|
Creatinine clearance urine
|
$19.80 |
$19.80 |
$19.80 |
$73.86
|
|
#creutz-prot.,western blot
|
$52.80 |
$52.80 |
$52.80 |
$178.10
|
|
Critical care 30-74 minutes
|
$2,794.80 |
$2,794.80 |
$2,794.80 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$807.60 |
$807.60 |
$807.60 |
$663.00
|
|
Cryptosporidium antigen
|
$96.00 |
$96.00 |
$96.00 |
$65.55
|
|
Crystal identification light microscopy
|
$52.80 |
$52.80 |
$52.80 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,745.40 |
$1,745.40 |
$1,745.40 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,728.80
|
|
CT Angiogram of the Head
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$1,951.50
|
|
CT angio pelvis
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,650.60
|
|
CT heart w/evaluation of calcium without contrast
|
$225.00 |
$225.00 |
$225.00 |
$176.89
|
|
CT lower extremity w/contrast (both sides)
|
$3,361.20 |
$3,361.20 |
$3,361.20 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$3,415.20 |
$3,415.20 |
$3,415.20 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$885.00 |
$885.00 |
$885.00 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$994.20 |
$994.20 |
$994.20 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$885.00 |
$885.00 |
$885.00 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,722.60 |
$1,722.60 |
$1,722.60 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,722.60 |
$1,722.60 |
$1,722.60 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$885.00 |
$885.00 |
$885.00 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$885.00 |
$885.00 |
$885.00 |
$418.50
|
|
CT t-spine w /wo contrast
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$3,361.20 |
$3,361.20 |
$3,361.20 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$3,415.20 |
$3,415.20 |
$3,415.20 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$69.60 |
$69.60 |
$69.60 |
$61.03
|
|
Culture afb any source
|
$189.60 |
$189.60 |
$189.60 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$105.00 |
$105.00 |
$105.00 |
$73.00
|
|
Culture anaerobic except blood
|
$141.60 |
$141.60 |
$141.60 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$62.40 |
$62.40 |
$62.40 |
$49.40
|
|
Culture body fluid
|
$145.80 |
$145.80 |
$145.80 |
$111.15
|
|
Culture fungi definitive id mold
|
$82.20 |
$82.20 |
$82.20 |
$70.00
|
|
Culture fungi definitive id yeast
|
$81.60 |
$81.60 |
$81.60 |
$68.00
|
|
Culture fungi other (except blood)
|
$133.80 |
$133.80 |
$133.80 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$123.60 |
$123.60 |
$123.60 |
$74.75
|
|
Culture quantitative aerobic other source
|
$89.40 |
$89.40 |
$89.40 |
$63.45
|
|
Culture screening strep group a
|
$63.60 |
$63.60 |
$63.60 |
$76.00
|
|
Culture typing immunologic
|
$61.20 |
$61.20 |
$61.20 |
$38.58
|
|
Culture urine each isolate
|
$36.60 |
$36.60 |
$36.60 |
$44.80
|
|
Cyanocobalamin unsat binding capacity
|
$119.40 |
$119.40 |
$119.40 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$42.47 |
$42.47 |
$42.47 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$133.80 |
$133.80 |
$133.80 |
$91.20
|
|
Cyclosporine 2 hour
|
$205.20 |
$205.20 |
$205.20 |
$126.10
|
|
Cystatin c
|
$106.20 |
$106.20 |
$106.20 |
$83.20
|
|
Cytomegalovirus (cmv) antibody igg
|
$126.00 |
$126.00 |
$126.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$258.60 |
$258.60 |
$258.60 |
$95.00
|
|
Cyto/molecular report
|
$130.20 |
$130.20 |
$130.20 |
$91.65
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$156.00 |
$156.00 |
$156.00 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$212.40 |
$212.40 |
$212.40 |
$142.94
|
|
Cytopath tbs c/v manual
|
$75.00 |
$75.00 |
$75.00 |
$57.94
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.18 |
$2.18 |
$2.18 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,200.10 |
$2,200.10 |
$2,200.10 |
$4,542.99
|
|
Dch glucoscan
|
$79.80 |
$79.80 |
$79.80 |
$28.10
|
|
Dch validity tests
|
$15.60 |
$15.60 |
$15.60 |
$25.00
|
|
Debridement (>20 cm) charge pt
|
$81.00 |
$81.00 |
$81.00 |
$313.30
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$199.20 |
$199.20 |
$199.20 |
$482.35
|
|
Demonstrate use home inr mon
|
$423.60 |
$423.60 |
$423.60 |
$340.79
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$159.00 |
$159.00 |
$159.00 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,545.22 |
$2,545.22 |
$2,545.22 |
$4,681.80
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$40.82 |
$40.82 |
$40.82 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$58.32 |
$58.32 |
$58.32 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$7.20 |
$7.20 |
$7.20 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.68 |
$49.68 |
$49.68 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$78.86 |
$78.86 |
$78.86 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$280.20 |
$280.20 |
$280.20 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$48.00 |
$48.00 |
$48.00 |
$70.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$80.83 |
$80.83 |
$80.83 |
$42.12
|
|
Dicyclomine injection
|
$193.54 |
$193.54 |
$193.54 |
$153.53
|
|
Diffusing capacity
|
$311.40 |
$311.40 |
$311.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$41.63 |
$41.63 |
$41.63 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$88.80 |
$88.80 |
$88.80 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$308.90 |
$308.90 |
$308.90 |
$297.86
|
|
Dimethyl sulfoxide 50% 50 ml
|
$1,001.55 |
$1,001.55 |
$1,001.55 |
$1,001.55
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$38.75 |
$38.75 |
$38.75 |
$9.29
|
|
Disability dlco
|
$182.40 |
$182.40 |
$182.40 |
$289.08
|
|
Disaccharidases
|
$253.20 |
$253.20 |
$253.20 |
$224.58
|
|
Dna antibody native/double stranded
|
$157.20 |
$157.20 |
$157.20 |
$101.40
|
|
Dna gardnerella
|
$75.00 |
$75.00 |
$75.00 |
$67.68
|
|
Dna trichomonas
|
$75.00 |
$75.00 |
$75.00 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$99.10 |
$99.10 |
$99.10 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$104.59 |
$104.59 |
$104.59 |
$60.21
|
|
Doppler echo complete
|
$865.80 |
$865.80 |
$865.80 |
$517.94
|
|
Drain blood from under nail 11740
|
$159.60 |
$159.60 |
$159.60 |
$173.21
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$450.00 |
$450.00 |
$450.00 |
$353.60
|
|
Drug test def 1-7 classes
|
$209.40 |
$209.40 |
$209.40 |
$316.80
|
|
Drug test prsmv instrmnt
|
$97.20 |
$97.20 |
$97.20 |
$76.70
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$193.20 |
$193.20 |
$193.20 |
$278.85
|
|
Drvvt confirm - quest
|
$132.60 |
$132.60 |
$132.60 |
$108.55
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,204.20 |
$1,204.20 |
$1,204.20 |
$852.57
|
|
Ear irrigation 69209
|
$280.80 |
$280.80 |
$280.80 |
$152.50
|