|
CT scan for therapy guide
|
$720.00 |
$720.00 |
$744.70 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,002.00 |
$2,002.00 |
$2,090.00 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,930.50 |
$1,930.50 |
$2,062.50 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,115.40 |
$1,115.40 |
$1,650.00 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,501.50 |
$1,501.50 |
$1,576.85 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$858.00 |
$858.00 |
$935.00 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$101.20 |
$101.20 |
$101.20 |
$400.20
|
|
CT t-spine w /wo contrast
|
$1,858.45 |
$1,858.45 |
$2,030.60 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$1,265.00 |
$1,265.00 |
$1,501.50 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$878.02 |
$878.02 |
$990.00 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$1,493.80 |
$1,493.80 |
$2,002.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$42.35 |
$42.35 |
$44.00 |
$63.75
|
|
Culture afb any source
|
$80.85 |
$80.85 |
$110.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$12.65 |
$12.65 |
$53.90 |
$77.31
|
|
Culture anaerobic except blood
|
$45.10 |
$45.10 |
$71.50 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$38.50 |
$38.50 |
$42.35 |
$52.80
|
|
Culture body fluid
|
$66.00 |
$66.00 |
$116.05 |
$130.50
|
|
Culture fungi definitive id mold
|
$44.00 |
$44.00 |
$50.05 |
$70.00
|
|
Culture fungi definitive id yeast
|
$48.40 |
$48.40 |
$49.50 |
$80.60
|
|
Culture fungi other (except blood)
|
$40.15 |
$40.15 |
$82.50 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$46.20 |
$46.20 |
$88.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$60.50 |
$60.50 |
$133.10 |
$84.75
|
|
Culture mycoplasma any source
|
$82.50 |
$82.50 |
$133.10 |
$90.37
|
|
Culture quantitative aerobic other source
|
$112.75 |
$112.75 |
$247.50 |
$87.02
|
|
Culture screening strep group a
|
$38.50 |
$38.50 |
$61.60 |
$81.60
|
|
Culture typing immunologic
|
$33.00 |
$33.00 |
$40.70 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$462.00 |
$462.00 |
$514.80 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$64.35 |
$64.35 |
$93.50 |
$124.40
|
|
Culture urine each isolate
|
$37.95 |
$37.95 |
$44.00 |
$46.20
|
|
Cutter lead
|
$569.11 |
$569.11 |
$1,849.23 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,937.10 |
$1,937.10 |
$2,852.14 |
$1,829.42
|
|
Cyanocobalamin unsat binding capacity
|
$37.40 |
$37.40 |
$37.40 |
$60.00
|
|
Cyclic citrullinated peptide antibody
|
$45.65 |
$45.65 |
$55.00 |
$80.05
|
|
Cyclosporine 2 hour
|
$92.95 |
$92.95 |
$110.00 |
$121.80
|
|
Cylinder pump set 20cm titan zero angl
|
$18,399.64 |
$18,399.64 |
$18,399.64 |
$22,594.80
|
|
Cystatin c
|
$34.65 |
$34.65 |
$66.00 |
$82.26
|
|
Cystic fibrosis cftr
|
$1,335.95 |
$1,335.95 |
$1,335.95 |
$1,041.95
|
|
Cystine urine quantitative
|
$59.95 |
$59.95 |
$882.20 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$631.40 |
$631.40 |
$956.82 |
$539.55
|
|
Cystoscopy and treatment
|
$4,466.00 |
$4,466.00 |
$4,466.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,829.85 |
$1,829.85 |
$2,759.90 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$968.00 |
$968.00 |
$968.00 |
$1,610.20
|
|
Cystoscopy removal of clots
|
$1,840.85 |
$1,840.85 |
$1,840.85 |
$3,970.98
|
|
Cystoscopy & ureter catheter
|
$2,849.55 |
$2,849.55 |
$2,849.55 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$5,191.45 |
$5,191.45 |
$5,191.45 |
$3,774.40
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,849.55 |
$2,849.55 |
$2,849.55 |
$2,874.36
|
|
Cytogenetics 25-99
|
$440.00 |
$440.00 |
$462.00 |
$180.32
|
|
Cytogenetics 3-5
|
$100.65 |
$100.65 |
$165.00 |
$127.64
|
|
Cytogenomic neo microra alys
|
$1,773.20 |
$1,773.20 |
$2,086.15 |
$1,911.78
|
|
Cytogenom microarray copy nmbr var
|
$3,424.85 |
$3,424.85 |
$3,630.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$180.40 |
$180.40 |
$242.55 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$40.70 |
$40.70 |
$104.50 |
$96.80
|
|
Cyto/molecular report
|
$187.00 |
$187.00 |
$391.05 |
$144.75
|
|
Cytopath fl nongyn filter
|
$73.70 |
$73.70 |
$73.70 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$111.65 |
$111.65 |
$148.50 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$31.90 |
$31.90 |
$47.85 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$37.95 |
$37.95 |
$92.40 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$86.90 |
$86.90 |
$124.85 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$108.90 |
$108.90 |
$190.85 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$15.40 |
$15.40 |
$123.20 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$154.55 |
$154.55 |
$227.70 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$57.20 |
$57.20 |
$143.55 |
$205.00
|
|
Cytopath smear other source
|
$74.80 |
$74.80 |
$74.80 |
$85.80
|
|
Cytopath smear oth prep screen & interp
|
$30.25 |
$30.25 |
$102.85 |
$95.89
|
|
Cytopath tbs c/v manual
|
$35.75 |
$35.75 |
$51.70 |
$57.94
|
|
Cytotoxic antibody screening
|
$67.10 |
$67.10 |
$165.55 |
$157.60
|
|
Cytotoxic antibody screening
|
$579.70 |
$579.70 |
$1,006.50 |
$75.20
|
|
Cytp urine 3-5 probes cmptr
|
$1,133.55 |
$1,133.55 |
$1,133.55 |
$690.00
|
|
Dch pulmonary stress test
|
$752.90 |
$752.90 |
$1,089.55 |
$964.41
|
|
Dch validity tests
|
$22.00 |
$22.00 |
$95.70 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$12.10 |
$12.10 |
$98.45 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,056.06 |
$1,056.06 |
$1,056.06 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$221.65 |
$221.65 |
$274.56 |
$262.60
|
|
Debridement bone <= 20 sq cm
|
$2,293.00 |
$2,293.00 |
$2,791.80 |
$2,553.60
|
|
Debridement/bone/20 sq cm or less 11046
|
$629.92 |
$629.92 |
$910.25 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,632.34 |
$1,632.34 |
$1,632.34 |
$1,283.44
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,131.13 |
$1,131.13 |
$2,228.05 |
$810.50
|
|
Debride nail1-5 11720
|
$108.90 |
$108.90 |
$180.90 |
$173.25
|
|
Debride nail6 or more 11721
|
$108.90 |
$108.90 |
$108.90 |
$195.20
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$3,387.45 |
$3,387.45 |
$3,387.45 |
$1,265.16
|
|
Debride skin bone at fx site
|
$2,569.00 |
$2,569.00 |
$5,133.70 |
$3,278.34
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$793.65 |
$793.65 |
$1,065.90 |
$663.30
|
|
Debrid mastoidectomy cavity simple 69220
|
$263.12 |
$263.12 |
$341.55 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$852.50 |
$852.50 |
$1,734.59 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$274.56 |
$274.56 |
$274.56 |
$113.05
|
|
Debr musc/fascia 20sq cm/< 11043
|
$2,814.35 |
$2,814.35 |
$2,814.35 |
$1,193.40
|
|
Decalcification
|
$27.50 |
$27.50 |
$102.30 |
$73.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$878.02 |
$878.02 |
$1,782.00 |
$545.90
|
|
Decomp forearm 1 space 25020
|
$6,405.85 |
$6,405.85 |
$6,405.85 |
$3,137.60
|
|
Deep muscle biopsy 20205
|
$4,954.24 |
$4,954.24 |
$5,715.05 |
$3,370.52
|
|
Delay flap arms/legs
|
$7,610.35 |
$7,610.35 |
$7,610.35 |
$2,164.64
|
|
Delay flap eye/nos/ear/lip
|
$181.32 |
$181.32 |
$181.32 |
$2,190.24
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$175.18 |
$175.18 |
$198.00 |
$196.26
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$238.81 |
$238.81 |
$1,162.70 |
$460.50
|
|
Descend thora aorta rpr/lt sub art 33880
|
$3,093.75 |
$3,093.75 |
$3,093.75 |
$5,702.04
|
|
Design mlc device for imrt
|
$1,570.25 |
$1,570.25 |
$1,570.25 |
$1,669.85
|
|
Desoxycorticosterone
|
$173.80 |
$173.80 |
$173.80 |
$109.28
|
|
Des thora aorta/ea add prox prosth 33884
|
$1,304.05 |
$1,304.05 |
$1,304.05 |
$1,285.78
|
|
Des thora aorta rpr without left sub art 33881
|
$2,688.95 |
$2,688.95 |
$2,688.95 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$1,645.60 |
$1,645.60 |
$1,645.60 |
$2,498.88
|
