|
CT lwr extremity w/o&w/dye
|
$1,065.25 |
$1,065.25 |
$1,249.32 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,305.05 |
$1,305.05 |
$1,530.55 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,057.21 |
$1,057.21 |
$1,239.90 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$1,435.59 |
$1,435.59 |
$1,683.66 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$826.25 |
$826.25 |
$969.02 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$634.65 |
$634.65 |
$744.32 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$598.90 |
$598.90 |
$702.39 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$153.44 |
$153.44 |
$192.39 |
$456.00
|
|
CT scan for therapy guide
|
$207.67 |
$207.67 |
$487.10 |
$777.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,606.70 |
$1,606.70 |
$2,276.36 |
$3,329.15
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,606.70 |
$1,606.70 |
$1,884.34 |
$2,883.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,429.97 |
$1,429.97 |
$1,677.06 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,190.17 |
$1,190.17 |
$1,395.82 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,060.83 |
$1,060.83 |
$1,516.89 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$740.29 |
$740.29 |
$868.21 |
$426.62
|
|
CT t-spine w /wo contrast
|
$1,164.06 |
$1,164.06 |
$1,623.36 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$749.13 |
$749.13 |
$867.74 |
$1,697.85
|
|
CT upper extremity without contrast (both sides)
|
$739.89 |
$739.89 |
$1,058.53 |
$1,473.75
|
|
CT uppr extremity w/o&w/dye
|
$938.32 |
$938.32 |
$1,100.45 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$55.44 |
$55.44 |
$69.50 |
$63.02
|
|
Culture afb any source
|
$69.90 |
$69.90 |
$87.63 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$73.11 |
$73.11 |
$91.66 |
$76.35
|
|
Culture anaerobic except blood
|
$87.17 |
$87.17 |
$109.29 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$49.41 |
$49.41 |
$61.95 |
$52.50
|
|
Culture body fluid
|
$70.30 |
$70.30 |
$82.44 |
$130.40
|
|
Culture fungi definitive id mold
|
$48.21 |
$48.21 |
$56.53 |
$70.00
|
|
Culture fungi definitive id yeast
|
$53.43 |
$53.43 |
$62.66 |
$79.10
|
|
Culture fungi other (except blood)
|
$69.09 |
$69.09 |
$81.03 |
$95.93
|
|
Culture fungi skin/hair/nail
|
$25.71 |
$25.71 |
$30.15 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$326.97 |
$326.97 |
$409.95 |
$88.14
|
|
Culture mycoplasma any source
|
$40.98 |
$40.98 |
$51.37 |
$90.37
|
|
Culture quantitative aerobic other source
|
$52.62 |
$52.62 |
$61.72 |
$85.80
|
|
Culture screening strep group a
|
$157.46 |
$157.46 |
$197.42 |
$78.60
|
|
Culture typing added method
|
$173.13 |
$173.13 |
$203.04 |
$34.45
|
|
Culture typing immunologic
|
$16.88 |
$16.88 |
$21.16 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$228.96 |
$228.96 |
$287.07 |
$115.05
|
|
Culture urine each isolate
|
$31.74 |
$31.74 |
$39.79 |
$46.20
|
|
Cutter lead
|
$809.54 |
$809.54 |
$1,015.00 |
$2,205.00
|
|
Cv line/pic reposition
|
$1,393.82 |
$1,393.82 |
$1,634.66 |
$1,789.77
|
|
Cyanocobalamin unsat binding capacity
|
$44.99 |
$44.99 |
$52.77 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$26.71 |
$26.71 |
$33.49 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$27.72 |
$27.72 |
$32.51 |
$85.20
|
|
Cyclophosphamide 25 mg capsule
|
$277.06 |
$277.06 |
$347.38 |
$22.51
|
|
Cyclosporine 2 hour
|
$127.34 |
$127.34 |
$149.34 |
$119.40
|
|
Cyclosporine modified 25 mg capsule
|
$27.54 |
$27.54 |
$34.52 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$1,015.37 |
$1,015.37 |
$1,273.07 |
$42.97
|
|
Cylinder pump set 20cm titan zero angl
|
$6,103.21 |
$6,103.21 |
$7,652.18 |
$18,784.86
|
|
Cyp2c19 gene com variants
|
$598.90 |
$598.90 |
$702.39 |
$567.75
|
|
Cyp2c9 gene com variants
|
$1,098.59 |
$1,098.59 |
$1,288.42 |
$275.10
|
|
Cyp2d6 gene com variants
|
$667.59 |
$667.59 |
$837.02 |
$537.50
|
|
Cystatin c
|
$68.69 |
$68.69 |
$80.56 |
$82.50
|
|
Cystic fibrosis cftr
|
$1,114.65 |
$1,114.65 |
$1,397.55 |
$1,041.95
|
|
Cystine urine quantitative
|
$377.98 |
$377.98 |
$443.29 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$302.87 |
$302.87 |
$355.20 |
$527.50
|
|
Cystoscopy and treatment
|
$888.11 |
$888.11 |
$1,041.57 |
$2,906.75
|
|
Cystoscopy and treatment
|
$1,128.31 |
$1,128.31 |
$1,414.67 |
$3,219.80
|
|
Cystoscopy (Bladder Scope)
|
$956.79 |
$956.79 |
$1,510.30 |
$1,619.67
|
|
Cystoscopy removal of clots
|
$1,972.90 |
$1,972.90 |
$1,972.90 |
$3,817.53
|
|
Cystoscopy & ureter catheter
|
$1,102.60 |
$1,102.60 |
$1,293.13 |
$3,274.00
|
|
Cystostomy cystotomy w/drainage 51040
|
$1,017.85 |
$1,017.85 |
$1,193.73 |
$3,623.90
|
|
Cysto/uretero stricture tx
|
$1,198.20 |
$1,198.20 |
$1,405.25 |
$4,024.52
|
|
Cysto/uretero w/lithotripsy
|
$1,390.20 |
$1,390.20 |
$1,630.42 |
$5,844.61
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,079.71 |
$1,079.71 |
$1,353.73 |
$2,845.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$1,287.77 |
$1,287.77 |
$1,510.30 |
$3,970.98
|
|
Cytogenetics 25-99
|
$159.47 |
$159.47 |
$187.02 |
$180.32
|
|
Cytomegalovirus (cmv) antibody igg
|
$40.17 |
$40.17 |
$47.11 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$102.83 |
$102.83 |
$120.60 |
$103.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$95.20 |
$95.20 |
$111.65 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$63.47 |
$63.47 |
$79.58 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$121.71 |
$121.71 |
$152.60 |
$124.30
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$30.13 |
$30.13 |
$37.78 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$125.73 |
$125.73 |
$147.45 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$87.57 |
$87.57 |
$109.79 |
$203.08
|
|
Cytopath smear other source
|
$15.27 |
$15.27 |
$17.91 |
$85.80
|
|
Cytopath smear oth prep screen & interp
|
$22.90 |
$22.90 |
$28.71 |
$95.00
|
|
Cytopath tbs c/v manual
|
$63.87 |
$63.87 |
$63.87 |
$57.94
|
|
Cytotoxic antibody screening
|
$187.99 |
$187.99 |
$220.47 |
$157.60
|
|
Dacarbazine 100 mg intravenous solution
|
$160.53 |
$160.53 |
$201.27 |
$61.64
|
|
Dalbavancin 500 mg intravenous solution
|
$4,100.79 |
$4,100.79 |
$5,141.56 |
$3,591.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,181.06 |
$1,181.06 |
$1,480.80 |
$544.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$23,071.97 |
$23,071.97 |
$28,927.54 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,503.19 |
$4,503.19 |
$5,646.08 |
$5,500.25
|
|
Darbepoetin alfa, esrd use
|
$152.66 |
$152.66 |
$191.40 |
$89.04
|
|
D&c after delivery 59160
|
$1,153.22 |
$1,153.22 |
$3,047.91 |
$3,474.84
|
|
Dch glucoscan
|
$6.83 |
$6.83 |
$8.57 |
$23.25
|
|
Dch pulmonary stress test
|
$367.54 |
$367.54 |
$431.05 |
$964.41
|
|
Dch validity tests
|
$24.11 |
$24.11 |
$28.27 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$4.83 |
$4.83 |
$5.66 |
$44.20
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$296.44 |
$296.44 |
$347.66 |
$677.54
|
|
Debridement (>20 cm) charge pt
|
$116.09 |
$116.09 |
$285.01 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$1,110.64 |
$1,110.64 |
$1,392.51 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$449.08 |
$449.08 |
$526.68 |
$681.60
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$224.54 |
$224.54 |
$263.34 |
$1,407.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$473.98 |
$473.98 |
$731.60 |
$810.50
|
|
Debride nail1-5 11720
|
$161.08 |
$161.08 |
$188.91 |
$173.25
|
|
Debride nail6 or more 11721
|
$161.08 |
$161.08 |
$188.91 |
$200.21
|
|
Debride skin bone at fx site
|
$1,052.79 |
$1,052.79 |
$1,319.99 |
$3,167.89
|
|
Debride skn/sq t/m/f necro infctj abdl wall 11005
|
$857.18 |
$857.18 |
$1,005.30 |
$2,328.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$199.64 |
$199.64 |
$250.30 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$416.14 |
$416.14 |
$488.05 |
$1,129.45
|