|
Computed tomographic angiography head and neck with contrast
|
$1,069.29 |
$1,069.29 |
$1,069.29 |
$2,237.25
|
|
Conjugated estrogens 25 mg solution for injection
|
$438.50 |
$438.50 |
$438.50 |
$839.07
|
|
Consultation pathology during surgery cytological exam initial site
|
$600.60 |
$600.60 |
$600.60 |
$407.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$118.97 |
$118.97 |
$118.97 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,022.77 |
$1,022.77 |
$1,022.77 |
$224.87
|
|
Consultation/report referred slides prepared elsewhere
|
$1,273.56 |
$1,273.56 |
$1,273.56 |
$176.15
|
|
Coombs indirect qualitative each reagent red cell reference
|
$45.82 |
$45.82 |
$45.82 |
$102.90
|
|
Cortisol acth stimulation test - sendout
|
$199.59 |
$199.59 |
$199.59 |
$146.25
|
|
Cortisol total am
|
$974.82 |
$974.82 |
$974.82 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$547.58 |
$547.58 |
$547.58 |
$189.02
|
|
C-peptide
|
$825.13 |
$825.13 |
$825.13 |
$93.60
|
|
Crbrospnl fld flw imag cistern
|
$16,303.19 |
$16,303.19 |
$16,303.19 |
$1,281.00
|
|
C-reactive protein high sensitivity
|
$1,283.75 |
$1,283.75 |
$1,283.75 |
$85.00
|
|
Creatine kinase
|
$422.17 |
$422.17 |
$422.17 |
$65.60
|
|
Creatine kinase isoenzymes
|
$224.50 |
$224.50 |
$224.50 |
$54.60
|
|
Creatine kinase mb
|
$888.46 |
$888.46 |
$888.46 |
$113.63
|
|
Creatinine
|
$318.55 |
$318.55 |
$318.55 |
$45.65
|
|
Creatinine clearance urine
|
$671.61 |
$671.61 |
$671.61 |
$89.28
|
|
#creutz-prot.,western blot
|
$1,059.24 |
$1,059.24 |
$1,059.24 |
$163.50
|
|
Critical care 30-74 minutes
|
$7,093.93 |
$7,093.93 |
$7,093.93 |
$2,519.00
|
|
Crotalidae poly immune fab
|
$10,352.41 |
$10,352.41 |
$10,352.41 |
$5,760.00
|
|
Cryptococcus abs qn - sendout
|
$230.25 |
$230.25 |
$230.25 |
$89.70
|
|
Crystal identification light microscopy
|
$316.62 |
$316.62 |
$316.62 |
$65.50
|
|
Cta abdomen without & /or w/contrast
|
$26,664.07 |
$26,664.07 |
$26,664.07 |
$2,002.00
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$26,664.07 |
$26,664.07 |
$26,664.07 |
$1,916.50
|
|
CT Angiogram of Abdomen and Pelvis
|
$55,991.35 |
$55,991.35 |
$55,991.35 |
$2,842.40
|
|
CT angio hrt w/3d image
|
$782.82 |
$782.82 |
$782.82 |
$1,424.40
|
|
CT guidance for needle placement
|
$17,581.34 |
$17,581.34 |
$17,581.34 |
$1,498.20
|
|
CT guid parench tis ablat
|
$7,603.62 |
$7,603.62 |
$7,603.62 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$462.32 |
$462.32 |
$462.32 |
$156.00
|
|
CT hrt c+ strux cgen hrt ds
|
$782.82 |
$782.82 |
$782.82 |
$1,371.50
|
|
CT hrt w/3d image
|
$2,666.12 |
$2,666.12 |
$2,666.12 |
$1,350.03
|
|
Ctlso a-p-l control molded
|
$10,142.00 |
$10,142.00 |
$10,142.00 |
$3,746.69
|
|
CT scan for localization
|
$13,880.01 |
$13,880.01 |
$13,880.01 |
$1,205.14
|
|
CT scan for therapy guide
|
$9,155.02 |
$9,155.02 |
$9,155.02 |
$656.13
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$30,180.34 |
$30,180.34 |
$30,180.34 |
$3,408.50
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$24,142.55 |
$24,142.55 |
$24,142.55 |
$2,871.05
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$26,247.67 |
$26,247.67 |
$26,247.67 |
$2,295.00
|
|
CT thorax low dose for lung screening without contrast
|
$726.21 |
$726.21 |
$726.21 |
$332.00
|
|
Culture afb any source
|
$479.78 |
$479.78 |
$479.78 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$95.33 |
$95.33 |
$95.33 |
$84.76
|
|
Culture anaerobic except blood
|
$385.47 |
$385.47 |
$385.47 |
$120.54
|
|
Culture fungi definitive id mold
|
$496.32 |
$496.32 |
$496.32 |
$80.00
|
|
Culture fungi definitive id yeast
|
$496.32 |
$496.32 |
$496.32 |
$79.50
|
|
Culture mycobacteria definitive id each isolate
|
$496.32 |
$496.32 |
$496.32 |
$100.00
|
|
Culture mycoplasma any source
|
$626.38 |
$626.38 |
$626.38 |
$81.62
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$28.41 |
$28.41 |
$28.41 |
$138.40
|
|
Culture urine each isolate
|
$496.32 |
$496.32 |
$496.32 |
$54.78
|
|
Cyanocobalamin unsat binding capacity
|
$710.01 |
$710.01 |
$710.01 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$90.50 |
$90.50 |
$90.50 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$356.92 |
$356.92 |
$356.92 |
$72.15
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$113.64 |
$113.64 |
$113.64 |
$140.78
|
|
Cyclosporine 2 hour
|
$1,170.55 |
$1,170.55 |
$1,170.55 |
$129.48
|
|
Cystatin c
|
$383.78 |
$383.78 |
$383.78 |
$76.48
|
|
Cytarabine 20 mg/ml injection solution
|
$359.70 |
$359.70 |
$359.70 |
$90.00
|
|
Cytogenetics 25-99
|
$138.12 |
$138.12 |
$138.12 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$46.05 |
$46.05 |
$46.05 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$1,608.03 |
$1,608.03 |
$1,608.03 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$140.08 |
$140.08 |
$140.08 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$67.25 |
$67.25 |
$67.25 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$278.24 |
$278.24 |
$278.24 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$199.59 |
$199.59 |
$199.59 |
$124.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$305.10 |
$305.10 |
$305.10 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$734.94 |
$734.94 |
$734.94 |
$209.92
|
|
Cytopath smear other source
|
$1,099.53 |
$1,099.53 |
$1,099.53 |
$140.07
|
|
Cytopath smear oth prep screen & interp
|
$880.76 |
$880.76 |
$880.76 |
$96.20
|
|
Cytopath tbs c/v manual
|
$710.01 |
$710.01 |
$710.01 |
$59.28
|
|
Cytopath tbs c/v redo
|
$752.22 |
$752.22 |
$752.22 |
$84.80
|
|
Dacarbazine 100 mg intravenous solution
|
$90.50 |
$90.50 |
$90.50 |
$62.70
|
|
Dactinomycin 0.5 mg intravenous solution
|
$4,293.52 |
$4,293.52 |
$4,293.52 |
$3,047.85
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$31,755.54 |
$31,755.54 |
$31,755.54 |
$21,063.03
|
|
Decalcification
|
$218.75 |
$218.75 |
$218.75 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$362.88 |
$362.88 |
$362.88 |
$1,073.52
|
|
Deferoxamine 500 mg solution for injection
|
$114.18 |
$114.18 |
$114.18 |
$95.85
|
|
Degarelix 120 mg subcutaneous solution
|
$1,145.12 |
$1,145.12 |
$1,145.12 |
$1,855.50
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$175.62 |
$175.62 |
$175.62 |
$182.40
|
|
Desmopressin 4 mcg/ml injection solution
|
$144.95 |
$144.95 |
$144.95 |
$93.84
|
|
Dexrazoxane hcl 250 mg intravenous solution
|
$1,600.80 |
$1,600.80 |
$1,600.80 |
$884.80
|
|
Dextran 40 infusion
|
$179.90 |
$179.90 |
$179.90 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$89.90 |
$89.90 |
$89.90 |
$36.00
|
|
Dextrose 5 % IV bolus
|
$128.56 |
$128.56 |
$128.56 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$951.75 |
$951.75 |
$951.75 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$406.81 |
$406.81 |
$406.81 |
$79.20
|
|
Diagnostic Mammogram (both breasts)
|
$1,503.61 |
$1,503.61 |
$1,503.61 |
$413.50
|
|
Diatrizoate meglumine 18 % urethral solution
|
$90.50 |
$90.50 |
$90.50 |
$115.15
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$313.11 |
$313.11 |
$313.11 |
$77.25
|
|
Dicyclomine injection
|
$146.68 |
$146.68 |
$146.68 |
$150.91
|
|
Diffusing capacity
|
$966.59 |
$966.59 |
$966.59 |
$335.20
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$90.50 |
$90.50 |
$90.50 |
$65.84
|
|
Digoxin immune fab 40 mg intravenous solution
|
$11,780.02 |
$11,780.02 |
$11,780.02 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$708.07 |
$708.07 |
$708.07 |
$102.07
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$143.85 |
$143.85 |
$143.85 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$90.50 |
$90.50 |
$90.50 |
$18.35
|
|
Disaccharidases
|
$152.70 |
$152.70 |
$152.70 |
$224.31
|
|
Dmd dup/delet analysis
|
$3,809.37 |
$3,809.37 |
$3,809.37 |
$418.50
|
|
Dna antibody native/double stranded
|
$326.24 |
$326.24 |
$326.24 |
$100.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$179.90 |
$179.90 |
$179.90 |
$98.29
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$179.90 |
$179.90 |
$179.90 |
$67.28
|
|
Dornase alfa non-comp unit
|
$224.10 |
$224.10 |
$224.10 |
$386.42
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$38,899.38 |
$38,899.38 |
$38,899.38 |
$23,613.78
|