|
CT lwr extremity w/o&w/dye
|
$1,964.95 |
$1,964.95 |
$1,964.95 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$2,193.75 |
$2,193.75 |
$2,193.75 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$2,126.80 |
$2,126.80 |
$2,126.80 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,976.65 |
$1,976.65 |
$1,976.65 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,834.30 |
$1,834.30 |
$1,834.30 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,534.00 |
$1,534.00 |
$1,534.00 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,409.20 |
$1,409.20 |
$1,409.20 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,080.95 |
$1,080.95 |
$1,080.95 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,080.95 |
$1,080.95 |
$1,080.95 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,832.35 |
$1,832.35 |
$1,832.35 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,883.05 |
$1,883.05 |
$1,883.05 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$245.05 |
$245.05 |
$245.05 |
$418.50
|
|
CT t-spine w /wo contrast
|
$2,059.85 |
$2,059.85 |
$2,059.85 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$1,203.15 |
$1,203.15 |
$1,203.15 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$1,104.35 |
$1,104.35 |
$1,104.35 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,901.90 |
$1,901.90 |
$1,901.90 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$81.25 |
$81.25 |
$81.25 |
$61.03
|
|
Culture afb any source
|
$70.20 |
$70.20 |
$70.20 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$84.50 |
$84.50 |
$84.50 |
$73.00
|
|
Culture anaerobic except blood
|
$213.20 |
$213.20 |
$213.20 |
$110.00
|
|
Culture body fluid
|
$180.05 |
$180.05 |
$180.05 |
$111.15
|
|
Culture fungi definitive id mold
|
$43.55 |
$43.55 |
$43.55 |
$70.00
|
|
Culture fungi definitive id yeast
|
$60.45 |
$60.45 |
$60.45 |
$68.00
|
|
Culture fungi other (except blood)
|
$141.05 |
$141.05 |
$141.05 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$29.25 |
$29.25 |
$29.25 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$70.85 |
$70.85 |
$70.85 |
$79.00
|
|
Culture screening strep group a
|
$134.55 |
$134.55 |
$134.55 |
$76.00
|
|
Culture typing immunologic
|
$50.70 |
$50.70 |
$50.70 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$488.80 |
$488.80 |
$488.80 |
$392.40
|
|
Culture urine each isolate
|
$35.75 |
$35.75 |
$35.75 |
$44.80
|
|
Cv line/pic reposition
|
$51,392.17 |
$51,392.17 |
$51,392.17 |
$1,681.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$60.45 |
$60.45 |
$60.45 |
$91.20
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,388.42 |
$2,388.42 |
$2,388.42 |
$2.42
|
|
Cyclosporine 2 hour
|
$284.70 |
$284.70 |
$284.70 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$4.87 |
$4.87 |
$4.87 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$16.07 |
$16.07 |
$16.07 |
$19.50
|
|
Cyp2c19 gene com variants
|
$583.05 |
$583.05 |
$583.05 |
$583.20
|
|
Cyp3a4 gene common variants
|
$538.85 |
$538.85 |
$538.85 |
$245.31
|
|
Cystatin c
|
$67.60 |
$67.60 |
$67.60 |
$83.20
|
|
Cystic fibrosis cftr
|
$936.65 |
$936.65 |
$936.65 |
$1,041.95
|
|
Cystine urine quantitative
|
$136.50 |
$136.50 |
$136.50 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$644.80 |
$644.80 |
$644.80 |
$487.04
|
|
Cystoscopy and biopsy
|
$15,227.34 |
$15,227.34 |
$15,227.34 |
$3,769.31
|
|
Cystoscopy and treatment
|
$13,334.94 |
$13,334.94 |
$13,334.94 |
$3,970.98
|
|
Cystoscopy and treatment
|
$13,718.72 |
$13,718.72 |
$13,718.72 |
$4,160.10
|
|
Cystoscopy and treatment
|
$18,231.92 |
$18,231.92 |
$18,231.92 |
$4,846.99
|
|
Cystoscopy and treatment
|
$18,572.81 |
$18,572.81 |
$18,572.81 |
$4,846.99
|
|
Cystoscopy and treatment
|
$20,041.38 |
$20,041.38 |
$20,041.38 |
$5,949.75
|
|
Cystoscopy and treatment
|
$12,692.29 |
$12,692.29 |
$12,692.29 |
$2,355.42
|
|
Cystoscopy and treatment
|
$15,976.95 |
$15,976.95 |
$15,976.95 |
$2,331.55
|
|
Cystoscopy and treatment
|
$13,919.62 |
$13,919.62 |
$13,919.62 |
$2,267.41
|
|
Cystoscopy and treatment
|
$10,503.82 |
$10,503.82 |
$10,503.82 |
$802.40
|
|
Cystoscopy and treatment
|
$27,100.50 |
$27,100.50 |
$27,100.50 |
$2,874.36
|
|
Cystoscopy and treatment
|
$20,605.47 |
$20,605.47 |
$20,605.47 |
$3,769.20
|
|
Cystoscopy (Bladder Scope)
|
$15,258.72 |
$15,258.72 |
$15,258.72 |
$1,633.60
|
|
Cystoscopy chemodenervation
|
$12,319.08 |
$12,319.08 |
$12,319.08 |
$2,412.45
|
|
Cystoscopy & ureter catheter
|
$13,474.62 |
$13,474.62 |
$13,474.62 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$14,453.61 |
$14,453.61 |
$14,453.61 |
$3,276.00
|
|
Cystouretero & or pyeloscope
|
$14,682.65 |
$14,682.65 |
$14,682.65 |
$4,061.71
|
|
Cysto/uretero stricture tx
|
$22,376.69 |
$22,376.69 |
$22,376.69 |
$3,820.84
|
|
Cystouretero w/biopsy
|
$20,569.96 |
$20,569.96 |
$20,569.96 |
$4,447.24
|
|
Cysto/uretero w/lithotripsy
|
$34,015.04 |
$34,015.04 |
$34,015.04 |
$7,372.68
|
|
Cystouretero w/lithotripsy
|
$31,362.94 |
$31,362.94 |
$31,362.94 |
$7,372.68
|
|
Cystouretero w/stone remove
|
$19,825.68 |
$19,825.68 |
$19,825.68 |
$4,846.99
|
|
Cystourethroscop/calib/dilat stric 52281
|
$13,053.69 |
$13,053.69 |
$13,053.69 |
$2,874.36
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$15,882.54 |
$15,882.54 |
$15,882.54 |
$3,970.98
|
|
Cysto w/ureter stricture tx
|
$23,402.79 |
$23,402.79 |
$23,402.79 |
$4,074.86
|
|
Cytogenetics 25-99
|
$177.45 |
$177.45 |
$177.45 |
$188.40
|
|
Cytomegalovirus (cmv) antibody igg
|
$194.35 |
$194.35 |
$194.35 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$189.80 |
$189.80 |
$189.80 |
$95.00
|
|
Cyto/molecular report
|
$57.85 |
$57.85 |
$57.85 |
$91.65
|
|
Cytopathology cellular enhancement technique non-gyn
|
$40.95 |
$40.95 |
$40.95 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$49.40 |
$49.40 |
$49.40 |
$98.00
|
|
Cytopathology concentration technique smears & interpretation
|
$219.05 |
$219.05 |
$219.05 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$226.20 |
$226.20 |
$226.20 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$33.80 |
$33.80 |
$33.80 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$33.80 |
$33.80 |
$33.80 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$33.80 |
$33.80 |
$33.80 |
$205.00
|
|
Cytopath smear other source
|
$130.00 |
$130.00 |
$130.00 |
$88.13
|
|
Dacarbazine 100 mg intravenous solution
|
$35.75 |
$35.75 |
$35.75 |
$39.53
|
|
Dalbavancin 500 mg intravenous solution
|
$3,469.30 |
$3,469.30 |
$3,469.30 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$60.42 |
$60.42 |
$60.42 |
$1.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$18,269.38 |
$18,269.38 |
$18,269.38 |
$15,683.37
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$7,546.50 |
$7,546.50 |
$7,546.50 |
$4,542.99
|
|
Dch validity tests
|
$40.30 |
$40.30 |
$40.30 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$39.65 |
$39.65 |
$39.65 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$332.15 |
$332.15 |
$332.15 |
$313.30
|
|
Decalcification
|
$9,633.90 |
$9,633.90 |
$9,633.90 |
$72.15
|
|
Decitabine 50 mg intravenous solution
|
$787.80 |
$787.80 |
$787.80 |
$225.55
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$5,239.10 |
$5,239.10 |
$5,239.10 |
$482.35
|
|
Decompression unspecified nerve 64722
|
$18,440.60 |
$18,440.60 |
$18,440.60 |
$2,163.32
|
|
Decompress spinal cord lmbr
|
$39,861.45 |
$39,861.45 |
$39,861.45 |
$7,907.11
|
|
Deferoxamine 500 mg solution for injection
|
$47.97 |
$47.97 |
$47.97 |
$47.62
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$224.25 |
$224.25 |
$224.25 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$5,781.80 |
$5,781.80 |
$5,781.80 |
$4,681.80
|
|
Design mlc device for imrt
|
$36,631.40 |
$36,631.40 |
$36,631.40 |
$1,677.86
|
|
Desmopressin 4 mcg/ml injection solution
|
$32.10 |
$32.10 |
$32.10 |
$37.26
|
|
Dest mal lesion feenlm <0.5cm 17280
|
$68.90 |
$68.90 |
$68.90 |
$307.26
|