|
Cryofibrinogen qualitative - sendout
|
$17.12 |
$17.12 |
$17.12 |
$52.50
|
|
Cryoprecipitate each unit
|
$59.36 |
$59.36 |
$59.36 |
$182.25
|
|
Cryptococcus abs qn - sendout
|
$40.96 |
$40.96 |
$40.96 |
$89.70
|
|
Cryptosporidium antigen
|
$51.37 |
$51.37 |
$51.37 |
$65.55
|
|
Crystal identification light microscopy
|
$6.50 |
$6.50 |
$6.50 |
$56.44
|
|
CT 3d report other modality w/workstation
|
$136.08 |
$136.08 |
$136.08 |
$607.80
|
|
Cta abdomen without & /or w/contrast
|
$489.44 |
$489.44 |
$489.44 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$575.68 |
$575.68 |
$575.68 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,447.60 |
$1,447.60 |
$1,447.60 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$568.40 |
$568.40 |
$568.40 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,996.40 |
$1,996.40 |
$1,996.40 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$779.52 |
$779.52 |
$779.52 |
$1,728.80
|
|
CT Angiogram of the Head
|
$1,207.92 |
$1,207.92 |
$1,207.92 |
$1,951.50
|
|
CT angio pelvis
|
$448.56 |
$448.56 |
$448.56 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$421.68 |
$421.68 |
$421.68 |
$1,650.60
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$237.44 |
$237.44 |
$237.44 |
$1,007.29
|
|
CT lower extremity w/contrast (both sides)
|
$700.56 |
$700.56 |
$700.56 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$632.24 |
$632.24 |
$632.24 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$518.00 |
$518.00 |
$518.00 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$490.56 |
$490.56 |
$490.56 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$421.68 |
$421.68 |
$421.68 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$557.20 |
$557.20 |
$557.20 |
$1,752.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$490.56 |
$490.56 |
$490.56 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$421.68 |
$421.68 |
$421.68 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,237.04 |
$1,237.04 |
$1,237.04 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,102.64 |
$1,102.64 |
$1,102.64 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$966.00 |
$966.00 |
$966.00 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$705.60 |
$705.60 |
$705.60 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$664.72 |
$664.72 |
$664.72 |
$1,381.20
|
|
CT upper extremity w/contrast (both sides)
|
$490.56 |
$490.56 |
$490.56 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$632.24 |
$632.24 |
$632.24 |
$1,408.54
|
|
Culture aerobic additional method definitive id each
|
$37.20 |
$37.20 |
$37.20 |
$61.03
|
|
Culture afb any source
|
$28.94 |
$28.94 |
$28.94 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$63.18 |
$63.18 |
$63.18 |
$73.00
|
|
Culture anaerobic except blood
|
$40.16 |
$40.16 |
$40.16 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$17.72 |
$17.72 |
$17.72 |
$49.40
|
|
Culture body fluid
|
$64.37 |
$64.37 |
$64.37 |
$111.15
|
|
Culture fungi definitive id mold
|
$46.06 |
$46.06 |
$46.06 |
$70.00
|
|
Culture fungi definitive id yeast
|
$51.97 |
$51.97 |
$51.97 |
$68.00
|
|
Culture fungi other (except blood)
|
$47.24 |
$47.24 |
$47.24 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$41.34 |
$41.34 |
$41.34 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$21.85 |
$21.85 |
$21.85 |
$79.00
|
|
Culture mycoplasma any source
|
$135.82 |
$135.82 |
$135.82 |
$94.00
|
|
Culture quantitative aerobic other source
|
$30.70 |
$30.70 |
$30.70 |
$63.45
|
|
Culture screening strep group a
|
$45.47 |
$45.47 |
$45.47 |
$76.00
|
|
Culture urine each isolate
|
$33.07 |
$33.07 |
$33.07 |
$44.80
|
|
Cutter lead
|
$2,122.40 |
$2,122.40 |
$2,122.40 |
$5,644.60
|
|
Cyclic citrullinated peptide antibody
|
$26.57 |
$26.57 |
$26.57 |
$91.20
|
|
Cyclosporine 2 hour
|
$37.79 |
$37.79 |
$37.79 |
$126.10
|
|
Cylinder pump set 20cm titan zero angl
|
$12,096.00 |
$12,096.00 |
$12,096.00 |
$25,255.20
|
|
Cyp2c19 gene com variants
|
$185.36 |
$185.36 |
$185.36 |
$583.20
|
|
Cystatin c
|
$34.72 |
$34.72 |
$34.72 |
$83.20
|
|
Cystic fibrosis cftr
|
$589.12 |
$589.12 |
$589.12 |
$1,041.95
|
|
Cystine urine quantitative
|
$36.25 |
$36.25 |
$36.25 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$155.12 |
$155.12 |
$155.12 |
$487.04
|
|
Cytogenetics 25-99
|
$165.20 |
$165.20 |
$165.20 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$30.76 |
$30.76 |
$30.76 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$36.11 |
$36.11 |
$36.11 |
$95.00
|
|
Cyto/molecular report
|
$19.86 |
$19.86 |
$19.86 |
$91.65
|
|
Cytopath fl nongyn filter
|
$30.80 |
$30.80 |
$30.80 |
$91.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$114.24 |
$114.24 |
$114.24 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$66.08 |
$66.08 |
$66.08 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$38.64 |
$38.64 |
$38.64 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$28.56 |
$28.56 |
$28.56 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$26.32 |
$26.32 |
$26.32 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$9.52 |
$9.52 |
$9.52 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$26.32 |
$26.32 |
$26.32 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$57.68 |
$57.68 |
$57.68 |
$205.00
|
|
Cytopath smear other source
|
$30.24 |
$30.24 |
$30.24 |
$88.13
|
|
Cytopath smear other source
|
$25.20 |
$25.20 |
$25.20 |
$145.31
|
|
Cytopath smear oth prep screen & interp
|
$34.16 |
$34.16 |
$34.16 |
$95.00
|
|
Cytopath tbs c/v manual
|
$21.84 |
$21.84 |
$21.84 |
$57.94
|
|
Cytotoxic antibody screening
|
$158.48 |
$158.48 |
$158.48 |
$184.63
|
|
Cytp urine 3-5 probes cmptr
|
$252.84 |
$252.84 |
$252.84 |
$779.00
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$85.59 |
$85.59 |
$85.59 |
$1.80
|
|
Dch validity tests
|
$4.73 |
$4.73 |
$4.73 |
$25.00
|
|
Decalcification
|
$12.88 |
$12.88 |
$12.88 |
$72.15
|
|
Dermagraft
|
$55.44 |
$55.44 |
$55.44 |
$100.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$13.16 |
$13.16 |
$13.16 |
$37.26
|
|
Desoxycorticosterone
|
$96.44 |
$96.44 |
$96.44 |
$109.28
|
|
Devel tst phys/qhp 1st hr
|
$163.52 |
$163.52 |
$163.52 |
$364.48
|
|
Device ablt adv novasure
|
$2,963.52 |
$2,963.52 |
$2,963.52 |
$7,153.60
|
|
Device sut capio slim opn
|
$576.24 |
$576.24 |
$576.24 |
$1,454.07
|
|
Device tiss remov myosure reach
|
$787.36 |
$787.36 |
$787.36 |
$1,070.85
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$82.32 |
$82.32 |
$82.32 |
$203.19
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$91.28 |
$91.28 |
$91.28 |
$220.43
|
|
Dexamethasone 4 mg tablet
|
$0.62 |
$0.62 |
$0.62 |
$4.87
|
|
Dhea-s (dehydroepiand sulfate)
|
$64.79 |
$64.79 |
$64.79 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$23.62 |
$23.62 |
$23.62 |
$70.00
|
|
Diagnostic Mammogram (both breasts)
|
$423.92 |
$423.92 |
$423.92 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$314.72 |
$314.72 |
$314.72 |
$276.60
|
|
Diffusing capacity
|
$120.40 |
$120.40 |
$120.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$170.75 |
$170.75 |
$170.75 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$41.34 |
$41.34 |
$41.34 |
$92.95
|
|
Dilator fascial 10fx20cm
|
$120.96 |
$120.96 |
$120.96 |
$291.87
|
|
Disaccharidases
|
$231.67 |
$231.67 |
$231.67 |
$224.58
|
|
Dmd dup/delet analysis
|
$329.28 |
$329.28 |
$329.28 |
$418.50
|
|
Dna antibody native/double stranded
|
$34.10 |
$34.10 |
$34.10 |
$101.40
|
|
Dna gardnerella
|
$68.50 |
$68.50 |
$68.50 |
$67.68
|
|
Dna probe chlamydia
|
$112.20 |
$112.20 |
$112.20 |
$98.40
|
