|
Cholesterol (Lipid) Test
|
$88.00 |
$88.00 |
$88.00 |
$101.43
|
|
Chromatography
|
$52.00 |
$52.00 |
$52.00 |
$81.25
|
|
Chromogenic substrate assay
|
$17.60 |
$17.60 |
$17.60 |
$188.40
|
|
Chromosome analysis 15-20 cell count
|
$349.60 |
$349.60 |
$349.60 |
$558.25
|
|
Chromosome karyotype study
|
$117.60 |
$117.60 |
$117.60 |
$120.60
|
|
Circumcision (newborn)
|
$1,395.20 |
$1,395.20 |
$1,395.20 |
$1,516.80
|
|
Clearance of airways
|
$332.40 |
$332.40 |
$332.40 |
$208.00
|
|
Clot factor xiii fibrin stab
|
$33.60 |
$33.60 |
$33.60 |
$84.27
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$43.60 |
$43.60 |
$43.60 |
$426.82
|
|
Clsd tx elbow dislocation child 24640
|
$402.40 |
$402.40 |
$402.40 |
$520.00
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$55.60 |
$55.60 |
$55.60 |
$376.11
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$68.00 |
$68.00 |
$68.00 |
$567.20
|
|
Clsd tx fx radius/ulna without manip 25560
|
$63.20 |
$63.20 |
$63.20 |
$634.40
|
|
Clsd tx/metatarsal fx without manip 28470
|
$63.20 |
$63.20 |
$63.20 |
$414.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$63.20 |
$63.20 |
$63.20 |
$476.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$273.20 |
$273.20 |
$273.20 |
$1,797.83
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$63.20 |
$63.20 |
$63.20 |
$473.00
|
|
Cmv pcr-sendout
|
$155.20 |
$155.20 |
$155.20 |
$177.50
|
|
Coagulation time activated teg
|
$14.40 |
$14.40 |
$14.40 |
$37.05
|
|
Cold agglutinin titer
|
$28.80 |
$28.80 |
$28.80 |
$48.57
|
|
Collection of venous blood by venipuncture
|
$18.00 |
$18.00 |
$18.00 |
$20.30
|
|
Colonoscopy thru stoma spx
|
$717.60 |
$717.60 |
$717.60 |
$1,261.31
|
|
Compatibility test each unit antiglobulin technique
|
$89.60 |
$89.60 |
$89.60 |
$156.60
|
|
Compatibility test each unit immediate spin technique
|
$98.00 |
$98.00 |
$98.00 |
$156.24
|
|
Concentration infection agents any type
|
$32.40 |
$32.40 |
$32.40 |
$48.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$100.80 |
$100.80 |
$100.80 |
$115.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$118.40 |
$118.40 |
$118.40 |
$200.00
|
|
Consultation/report referred material w/preparation of slides
|
$108.80 |
$108.80 |
$108.80 |
$231.75
|
|
Contrast exam abdominl aorta 75625-26
|
$2,088.80 |
$2,088.80 |
$2,088.80 |
$3,458.54
|
|
Contrast x-ray of elbow
|
$628.80 |
$628.80 |
$628.80 |
$566.28
|
|
Contrast x-ray of hip
|
$628.80 |
$628.80 |
$628.80 |
$676.12
|
|
Coombs direct
|
$42.00 |
$42.00 |
$42.00 |
$70.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$89.60 |
$89.60 |
$89.60 |
$76.70
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$4,732.40 |
$4,732.40 |
$4,732.40 |
$11,903.70
|
|
Coronary angio/lv gram/lt heart
|
$3,761.20 |
$3,761.20 |
$3,761.20 |
$11,772.00
|
|
Coronary angio/lv gram/rt< heart
|
$6,239.20 |
$6,239.20 |
$6,239.20 |
$12,021.10
|
|
Coronary art/grft angio s&i
|
$3,774.40 |
$3,774.40 |
$3,774.40 |
$9,162.00
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$4,750.80 |
$4,750.80 |
$4,750.80 |
$9,198.18
|
|
Coronary thrombolysis/iv infusion 92977
|
$422.00 |
$422.00 |
$422.00 |
$537.60
|
|
Cortisol total am
|
$56.00 |
$56.00 |
$56.00 |
$117.81
|
|
Co-treatment - group 15 mins, st
|
$70.00 |
$70.00 |
$70.00 |
$108.81
|
|
#coxa-coxsackie a serotype a16
|
$61.20 |
$61.20 |
$61.20 |
$65.36
|
|
C-peptide
|
$58.80 |
$58.80 |
$58.80 |
$111.20
|
|
Crbrospnl fld flw imag cistern
|
$725.60 |
$725.60 |
$725.60 |
$1,170.64
|
|
C-reactive protein
|
$39.20 |
$39.20 |
$39.20 |
$54.43
|
|
C-reactive protein high sensitivity
|
$36.80 |
$36.80 |
$36.80 |
$91.65
|
|
Creatine kinase
|
$30.80 |
$30.80 |
$30.80 |
$55.00
|
|
Creatine kinase isoenzymes
|
$26.40 |
$26.40 |
$26.40 |
$66.00
|
|
Creatine kinase mb
|
$40.00 |
$40.00 |
$40.00 |
$100.75
|
|
Creatinine
|
$20.40 |
$20.40 |
$20.40 |
$40.00
|
|
Creatinine 24 hour urine
|
$35.60 |
$35.60 |
$35.60 |
$54.40
|
|
Creatinine clearance urine
|
$69.60 |
$69.60 |
$69.60 |
$73.86
|
|
Critical care 30-74 minutes
|
$2,868.80 |
$2,868.80 |
$2,868.80 |
$2,540.23
|
|
Cryptococcus abs qn - sendout
|
$112.80 |
$112.80 |
$112.80 |
$89.70
|
|
Crystal identification light microscopy
|
$78.00 |
$78.00 |
$78.00 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$832.00 |
$832.00 |
$832.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,346.40 |
$1,346.40 |
$1,346.40 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,402.40 |
$2,402.40 |
$2,402.40 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$1,728.80
|
|
CT Angiogram of the Head
|
$925.20 |
$925.20 |
$925.20 |
$1,951.50
|
|
CT angio hrt w/3d image
|
$737.20 |
$737.20 |
$737.20 |
$1,618.00
|
|
CT angio pelvis
|
$832.00 |
$832.00 |
$832.00 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$1,650.60
|
|
CT colonography dx
|
$518.40 |
$518.40 |
$518.40 |
$770.90
|
|
CT guidance for needle placement
|
$735.20 |
$735.20 |
$735.20 |
$1,425.85
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$728.80 |
$728.80 |
$728.80 |
$1,007.29
|
|
CT heart w/evaluation of calcium without contrast
|
$236.00 |
$236.00 |
$236.00 |
$176.89
|
|
CT limited or localized follow-up study
|
$236.00 |
$236.00 |
$236.00 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$730.00 |
$730.00 |
$730.00 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$836.40 |
$836.40 |
$836.40 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$1,039.60 |
$1,039.60 |
$1,039.60 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,178.40 |
$1,178.40 |
$1,178.40 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$887.20 |
$887.20 |
$887.20 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,154.80 |
$1,154.80 |
$1,154.80 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$974.80 |
$974.80 |
$974.80 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,045.20 |
$1,045.20 |
$1,045.20 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,551.20 |
$2,551.20 |
$2,551.20 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,256.00 |
$2,256.00 |
$2,256.00 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,138.40 |
$2,138.40 |
$2,138.40 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$887.20 |
$887.20 |
$887.20 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$534.00 |
$534.00 |
$534.00 |
$418.50
|
|
CT upper extremity w/contrast (both sides)
|
$939.20 |
$939.20 |
$939.20 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$981.60 |
$981.60 |
$981.60 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,058.80 |
$1,058.80 |
$1,058.80 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$42.40 |
$42.40 |
$42.40 |
$61.03
|
|
Culture anaerobic except blood
|
$98.00 |
$98.00 |
$98.00 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$49.20 |
$49.20 |
$49.20 |
$49.40
|
|
Culture body fluid
|
$154.40 |
$154.40 |
$154.40 |
$111.15
|
|
Culture fungi definitive id mold
|
$56.00 |
$56.00 |
$56.00 |
$70.00
|
|
Culture fungi other (except blood)
|
$82.00 |
$82.00 |
$82.00 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$22.80 |
$22.80 |
$22.80 |
$74.75
|
|
Culture screening strep group a
|
$137.60 |
$137.60 |
$137.60 |
$76.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$138.80 |
$138.80 |
$138.80 |
$100.20
|
|
Culture urine each isolate
|
$53.60 |
$53.60 |
$53.60 |
$44.80
|
|
Cv stress test i&r only 93018
|
$36.40 |
$36.40 |
$36.40 |
$42.00
|
|
Cyclic citrullinated peptide antibody
|
$91.60 |
$91.60 |
$91.60 |
$91.20
|