|
Control of nosebleed ant comp 30903
|
$416.80 |
$416.80 |
$416.80 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$390.40 |
$390.40 |
$390.40 |
$352.80
|
|
Coombs direct
|
$80.00 |
$80.00 |
$80.00 |
$76.80
|
|
Coombs indirect titer reference
|
$62.40 |
$62.40 |
$62.40 |
$156.71
|
|
Copper intrauterine device
|
$2,848.80 |
$2,848.80 |
$2,848.80 |
$1,953.00
|
|
Cortisol total am
|
$69.60 |
$69.60 |
$69.60 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$219.49 |
$219.49 |
$219.49 |
$189.22
|
|
Covid-19 administration immunization im inj 1st/only component
|
$71.20 |
$71.20 |
$71.20 |
$49.13
|
|
#covid19rsv-rsv
|
$171.20 |
$171.20 |
$171.20 |
$145.60
|
|
CPAP or BiPAP Setup (first day)
|
$600.00 |
$600.00 |
$600.00 |
$584.50
|
|
C-peptide
|
$178.40 |
$178.40 |
$178.40 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,085.60 |
$1,085.60 |
$1,085.60 |
$777.71
|
|
C-reactive protein
|
$67.20 |
$67.20 |
$67.20 |
$69.36
|
|
C-reactive protein high sensitivity
|
$130.40 |
$130.40 |
$130.40 |
$85.50
|
|
Creatine kinase
|
$72.80 |
$72.80 |
$72.80 |
$66.30
|
|
Creatine kinase isoenzymes
|
$113.60 |
$113.60 |
$113.60 |
$56.20
|
|
Creatine kinase mb
|
$148.00 |
$148.00 |
$148.00 |
$113.63
|
|
Creatinine
|
$52.00 |
$52.00 |
$52.00 |
$46.20
|
|
Creatinine 24 hour urine
|
$44.00 |
$44.00 |
$44.00 |
$57.85
|
|
Creatinine clearance urine
|
$109.60 |
$109.60 |
$109.60 |
$90.26
|
|
Critical care each additional 30 minutes
|
$825.60 |
$825.60 |
$825.60 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,857.60 |
$2,857.60 |
$2,857.60 |
$2,535.00
|
|
Cryofibrinogen qualitative - sendout
|
$57.60 |
$57.60 |
$57.60 |
$52.50
|
|
Crystal identification light microscopy
|
$45.60 |
$45.60 |
$45.60 |
$66.43
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,181.60 |
$4,181.60 |
$4,181.60 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,885.60 |
$2,885.60 |
$2,885.60 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,920.00 |
$2,920.00 |
$2,920.00 |
$1,881.75
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,394.40 |
$4,394.40 |
$4,394.40 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,086.40 |
$4,086.40 |
$4,086.40 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,645.60 |
$3,645.60 |
$3,645.60 |
$2,272.00
|
|
Culture aerobic additional method definitive id each
|
$100.00 |
$100.00 |
$100.00 |
$72.00
|
|
Culture afb any source
|
$67.20 |
$67.20 |
$67.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$101.60 |
$101.60 |
$101.60 |
$84.76
|
|
Culture anaerobic except blood
|
$129.60 |
$129.60 |
$129.60 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$51.20 |
$51.20 |
$51.20 |
$52.50
|
|
Culture body fluid
|
$99.20 |
$99.20 |
$99.20 |
$126.75
|
|
Culture fungi definitive id mold
|
$108.00 |
$108.00 |
$108.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$101.60 |
$101.60 |
$101.60 |
$80.00
|
|
Culture fungi other (except blood)
|
$119.20 |
$119.20 |
$119.20 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$112.80 |
$112.80 |
$112.80 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$180.00 |
$180.00 |
$180.00 |
$100.00
|
|
Culture screening strep group a
|
$73.60 |
$73.60 |
$73.60 |
$84.60
|
|
Culture typing immunologic
|
$65.60 |
$65.60 |
$65.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$604.80 |
$604.80 |
$604.80 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$185.60 |
$185.60 |
$185.60 |
$140.80
|
|
Culture urine each isolate
|
$89.60 |
$89.60 |
$89.60 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$62.38 |
$62.38 |
$62.38 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$133.60 |
$133.60 |
$133.60 |
$72.36
|
|
Cyclosporine 2 hour
|
$118.40 |
$118.40 |
$118.40 |
$130.40
|
|
Cystatin c
|
$99.20 |
$99.20 |
$99.20 |
$77.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$876.00 |
$876.00 |
$876.00 |
$586.95
|
|
Cystoscopy (Bladder Scope)
|
$3,423.20 |
$3,423.20 |
$3,423.20 |
$1,493.80
|
|
Cytogenetics 25-99
|
$103.20 |
$103.20 |
$103.20 |
$189.80
|
|
Cytogenetics 3-5
|
$99.20 |
$99.20 |
$99.20 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$71.20 |
$71.20 |
$71.20 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$71.20 |
$71.20 |
$71.20 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$119.20 |
$119.20 |
$119.20 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$116.80 |
$116.80 |
$116.80 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$119.20 |
$119.20 |
$119.20 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$110.40 |
$110.40 |
$110.40 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$248.80 |
$248.80 |
$248.80 |
$213.85
|
|
Cytopath smear other source
|
$112.80 |
$112.80 |
$112.80 |
$92.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$73.43 |
$73.43 |
$73.43 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$9,755.80 |
$9,755.80 |
$9,755.80 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$603.21 |
$603.21 |
$603.21 |
$6,281.29
|
|
Deamidated gliadin antibody iga
|
$59.20 |
$59.20 |
$59.20 |
$43.35
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$835.20
|
|
Debride nail1-5 11720
|
$140.00 |
$140.00 |
$140.00 |
$149.60
|
|
Debride nail6 or more 11721
|
$158.40 |
$158.40 |
$158.40 |
$169.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$844.00 |
$844.00 |
$844.00 |
$663.30
|
|
Decalcification
|
$28.00 |
$28.00 |
$28.00 |
$68.34
|
|
Degarelix 120 mg subcutaneous solution
|
$1,302.51 |
$1,302.51 |
$1,302.51 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$110.40 |
$110.40 |
$110.40 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,759.43 |
$2,759.43 |
$2,759.43 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$494.40 |
$494.40 |
$494.40 |
$401.60
|
|
Destroy premlg lesns;1st lesn 17000
|
$219.20 |
$219.20 |
$219.20 |
$202.40
|
|
Destruction 2-14 lesions 17003
|
$36.00 |
$36.00 |
$36.00 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$243.20 |
$243.20 |
$243.20 |
$240.24
|
|
Device intraute mirena
|
$845.72 |
$845.72 |
$845.72 |
$2,125.00
|
|
Dexamethasone 4 mg tablet
|
$4.70 |
$4.70 |
$4.70 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$61.00 |
$61.00 |
$61.00 |
$20.76
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$280.64 |
$280.64 |
$280.64 |
$884.80
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$86.40 |
$86.40 |
$86.40 |
$36.05
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$86.40 |
$86.40 |
$86.40 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$86.40 |
$86.40 |
$86.40 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$197.60 |
$197.60 |
$197.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$87.20 |
$87.20 |
$87.20 |
$79.30
|
|
Diab manage trn ind/group
|
$64.00 |
$64.00 |
$64.00 |
$54.99
|
|
Diagnostic Mammogram (both breasts)
|
$424.00 |
$424.00 |
$424.00 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$272.80 |
$272.80 |
$272.80 |
$314.00
|
|
Diathermy eg microwave
|
$89.60 |
$89.60 |
$89.60 |
$29.68
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$66.64 |
$66.64 |
$66.64 |
$79.71
|
|
Diffusing capacity
|
$234.40 |
$234.40 |
$234.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$64.80 |
$64.80 |
$64.80 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$4,438.71 |
$4,438.71 |
$4,438.71 |
$10,279.62
|
|
Digoxin total therapeutic drug level
|
$114.40 |
$114.40 |
$114.40 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$96.63 |
$96.63 |
$96.63 |
$297.86
|
|
Dilate esophagus
|
$2,518.40 |
$2,518.40 |
$2,518.40 |
$2,142.40
|
|
Diltiazem 5 mg/ml intravenous solution
|
$61.25 |
$61.25 |
$61.25 |
$45.60
|
