|
Brain MRA (blood vessel MRI, with contrast)
|
$12,880.04 |
$12,880.04 |
$12,880.04 |
$2,136.60
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$11,704.89 |
$11,704.89 |
$11,704.89 |
$1,875.25
|
|
Brain MRI (with and without contrast)
|
$14,549.46 |
$14,549.46 |
$14,549.46 |
$2,837.12
|
|
Brain MRI (with contrast)
|
$14,360.31 |
$14,360.31 |
$14,360.31 |
$2,264.60
|
|
Brain MRI (without contrast)
|
$13,972.17 |
$13,972.17 |
$13,972.17 |
$1,932.50
|
|
Brcassure comprehensive panel-sendout
|
$4,508.10 |
$4,508.10 |
$4,508.10 |
$2,365.20
|
|
Brentuximab vedotin 50 mg intravenous solution
|
$38,073.00 |
$38,073.00 |
$38,073.00 |
$22,383.57
|
|
Bronchial challenge
|
$3,448.28 |
$3,448.28 |
$3,448.28 |
$805.90
|
|
Bundle his recording
|
$26,836.21 |
$26,836.21 |
$26,836.21 |
$4,781.70
|
|
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet
|
$7.50 |
$7.50 |
$7.50 |
$11.72
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$11.50 |
$11.50 |
$11.50 |
$14.42
|
|
Buprenorphine oral 1mg
|
$6.50 |
$6.50 |
$6.50 |
$10.74
|
|
Butorphanol tartrate 1 mg
|
$133.75 |
$133.75 |
$133.75 |
$41.79
|
|
C-1 esterase, berinert
|
$9,642.50 |
$9,642.50 |
$9,642.50 |
$7,815.00
|
|
Cabazitaxel 10 mg/ml (first dilution) intravenous solution
|
$47,128.17 |
$47,128.17 |
$47,128.17 |
$26,328.21
|
|
Cadd pump refill
|
$1,327.01 |
$1,327.01 |
$1,327.01 |
$380.00
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$9,509.50 |
$9,509.50 |
$9,509.50 |
$2,177.05
|
|
Calculi urinary-sendout
|
$919.72 |
$919.72 |
$919.72 |
$68.05
|
|
Calculus analysis qual
|
$191.17 |
$191.17 |
$191.17 |
$81.90
|
|
Calprotectin fecal
|
$751.56 |
$751.56 |
$751.56 |
$170.00
|
|
Candida skin test
|
$321.15 |
$321.15 |
$321.15 |
$62.05
|
|
Carbamazepine free -sendout
|
$896.56 |
$896.56 |
$896.56 |
$49.80
|
|
Carbamazepine total therapeutic drug level
|
$258.69 |
$258.69 |
$258.69 |
$122.85
|
|
Cardiac MRI w/stress img
|
$11,220.18 |
$11,220.18 |
$11,220.18 |
$1,474.98
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$613.44 |
$613.44 |
$613.44 |
$248.00
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$248.99 |
$248.99 |
$248.99 |
$203.34
|
|
Card MRI veloc flow mapping
|
$3,970.63 |
$3,970.63 |
$3,970.63 |
$601.90
|
|
Carotene
|
$535.25 |
$535.25 |
$535.25 |
$46.20
|
|
Catecholamines,fractionated, urine
|
$938.91 |
$938.91 |
$938.91 |
$135.88
|
|
Cath ext adhere actv m 28mm
|
$3.00 |
$3.00 |
$3.00 |
$1.81
|
|
Cath stripping venous s&i
|
$2,259.46 |
$2,259.46 |
$2,259.46 |
$682.34
|
|
Cebpa gene full sequence
|
$1,761.28 |
$1,761.28 |
$1,761.28 |
$488.22
|
|
Cefotaxime sodium injection
|
$133.10 |
$133.10 |
$133.10 |
$43.10
|
|
Cell function assay w/stim
|
$434.91 |
$434.91 |
$434.91 |
$318.58
|
|
Cemiplimab-rwlc 50 mg/ml intravenous solution
|
$34,992.58 |
$34,992.58 |
$34,992.58 |
$21,238.53
|
|
Chemo ia push tecnique
|
$1,545.87 |
$1,545.87 |
$1,545.87 |
$495.00
|
|
Chlamydia culture
|
$735.93 |
$735.93 |
$735.93 |
$92.16
|
|
Chlamydia trachomatis ag if
|
$107.05 |
$107.05 |
$107.05 |
$67.20
|
|
Chlamydia type
|
$197.37 |
$197.37 |
$197.37 |
$34.98
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$152.00 |
$152.00 |
$152.00 |
$78.43
|
|
Chorionic gonadotropin/1000u
|
$46.20 |
$46.20 |
$46.20 |
$548.36
|
|
Chrom analysis
|
$1,464.10 |
$1,464.10 |
$1,464.10 |
$156.00
|
|
Chromosome analys amniotic
|
$1,881.14 |
$1,881.14 |
$1,881.14 |
$450.00
|
|
Chromosome analysis 15-20 cell count
|
$1,473.42 |
$1,473.42 |
$1,473.42 |
$512.20
|
|
Chromosome analysis 45
|
$1,952.49 |
$1,952.49 |
$1,952.49 |
$380.91
|
|
Chromosome analysis 5
|
$1,464.10 |
$1,464.10 |
$1,464.10 |
$644.80
|
|
Chromosome karyotype study
|
$806.59 |
$806.59 |
$806.59 |
$120.00
|
|
Chromosome study additional
|
$708.08 |
$708.08 |
$708.08 |
$152.86
|
|
Cidofovir injection
|
$1,586.24 |
$1,586.24 |
$1,586.24 |
$1,447.81
|
|
C-kit mutation liquid tumor - sendout
|
$3,793.35 |
$3,793.35 |
$3,793.35 |
$659.20
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$1,522.50 |
$1,522.50 |
$1,522.50 |
$586.54
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$253.72 |
$253.72 |
$253.72 |
$83.14
|
|
Clot factor viii reltd antgn
|
$601.04 |
$601.04 |
$601.04 |
$159.06
|
|
Clotting assay whole blood
|
$976.95 |
$976.95 |
$976.95 |
$105.95
|
|
Clsd ostomy pouch without barr
|
$3.00 |
$3.00 |
$3.00 |
$1.33
|
|
C motor evoked upr&lwr limbs
|
$5,099.09 |
$5,099.09 |
$5,099.09 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$1,558.89 |
$1,558.89 |
$1,558.89 |
$87.75
|
|
Coagulation time activated teg
|
$496.20 |
$496.20 |
$496.20 |
$53.55
|
|
Cold agglutinin screen (arc)
|
$136.04 |
$136.04 |
$136.04 |
$45.00
|
|
Colistimethate sodium inj
|
$91.11 |
$91.11 |
$91.11 |
$71.09
|
|
Collagen dressing <=16 sq in
|
$148.00 |
$148.00 |
$148.00 |
$42.50
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$402.00 |
$402.00 |
$402.00 |
$62.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$430.43 |
$430.43 |
$430.43 |
$155.40
|
|
Colon motility 6 hr study
|
$473.45 |
$473.45 |
$473.45 |
$477.92
|
|
Compatibility test each unit antiglobulin technique
|
$361.28 |
$361.28 |
$361.28 |
$172.00
|
|
Compatibility test each unit immediate spin technique
|
$632.23 |
$632.23 |
$632.23 |
$167.17
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$5,806.00 |
$5,806.00 |
$5,806.00 |
$1,350.27
|
|
Conivaptan hcl
|
$3,119.62 |
$3,119.62 |
$3,119.62 |
$1,625.08
|
|
Conjugated estrogens 25 mg solution for injection
|
$737.23 |
$737.23 |
$737.23 |
$839.07
|
|
Consultation pathology during surgery cytological exam initial site
|
$124.06 |
$124.06 |
$124.06 |
$407.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$306.13 |
$306.13 |
$306.13 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,059.32 |
$1,059.32 |
$1,059.32 |
$224.87
|
|
Consultation/report referred slides prepared elsewhere
|
$832.04 |
$832.04 |
$832.04 |
$176.15
|
|
Contact layer >16<= 48 sq in
|
$297.00 |
$297.00 |
$297.00 |
$41.92
|
|
Coombs indirect qualitative each reagent red cell reference
|
$59.74 |
$59.74 |
$59.74 |
$102.90
|
|
Copper cu 64 dotatate diag
|
$1,892.42 |
$1,892.42 |
$1,892.42 |
$2,293.68
|
|
Counseling smoke cess interm >10mins
|
$112.04 |
$112.04 |
$112.04 |
$54.12
|
|
Cr-51 sodium chromate
|
$8,663.06 |
$8,663.06 |
$8,663.06 |
$688.80
|
|
Crbrospnl fld flw imag cistern
|
$12,705.27 |
$12,705.27 |
$12,705.27 |
$1,281.00
|
|
Creatine kinase isoenzymes
|
$272.10 |
$272.10 |
$272.10 |
$54.60
|
|
#creutz-prot.,western blot
|
$369.08 |
$369.08 |
$369.08 |
$163.50
|
|
Crotalidae poly immune fab
|
$8,281.93 |
$8,281.93 |
$8,281.93 |
$5,760.00
|
|
CT angio hrt w/3d image
|
$10,265.59 |
$10,265.59 |
$10,265.59 |
$1,424.40
|
|
CT guid parench tis ablat
|
$5,782.18 |
$5,782.18 |
$5,782.18 |
$1,282.50
|
|
CT hrt c+ strux cgen hrt ds
|
$10,265.59 |
$10,265.59 |
$10,265.59 |
$1,371.50
|
|
Ctlso a-p-l control molded
|
$15,300.00 |
$15,300.00 |
$15,300.00 |
$3,746.69
|
|
CT thorax low dose for lung screening without contrast
|
$286.27 |
$286.27 |
$286.27 |
$332.00
|
|
Culture afb any source
|
$718.11 |
$718.11 |
$718.11 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$132.70 |
$132.70 |
$132.70 |
$84.76
|
|
Culture anaerobic except blood
|
$583.21 |
$583.21 |
$583.21 |
$120.54
|
|
Culture fungi definitive id mold
|
$698.05 |
$698.05 |
$698.05 |
$80.00
|
|
Culture fungi definitive id yeast
|
$698.05 |
$698.05 |
$698.05 |
$79.50
|
|
Culture mycobacteria definitive id each isolate
|
$698.05 |
$698.05 |
$698.05 |
$100.00
|
|
Culture mycoplasma any source
|
$865.32 |
$865.32 |
$865.32 |
$81.62
|
|
Culture type pulse field gel
|
$698.05 |
$698.05 |
$698.05 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$37.17 |
$37.17 |
$37.17 |
$138.40
|
|
Culture urine each isolate
|
$698.05 |
$698.05 |
$698.05 |
$54.78
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$131.25 |
$131.25 |
$131.25 |
$25.16
|
|
Cyclophosphamide 25 mg capsule
|
$7.50 |
$7.50 |
$7.50 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$185.00 |
$185.00 |
$185.00 |
$140.78
|
