|
CT limited or localized follow-up study
|
$973.80 |
$973.80 |
$973.80 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,927.20 |
$1,927.20 |
$1,927.20 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$1,421.85
|
|
Ctlso a-p-l control molded
|
$3,196.43 |
$3,196.43 |
$3,196.43 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$3,513.75 |
$3,513.75 |
$3,513.75 |
$4,186.78
|
|
Ctlso axilla sling
|
$135.26 |
$135.26 |
$135.26 |
$197.97
|
|
Ctlso milwauke initial model
|
$3,255.87 |
$3,255.87 |
$3,255.87 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$2,167.20 |
$2,167.20 |
$2,167.20 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$2,048.40 |
$2,048.40 |
$2,048.40 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,794.00 |
$1,794.00 |
$1,794.00 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,304.60 |
$2,304.60 |
$2,304.60 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,304.60 |
$2,304.60 |
$2,304.60 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$2,048.40 |
$2,048.40 |
$2,048.40 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,794.00 |
$1,794.00 |
$1,794.00 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$405.60 |
$405.60 |
$405.60 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,456.80 |
$4,456.80 |
$4,456.80 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,876.60 |
$3,876.60 |
$3,876.60 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,865.00 |
$2,865.00 |
$2,865.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,927.20 |
$1,927.20 |
$1,927.20 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$262.20 |
$262.20 |
$262.20 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,167.20 |
$2,167.20 |
$2,167.20 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,927.20 |
$1,927.20 |
$1,927.20 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,687.20 |
$1,687.20 |
$1,687.20 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,167.20 |
$2,167.20 |
$2,167.20 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$1,570.12 |
$1,570.12 |
$1,570.12 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$107.40 |
$107.40 |
$107.40 |
$68.64
|
|
Culture afb any source
|
$189.00 |
$189.00 |
$189.00 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$28.80 |
$28.80 |
$28.80 |
$79.00
|
|
Culture anaerobic except blood
|
$102.00 |
$102.00 |
$102.00 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$25.20 |
$25.20 |
$25.20 |
$51.45
|
|
Culture body fluid
|
$166.80 |
$166.80 |
$166.80 |
$126.75
|
|
Culture fungi definitive id mold
|
$48.00 |
$48.00 |
$48.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$57.00 |
$57.00 |
$57.00 |
$79.10
|
|
Culture fungi other (except blood)
|
$140.40 |
$140.40 |
$140.40 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$22.80 |
$22.80 |
$22.80 |
$74.88
|
|
Culture mycoplasma any source
|
$45.00 |
$45.00 |
$45.00 |
$85.26
|
|
Culture screening strep group a
|
$74.40 |
$74.40 |
$74.40 |
$81.00
|
|
Culture typing added method
|
$110.40 |
$110.40 |
$110.40 |
$38.58
|
|
Culture typing immunologic
|
$18.00 |
$18.00 |
$18.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$893.40 |
$893.40 |
$893.40 |
$133.90
|
|
Culture urine each isolate
|
$192.00 |
$192.00 |
$192.00 |
$57.00
|
|
Cutter lead
|
$6,357.46 |
$6,357.46 |
$6,357.46 |
$6,092.06
|
|
Cv line/pic reposition
|
$3,360.60 |
$3,360.60 |
$3,360.60 |
$1,720.93
|
|
Cyanocobalamin unsat binding capacity
|
$33.60 |
$33.60 |
$33.60 |
$64.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$100.80 |
$100.80 |
$100.80 |
$70.72
|
|
Cyclophosphamide 25 mg capsule
|
$11.70 |
$11.70 |
$11.70 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$350.22 |
$350.22 |
$350.22 |
$140.78
|
|
Cyclosporine 2 hour
|
$93.00 |
$93.00 |
$93.00 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$5.58 |
$5.58 |
$5.58 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$22.08 |
$22.08 |
$22.08 |
$34.88
|
|
Cygnus, per sq cm
|
$14,266.80 |
$14,266.80 |
$14,266.80 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$46,196.06 |
$46,196.06 |
$46,196.06 |
$22,803.38
|
|
Cyp2c19 gene com variants
|
$481.20 |
$481.20 |
$481.20 |
$504.00
|
|
Cyp2c9 gene com variants
|
$289.80 |
$289.80 |
$289.80 |
$275.10
|
|
Cyp2d6 gene com variants
|
$1,054.80 |
$1,054.80 |
$1,054.80 |
$554.00
|
|
Cyp3a5 gene common variants
|
$289.80 |
$289.80 |
$289.80 |
$245.31
|
|
Cystatin c
|
$49.80 |
$49.80 |
$49.80 |
$77.50
|
|
Cystic fibrosis cftr
|
$2,852.40 |
$2,852.40 |
$2,852.40 |
$1,100.00
|
|
Cystine urine quantitative
|
$91.20 |
$91.20 |
$91.20 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$492.00 |
$492.00 |
$492.00 |
$542.10
|
|
Cystoscopy and treatment
|
$12,123.01 |
$12,123.01 |
$12,123.01 |
$4,081.37
|
|
Cystoscopy and treatment
|
$12,135.91 |
$12,135.91 |
$12,135.91 |
$4,160.10
|
|
Cystoscopy and treatment
|
$11,666.65 |
$11,666.65 |
$11,666.65 |
$5,162.50
|
|
Cystoscopy and treatment
|
$26,143.54 |
$26,143.54 |
$26,143.54 |
$5,995.60
|
|
Cystoscopy and treatment
|
$20,204.62 |
$20,204.62 |
$20,204.62 |
$6,475.26
|
|
Cystoscopy and treatment
|
$20,354.27 |
$20,354.27 |
$20,354.27 |
$4,045.60
|
|
Cystoscopy and treatment
|
$58,884.31 |
$58,884.31 |
$58,884.31 |
$2,874.36
|
|
Cystoscopy and treatment
|
$2,859.60 |
$2,859.60 |
$2,859.60 |
$3,203.50
|
|
Cystoscopy and treatment
|
$60,711.98 |
$60,711.98 |
$60,711.98 |
$3,820.84
|
|
Cystoscopy (Bladder Scope)
|
$1,074.60 |
$1,074.60 |
$1,074.60 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$12,308.71 |
$12,308.71 |
$12,308.71 |
$3,786.00
|
|
Cystouretero & or pyeloscope
|
$14,301.54 |
$14,301.54 |
$14,301.54 |
$4,315.98
|
|
Cystouretero w/biopsy
|
$21,941.92 |
$21,941.92 |
$21,941.92 |
$5,986.78
|
|
Cysto/uretero w/lithotripsy
|
$26,143.54 |
$26,143.54 |
$26,143.54 |
$9,002.88
|
|
Cystouretero w/lithotripsy
|
$19,764.18 |
$19,764.18 |
$19,764.18 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$14,643.53 |
$14,643.53 |
$14,643.53 |
$5,110.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$12,226.40 |
$12,226.40 |
$12,226.40 |
$3,065.15
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$20,815.92 |
$20,815.92 |
$20,815.92 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$89.94
|
|
Cytogenetics 25-99
|
$552.00 |
$552.00 |
$552.00 |
$190.00
|
|
Cytogenomic neo microra alys
|
$3,455.40 |
$3,455.40 |
$3,455.40 |
$2,020.20
|
|
Cytomegalovirus (cmv) antibody igg
|
$220.80 |
$220.80 |
$220.80 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$222.60 |
$222.60 |
$222.60 |
$97.50
|
|
Cyto/molecular report
|
$121.80 |
$121.80 |
$121.80 |
$133.20
|
|
Cytopath c/v thin layer redo
|
$64.80 |
$64.80 |
$64.80 |
$61.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$70.80 |
$70.80 |
$70.80 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$212.40 |
$212.40 |
$212.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$48.00 |
$48.00 |
$48.00 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$147.60 |
$147.60 |
$147.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$64.20 |
$64.20 |
$64.20 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$133.20 |
$133.20 |
$133.20 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$210.00 |
$210.00 |
$210.00 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$316.20 |
$316.20 |
$316.20 |
$209.23
|
|
Cytopath smear other source
|
$84.60 |
$84.60 |
$84.60 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$126.60 |
$126.60 |
$126.60 |
$96.20
|
|
Cytopath tbs c/v manual
|
$121.20 |
$121.20 |
$121.20 |
$59.28
|
|
Cytotoxic antibody screening
|
$223.20 |
$223.20 |
$223.20 |
$189.00
|
|
Cytp urine 3-5 probes cmptr
|
$418.20 |
$418.20 |
$418.20 |
$690.00
|
