|
CT orbit/sella/fossa w/wo contrast
|
$697.80 |
$697.80 |
$697.80 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$590.31 |
$590.31 |
$590.31 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$364.02 |
$364.02 |
$364.02 |
$1,345.05
|
|
Ctrl nosebld postir subsq 30906
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$768.78 |
$768.78 |
$768.78 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$609.24 |
$609.24 |
$609.24 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$513.76 |
$513.76 |
$513.76 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$653.52 |
$653.52 |
$653.52 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$481.65 |
$481.65 |
$481.65 |
$1,436.50
|
|
CT thorax low dose for lung screening without contrast
|
$363.18 |
$363.18 |
$363.18 |
$420.60
|
|
CT t-spine w /wo contrast
|
$804.60 |
$804.60 |
$804.60 |
$2,030.60
|
|
Cult skin graft fnhfg 15155
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,528.11
|
|
Cult skin grft t/arm/leg
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,164.64
|
|
Culture aerobic additional method definitive id each
|
$8.89 |
$8.89 |
$8.89 |
$62.65
|
|
Culture afb any source
|
$11.88 |
$11.88 |
$11.88 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$8.89 |
$8.89 |
$8.89 |
$75.29
|
|
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 |
$129.21
|
|
Culture fungi definitive id mold
|
$11.35 |
$11.35 |
$11.35 |
$70.00
|
|
Culture fungi definitive id yeast
|
$11.35 |
$11.35 |
$11.35 |
$79.00
|
|
Culture fungi other (except blood)
|
$9.25 |
$9.25 |
$9.25 |
$94.90
|
|
Culture fungi skin/hair/nail
|
$8.48 |
$8.48 |
$8.48 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$16.07 |
$16.07 |
$16.07 |
$88.14
|
|
Culture mycoplasma any source
|
$16.93 |
$16.93 |
$16.93 |
$90.37
|
|
Culture quantitative aerobic other source
|
$10.88 |
$10.88 |
$10.88 |
$85.80
|
|
Culture screening strep group a
|
$7.29 |
$7.29 |
$7.29 |
$78.47
|
|
Culture typing added method
|
$8.51 |
$8.51 |
$8.51 |
$34.45
|
|
Culture typing immunologic
|
$5.70 |
$5.70 |
$5.70 |
$41.19
|
|
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 |
$101.45
|
|
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
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,200.60
|
|
Curette/treat cornea
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,760.73
|
|
Cv line/pic reposition
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,789.77
|
|
Cyanocobalamin unsat binding capacity
|
$15.75 |
$15.75 |
$15.75 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$14.25 |
$14.25 |
$14.25 |
$85.03
|
|
Cyclosporine 2 hour
|
$19.86 |
$19.86 |
$19.86 |
$119.40
|
|
Cyp2c19 gene com variants
|
$320.50 |
$320.50 |
$320.50 |
$553.00
|
|
Cyp2c9 gene com variants
|
$192.29 |
$192.29 |
$192.29 |
$275.10
|
|
Cyp2d6 gene com variants
|
$496.00 |
$496.00 |
$496.00 |
$525.95
|
|
Cyp3a4 gene common variants
|
$192.29 |
$192.29 |
$192.29 |
$230.01
|
|
Cyp3a5 gene common variants
|
$192.29 |
$192.29 |
$192.29 |
$220.50
|
|
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
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,081.37
|
|
Cystogram >= 3 views supervision & interpretation
|
$176.60 |
$176.60 |
$176.60 |
$527.50
|
|
Cystometrogram w/up 51727
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$857.38
|
|
Cystorrhaphy wound simple 51860
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,627.00
|
|
Cysto rx balo cath urtl strx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,015.75
|
|
Cystoscopy and biopsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,057.88
|
|
Cystoscopy and radiotracer
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,056.00
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,846.99
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,949.75
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,820.84
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,358.72
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$802.40
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,817.53
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,900.67
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,339.00
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,874.36
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,219.80
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,970.98
|
|
Cystoscopy and treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,986.00
|
|
Cystoscopy (Bladder Scope)
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,619.67
|
|
Cystoscopy chemodenervation
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy & duct catheter
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$822.50
|
|
Cystoscopy implant stent
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,081.37
|
|
Cystoscopy inject material
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,881.00
|
|
Cystoscopy removal of clots
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,820.84
|
|
Cystoscopy & revise urethra
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,412.45
|
|
Cystoscopy & revise urethra
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,424.12
|
|
Cystoscopy stone removal
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,110.00
|
|
Cystoscopy & ureter catheter
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,274.00
|
|
Cystostomy cystotomy w/drainage 51040
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,465.00
|
|
Cystotomy/cystostomy fulg+/insj radact matrl 51020
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,986.00
|
|
Cystotomy excise/incise/repair 51535
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,940.80
|
|
Cystouretero & or pyeloscope
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,024.52
|
|
Cystouretero w/biopsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,881.00
|
|
Cystouretero w/excise tumor
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,627.00
|
|
Cysto/uretero w/lithotripsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,855.00
|
|
Cystouretero w/lithotripsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,015.75
|
|
Cystouretero w/renal strict
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,627.00
|
|
Cystouretero w/stone remove
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,724.46
|
|
Cysto/uretero w/up stricture
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,820.84
|
|
Cystourethro cut ejacul duct
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,817.53
|
|
Cystourethroscop/calib/dilat stric 52281
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,845.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,970.98
|
|
Cysto w/renal stricture tx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,817.53
|
|
Cysto w/up stricture tx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,891.34
|
