|
Cta abdomen without & /or w/contrast
|
$3,111.66 |
$3,111.66 |
$3,111.66 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,568.27 |
$2,568.27 |
$2,568.27 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,040.22 |
$2,040.22 |
$2,040.22 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,139.93 |
$2,139.93 |
$2,139.93 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,614.88 |
$2,614.88 |
$2,614.88 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,439.65 |
$2,439.65 |
$2,439.65 |
$1,940.00
|
|
CT Angiogram of the Head
|
$1,967.65 |
$1,967.65 |
$1,967.65 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$238.36 |
$238.36 |
$238.36 |
$1,500.38
|
|
CT angio pelvis
|
$1,031.32 |
$1,031.32 |
$1,031.32 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$2,044.35 |
$2,044.35 |
$2,044.35 |
$1,698.00
|
|
CT bone density axial
|
$251.93 |
$251.93 |
$251.93 |
$387.62
|
|
CT colonography dx
|
$1,316.29 |
$1,316.29 |
$1,316.29 |
$791.00
|
|
CT colonography dx w/dye
|
$1,643.74 |
$1,643.74 |
$1,643.74 |
$1,037.00
|
|
CT colonography screening
|
$2,793.06 |
$2,793.06 |
$2,793.06 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,576.48 |
$1,576.48 |
$1,576.48 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,903.34 |
$1,903.34 |
$1,903.34 |
$1,178.52
|
|
CT guid parench tis ablat
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$171.69 |
$171.69 |
$171.69 |
$171.60
|
|
CT hrt c+ strux cgen hrt ds
|
$214.76 |
$214.76 |
$214.76 |
$1,371.50
|
|
CT hrt w/3d image
|
$214.76 |
$214.76 |
$214.76 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$742.81 |
$742.81 |
$742.81 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,840.80 |
$1,840.80 |
$1,840.80 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,422.49 |
$1,422.49 |
$1,422.49 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$2,050.25 |
$2,050.25 |
$2,050.25 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,917.50 |
$1,917.50 |
$1,917.50 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,466.74 |
$1,466.74 |
$1,466.74 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,349.97 |
$2,349.97 |
$2,349.97 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,431.98 |
$2,431.98 |
$2,431.98 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$2,053.79 |
$2,053.79 |
$2,053.79 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,837.85 |
$1,837.85 |
$1,837.85 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$235.41 |
$235.41 |
$235.41 |
$437.04
|
|
CT scan for therapy guide
|
$820.69 |
$820.69 |
$820.69 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,089.34 |
$5,089.34 |
$5,089.34 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,558.88 |
$3,558.88 |
$3,558.88 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,704.56 |
$2,704.56 |
$2,704.56 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,920.45 |
$1,920.45 |
$1,920.45 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,674.42 |
$1,674.42 |
$1,674.42 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,239.00 |
$1,239.00 |
$1,239.00 |
$331.50
|
|
CT t-spine w /wo contrast
|
$1,936.97 |
$1,936.97 |
$1,936.97 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,767.64 |
$1,767.64 |
$1,767.64 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,515.12 |
$1,515.12 |
$1,515.12 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,124.59 |
$2,124.59 |
$2,124.59 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$71.39 |
$71.39 |
$71.39 |
$68.64
|
|
Culture afb any source
|
$184.08 |
$184.08 |
$184.08 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$54.28 |
$54.28 |
$54.28 |
$79.00
|
|
Culture anaerobic except blood
|
$116.82 |
$116.82 |
$116.82 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$57.82 |
$57.82 |
$57.82 |
$51.45
|
|
Culture body fluid
|
$105.02 |
$105.02 |
$105.02 |
$126.75
|
|
Culture fungi definitive id mold
|
$105.61 |
$105.61 |
$105.61 |
$77.28
|
|
Culture fungi definitive id yeast
|
$97.94 |
$97.94 |
$97.94 |
$79.10
|
|
Culture fungi other (except blood)
|
$178.77 |
$178.77 |
$178.77 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$112.69 |
$112.69 |
$112.69 |
$74.88
|
|
Culture mycoplasma any source
|
$43.07 |
$43.07 |
$43.07 |
$85.26
|
|
Culture screening strep group a
|
$75.52 |
$75.52 |
$75.52 |
$81.00
|
|
Culture typing immunologic
|
$52.51 |
$52.51 |
$52.51 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$159.30 |
$159.30 |
$159.30 |
$133.90
|
|
Culture urine each isolate
|
$79.06 |
$79.06 |
$79.06 |
$57.00
|
|
Cutter lead
|
$5,074.59 |
$5,074.59 |
$5,074.59 |
$6,092.06
|
|
Cv line/pic reposition
|
$1,070.85 |
$1,070.85 |
$1,070.85 |
$1,720.93
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$3.78 |
$3.78 |
$3.78 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$113.28 |
$113.28 |
$113.28 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$205.87 |
$205.87 |
$205.87 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$4.05 |
$4.05 |
$4.05 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$7.54 |
$7.54 |
$7.54 |
$140.78
|
|
Cyclosporine 2 hour
|
$41.89 |
$41.89 |
$41.89 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$2.43 |
$2.43 |
$2.43 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$8.51 |
$8.51 |
$8.51 |
$34.88
|
|
Cylinder pump set 20cm titan zero angl
|
$15,688.22 |
$15,688.22 |
$15,688.22 |
$22,803.38
|
|
Cystatin c
|
$58.41 |
$58.41 |
$58.41 |
$77.50
|
|
Cystine urine quantitative
|
$205.32 |
$205.32 |
$205.32 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$538.67 |
$538.67 |
$538.67 |
$542.10
|
|
Cystouretero & or pyeloscope
|
$2,443.78 |
$2,443.78 |
$2,443.78 |
$4,315.98
|
|
Cytarabine 20 mg/ml injection solution
|
$0.55 |
$0.55 |
$0.55 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$79.06 |
$79.06 |
$79.06 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$83.19 |
$83.19 |
$83.19 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$107.97 |
$107.97 |
$107.97 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$57.82 |
$57.82 |
$57.82 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$40.71 |
$40.71 |
$40.71 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$116.82 |
$116.82 |
$116.82 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$116.23 |
$116.23 |
$116.23 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$21.83 |
$21.83 |
$21.83 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$300.31 |
$300.31 |
$300.31 |
$209.23
|
|
Cytopath smear oth prep screen & interp
|
$64.90 |
$64.90 |
$64.90 |
$96.20
|
|
Dacarbazine 100 mg intravenous solution
|
$6.37 |
$6.37 |
$6.37 |
$58.22
|
|
Dactinomycin 0.5 mg intravenous solution
|
$378.06 |
$378.06 |
$378.06 |
$3,024.59
|
|
Dalbavancin 500 mg intravenous solution
|
$912.04 |
$912.04 |
$912.04 |
$3,480.35
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$413.75 |
$413.75 |
$413.75 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,200.55 |
$2,200.55 |
$2,200.55 |
$6,072.48
|
|
Dch pulmonary stress test
|
$1,049.02 |
$1,049.02 |
$1,049.02 |
$963.30
|
|
Dch validity tests
|
$21.83 |
$21.83 |
$21.83 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$57.23 |
$57.23 |
$57.23 |
$43.60
|
|
Debridement (>20 cm) charge pt
|
$372.29 |
$372.29 |
$372.29 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$1,197.11 |
$1,197.11 |
$1,197.11 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$687.35 |
$687.35 |
$687.35 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$746.94 |
$746.94 |
$746.94 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$849.01 |
$849.01 |
$849.01 |
$810.50
|
|
Debride nail1-5 11720
|
$129.80 |
$129.80 |
$129.80 |
$148.80
|
|
Debride nail6 or more 11721
|
$139.83 |
$139.83 |
$139.83 |
$169.60
|
|
Debride skin bone at fx site
|
$1,251.98 |
$1,251.98 |
$1,251.98 |
$3,015.00
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$577.02 |
$577.02 |
$577.02 |
$639.60
|