|
Creatinine clearance urine
|
$181.80 |
$181.80 |
$181.80 |
$73.86
|
|
#creutz-prot.,western blot
|
$210.60 |
$210.60 |
$210.60 |
$178.10
|
|
Critical care 30-74 minutes
|
$2,231.40 |
$2,231.40 |
$2,231.40 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$558.60 |
$558.60 |
$558.60 |
$663.00
|
|
Cryptosporidium antigen
|
$86.40 |
$86.40 |
$86.40 |
$65.55
|
|
Crystal identification light microscopy
|
$99.60 |
$99.60 |
$99.60 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$2,289.60 |
$2,289.60 |
$2,289.60 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,750.40 |
$2,750.40 |
$2,750.40 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$4,506.00 |
$4,506.00 |
$4,506.00 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,772.40 |
$1,772.40 |
$1,772.40 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,270.60 |
$3,270.60 |
$3,270.60 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,728.80
|
|
CT Angiogram of the Head
|
$2,021.40 |
$2,021.40 |
$2,021.40 |
$1,951.50
|
|
CT angio pelvis
|
$2,102.40 |
$2,102.40 |
$2,102.40 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$2,622.60 |
$2,622.60 |
$2,622.60 |
$1,650.60
|
|
CT heart w/evaluation of calcium without contrast
|
$256.80 |
$256.80 |
$256.80 |
$176.89
|
|
CT limited or localized follow-up study
|
$255.00 |
$255.00 |
$255.00 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$2,630.40 |
$2,630.40 |
$2,630.40 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,104.80 |
$2,104.80 |
$2,104.80 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$3,157.20 |
$3,157.20 |
$3,157.20 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,182.00 |
$1,182.00 |
$1,182.00 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$886.80 |
$886.80 |
$886.80 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,477.20 |
$1,477.20 |
$1,477.20 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,705.20 |
$1,705.20 |
$1,705.20 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,420.80 |
$1,420.80 |
$1,420.80 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,081.20 |
$1,081.20 |
$1,081.20 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,221.40 |
$3,221.40 |
$3,221.40 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,623.20 |
$2,623.20 |
$2,623.20 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,095.20 |
$2,095.20 |
$2,095.20 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,369.80 |
$1,369.80 |
$1,369.80 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,096.80 |
$1,096.80 |
$1,096.80 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$541.20 |
$541.20 |
$541.20 |
$418.50
|
|
CT t-spine w /wo contrast
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$2,162.40 |
$2,162.40 |
$2,162.40 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$3,241.20 |
$3,241.20 |
$3,241.20 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$66.00 |
$66.00 |
$66.00 |
$61.03
|
|
Culture afb any source
|
$167.40 |
$167.40 |
$167.40 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$114.00 |
$114.00 |
$114.00 |
$73.00
|
|
Culture anaerobic except blood
|
$144.00 |
$144.00 |
$144.00 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$107.40 |
$107.40 |
$107.40 |
$49.40
|
|
Culture body fluid
|
$160.80 |
$160.80 |
$160.80 |
$111.15
|
|
Culture fungi definitive id mold
|
$125.40 |
$125.40 |
$125.40 |
$70.00
|
|
Culture fungi definitive id yeast
|
$100.80 |
$100.80 |
$100.80 |
$68.00
|
|
Culture fungi other (except blood)
|
$136.80 |
$136.80 |
$136.80 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$138.00 |
$138.00 |
$138.00 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$70.20 |
$70.20 |
$70.20 |
$79.00
|
|
Culture mycoplasma any source
|
$187.20 |
$187.20 |
$187.20 |
$94.00
|
|
Culture quantitative aerobic other source
|
$177.00 |
$177.00 |
$177.00 |
$63.45
|
|
Culture screening strep group a
|
$105.60 |
$105.60 |
$105.60 |
$76.00
|
|
Culture typing immunologic
|
$69.00 |
$69.00 |
$69.00 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$392.40 |
$392.40 |
$392.40 |
$392.40
|
|
Culture urine each isolate
|
$73.80 |
$73.80 |
$73.80 |
$44.80
|
|
Cyanocobalamin unsat binding capacity
|
$142.80 |
$142.80 |
$142.80 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$42.47 |
$42.47 |
$42.47 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$176.40 |
$176.40 |
$176.40 |
$91.20
|
|
Cyclosporine 2 hour
|
$289.80 |
$289.80 |
$289.80 |
$126.10
|
|
Cystatin c
|
$142.80 |
$142.80 |
$142.80 |
$83.20
|
|
Cystine urine quantitative
|
$521.40 |
$521.40 |
$521.40 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$330.60 |
$330.60 |
$330.60 |
$487.04
|
|
Cytogenetics 25-99
|
$558.00 |
$558.00 |
$558.00 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$150.00 |
$150.00 |
$150.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$182.40 |
$182.40 |
$182.40 |
$95.00
|
|
Cyto/molecular report
|
$216.60 |
$216.60 |
$216.60 |
$91.65
|
|
Cytopathology cellular enhancement technique non-gyn
|
$163.80 |
$163.80 |
$163.80 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$182.40 |
$182.40 |
$182.40 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$172.80 |
$172.80 |
$172.80 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$216.60 |
$216.60 |
$216.60 |
$142.94
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$276.00 |
$276.00 |
$276.00 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$424.80 |
$424.80 |
$424.80 |
$205.00
|
|
Cytotoxic antibody screening
|
$122.40 |
$122.40 |
$122.40 |
$184.63
|
|
Cytotoxic antibody screening
|
$387.00 |
$387.00 |
$387.00 |
$96.46
|
|
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
|
$42.00 |
$42.00 |
$42.00 |
$28.10
|
|
Debridement (>20 cm) charge pt
|
$816.00 |
$816.00 |
$816.00 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$3,171.60 |
$3,171.60 |
$3,171.60 |
$2,481.05
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,167.00 |
$1,167.00 |
$1,167.00 |
$717.92
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$1,738.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$778.80 |
$778.80 |
$778.80 |
$779.35
|
|
Debride nail1-5 11720
|
$485.40 |
$485.40 |
$485.40 |
$186.88
|
|
Debride nail6 or more 11721
|
$357.60 |
$357.60 |
$357.60 |
$200.21
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$796.80 |
$796.80 |
$796.80 |
$728.40
|
|
Debr musc/fascia 20sq cm/< 11043
|
$3,171.60 |
$3,171.60 |
$3,171.60 |
$1,101.10
|
|
Decalcification
|
$130.80 |
$130.80 |
$130.80 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,179.00 |
$1,179.00 |
$1,179.00 |
$482.35
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$147.00 |
$147.00 |
$147.00 |
$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
|
|
Destroy premlg lesns;1st lesn 17000
|
$186.60 |
$186.60 |
$186.60 |
$199.50
|
|
Destruction 2-14 lesions 17003
|
$119.40 |
$119.40 |
$119.40 |
$78.61
|
|
Destruction premal lesions 15/> 17004
|
$285.00 |
$285.00 |
$285.00 |
$442.61
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$159.60 |
$159.60 |
$159.60 |
$220.43
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$41.53 |
$41.53 |
$41.53 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$78.83 |
$78.83 |
$78.83 |
$37.50
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$78.65 |
$78.65 |
$78.65 |
$68.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$49.75 |
$49.75 |
$49.75 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$78.86 |
$78.86 |
$78.86 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$315.60 |
$315.60 |
$315.60 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$152.40 |
$152.40 |
$152.40 |
$70.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$53.40 |
$53.40 |
$53.40 |
$117.94
|