|
Complement antigen each component c3
|
$423.50 |
$423.50 |
$423.50 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,581.30 |
$1,581.30 |
$1,581.30 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,575.70 |
$1,575.70 |
$1,575.70 |
$1,049.60
|
|
Complx repair fccmnaxghf 13133
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$493.50
|
|
Comprehensive hearing test
|
$256.90 |
$256.90 |
$256.90 |
$260.40
|
|
Computed tomographic angiography head and neck with contrast
|
$7,464.10 |
$7,464.10 |
$7,464.10 |
$2,237.25
|
|
Concentration infection agents any type
|
$46.20 |
$46.20 |
$46.20 |
$51.32
|
|
Consultation pathology during surgery cytological exam initial site
|
$618.80 |
$618.80 |
$618.80 |
$407.20
|
|
Consultation/report referred material w/preparation of slides
|
$226.10 |
$226.10 |
$226.10 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$456.40 |
$456.40 |
$456.40 |
$176.15
|
|
Consult comp w/report rfrd material
|
$312.20 |
$312.20 |
$312.20 |
$375.00
|
|
Contrast exam abdominl aorta 75625-26
|
$4,842.60 |
$4,842.60 |
$4,842.60 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$3,616.90 |
$3,616.90 |
$3,616.90 |
$3,570.00
|
|
Contrast exam thoracic aorta 75605-26
|
$6,809.60 |
$6,809.60 |
$6,809.60 |
$3,663.60
|
|
Contrast x-ray of ankle
|
$1,136.80 |
$1,136.80 |
$1,136.80 |
$676.80
|
|
Contrast x-ray of elbow
|
$765.80 |
$765.80 |
$765.80 |
$686.95
|
|
Contrast x-ray of hip
|
$1,407.70 |
$1,407.70 |
$1,407.70 |
$781.13
|
|
Contrast x-ray of knee joint
|
$2,560.60 |
$2,560.60 |
$2,560.60 |
$777.00
|
|
Contrast x-ray of wrist
|
$1,440.60 |
$1,440.60 |
$1,440.60 |
$655.00
|
|
Control oropharyngeal hemorr/simp 42960
|
$3,236.10 |
$3,236.10 |
$3,236.10 |
$618.80
|
|
Convert nephrostomy catheter
|
$4,249.00 |
$4,249.00 |
$4,249.00 |
$2,777.60
|
|
Coombs direct
|
$94.50 |
$94.50 |
$94.50 |
$76.44
|
|
Coombs indirect titer reference
|
$153.30 |
$153.30 |
$153.30 |
$155.40
|
|
Copper cu 64 dotatate diag
|
$3,836.00 |
$3,836.00 |
$3,836.00 |
$2,293.68
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$14,802.20 |
$14,802.20 |
$14,802.20 |
$7,950.49
|
|
Cortisol total am
|
$135.10 |
$135.10 |
$135.10 |
$121.20
|
|
Co-treatment - group 15 mins, st
|
$156.10 |
$156.10 |
$156.10 |
$114.00
|
|
Coveredge 32 lead kit 40cm 48
|
$3,141.60 |
$3,141.60 |
$3,141.60 |
$4,395.30
|
|
Cover eye w/membrane
|
$3,536.40 |
$3,536.40 |
$3,536.40 |
$2,550.48
|
|
Covid-19 administration immunization im inj 1st/only component
|
$61.60 |
$61.60 |
$61.60 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$588.08
|
|
#covid19rsv-rsv
|
$156.10 |
$156.10 |
$156.10 |
$145.60
|
|
#coxa-coxsackie a serotype a16
|
$79.10 |
$79.10 |
$79.10 |
$60.00
|
|
C-peptide
|
$108.50 |
$108.50 |
$108.50 |
$93.60
|
|
C-reactive protein
|
$92.40 |
$92.40 |
$92.40 |
$68.38
|
|
C-reactive protein high sensitivity
|
$92.40 |
$92.40 |
$92.40 |
$85.00
|
|
C-reactive protein, quantitative
|
$254.10 |
$254.10 |
$254.10 |
$62.50
|
|
Creatine kinase
|
$25.20 |
$25.20 |
$25.20 |
$65.60
|
|
Creatine kinase mb
|
$123.90 |
$123.90 |
$123.90 |
$113.63
|
|
Creatine - sendout
|
$37.10 |
$37.10 |
$37.10 |
$39.29
|
|
Creatinine
|
$55.30 |
$55.30 |
$55.30 |
$45.65
|
|
Creatinine 24 hour urine
|
$69.30 |
$69.30 |
$69.30 |
$57.60
|
|
Creatinine clearance urine
|
$94.50 |
$94.50 |
$94.50 |
$89.28
|
|
#creutz-prot.,western blot
|
$859.60 |
$859.60 |
$859.60 |
$163.50
|
|
Cryofibrinogen qualitative - sendout
|
$40.60 |
$40.60 |
$40.60 |
$52.50
|
|
Cryoprecipitate each unit
|
$338.80 |
$338.80 |
$338.80 |
$144.78
|
|
Cryptococcus abs qn - sendout
|
$73.50 |
$73.50 |
$73.50 |
$89.70
|
|
Crystal identification light microscopy
|
$81.90 |
$81.90 |
$81.90 |
$65.50
|
|
Csf leakage imaging
|
$4,918.90 |
$4,918.90 |
$4,918.90 |
$1,564.11
|
|
Cstb gene full gene sequence
|
$634.20 |
$634.20 |
$634.20 |
$302.31
|
|
CT 3d report other modality w/workstation
|
$791.00 |
$791.00 |
$791.00 |
$637.41
|
|
Cta abdomen without & /or w/contrast
|
$4,312.70 |
$4,312.70 |
$4,312.70 |
$2,002.00
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$3,889.90 |
$3,889.90 |
$3,889.90 |
$1,916.50
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,359.30 |
$3,359.30 |
$3,359.30 |
$2,002.44
|
|
Cta neck without &/or w/contrast
|
$3,808.00 |
$3,808.00 |
$3,808.00 |
$1,899.75
|
|
CT Angiogram of Abdomen and Pelvis
|
$5,420.10 |
$5,420.10 |
$5,420.10 |
$2,842.40
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,502.80 |
$3,502.80 |
$3,502.80 |
$1,912.50
|
|
CT Angiogram of the Head
|
$3,656.10 |
$3,656.10 |
$3,656.10 |
$1,946.10
|
|
CT angio hrt w/3d image
|
$3,641.40 |
$3,641.40 |
$3,641.40 |
$1,424.40
|
|
CT angio pelvis
|
$3,382.40 |
$3,382.40 |
$3,382.40 |
$1,795.97
|
|
Cta upper extremity w &/or without contrast left
|
$3,026.10 |
$3,026.10 |
$3,026.10 |
$1,681.50
|
|
CT cerebral perf w cont & prcssng
|
$2,937.20 |
$2,937.20 |
$2,937.20 |
$1,040.00
|
|
CT guidance for needle placement
|
$2,842.00 |
$2,842.00 |
$2,842.00 |
$1,498.20
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,484.70 |
$1,484.70 |
$1,484.70 |
$1,178.52
|
|
CT guid cryo ablat intramuscular
|
$7,770.70 |
$7,770.70 |
$7,770.70 |
$1,643.20
|
|
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
|
$78.40 |
$78.40 |
$78.40 |
$71.40
|
|
Culture afb any source
|
$141.40 |
$141.40 |
$141.40 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$88.20 |
$88.20 |
$88.20 |
$84.76
|
|
Culture anaerobic except blood
|
$146.30 |
$146.30 |
$146.30 |
$120.54
|
|
Culture bact stool aero addl path ea
|
$63.70 |
$63.70 |
$63.70 |
$52.50
|
|
Culture body fluid
|
$132.30 |
$132.30 |
$132.30 |
$126.00
|
|
Culture fungi definitive id mold
|
$84.00 |
$84.00 |
$84.00 |
$80.00
|
