|
Coombs indirect titer reference
|
$56.00 |
$56.00 |
$56.00 |
$156.71
|
|
Copper intrauterine device
|
$3,324.00 |
$3,324.00 |
$3,324.00 |
$1,953.00
|
|
Cortisol total am
|
$121.60 |
$121.60 |
$121.60 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$219.49 |
$219.49 |
$219.49 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$79.20 |
$79.20 |
$79.20 |
$54.60
|
|
Covid-19 administration immunization im inj 1st/only component
|
$71.20 |
$71.20 |
$71.20 |
$49.13
|
|
Covid-19 convalescent plasma
|
$880.00 |
$880.00 |
$880.00 |
$590.80
|
|
#covid19rsv-rsv
|
$171.20 |
$171.20 |
$171.20 |
$145.60
|
|
#coxa-coxsackie a serotype a16
|
$100.80 |
$100.80 |
$100.80 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$635.20 |
$635.20 |
$635.20 |
$584.50
|
|
C-peptide
|
$101.60 |
$101.60 |
$101.60 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,220.80 |
$1,220.80 |
$1,220.80 |
$777.71
|
|
C-reactive protein
|
$59.20 |
$59.20 |
$59.20 |
$69.36
|
|
C-reactive protein high sensitivity
|
$104.80 |
$104.80 |
$104.80 |
$85.50
|
|
Creatine kinase
|
$48.80 |
$48.80 |
$48.80 |
$66.30
|
|
Creatine kinase isoenzymes
|
$108.00 |
$108.00 |
$108.00 |
$56.20
|
|
Creatine kinase mb
|
$133.60 |
$133.60 |
$133.60 |
$113.63
|
|
Creatinine
|
$33.60 |
$33.60 |
$33.60 |
$46.20
|
|
Creatinine 24 hour urine
|
$48.80 |
$48.80 |
$48.80 |
$57.85
|
|
Creatinine clearance urine
|
$56.80 |
$56.80 |
$56.80 |
$90.26
|
|
#creutz-prot.,western blot
|
$114.40 |
$114.40 |
$114.40 |
$163.50
|
|
Critical care each additional 30 minutes
|
$827.20 |
$827.20 |
$827.20 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,859.20 |
$2,859.20 |
$2,859.20 |
$2,535.00
|
|
Crystal identification light microscopy
|
$57.60 |
$57.60 |
$57.60 |
$66.43
|
|
CT 3d report other modality w/workstation
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$661.13
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,990.40 |
$4,990.40 |
$4,990.40 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$3,057.60 |
$3,057.60 |
$3,057.60 |
$1,994.52
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,847.20 |
$2,847.20 |
$2,847.20 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,859.20 |
$2,859.20 |
$2,859.20 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,859.20 |
$2,859.20 |
$2,859.20 |
$1,881.75
|
|
CT angio pelvis
|
$3,117.60 |
$3,117.60 |
$3,117.60 |
$1,806.60
|
|
CT limited or localized follow-up study
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$2,696.00 |
$2,696.00 |
$2,696.00 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,248.80 |
$5,248.80 |
$5,248.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,468.80 |
$4,468.80 |
$4,468.80 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,804.80 |
$3,804.80 |
$3,804.80 |
$2,272.00
|
|
CT uppr extremity w/o&w/dye
|
$2,664.00 |
$2,664.00 |
$2,664.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$92.80 |
$92.80 |
$92.80 |
$72.00
|
|
Culture afb any source
|
$101.60 |
$101.60 |
$101.60 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$72.00 |
$72.00 |
$72.00 |
$84.76
|
|
Culture anaerobic except blood
|
$125.60 |
$125.60 |
$125.60 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$51.20 |
$51.20 |
$51.20 |
$52.50
|
|
Culture body fluid
|
$104.80 |
$104.80 |
$104.80 |
$126.75
|
|
Culture fungi definitive id mold
|
$82.40 |
$82.40 |
$82.40 |
$80.00
|
|
Culture fungi definitive id yeast
|
$137.60 |
$137.60 |
$137.60 |
$80.00
|
|
Culture fungi other (except blood)
|
$111.20 |
$111.20 |
$111.20 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$112.00 |
$112.00 |
$112.00 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$196.00 |
$196.00 |
$196.00 |
$100.00
|
|
Culture mycoplasma any source
|
$190.40 |
$190.40 |
$190.40 |
$83.21
|
|
Culture screening strep group a
|
$57.60 |
$57.60 |
$57.60 |
$84.60
|
|
Culture typing immunologic
|
$33.60 |
$33.60 |
$33.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$576.00 |
$576.00 |
$576.00 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$248.00 |
$248.00 |
$248.00 |
$140.80
|
|
Culture urine each isolate
|
$56.00 |
$56.00 |
$56.00 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$63.36 |
$63.36 |
$63.36 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$120.80 |
$120.80 |
$120.80 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,039.99 |
$1,039.99 |
$1,039.99 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$211.20 |
$211.20 |
$211.20 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$7.38 |
$7.38 |
$7.38 |
$7.48
|
|
Cyp2c19 gene com variants
|
$256.00 |
$256.00 |
$256.00 |
$524.00
|
|
Cystogram >= 3 views supervision & interpretation
|
$838.40 |
$838.40 |
$838.40 |
$586.95
|
|
Cystoscopy (Bladder Scope)
|
$3,592.80 |
$3,592.80 |
$3,592.80 |
$1,493.80
|
|
Cytogenetics 25-99
|
$103.20 |
$103.20 |
$103.20 |
$189.80
|
|
Cytogenetics 3-5
|
$99.20 |
$99.20 |
$99.20 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$107.20 |
$107.20 |
$107.20 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$111.20 |
$111.20 |
$111.20 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$267.20 |
$267.20 |
$267.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$140.00 |
$140.00 |
$140.00 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$304.00 |
$304.00 |
$304.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$319.20 |
$319.20 |
$319.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$664.00 |
$664.00 |
$664.00 |
$213.85
|
|
Cytopath smear other source
|
$270.40 |
$270.40 |
$270.40 |
$92.50
|
|
Dalbavancin 500 mg intravenous solution
|
$2,699.20 |
$2,699.20 |
$2,699.20 |
$3,493.11
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$726.68 |
$726.68 |
$726.68 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$6,281.29
|
|
Dch glucoscan
|
$18.40 |
$18.40 |
$18.40 |
$29.16
|
|
Dch pulmonary stress test
|
$1,247.20 |
$1,247.20 |
$1,247.20 |
$963.30
|
|
Dch validity tests
|
$22.40 |
$22.40 |
$22.40 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$54.40 |
$54.40 |
$54.40 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$963.20 |
$963.20 |
$963.20 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$379.20 |
$379.20 |
$379.20 |
$284.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$904.00 |
$904.00 |
$904.00 |
$702.28
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,088.80 |
$1,088.80 |
$1,088.80 |
$835.20
|
|
Debride nail1-5 11720
|
$205.60 |
$205.60 |
$205.60 |
$149.60
|
|
Debride nail6 or more 11721
|
$231.20 |
$231.20 |
$231.20 |
$169.80
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$4,966.40 |
$4,966.40 |
$4,966.40 |
$1,899.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$784.00 |
$784.00 |
$784.00 |
$663.30
|
|
Decalcification
|
$92.80 |
$92.80 |
$92.80 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$676.80 |
$676.80 |
$676.80 |
$572.95
|
|
Deferoxamine 500 mg solution for injection
|
$85.49 |
$85.49 |
$85.49 |
$95.85
|
|
Delivery of placenta 59414
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$218.40 |
$218.40 |
$218.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,841.64 |
$2,841.64 |
$2,841.64 |
$6,324.98
|
|
Desmopressin 4 mcg/ml injection solution
|
$64.08 |
$64.08 |
$64.08 |
$91.84
|
|
Dexamethasone 4 mg tablet
|
$50.84 |
$50.84 |
$50.84 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$65.88 |
$65.88 |
$65.88 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$235.99 |
$235.99 |
$235.99 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$144.00 |
$144.00 |
$144.00 |
$46.35
|
