60 |
$1,788.60 |
$1,788.60 |
$1,104.40
|
|
Cystine urine quantitative
|
$271.80 |
$271.80 |
$271.80 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$318.60 |
$318.60 |
$318.60 |
$586.95
|
|
Cystometrogram w/up 51727
|
$600.60 |
$600.60 |
$600.60 |
$908.59
|
|
Cystorrhaphy wound comp 51865
|
$1,756.80 |
$1,756.80 |
$1,756.80 |
$1,756.80
|
|
Cystorrhaphy wound simple 51860
|
$1,453.80 |
$1,453.80 |
$1,453.80 |
$6,297.20
|
|
Cystoscopy and treatment
|
$1,108.80 |
$1,108.80 |
$1,108.80 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$398.40 |
$398.40 |
$398.40 |
$1,493.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$696.60 |
$696.60 |
$696.60 |
$4,129.45
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$922.80 |
$922.80 |
$922.80 |
$4,081.37
|
|
Cystotomy excise/incise/repair 51535
|
$1,532.40 |
$1,532.40 |
$1,532.40 |
$4,081.37
|
|
Cystourethroscop/calib/dilat stric 52281
|
$543.60 |
$543.60 |
$543.60 |
$3,245.90
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$751.80 |
$751.80 |
$751.80 |
$4,057.50
|
|
Cystourethro w/addl implant 52442
|
$129.60 |
$129.60 |
$129.60 |
$2,161.60
|
|
Cystourethro w/implant
|
$482.40 |
$482.40 |
$482.40 |
$2,777.60
|
|
Cytarabine 20 mg/ml injection solution
|
$92.04 |
$92.04 |
$92.04 |
$90.00
|
|
Cytogenomic neo microra alys
|
$3,098.40 |
$3,098.40 |
$3,098.40 |
$2,198.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$51.60 |
$51.60 |
$51.60 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$62.40 |
$62.40 |
$62.40 |
$100.00
|
|
Cytopath fl nongyn filter
|
$27.00 |
$27.00 |
$27.00 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$211.20 |
$211.20 |
$211.20 |
$159.90
|
|
Cytopathology concentration technique smears & interpretation
|
$63.00 |
$63.00 |
$63.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$66.00 |
$66.00 |
$66.00 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$100.80 |
$100.80 |
$100.80 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$169.80 |
$169.80 |
$169.80 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$134.40 |
$134.40 |
$134.40 |
$213.85
|
|
Cytopath smear other source
|
$79.80 |
$79.80 |
$79.80 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$80.40 |
$80.40 |
$80.40 |
$96.20
|
|
Cytopath tbs c/v manual
|
$40.20 |
$40.20 |
$40.20 |
$59.28
|
|
Dacarbazine 100 mg intravenous solution
|
$82.33 |
$82.33 |
$82.33 |
$62.41
|
|
Dalbavancin 500 mg intravenous solution
|
$3,180.80 |
$3,180.80 |
$3,180.80 |
$3,493.11
|
|
Dalteparin sodium
|
$41.88 |
$41.88 |
$41.88 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$801.47 |
$801.47 |
$801.47 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$18,766.29 |
$18,766.29 |
$18,766.29 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$6,866.96 |
$6,866.96 |
$6,866.96 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$6,866.96 |
$6,866.96 |
$6,866.96 |
$7.20
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$292.03 |
$292.03 |
$292.03 |
$259.58
|
|
D&c after delivery 59160
|
$424.20 |
$424.20 |
$424.20 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$639.60 |
$639.60 |
$639.60 |
$3,774.81
|
|
Dch glucoscan
|
$32.40 |
$32.40 |
$32.40 |
$29.16
|
|
Dch pulmonary stress test
|
$472.80 |
$472.80 |
$472.80 |
$963.30
|
|
Dch validity tests
|
$15.60 |
$15.60 |
$15.60 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,724.40 |
$1,724.40 |
$1,724.40 |
$5,121.00
|
|
Deamidated gliadin antibody iga
|
$31.20 |
$31.20 |
$31.20 |
$43.35
|