|
C-reactive protein high sensitivity
|
$76.00 |
$76.00 |
$76.00 |
$85.50
|
|
Creatine kinase
|
$35.20 |
$35.20 |
$35.20 |
$66.30
|
|
Creatine kinase mb
|
$94.40 |
$94.40 |
$94.40 |
$113.63
|
|
Creatinine
|
$28.80 |
$28.80 |
$28.80 |
$46.20
|
|
Creatinine 24 hour urine
|
$29.60 |
$29.60 |
$29.60 |
$57.85
|
|
Creatinine clearance urine
|
$50.40 |
$50.40 |
$50.40 |
$90.26
|
|
Critical care each additional 30 minutes
|
$808.80 |
$808.80 |
$808.80 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,088.80 |
$2,088.80 |
$2,088.80 |
$2,535.00
|
|
Crystal identification light microscopy
|
$43.20 |
$43.20 |
$43.20 |
$66.43
|
|
CT 3d report other modality w/workstation
|
$802.40 |
$802.40 |
$802.40 |
$661.13
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,839.20 |
$4,839.20 |
$4,839.20 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$3,443.20 |
$3,443.20 |
$3,443.20 |
$1,994.52
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,344.00 |
$3,344.00 |
$3,344.00 |
$1,915.30
|
|
CT Angiogram of the Head
|
$3,188.80 |
$3,188.80 |
$3,188.80 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$3,288.80 |
$3,288.80 |
$3,288.80 |
$1,881.75
|
|
CT guidance for needle placement
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$1,215.06
|
|
CT limited or localized follow-up study
|
$1,361.60 |
$1,361.60 |
$1,361.60 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$3,152.80 |
$3,152.80 |
$3,152.80 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,067.20 |
$5,067.20 |
$5,067.20 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,336.00 |
$4,336.00 |
$4,336.00 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,158.40 |
$3,158.40 |
$3,158.40 |
$2,272.00
|
|
CT uppr extremity w/o&w/dye
|
$3,199.20 |
$3,199.20 |
$3,199.20 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$90.40 |
$90.40 |
$90.40 |
$72.00
|
|
Culture afb any source
|
$71.20 |
$71.20 |
$71.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$44.80 |
$44.80 |
$44.80 |
$84.76
|
|
Culture anaerobic except blood
|
$77.60 |
$77.60 |
$77.60 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$44.80 |
$44.80 |
$44.80 |
$52.50
|
|
Culture body fluid
|
$48.00 |
$48.00 |
$48.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$62.40 |
$62.40 |
$62.40 |
$80.00
|
|
Culture fungi definitive id yeast
|
$110.40 |
$110.40 |
$110.40 |
$80.00
|
|
Culture fungi other (except blood)
|
$66.40 |
$66.40 |
$66.40 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$78.40 |
$78.40 |
$78.40 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$149.60 |
$149.60 |
$149.60 |
$100.00
|
|
Culture mycoplasma any source
|
$164.00 |
$164.00 |
$164.00 |
$83.21
|
|
Culture screening strep group a
|
$41.60 |
$41.60 |
$41.60 |
$84.60
|
|
Culture typing immunologic
|
$40.00 |
$40.00 |
$40.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$576.00 |
$576.00 |
$576.00 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$172.00 |
$172.00 |
$172.00 |
$140.80
|
|
Culture urine each isolate
|
$40.80 |
$40.80 |
$40.80 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$61.72 |
$61.72 |
$61.72 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$81.60 |
$81.60 |
$81.60 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$968.48 |
$968.48 |
$968.48 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$214.40 |
$214.40 |
$214.40 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$4.85 |
$4.85 |
$4.85 |
$7.48
|
|
Cystogram >= 3 views supervision & interpretation
|
$478.40 |
$478.40 |
$478.40 |
$586.95
|
|
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
|
$78.40 |
$78.40 |
$78.40 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$80.80 |
$80.80 |
$80.80 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$148.00 |
$148.00 |
$148.00 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$108.80 |
$108.80 |
$108.80 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$84.00 |
$84.00 |
$84.00 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$166.40 |
$166.40 |
$166.40 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$155.20 |
$155.20 |
$155.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$301.60 |
$301.60 |
$301.60 |
$213.85
|
|
Cytopath smear other source
|
$152.80 |
$152.80 |
$152.80 |
$92.50
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$9,315.64 |
$9,315.64 |
$9,315.64 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,571.60 |
$2,571.60 |
$2,571.60 |
$6,281.29
|
|
Dch glucoscan
|
$16.80 |
$16.80 |
$16.80 |
$29.16
|
|
Dch validity tests
|
$19.20 |
$19.20 |
$19.20 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$66.40 |
$66.40 |
$66.40 |
$43.35
|
|
Decalcification
|
$72.80 |
$72.80 |
$72.80 |
$68.34
|
|
Decitabine 50 mg intravenous solution
|
$1,537.37 |
$1,537.37 |
$1,537.37 |
$1,073.52
|
|
Deferoxamine 500 mg solution for injection
|
$85.49 |
$85.49 |
$85.49 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$1,214.60 |
$1,214.60 |
$1,214.60 |
$1,856.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$180.00 |
$180.00 |
$180.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,887.27 |
$4,887.27 |
$4,887.27 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$498.40 |
$498.40 |
$498.40 |
$401.60
|
|
Device intraute mirena
|
$912.12 |
$912.12 |
$912.12 |
$2,125.00
|
|
Device sut capio slim opn
|
$1,390.40 |
$1,390.40 |
$1,390.40 |
$1,860.95
|
|
Dexamethasone 4 mg tablet
|
$5.53 |
$5.53 |
$5.53 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$60.53 |
$60.53 |
$60.53 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$70.79 |
$70.79 |
$70.79 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$70.79 |
$70.79 |
$70.79 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$70.79 |
$70.79 |
$70.79 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$70.79 |
$70.79 |
$70.79 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$120.00 |
$120.00 |
$120.00 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$55.20 |
$55.20 |
$55.20 |
$79.30
|
|
Diab manage trn ind/group
|
$49.60 |
$49.60 |
$49.60 |
$54.99
|
|
Diagnostic Mammogram (both breasts)
|
$550.40 |
$550.40 |
$550.40 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$460.80 |
$460.80 |
$460.80 |
$314.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$68.84 |
$68.84 |
$68.84 |
$79.71
|
|
Diffusing capacity
|
$370.40 |
$370.40 |
$370.40 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$62.37 |
$62.37 |
$62.37 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$72.00 |
$72.00 |
$72.00 |
$102.07
|
|
Diltiazem 5 mg/ml intravenous solution
|
$61.19 |
$61.19 |
$61.19 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$1.20 |
$1.20 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$60.51 |
$60.51 |
$60.51 |
$18.32
|
|
Dna antibody native/double stranded
|
$85.60 |
$85.60 |
$85.60 |
$100.00
|
|
Dna gardnerella
|
$100.00 |
$100.00 |
$100.00 |
$61.83
|
|
Dna probe chlamydia
|
$85.60 |
$85.60 |
$85.60 |
$82.20
|
|
Dna probe gc
|
$88.00 |
$88.00 |
$88.00 |
$79.38
|
|
Dna trichomonas
|
$99.20 |
$99.20 |
$99.20 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$240.48 |
$240.48 |
$240.48 |
$95.06
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$2,369.68 |
$2,369.68 |
$2,369.68 |
$949.39
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$210.08 |
$210.08 |
$210.08 |
$65.40
|
|
Doppler echo complete
|
$708.00 |
$708.00 |
$708.00 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$900.80 |
$900.80 |
$900.80 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$735.20 |
$735.20 |
$735.20 |
$481.65
|