|
CT thoracic spine w/contrast
|
$558.24 |
$558.24 |
$558.24 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$503.04 |
$503.04 |
$503.04 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$428.47 |
$428.47 |
$428.47 |
$427.43
|
|
CT t-spine w /wo contrast
|
$575.94 |
$575.94 |
$575.94 |
$2,033.46
|
|
Cult skin graft fnhfg 15155
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,528.11
|
|
Cult skin grft t/arm/leg
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,154.21
|
|
Culture aerobic additional method definitive id each
|
$8.89 |
$8.89 |
$8.89 |
$63.12
|
|
Culture afb any source
|
$11.88 |
$11.88 |
$11.88 |
$107.92
|
|
Culture anaerobic additional method definitive id each
|
$8.89 |
$8.89 |
$8.89 |
$77.31
|
|
Culture anaerobic except blood
|
$10.42 |
$10.42 |
$10.42 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$10.38 |
$10.38 |
$10.38 |
$52.50
|
|
Culture body fluid
|
$9.48 |
$9.48 |
$9.48 |
$130.50
|
|
Culture fungi definitive id mold
|
$11.35 |
$11.35 |
$11.35 |
$70.00
|
|
Culture fungi definitive id yeast
|
$11.35 |
$11.35 |
$11.35 |
$79.10
|
|
Culture fungi other (except blood)
|
$9.25 |
$9.25 |
$9.25 |
$96.00
|
|
Culture fungi skin/hair/nail
|
$8.48 |
$8.48 |
$8.48 |
$77.22
|
|
Culture mycobacteria definitive id each isolate
|
$16.07 |
$16.07 |
$16.07 |
$88.14
|
|
Culture mycoplasma any source
|
$16.93 |
$16.93 |
$16.93 |
$90.75
|
|
Culture quantitative aerobic other source
|
$10.88 |
$10.88 |
$10.88 |
$85.80
|
|
Culture screening strep group a
|
$7.29 |
$7.29 |
$7.29 |
$78.80
|
|
Culture typing added method
|
$8.51 |
$8.51 |
$8.51 |
$34.45
|
|
Culture typing immunologic
|
$5.70 |
$5.70 |
$5.70 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$239.87 |
$239.87 |
$239.87 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$38.60 |
$38.60 |
$38.60 |
$115.05
|
|
Culture urine each isolate
|
$8.90 |
$8.90 |
$8.90 |
$46.20
|
|
Culture virus isolation
|
$21.52 |
$21.52 |
$21.52 |
$39.20
|
|
Curette/treat cornea
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,317.39
|
|
Curette/treat cornea
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,760.73
|
|
Cv line/pic reposition
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,761.07
|
|
Cyanocobalamin unsat binding capacity
|
$15.75 |
$15.75 |
$15.75 |
$64.28
|
|
Cyclic citrullinated peptide antibody
|
$14.25 |
$14.25 |
$14.25 |
$85.20
|
|
Cyclosporine 2 hour
|
$19.86 |
$19.86 |
$19.86 |
$119.40
|
|
Cyp2c19 gene com variants
|
$320.50 |
$320.50 |
$320.50 |
$567.75
|
|
Cyp2c9 gene com variants
|
$192.29 |
$192.29 |
$192.29 |
$275.10
|
|
Cyp2d6 gene com variants
|
$496.00 |
$496.00 |
$496.00 |
$537.50
|
|
Cyp3a4 gene common variants
|
$192.29 |
$192.29 |
$192.29 |
$235.20
|
|
Cyp3a5 gene common variants
|
$192.29 |
$192.29 |
$192.29 |
$230.01
|
|
Cystatin c
|
$20.37 |
$20.37 |
$20.37 |
$82.50
|
|
Cystic fibrosis cftr
|
$548.90 |
$548.90 |
$548.90 |
$1,041.95
|
|
Cystine urine quantitative
|
$25.28 |
$25.28 |
$25.28 |
$103.35
|
|
Cysto cgen post urtl valves
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,061.71
|
|
Cystogram >= 3 views supervision & interpretation
|
$287.66 |
$287.66 |
$287.66 |
$527.50
|
|
Cystometrogram w/up 51727
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$857.38
|
|
Cystorrhaphy wound simple 51860
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,296.14
|
|
Cysto rx balo cath urtl strx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,015.75
|
|
Cystoscopy and biopsy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,986.00
|
|
Cystoscopy and radiotracer
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,056.00
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,160.10
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,846.99
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,949.75
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,331.55
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,817.53
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,358.72
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$802.40
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,412.45
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,786.00
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,900.67
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,881.00
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,018.60
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,219.80
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,891.34
|
|
Cystoscopy and treatment
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,820.84
|
|
Cystoscopy (Bladder Scope)
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$1,619.67
|
|
Cystoscopy chemodenervation
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,331.55
|
|
Cystoscopy & duct catheter
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$822.50
|
|
Cystoscopy implant stent
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,990.61
|
|
Cystoscopy inject material
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,350.00
|
|
Cystoscopy removal of clots
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,817.53
|
|
Cystoscopy & revise urethra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,269.38
|
|
Cystoscopy & revise urethra
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,412.45
|
|
Cystoscopy stone removal
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,627.00
|
|
Cystoscopy & ureter catheter
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,416.48
|
|
Cystostomy cystotomy w/drainage 51040
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,786.00
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,820.84
|
|
Cystotomy excise/incise/repair 51535
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,940.80
|
|
Cystouretero & or pyeloscope
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,024.52
|
|
Cystouretero w/biopsy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,447.24
|
|
Cystouretero w/excise tumor
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,986.00
|
|
Cysto/uretero w/lithotripsy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$5,741.00
|
|
Cystouretero w/lithotripsy
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$6,015.75
|
|
Cystouretero w/renal strict
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,986.00
|
|
Cystouretero w/stone remove
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,724.46
|
|
Cysto/uretero w/up stricture
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,817.53
|
|
Cystourethro cut ejacul duct
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,817.53
|
|
Cystourethroscop/calib/dilat stric 52281
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,845.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,970.98
|
|
Cysto w/renal stricture tx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,817.53
|
|
Cysto w/up stricture tx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$3,820.84
|
|
Cysto w/ureter stricture tx
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$4,081.37
|
|
Cytogenetics 25-99
|
$46.62 |
$46.62 |
$46.62 |
$180.32
|
|
Cytogenetics 3-5
|
$44.77 |
$44.77 |
$44.77 |
$127.64
|
|
Cytogenomic neo microra alys
|
$1,276.00 |
$1,276.00 |
$1,276.00 |
$1,773.20
|
|
Cytogenom microarray copy nmbr var
|
$990.00 |
$990.00 |
$990.00 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$15.83 |
$15.83 |
$15.83 |
$102.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$18.54 |
$18.54 |
$18.54 |
$104.50
|