|
Cryosurgery penis lesion(s) 54056
|
$89.05 |
$89.05 |
$89.05 |
$346.40
|
|
Cryptosporidium antigen
|
$114.40 |
$114.40 |
$114.40 |
$65.55
|
|
Crystal identification light microscopy
|
$89.05 |
$89.05 |
$89.05 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$2,208.05 |
$2,208.05 |
$2,208.05 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,181.70 |
$1,181.70 |
$1,181.70 |
$2,092.73
|
|
Cta neck without &/or w/contrast
|
$1,998.10 |
$1,998.10 |
$1,998.10 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,545.10 |
$3,545.10 |
$3,545.10 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,504.10 |
$1,504.10 |
$1,504.10 |
$1,728.80
|
|
CT Angiogram of the Head
|
$2,001.35 |
$2,001.35 |
$2,001.35 |
$1,951.50
|
|
CT angio pelvis
|
$772.85 |
$772.85 |
$772.85 |
$1,775.28
|
|
CT heart w/evaluation of calcium without contrast
|
$84.50 |
$84.50 |
$84.50 |
$176.89
|
|
CT limited or localized follow-up study
|
$713.05 |
$713.05 |
$713.05 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$1,426.75 |
$1,426.75 |
$1,426.75 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,196.35 |
$2,196.35 |
$2,196.35 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$1,817.40 |
$1,817.40 |
$1,817.40 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,444.30 |
$1,444.30 |
$1,444.30 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$1,191.45 |
$1,191.45 |
$1,191.45 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,794.00 |
$1,794.00 |
$1,794.00 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,002.65 |
$2,002.65 |
$2,002.65 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,740.05 |
$1,740.05 |
$1,740.05 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,370.85 |
$1,370.85 |
$1,370.85 |
$1,250.00
|
|
Ctrl nosebld postir subsq 30906
|
$569.40 |
$569.40 |
$569.40 |
$449.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,845.40 |
$3,845.40 |
$3,845.40 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,019.90 |
$3,019.90 |
$3,019.90 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,557.10 |
$2,557.10 |
$2,557.10 |
$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
|
$1,277.25 |
$1,277.25 |
$1,277.25 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$801.45 |
$801.45 |
$801.45 |
$418.50
|
|
CT t-spine w /wo contrast
|
$2,401.75 |
$2,401.75 |
$2,401.75 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$1,537.90 |
$1,537.90 |
$1,537.90 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$2,189.85 |
$2,189.85 |
$2,189.85 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,652.95 |
$1,652.95 |
$1,652.95 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$70.85 |
$70.85 |
$70.85 |
$61.03
|
|
Culture afb any source
|
$139.75 |
$139.75 |
$139.75 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$79.95 |
$79.95 |
$79.95 |
$73.00
|
|
Culture anaerobic except blood
|
$141.70 |
$141.70 |
$141.70 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$70.20 |
$70.20 |
$70.20 |
$49.40
|
|
Culture body fluid
|
$141.70 |
$141.70 |
$141.70 |
$111.15
|
|
Culture fungi definitive id mold
|
$72.15 |
$72.15 |
$72.15 |
$70.00
|
|
Culture fungi definitive id yeast
|
$72.80 |
$72.80 |
$72.80 |
$68.00
|
|
Culture fungi other (except blood)
|
$131.95 |
$131.95 |
$131.95 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$130.65 |
$130.65 |
$130.65 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$83.20 |
$83.20 |
$83.20 |
$79.00
|
|
Culture mycoplasma any source
|
$122.20 |
$122.20 |
$122.20 |
$94.00
|
|
Culture quantitative aerobic other source
|
$137.15 |
$137.15 |
$137.15 |
$63.45
|
|
Culture screening strep group a
|
$88.40 |
$88.40 |
$88.40 |
$76.00
|
|
Culture typing immunologic
|
$52.00 |
$52.00 |
$52.00 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$726.70 |
$726.70 |
$726.70 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$22.75 |
$22.75 |
$22.75 |
$100.20
|
|
Culture urine each isolate
|
$70.85 |
$70.85 |
$70.85 |
$44.80
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$112.45 |
$112.45 |
$112.45 |
$91.20
|
|
Cyclosporine 2 hour
|
$217.75 |
$217.75 |
$217.75 |
$126.10
|
|
Cyp2c19 gene com variants
|
$586.95 |
$586.95 |
$586.95 |
$583.20
|
|
Cyp3a4 gene common variants
|
$410.80 |
$410.80 |
$410.80 |
$245.31
|
|
Cystatin c
|
$115.70 |
$115.70 |
$115.70 |
$83.20
|
|
Cystic fibrosis cftr
|
$1,128.40 |
$1,128.40 |
$1,128.40 |
$1,041.95
|
|
Cystine urine quantitative
|
$181.35 |
$181.35 |
$181.35 |
$112.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$607.75 |
$607.75 |
$607.75 |
$487.04
|
|
Cystoscopy (Bladder Scope)
|
$512.20 |
$512.20 |
$512.20 |
$1,633.60
|
|
Cytogenetics 25-99
|
$261.30 |
$261.30 |
$261.30 |
$188.40
|
|
Cytogenom microarray copy nmbr var
|
$1,235.65 |
$1,235.65 |
$1,235.65 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$139.10 |
$139.10 |
$139.10 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$143.00 |
$143.00 |
$143.00 |
$95.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$129.35 |
$129.35 |
$129.35 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$82.55 |
$82.55 |
$82.55 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$93.60 |
$93.60 |
$93.60 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$135.20 |
$135.20 |
$135.20 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$121.55 |
$121.55 |
$121.55 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$96.20 |
$96.20 |
$96.20 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$194.35 |
$194.35 |
$194.35 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$213.85 |
$213.85 |
$213.85 |
$205.00
|
|
Cytopath smear other source
|
$81.25 |
$81.25 |
$81.25 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$117.00 |
$117.00 |
$117.00 |
$95.00
|
|
Cytopath tbs c/v manual
|
$53.95 |
$53.95 |
$53.95 |
$57.94
|
|
Cytotoxic antibody screening
|
$276.25 |
$276.25 |
$276.25 |
$184.63
|
|
Dacarbazine 100 mg intravenous solution
|
$39.53 |
$39.53 |
$39.53 |
$39.53
|
|
Dalbavancin 500 mg intravenous solution
|
$3,746.85 |
$3,746.85 |
$3,746.85 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$113.75 |
$113.75 |
$113.75 |
$1.80
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$29,371.77 |
$29,371.77 |
$29,371.77 |
$15,683.37
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$9,433.12 |
$9,433.12 |
$9,433.12 |
$4,542.99
|
|
Dch glucoscan
|
$14.95 |
$14.95 |
$14.95 |
$28.10
|
|
Dch pulmonary stress test
|
$744.25 |
$744.25 |
$744.25 |
$964.41
|
|
Dch validity tests
|
$39.00 |
$39.00 |
$39.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$126.10 |
$126.10 |
$126.10 |
$53.95
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$119.60 |
$119.60 |
$119.60 |
$677.54
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$277.55 |
$277.55 |
$277.55 |
$779.35
|
|
Debride skin bone at fx site
|
$1,699.10 |
$1,699.10 |
$1,699.10 |
$3,127.88
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,146.60 |
$1,146.60 |
$1,146.60 |
$1,146.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$552.50 |
$552.50 |
$552.50 |
$1,101.10
|
|
Decalcification
|
$11,982.74 |
$11,982.74 |
$11,982.74 |
$72.15
|
|
Decitabine 50 mg intravenous solution
|
$268.45 |
$268.45 |
$268.45 |
$225.55
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$1,104.43 |
$1,104.43 |
$1,104.43 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$112.87 |
$112.87 |
$112.87 |
$47.62
|
|
Degarelix 120 mg subcutaneous solution
|
$1,998.50 |
$1,998.50 |
$1,998.50 |
$2,303.24
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$139.10 |
$139.10 |
$139.10 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$9,291.74 |
$9,291.74 |
$9,291.74 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$382.20 |
$382.20 |
$382.20 |
$460.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$30.87 |
$30.87 |
$30.87 |
$37.26
|
|
Desoxycorticosterone
|
$146.90 |
$146.90 |
$146.90 |
$109.28
|