|
Csf ventriculography
|
$756.00 |
$756.00 |
$756.00 |
$877.00
|
|
CT 3d report other modality w/workstation
|
$533.65 |
$533.65 |
$828.76 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,330.28 |
$3,330.28 |
$4,086.55 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$5,354.70 |
$5,354.70 |
$5,705.78 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$3,344.24 |
$3,344.24 |
$3,616.50 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$2,700.75 |
$2,700.75 |
$3,199.80 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,014.70 |
$3,014.70 |
$3,497.03 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,465.45 |
$2,465.45 |
$3,234.49 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,154.75 |
$2,154.75 |
$2,850.89 |
$1,881.75
|
|
CT angio hrt w/3d image
|
$780.00 |
$780.00 |
$2,474.58 |
$1,428.68
|
|
CT angio pelvis
|
$2,798.50 |
$2,798.50 |
$7,797.50 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,513.08 |
$2,513.08 |
$2,847.65 |
$1,691.30
|
|
CT bone density axial
|
$524.12 |
$524.12 |
$524.12 |
$385.15
|
|
CT cerebral perf w cont & prcssng
|
$349.70 |
$349.70 |
$349.70 |
$1,040.00
|
|
CT colonography dx
|
$1,592.33 |
$1,592.33 |
$1,592.33 |
$811.41
|
|
CT colonography dx w/dye
|
$1,882.80 |
$1,882.80 |
$1,882.80 |
$1,069.25
|
|
CT colonography screening
|
$1,569.56 |
$1,569.56 |
$1,569.56 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,177.80 |
$1,177.80 |
$1,961.51 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,162.85 |
$1,162.85 |
$1,383.60 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$3,547.32 |
$3,547.32 |
$3,547.32 |
$2,039.76
|
|
CT guid parench tis ablat
|
$2,040.73 |
$2,040.73 |
$2,115.10 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$192.00 |
$192.00 |
$313.00 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,474.58 |
$2,474.58 |
$2,474.58 |
$1,395.79
|
|
CT hrt w/3d image
|
$2,474.58 |
$2,474.58 |
$2,984.15 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$343.20 |
$343.20 |
$1,323.00 |
$636.55
|
|
Ctlso a-p-l control molded
|
$12,656.80 |
$12,656.80 |
$12,656.80 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$8,762.40 |
$8,762.40 |
$8,762.40 |
$4,186.78
|
|
CT lwr extremity w/o&w/dye
|
$2,700.75 |
$2,700.75 |
$2,852.22 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$860.80 |
$860.80 |
$860.80 |
$422.80
|
|
CT scan for localization
|
$912.60 |
$912.60 |
$2,227.89 |
$1,216.80
|
|
CT scan for therapy guide
|
$365.00 |
$365.00 |
$1,273.17 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,191.85 |
$4,191.85 |
$6,054.30 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,810.95 |
$3,810.95 |
$5,232.57 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,743.40 |
$4,743.40 |
$6,869.00 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$3,123.93 |
$3,123.93 |
$3,123.93 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,592.57 |
$2,592.57 |
$4,316.00 |
$1,845.36
|
|
Cultr oocyte/embryo <4 days
|
$2,114.40 |
$2,114.40 |
$2,114.40 |
$1,291.35
|
|
Cultr oocyte/embryo <4 days
|
$2,200.00 |
$2,200.00 |
$2,200.00 |
$441.00
|
|
Cult skin graft fnhfg 15155
|
$1,972.80 |
$1,972.80 |
$1,972.80 |
$4,052.18
|
|
Cult skin grft t/arm/leg
|
$1,709.60 |
$1,709.60 |
$1,709.60 |
$2,441.40
|
|
Culture aerobic additional method definitive id each
|
$38.58 |
$38.58 |
$6,350.40 |
$72.00
|
|
Culture afb any source
|
$38.58 |
$38.58 |
$290.55 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$38.58 |
$38.58 |
$83.85 |
$84.76
|
|
Culture anaerobic except blood
|
$38.58 |
$38.58 |
$38,260.44 |
$121.22
|
|
Culture bacteria anaerobic
|
$38.58 |
$38.58 |
$38.58 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$38.58 |
$38.58 |
$38.58 |
$52.50
|
|
Culture body fluid
|
$38.58 |
$38.58 |
$10,414.80 |
$126.75
|
|
Culture fungi definitive id mold
|
$38.58 |
$38.58 |
$103.35 |
$80.00
|
|
Culture fungi definitive id yeast
|
$38.58 |
$38.58 |
$81.25 |
$80.00
|
|
Culture fungi other (except blood)
|
$38.58 |
$38.58 |
$19,263.20 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$38.58 |
$38.58 |
$60.45 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$38.58 |
$38.58 |
$122.20 |
$100.00
|
|
Culture mycoplasma any source
|
$38.58 |
$38.58 |
$38.58 |
$83.21
|
|
Culture of specimen by kit
|
$54.40 |
$54.40 |
$54.40 |
$49.00
|
|
Culture quantitative aerobic other source
|
$38.58 |
$38.58 |
$92.30 |
$87.02
|
|
Culture screening strep group a
|
$38.58 |
$38.58 |
$38,260.44 |
$84.60
|
|
Culture type pulse field gel
|
$38.58 |
$38.58 |
$38.58 |
$38.58
|
|
Culture typing added method
|
$38.58 |
$38.58 |
$38.58 |
$42.60
|
|
Culture typing glc/hplc
|
$38.58 |
$38.58 |
$38.58 |
$53.75
|
|
Culture typing immunologic
|
$38.58 |
$38.58 |
$6,350.40 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$209.34 |
$209.34 |
$354.25 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$88.80 |
$88.80 |
$133.90 |
$140.80
|
|
Culture urine each isolate
|
$38.58 |
$38.58 |
$80.60 |
$55.50
|
|
Culture virus isolation
|
$39.20 |
$39.20 |
$39.20 |
$162.00
|
|
Curette/treat cornea
|
$720.28 |
$720.28 |
$720.28 |
$1,365.60
|
|
Curette/treat cornea
|
$1,921.60 |
$1,921.60 |
$1,921.60 |
$2,818.14
|
|
Cutter lead
|
$633.68 |
$633.68 |
$3,329.03 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,457.95 |
$1,457.95 |
$2,564.64 |
$1,681.20
|
|
Cv stress test i&r only 93018
|
$35.20 |
$35.20 |
$47.00 |
$36.40
|
|
Cv stress test/supervision only 93016
|
$51.20 |
$51.20 |
$70.00 |
$51.20
|
|
Cyanocobalamin unsat binding capacity
|
$64.28 |
$64.28 |
$64.28 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$16.40 |
$16.40 |
$81.20 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$48.57 |
$48.57 |
$92.95 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$10.52 |
$10.52 |
$2,577.10 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$7.65 |
$7.65 |
$10.85 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$133.55 |
$133.55 |
$344.85 |
$140.78
|
|
Cyclosporine 2 hour
|
$66.43 |
$66.43 |
$167.70 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$3.16 |
$3.16 |
$3.35 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$11.12 |
$11.12 |
$95.05 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$15,794.15 |
$15,794.15 |
$22,596.04 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$583.20 |
$583.20 |
$880.75 |
$524.00
|
|
Cyp2c9 gene com variants
|
$350.40 |
$350.40 |
$350.40 |
$275.10
|
|
Cyp2d6 gene com variants
|
$902.40 |
$902.40 |
$902.40 |
$570.70
|
|
Cyp3a4 gene common variants
|
$350.40 |
$350.40 |
$350.40 |
$241.24
|
|
Cyp3a5 gene common variants
|
$350.40 |
$350.40 |
$350.40 |
$245.31
|
|
Cystatin c
|
$64.28 |
$64.28 |
$76.05 |
$77.60
|
|
Cystic fibrosis cftr
|
$998.40 |
$998.40 |
$998.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$64.28 |
$64.28 |
$64.28 |
$100.70
|
|
Cysto cgen post urtl valves
|
$1,205.60 |
$1,205.60 |
$1,205.60 |
$4,175.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$668.06 |
$668.06 |
$696.15 |
$586.95
|
|
Cysto insj dev ischmc rmdlg
|
$5,203.20 |
$5,203.20 |
$5,203.20 |
$10,942.71
|
|
Cystometrogram w/up 51727
|
$851.20 |
$851.20 |
$851.20 |
$908.59
|
|
Cystorrhaphy wound comp 51865
|
$2,256.00 |
$2,256.00 |
$2,256.00 |
$1,756.80
|
|
Cystorrhaphy wound simple 51860
|
$1,863.20 |
$1,863.20 |
$1,863.20 |
$6,297.20
|
|
Cysto rx balo cath urtl strx
|
$6,853.60 |
$6,853.60 |
$6,853.60 |
$6,853.60
|
|
Cystoscopy and biopsy
|
$2,324.80 |
$2,324.80 |
$2,324.80 |
$4,081.37
|
|
Cystoscopy and radiotracer
|
$604.00 |
$604.00 |
$604.00 |
$4,846.99
|
|
Cystoscopy and treatment
|
$1,786.40 |
$1,786.40 |
$1,786.40 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,868.00 |
$1,868.00 |
$1,868.00 |
$4,638.40
|
|
Cystoscopy and treatment
|
$620.00 |
$620.00 |
$31,608.70 |
$5,304.00
|