|
Biotinidase - quest
|
$80.80 |
$80.80 |
$80.80 |
$88.00
|
|
Block tap inj(s) w/wo img uni
|
$1,064.00 |
$1,064.00 |
$1,064.00 |
$1,053.00
|
|
Blood Clotting (PT/INR) Test
|
$34.40 |
$34.40 |
$34.40 |
$45.00
|
|
Blood Clotting (PTT) Test
|
$76.40 |
$76.40 |
$76.40 |
$67.35
|
|
Blood Count (CBC) Test
|
$66.40 |
$66.40 |
$66.40 |
$66.30
|
|
Blood Count (CBC) Test (without differential)
|
$65.20 |
$65.20 |
$65.20 |
$52.43
|
|
Blood Culture Test
|
$136.80 |
$136.80 |
$136.80 |
$112.20
|
|
Blood draw capillary 36416
|
$20.00 |
$20.00 |
$20.00 |
$20.80
|
|
Blood occult feces 1-3 determinations other than neoplasm screening qualitative
|
$20.80 |
$20.80 |
$20.80 |
$32.50
|
|
Blood occult feces colorectal neoplasm screening qualitative
|
$20.80 |
$20.80 |
$20.80 |
$32.50
|
|
Blood occult peroxidase activity qualitative gastric
|
$14.40 |
$14.40 |
$14.40 |
$31.20
|
|
Blood smear microscopic w manual differential wbc count
|
$42.40 |
$42.40 |
$42.40 |
$34.40
|
|
Blood typing abo
|
$102.00 |
$102.00 |
$102.00 |
$71.40
|
|
Blood typing ag donor ea ag
|
$207.60 |
$207.60 |
$207.60 |
$134.40
|
|
Blood typing patient serum
|
$30.80 |
$30.80 |
$30.80 |
$80.00
|
|
Blood typing rbc ag non abo/rh ea
|
$207.60 |
$207.60 |
$207.60 |
$156.21
|
|
Blood typing rh (d)
|
$34.00 |
$34.00 |
$34.00 |
$52.73
|
|
Blood typing rh phenotype complete reference
|
$62.00 |
$62.00 |
$62.00 |
$70.20
|
|
Bone Density Scan (DEXA)
|
$140.40 |
$140.40 |
$140.40 |
$381.19
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$88.00 |
$88.00 |
$88.00 |
$105.90
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$1,852.40 |
$1,852.40 |
$1,852.40 |
$2,477.80
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$1,595.60 |
$1,595.60 |
$1,595.60 |
$1,795.95
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$1,741.80
|
|
Brain MRI (with and without contrast)
|
$1,762.80 |
$1,762.80 |
$1,762.80 |
$2,659.03
|
|
Brain MRI (with contrast)
|
$1,672.40 |
$1,672.40 |
$1,672.40 |
$2,110.55
|
|
Brain MRI (without contrast)
|
$1,402.00 |
$1,402.00 |
$1,402.00 |
$1,765.28
|
|
Brcassure comprehensive panel-sendout
|
$1,204.80 |
$1,204.80 |
$1,204.80 |
$2,287.20
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$1,694.00 |
$1,694.00 |
$1,694.00 |
$3,012.38
|
|
Breast punct aspir cyst, bil
|
$332.40 |
$332.40 |
$332.40 |
$832.00
|
|
Bundled special stain group 1 microorganisms
|
$48.00 |
$48.00 |
$48.00 |
$161.46
|
|
Bundled special stain group 2
|
$36.00 |
$36.00 |
$36.00 |
$169.60
|
|
Bx breast add lesion Ultrasound imag
|
$1,105.20 |
$1,105.20 |
$1,105.20 |
$1,944.10
|
|
Bx thyroid/percutan core needle 60100
|
$406.00 |
$406.00 |
$406.00 |
$995.00
|
|
C1 esterase inhibitor func - sendout
|
$90.40 |
$90.40 |
$90.40 |
$123.49
|
|
Calcium 24 hour urine
|
$26.80 |
$26.80 |
$26.80 |
$51.63
|
|
Calcium ionized
|
$82.80 |
$82.80 |
$82.80 |
$80.80
|
|
Calcium total
|
$52.40 |
$52.40 |
$52.40 |
$43.20
|
|
Calprotectin fecal
|
$46.40 |
$46.40 |
$46.40 |
$170.00
|
|
Candida dna
|
$43.20 |
$43.20 |
$43.20 |
$66.05
|
|
Carbamazepine total therapeutic drug level
|
$76.00 |
$76.00 |
$76.00 |
$108.81
|
|
Carbon dioxide
|
$44.00 |
$44.00 |
$44.00 |
$42.00
|
|
Carboxyhemoglobin quantitative
|
$45.20 |
$45.20 |
$45.20 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$74.00 |
$74.00 |
$74.00 |
$125.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$837.20 |
$837.20 |
$837.20 |
$2,538.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$78.80 |
$78.80 |
$78.80 |
$258.10
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$69.60 |
$69.60 |
$69.60 |
$208.00
|
|
Cardiolipin antibody iga
|
$81.60 |
$81.60 |
$81.60 |
$126.14
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$599.20 |
$599.20 |
$599.20 |
$1,461.75
|
|
Carotene
|
$48.80 |
$48.80 |
$48.80 |
$66.00
|
|
Carotid Artery Ultrasound (Duplex)
|
$297.60 |
$297.60 |
$297.60 |
$1,037.60
|
|
Cath/saline/contrast/sis/hysteosal 58340
|
$341.60 |
$341.60 |
$341.60 |
$505.90
|
|
Cdna analysis for variants
|
$215.60 |
$215.60 |
$215.60 |
$609.80
|
|
Ceftriaxone 1 gram solution for injection
|
$80.80 |
$80.80 |
$80.80 |
$51.80
|
|
Cell count w differential body fluid
|
$113.60 |
$113.60 |
$113.60 |
$83.71
|
|
Cell function assay w/stim
|
$115.20 |
$115.20 |
$115.20 |
$369.45
|
|
Change cystostomy tube simple
|
$173.20 |
$173.20 |
$173.20 |
$426.63
|
|
Chemodenerv musc migraine 64615
|
$241.60 |
$241.60 |
$241.60 |
$556.86
|
|
Chest CT scan (with and without contrast)
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,918.02
|
|
Chest CT scan (with contrast)
|
$944.00 |
$944.00 |
$944.00 |
$1,608.98
|
|
Chest CT scan (without contrast)
|
$850.40 |
$850.40 |
$850.40 |
$1,166.90
|
|
Chest X-ray
|
$219.20 |
$219.20 |
$219.20 |
$265.85
|
|
Chest X-ray (single view)
|
$149.20 |
$149.20 |
$149.20 |
$192.50
|
|
Chlamydia culture
|
$52.40 |
$52.40 |
$52.40 |
$96.51
|
|
Chlamydia type
|
$34.80 |
$34.80 |
$34.80 |
$34.80
|
|
Chloride 24 hour urine
|
$18.00 |
$18.00 |
$18.00 |
$40.80
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$242.00 |
$242.00 |
$242.00 |
$546.01
|
|
Cholesterol
|
$50.80 |
$50.80 |
$50.80 |
$40.95
|
|
Cholesterol (Lipid) Test
|
$82.80 |
$82.80 |
$82.80 |
$101.43
|
|
Chromatography
|
$30.80 |
$30.80 |
$30.80 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$314.80 |
$314.80 |
$314.80 |
$558.25
|
|
Chylomicron screen, bf - sendout
|
$54.40 |
$54.40 |
$54.40 |
$136.09
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$402.40 |
$402.40 |
$402.40 |
$413.00
|
|
Clot factor xii hageman
|
$84.40 |
$84.40 |
$84.40 |
$125.00
|
|
Clot factor xiii fibrin stab
|
$53.60 |
$53.60 |
$53.60 |
$84.27
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$446.40 |
$446.40 |
$446.40 |
$716.95
|
|
Clsd tx dist fib fx w/manip 27788
|
$723.20 |
$723.20 |
$723.20 |
$728.00
|
|
Clsd tx elbow dislocation child 24640
|
$402.40 |
$402.40 |
$402.40 |
$520.00
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$278.80 |
$278.80 |
$278.80 |
$441.18
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$171.60 |
$171.60 |
$171.60 |
$567.20
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$215.20 |
$215.20 |
$215.20 |
$519.12
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$402.40 |
$402.40 |
$402.40 |
$688.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$402.40 |
$402.40 |
$402.40 |
$476.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$287.60 |
$287.60 |
$287.60 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$194.00 |
$194.00 |
$194.00 |
$454.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$374.40 |
$374.40 |
$374.40 |
$1,632.60
|
|
Cmv pcr-sendout
|
$58.40 |
$58.40 |
$58.40 |
$177.50
|
|
Cold agglutinin titer
|
$31.20 |
$31.20 |
$31.20 |
$48.57
|
|
Collection blood specimen from completely implantable venous access device
|
$55.60 |
$55.60 |
$55.60 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$36.80 |
$36.80 |
$36.80 |
$20.30
|
|
Compatibility test each unit antiglobulin technique
|
$97.60 |
$97.60 |
$97.60 |
$156.60
|
|
Compatibility test each unit immediate spin technique
|
$93.60 |
$93.60 |
$93.60 |
$156.24
|
|
Compatibility test incubate
|
$98.40 |
$98.40 |
$98.40 |
$140.00
|
|
Complement antigen each component c3
|
$132.00 |
$132.00 |
$132.00 |
$110.00
|
|
Complx repair fccmnaxghf 13132
|
$501.60 |
$501.60 |
$501.60 |
$1,193.40
|
|
Complx repair sal addl 5 cm/> 13122
|
$73.60 |
$73.60 |
$73.60 |
$546.29
|
|
Concentration infection agents any type
|
$62.00 |
$62.00 |
$62.00 |
$48.00
|
|
Condylomata destruction 56420
|
$262.00 |
$262.00 |
$262.00 |
$472.50
|
|
Contrast baths charges
|
$85.20 |
$85.20 |
$85.20 |
$77.98
|
|
Control nosebleed pack+caut 30905
|
$176.40 |
$176.40 |
$176.40 |
$457.60
|
|
Control of nosebleed ant comp 30903
|
$295.60 |
$295.60 |
$295.60 |
$410.06
|
