|
CT Angiogram of the Neck
|
$799.16 |
$799.16 |
$799.16 |
$1,881.75
|
|
CT angio pelvis
|
$799.16 |
$799.16 |
$799.16 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$799.16 |
$799.16 |
$799.16 |
$1,691.30
|
|
CT cerebral perf w cont & prcssng
|
$267.13 |
$267.13 |
$267.13 |
$1,040.00
|
|
CT colonography dx w/dye
|
$395.14 |
$395.14 |
$395.14 |
$1,069.25
|
|
CT guidance for needle placement
|
$902.14 |
$902.14 |
$902.14 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$736.99 |
$736.99 |
$736.99 |
$1,215.06
|
|
CT limited or localized follow-up study
|
$274.25 |
$274.25 |
$274.25 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$799.16 |
$799.16 |
$799.16 |
$1,818.96
|
|
CT scan for therapy guide
|
$411.57 |
$411.57 |
$411.57 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$914.36 |
$914.36 |
$914.36 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$914.36 |
$914.36 |
$914.36 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$719.44 |
$719.44 |
$719.44 |
$2,272.00
|
|
Culture aerobic additional method definitive id each
|
$29.23 |
$29.23 |
$29.23 |
$72.00
|
|
Culture afb any source
|
$39.10 |
$39.10 |
$39.10 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$29.23 |
$29.23 |
$29.23 |
$84.76
|
|
Culture anaerobic except blood
|
$34.26 |
$34.26 |
$34.26 |
$121.22
|
|
Culture bacteria anaerobic
|
$34.19 |
$34.19 |
$34.19 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$34.19 |
$34.19 |
$34.19 |
$52.50
|
|
Culture body fluid
|
$31.19 |
$31.19 |
$31.19 |
$126.75
|
|
Culture fungi definitive id mold
|
$37.35 |
$37.35 |
$37.35 |
$80.00
|
|
Culture fungi definitive id yeast
|
$37.35 |
$37.35 |
$37.35 |
$80.00
|
|
Culture fungi other (except blood)
|
$30.43 |
$30.43 |
$30.43 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$27.88 |
$27.88 |
$27.88 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$42.84 |
$42.84 |
$42.84 |
$100.00
|
|
Culture mycoplasma any source
|
$55.69 |
$55.69 |
$55.69 |
$83.21
|
|
Culture screening strep group a
|
$23.98 |
$23.98 |
$23.98 |
$84.60
|
|
Culture typing added method
|
$19.60 |
$19.60 |
$19.60 |
$42.60
|
|
Culture typing immunologic
|
$18.74 |
$18.74 |
$18.74 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$513.64 |
$513.64 |
$513.64 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$108.84 |
$108.84 |
$108.84 |
$140.80
|
|
Culture urine each isolate
|
$29.28 |
$29.28 |
$29.28 |
$55.50
|
|
Cyanocobalamin unsat binding capacity
|
$51.81 |
$51.81 |
$51.81 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$4.80 |
$4.80 |
$4.80 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$46.85 |
$46.85 |
$46.85 |
$72.36
|
|
Cyclosporine 2 hour
|
$65.30 |
$65.30 |
$65.30 |
$130.40
|
|
Cyp2c19 gene com variants
|
$854.05 |
$854.05 |
$854.05 |
$524.00
|
|
Cyp2d6 gene com variants
|
$1,321.75 |
$1,321.75 |
$1,321.75 |
$570.70
|
|
Cyp3a4 gene common variants
|
$411.77 |
$411.77 |
$411.77 |
$241.24
|
|
Cyp3a5 gene common variants
|
$411.77 |
$411.77 |
$411.77 |
$245.31
|
|
Cystatin c
|
$54.28 |
$54.28 |
$54.28 |
$77.60
|
|
Cystic fibrosis cftr
|
$1,462.70 |
$1,462.70 |
$1,462.70 |
$1,104.40
|
|
Cystine urine quantitative
|
$67.37 |
$67.37 |
$67.37 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$732.28 |
$732.28 |
$732.28 |
$586.95
|
|
Cystoscopy & ureter catheter
|
$3,949.98 |
$3,949.98 |
$3,949.98 |
$3,728.50
|
|
Cytogenetics 25-99
|
$126.00 |
$126.00 |
$126.00 |
$189.80
|
|
Cytogenomic neo microra alys
|
$3,084.16 |
$3,084.16 |
$3,084.16 |
$2,198.00
|
|
Cytogenom microarray copy nmbr var
|
$2,638.16 |
$2,638.16 |
$2,638.16 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$52.10 |
$52.10 |
$52.10 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$60.97 |
$60.97 |
$60.97 |
$100.00
|
|
Cytomeg dna dir probe
|
$88.02 |
$88.02 |
$88.02 |
$178.88
|
|
Cyto/molecular report
|
$95.50 |
$95.50 |
$95.50 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$533.29 |
$533.29 |
$533.29 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$73.31 |
$73.31 |
$73.31 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$564.24 |
$564.24 |
$564.24 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$434.95 |
$434.95 |
$434.95 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$88.49 |
$88.49 |
$88.49 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$214.40 |
$214.40 |
$214.40 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$581.62 |
$581.62 |
$581.62 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$497.61 |
$497.61 |
$497.61 |
$96.20
|
|
Cytopath tbs c/v manual
|
$42.95 |
$42.95 |
$42.95 |
$59.28
|
|
Cytotoxic antibody screening
|
$199.15 |
$199.15 |
$199.15 |
$193.80
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.05 |
$0.05 |
$0.05 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$7.37 |
$7.37 |
$7.37 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$7.37 |
$7.37 |
$7.37 |
$7.20
|
|
Dch validity tests
|
$10.20 |
$10.20 |
$10.20 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$29.19 |
$29.19 |
$29.19 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,256.37 |
$1,256.37 |
$1,256.37 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$299.50 |
$299.50 |
$299.50 |
$284.00
|
|
Debridement bone <= 20 sq cm
|
$3,486.44 |
$3,486.44 |
$3,486.44 |
$2,320.80
|
|
Debridement/bone/20 sq cm or less 11046
|
$702.28 |
$702.28 |
$702.28 |
$702.28
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,672.01 |
$1,672.01 |
$1,672.01 |
$1,388.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,107.21 |
$1,107.21 |
$1,107.21 |
$835.20
|
|
Debride nail1-5 11720
|
$146.22 |
$146.22 |
$146.22 |
$149.60
|
|
Debride nail6 or more 11721
|
$146.22 |
$146.22 |
$146.22 |
$169.80
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$1,517.45 |
$1,517.45 |
$1,517.45 |
$1,163.24
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$537.82 |
$537.82 |
$537.82 |
$663.30
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,256.37 |
$1,256.37 |
$1,256.37 |
$1,165.50
|
|
Decalcification
|
$63.34 |
$63.34 |
$63.34 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$574.40 |
$574.40 |
$574.40 |
$572.95
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$401.62 |
$401.62 |
$401.62 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$63.98 |
$63.98 |
$63.98 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$255.27 |
$255.27 |
$255.27 |
$401.60
|
|
Design mlc device for imrt
|
$880.61 |
$880.61 |
$880.61 |
$1,753.00
|
|
Desoxycorticosterone
|
$112.12 |
$112.12 |
$112.12 |
$109.28
|
|
Dest mal lesion feenlm 1.1 - 2.0 cm 17282
|
$303.83 |
$303.83 |
$303.83 |
$408.50
|
|
Dest mal lesion tal 0.6-1.0cm 17261
|
$497.06 |
$497.06 |
$497.06 |
$274.80
|
|
Destruction benign lesions < 14 lesions
|
$497.06 |
$497.06 |
$497.06 |
$240.24
|
|
Detect agnt mult dna direc
|
$145.18 |
$145.18 |
$145.18 |
$166.77
|
|
Determination venous press
|
$194.12 |
$194.12 |
$194.12 |
$166.56
|
|
Developmental screen/score/document 96110
|
$141.93 |
$141.93 |
$141.93 |
$142.38
|
|
Devel tst phys/qhp 1st hr
|
$324.94 |
$324.94 |
$324.94 |
$350.40
|
|
Device intraute mirena
|
$2,565.91 |
$2,565.91 |
$2,565.91 |
$2,125.00
|
|
Dev tst admin phys/qhp ea addl 30 min
|
$162.48 |
$162.48 |
$162.48 |
$199.50
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$201.75 |
$201.75 |
$201.75 |
$227.25
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.32 |
$0.32 |
$0.32 |
$20.76
|
|
Dexamethasone intra implant
|
$414.35 |
$414.35 |
$414.35 |
$2,356.90
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$7.40 |
$7.40 |
$7.40 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$80.47 |
$80.47 |
$80.47 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$35.15 |
$35.15 |
$35.15 |
$79.30
|