|
Blood occult fecal hemoglobin immunoassay qualitative 1-3 simultaneous determinations diagnostic
|
$64.80 |
$64.80 |
$64.80 |
$57.60
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$14.40 |
$14.40 |
$14.40 |
$32.50
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$14.40 |
$14.40 |
$14.40 |
$32.50
|
|
Blood occult peroxidase activity qualitative gastric
|
$19.20 |
$19.20 |
$19.20 |
$31.20
|
|
Blood smear microscopic w manual differential wbc count
|
$40.20 |
$40.20 |
$40.20 |
$34.40
|
|
Blood typing abo
|
$125.40 |
$125.40 |
$125.40 |
$71.40
|
|
Blood typing rbc ag non abo/rh ea
|
$124.20 |
$124.20 |
$124.20 |
$156.21
|
|
Blood typing rh (d)
|
$75.00 |
$75.00 |
$75.00 |
$52.73
|
|
Bone survey-lead poisoning
|
$281.40 |
$281.40 |
$281.40 |
$343.33
|
|
Boot j walker l
|
$249.00 |
$249.00 |
$249.00 |
$301.60
|
|
Boot softgait shrt m
|
$178.80 |
$178.80 |
$178.80 |
$113.72
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$175.20 |
$175.20 |
$175.20 |
$105.90
|
|
Brace wrist classic lft sm
|
$36.00 |
$36.00 |
$36.00 |
$92.25
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$2,477.80
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$1,795.95
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$1,741.80
|
|
Brain MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,659.03
|
|
Brain MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,110.55
|
|
Brain MRI (without contrast)
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$1,765.28
|
|
Bundled special stain group 2
|
$228.00 |
$228.00 |
$228.00 |
$169.60
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$39.23 |
$39.23 |
$39.23 |
$15.11
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$12.17 |
$12.17 |
$12.17 |
$12.17
|
|
Buprenorphine oral 1mg
|
$11.24 |
$11.24 |
$11.24 |
$11.24
|
|
Butorphanol tartrate 1 mg
|
$42.76 |
$42.76 |
$42.76 |
$42.76
|
|
Calcium 24 hour urine
|
$79.20 |
$79.20 |
$79.20 |
$51.63
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$83.14 |
$83.14 |
$83.14 |
$50.14
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$62.87 |
$62.87 |
$62.87 |
$62.87
|
|
Calcium ionized
|
$189.00 |
$189.00 |
$189.00 |
$80.80
|
|
Calcium total
|
$32.40 |
$32.40 |
$32.40 |
$43.20
|
|
Calculus analysis qual
|
$88.80 |
$88.80 |
$88.80 |
$88.80
|
|
Calprotectin fecal
|
$256.20 |
$256.20 |
$256.20 |
$170.00
|
|
Candida dna
|
$75.00 |
$75.00 |
$75.00 |
$66.05
|
|
Carbamazepine total therapeutic drug level
|
$145.20 |
$145.20 |
$145.20 |
$108.81
|
|
Carbon dioxide
|
$21.60 |
$21.60 |
$21.60 |
$42.00
|
|
Carboxyhemoglobin quantitative
|
$132.00 |
$132.00 |
$132.00 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$150.00 |
$150.00 |
$150.00 |
$125.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$3,981.00 |
$3,981.00 |
$3,981.00 |
$2,538.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$286.80 |
$286.80 |
$286.80 |
$258.10
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$252.00 |
$252.00 |
$252.00 |
$208.00
|
|
Cardiolipin antibody iga
|
$338.40 |
$338.40 |
$338.40 |
$126.14
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$1,825.20 |
$1,825.20 |
$1,825.20 |
$1,461.75
|
|
Carotene
|
$78.60 |
$78.60 |
$78.60 |
$66.00
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$1,037.60
|
|
Catheterization collection of specimen single patient all places of service
|
$84.00 |
$84.00 |
$84.00 |
$58.50
|
|
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr
|
$63.49 |
$63.49 |
$63.49 |
$27.86
|
|
Cefepime 1 gram solution for injection
|
$322.05 |
$322.05 |
$322.05 |
$39.95
|
|
Cefoxitin 1 gram intravenous solution
|
$67.42 |
$67.42 |
$67.42 |
$42.00
|
|
Ceftaroline fosamil 600 mg intravenous solution
|
$660.79 |
$660.79 |
$660.79 |
$660.79
|
|
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr
|
$41.97 |
$41.97 |
$41.97 |
$46.57
|
|
Ceftazidime and avibactam
|
$662.30 |
$662.30 |
$662.30 |
$824.61
|
|
Ceftriaxone 1 gram solution for injection
|
$50.18 |
$50.18 |
$50.18 |
$51.80
|
|
Cell count w differential body fluid
|
$94.80 |
$94.80 |
$94.80 |
$83.71
|
|
Chest apical lordotic proj
|
$310.80 |
$310.80 |
$310.80 |
$274.10
|
|
Chest CT scan (with and without contrast)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,918.02
|
|
Chest CT scan (with contrast)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,608.98
|
|
Chest CT scan (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,166.90
|
|
Chest X-ray
|
$281.40 |
$281.40 |
$281.40 |
$265.85
|
|
Chest X-ray (single view)
|
$251.40 |
$251.40 |
$251.40 |
$192.50
|
|
Chg pr pul rehab for copd patients
|
$286.80 |
$286.80 |
$286.80 |
$150.40
|
|
Chloride
|
$67.80 |
$67.80 |
$67.80 |
$37.48
|
|
Chloride 24 hour urine
|
$53.40 |
$53.40 |
$53.40 |
$40.80
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$53.03 |
$53.03 |
$53.03 |
$53.03
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$739.80 |
$739.80 |
$739.80 |
$546.01
|
|
Cholesterol
|
$39.00 |
$39.00 |
$39.00 |
$40.95
|
|
Cholesterol body fluid
|
$66.60 |
$66.60 |
$66.60 |
$67.50
|
|
Cholesterol (Lipid) Test
|
$65.40 |
$65.40 |
$65.40 |
$101.43
|
|
Chromatography
|
$115.20 |
$115.20 |
$115.20 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$648.60 |
$648.60 |
$648.60 |
$558.25
|
|
Chromosome karyotype study
|
$123.60 |
$123.60 |
$123.60 |
$120.60
|
|
Cilastatin sodium injection
|
$119.35 |
$119.35 |
$119.35 |
$43.44
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$62.97 |
$62.97 |
$62.97 |
$35.00
|
|
Clearance of airways
|
$82.20 |
$82.20 |
$82.20 |
$208.00
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$66.73 |
$66.73 |
$66.73 |
$49.74
|
|
#cmvcul-virus inoculation shell
|
$141.00 |
$141.00 |
$141.00 |
$109.80
|
|
Cmv pcr-sendout
|
$381.00 |
$381.00 |
$381.00 |
$177.50
|
|
Collar cerv ascend 172 reg
|
$316.80 |
$316.80 |
$316.80 |
$151.05
|
|
Collection blood specimen from completely implantable venous access device
|
$159.60 |
$159.60 |
$159.60 |
$155.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$183.00 |
$183.00 |
$183.00 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$22.20 |
$22.20 |
$22.20 |
$20.30
|
|
Compatibility test each unit antiglobulin technique
|
$70.20 |
$70.20 |
$70.20 |
$156.60
|
|
Compatibility test each unit electronic
|
$138.00 |
$138.00 |
$138.00 |
$156.24
|
|
Compatibility test each unit immediate spin technique
|
$139.80 |
$139.80 |
$139.80 |
$156.24
|
|
Complement antigen each component c3
|
$172.80 |
$172.80 |
$172.80 |
$110.00
|
|
Concentration infection agents any type
|
$54.60 |
$54.60 |
$54.60 |
$48.00
|
|
Coombs direct
|
$82.80 |
$82.80 |
$82.80 |
$70.74
|
|
Cortisol acth stimulation test - sendout
|
$95.40 |
$95.40 |
$95.40 |
$143.40
|
|
Cortisol total am
|
$69.00 |
$69.00 |
$69.00 |
$117.81
|
|
Counseling smoke cess interm >10mins
|
$120.60 |
$120.60 |
$120.60 |
$57.85
|
|
Covid-19 administration immunization im inj 1st/only component
|
$72.00 |
$72.00 |
$72.00 |
$64.50
|
|
#covid19rsv-rsv
|
$171.00 |
$171.00 |
$171.00 |
$140.80
|
|
#coxa-coxsackie a serotype a16
|
$43.80 |
$43.80 |
$43.80 |
$65.36
|
|
C-peptide
|
$243.60 |
$243.60 |
$243.60 |
$111.20
|
|
C-reactive protein
|
$56.40 |
$56.40 |
$56.40 |
$54.43
|
|
C-reactive protein high sensitivity
|
$87.00 |
$87.00 |
$87.00 |
$91.65
|
|
Creatine kinase
|
$33.00 |
$33.00 |
$33.00 |
$55.00
|
|
Creatine kinase isoenzymes
|
$209.40 |
$209.40 |
$209.40 |
$66.00
|
|
Creatine kinase mb
|
$155.40 |
$155.40 |
$155.40 |
$100.75
|
|
Creatine - sendout
|
$41.40 |
$41.40 |
$41.40 |
$35.10
|
|
Creatinine
|
$21.00 |
$21.00 |
$21.00 |
$40.00
|
|
Creatinine 24 hour urine
|
$27.60 |
$27.60 |
$27.60 |
$54.40
|
