|
Chlamydia type
|
$19.80 |
$19.80 |
$19.80 |
$34.80
|
|
Chloride
|
$49.80 |
$49.80 |
$49.80 |
$37.48
|
|
Chloride 24 hour urine
|
$96.00 |
$96.00 |
$96.00 |
$40.80
|
|
Chloroprocaine hcl injection
|
$44.39 |
$44.39 |
$44.39 |
$68.40
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$220.01 |
$220.01 |
$220.01 |
$358.30
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$53.03 |
$53.03 |
$53.03 |
$53.03
|
|
Cholesterol
|
$83.40 |
$83.40 |
$83.40 |
$40.95
|
|
Cholesterol body fluid
|
$159.00 |
$159.00 |
$159.00 |
$67.50
|
|
Cholesterol (Lipid) Test
|
$282.60 |
$282.60 |
$282.60 |
$101.43
|
|
Cholinesterase
|
$186.60 |
$186.60 |
$186.60 |
$49.40
|
|
Chrom analysis
|
$204.60 |
$204.60 |
$204.60 |
$156.00
|
|
Chromatography
|
$84.60 |
$84.60 |
$84.60 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$1,126.80 |
$1,126.80 |
$1,126.80 |
$558.25
|
|
Chromosome analysis 5
|
$554.40 |
$554.40 |
$554.40 |
$719.23
|
|
Chromosome analys placenta
|
$563.40 |
$563.40 |
$563.40 |
$660.00
|
|
Chromosome karyotype study
|
$79.20 |
$79.20 |
$79.20 |
$120.60
|
|
Chromosome study additional
|
$108.00 |
$108.00 |
$108.00 |
$144.12
|
|
Chronic urticaria - sendout
|
$236.40 |
$236.40 |
$236.40 |
$100.00
|
|
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
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$66.73 |
$66.73 |
$66.73 |
$49.74
|
|
Clot factor xii hageman
|
$219.60 |
$219.60 |
$219.60 |
$125.00
|
|
Clot factor xiii fibrin scrn
|
$145.80 |
$145.80 |
$145.80 |
$81.25
|
|
#cmvcul-virus inoculation shell
|
$198.00 |
$198.00 |
$198.00 |
$109.80
|
|
Cold agglutinin titer
|
$127.20 |
$127.20 |
$127.20 |
$48.57
|
|
Colistimethate sodium inj
|
$48.13 |
$48.13 |
$48.13 |
$46.62
|
|
Collection blood specimen from completely implantable venous access device
|
$199.80 |
$199.80 |
$199.80 |
$155.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$154.80 |
$154.80 |
$154.80 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$35.40 |
$35.40 |
$35.40 |
$20.30
|
|
Compatibility test each unit antiglobulin technique
|
$138.00 |
$138.00 |
$138.00 |
$156.60
|
|
Compatibility test each unit electronic
|
$140.40 |
$140.40 |
$140.40 |
$156.24
|
|
Complement antigen each component c3
|
$204.00 |
$204.00 |
$204.00 |
$110.00
|
|
Concentration infection agents any type
|
$73.80 |
$73.80 |
$73.80 |
$48.00
|
|
Conjugated estrogens 25 mg solution for injection
|
$839.07 |
$839.07 |
$839.07 |
$768.50
|
|
Coombs direct
|
$120.60 |
$120.60 |
$120.60 |
$70.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$124.80 |
$124.80 |
$124.80 |
$76.70
|
|
Coombs indirect titer reference
|
$202.80 |
$202.80 |
$202.80 |
$122.85
|
|
Coronary thrombolysis/iv infusion 92977
|
$537.60 |
$537.60 |
$537.60 |
$537.60
|
|
Cortisol acth stimulation test - sendout
|
$87.60 |
$87.60 |
$87.60 |
$143.40
|
|
Cortisol total am
|
$241.80 |
$241.80 |
$241.80 |
$117.81
|
|
Cosyntropin 0.25 mg solution for injection
|
$121.34 |
$121.34 |
$121.34 |
$218.95
|
|
Covid-19 administration immunization im inj 1st/only component
|
$108.60 |
$108.60 |
$108.60 |
$64.50
|
|
#covid19rsv-rsv
|
$221.40 |
$221.40 |
$221.40 |
$140.80
|
|
C-peptide
|
$176.40 |
$176.40 |
$176.40 |
$111.20
|
|
C-reactive protein
|
$120.60 |
$120.60 |
$120.60 |
$54.43
|
|
C-reactive protein high sensitivity
|
$164.40 |
$164.40 |
$164.40 |
$91.65
|
|
C-reactive protein, quantitative
|
$159.60 |
$159.60 |
$159.60 |
$77.50
|
|
Creatine kinase
|
$70.20 |
$70.20 |
$70.20 |
$55.00
|
|
Creatine kinase isoenzymes
|
$45.60 |
$45.60 |
$45.60 |
$66.00
|
|
Creatine kinase mb
|
$99.60 |
$99.60 |
$99.60 |
$100.75
|
|
Creatine - sendout
|
$108.60 |
$108.60 |
$108.60 |
$35.10
|
|
Creatinine
|
$67.80 |
$67.80 |
$67.80 |
$40.00
|
|
Creatinine 24 hour urine
|
$88.20 |
$88.20 |
$88.20 |
$54.40
|
|
Creatinine clearance urine
|
$222.60 |
$222.60 |
$222.60 |
$73.86
|
|
#creutz-prot.,western blot
|
$52.80 |
$52.80 |
$52.80 |
$178.10
|
|
Critical care 30-74 minutes
|
$1,923.00 |
$1,923.00 |
$1,923.00 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$288.60 |
$288.60 |
$288.60 |
$663.00
|
|
Crotalidae poly immune fab
|
$5,263.85 |
$5,263.85 |
$5,263.85 |
$3,996.74
|
|
Cryofibrinogen qualitative - sendout
|
$28.80 |
$28.80 |
$28.80 |
$52.50
|
|
Crystal identification light microscopy
|
$134.40 |
$134.40 |
$134.40 |
$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
|
$3,405.00 |
$3,405.00 |
$3,405.00 |
$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 guidance for needle placement
|
$1,264.20 |
$1,264.20 |
$1,264.20 |
$1,425.85
|
|
CT heart w/evaluation of calcium without contrast
|
$255.60 |
$255.60 |
$255.60 |
$176.89
|
|
CT lower extremity w/contrast (both sides)
|
$2,232.00 |
$2,232.00 |
$2,232.00 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,359.20 |
$2,359.20 |
$2,359.20 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$2,356.80 |
$2,356.80 |
$2,356.80 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,356.60 |
$1,356.60 |
$1,356.60 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$1,344.60 |
$1,344.60 |
$1,344.60 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,963.20 |
$1,963.20 |
$1,963.20 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,939.20 |
$1,939.20 |
$1,939.20 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,608.00 |
$1,608.00 |
$1,608.00 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,241.40 |
$1,241.40 |
$1,241.40 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,805.80 |
$3,805.80 |
$3,805.80 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,012.00 |
$3,012.00 |
$3,012.00 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,405.40 |
$2,405.40 |
$2,405.40 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,285.80 |
$1,285.80 |
$1,285.80 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$562.80 |
$562.80 |
$562.80 |
$418.50
|
|
CT t-spine w /wo contrast
|
$1,510.20 |
$1,510.20 |
$1,510.20 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$2,073.60 |
$2,073.60 |
$2,073.60 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$2,354.40 |
$2,354.40 |
$2,354.40 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$2,450.40 |
$2,450.40 |
$2,450.40 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$174.00 |
$174.00 |
$174.00 |
$61.03
|
|
Culture afb any source
|
$174.00 |
$174.00 |
$174.00 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$129.60 |
$129.60 |
$129.60 |
$73.00
|
|
Culture anaerobic except blood
|
$168.00 |
$168.00 |
$168.00 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$114.00 |
$114.00 |
$114.00 |
$49.40
|
|
Culture body fluid
|
$184.80 |
$184.80 |
$184.80 |
$111.15
|
|
Culture fungi definitive id mold
|
$129.00 |
$129.00 |
$129.00 |
$70.00
|
|
Culture fungi definitive id yeast
|
$135.60 |
$135.60 |
$135.60 |
$68.00
|
|
Culture fungi other (except blood)
|
$174.00 |
$174.00 |
$174.00 |
$92.95
|
|
Culture mycoplasma any source
|
$199.80 |
$199.80 |
$199.80 |
$94.00
|
