|
CT Angiogram of Abdomen and Pelvis
|
$1,634.00 |
$1,634.00 |
$1,634.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,528.50 |
$1,528.50 |
$1,528.50 |
$1,940.00
|
|
CT Angiogram of the Head
|
$1,503.50 |
$1,503.50 |
$1,503.50 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$375.00 |
$375.00 |
$375.00 |
$1,500.38
|
|
CT angio pelvis
|
$1,979.50 |
$1,979.50 |
$1,979.50 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$1,848.50 |
$1,848.50 |
$1,848.50 |
$1,698.00
|
|
CT colonography dx
|
$567.50 |
$567.50 |
$567.50 |
$791.00
|
|
CT colonography dx w/dye
|
$612.50 |
$612.50 |
$612.50 |
$1,037.00
|
|
CT colonography screening
|
$567.50 |
$567.50 |
$567.50 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,776.50 |
$1,776.50 |
$1,776.50 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,979.50 |
$1,979.50 |
$1,979.50 |
$1,178.52
|
|
CT guid cryo ablat intramuscular
|
$3,300.00 |
$3,300.00 |
$3,300.00 |
$1,643.20
|
|
CT guid parench tis ablat
|
$2,315.00 |
$2,315.00 |
$2,315.00 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$293.00 |
$293.00 |
$293.00 |
$171.60
|
|
CT hrt c+ strux cgen hrt ds
|
$1,400.50 |
$1,400.50 |
$1,400.50 |
$1,371.50
|
|
CT hrt w/3d image
|
$1,400.50 |
$1,400.50 |
$1,400.50 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$904.50 |
$904.50 |
$904.50 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$2,511.00 |
$2,511.00 |
$2,511.00 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,495.50 |
$1,495.50 |
$1,495.50 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$2,624.50 |
$2,624.50 |
$2,624.50 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,397.50 |
$1,397.50 |
$1,397.50 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,220.50 |
$1,220.50 |
$1,220.50 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$1,549.50 |
$1,549.50 |
$1,549.50 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,333.50 |
$1,333.50 |
$1,333.50 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,041.00 |
$1,041.00 |
$1,041.00 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$196.00 |
$196.00 |
$196.00 |
$437.04
|
|
CT scan for localization
|
$2,232.00 |
$2,232.00 |
$2,232.00 |
$1,205.14
|
|
CT scan for therapy guide
|
$708.00 |
$708.00 |
$708.00 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,224.50 |
$2,224.50 |
$2,224.50 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,046.00 |
$2,046.00 |
$2,046.00 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,880.00 |
$1,880.00 |
$1,880.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$2,130.00 |
$2,130.00 |
$2,130.00 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,569.50 |
$1,569.50 |
$1,569.50 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$558.00 |
$558.00 |
$558.00 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,282.00 |
$2,282.00 |
$2,282.00 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$2,406.00 |
$2,406.00 |
$2,406.00 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,411.00 |
$1,411.00 |
$1,411.00 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,511.00 |
$2,511.00 |
$2,511.00 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$723.98 |
$723.98 |
$723.98 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$75.00 |
$75.00 |
$75.00 |
$68.64
|
|
Culture afb any source
|
$101.00 |
$101.00 |
$101.00 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$76.50 |
$76.50 |
$76.50 |
$79.00
|
|
Culture anaerobic except blood
|
$111.50 |
$111.50 |
$111.50 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$60.50 |
$60.50 |
$60.50 |
$51.45
|
|
Culture body fluid
|
$74.00 |
$74.00 |
$74.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$14.00 |
$14.00 |
$14.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$91.50 |
$91.50 |
$91.50 |
$79.10
|
|
Culture fungi other (except blood)
|
$93.50 |
$93.50 |
$93.50 |
$108.00
|
|
Culture mycoplasma any source
|
$62.50 |
$62.50 |
$62.50 |
$85.26
|
|
Culture of specimen by kit
|
$49.00 |
$49.00 |
$49.00 |
$49.00
|
|
Culture quantitative aerobic other source
|
$13.00 |
$13.00 |
$13.00 |
$90.35
|
|
Culture screening strep group a
|
$46.50 |
$46.50 |
$46.50 |
$81.00
|
|
Culture typing immunologic
|
$26.00 |
$26.00 |
$26.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$91.50 |
$91.50 |
$91.50 |
$133.90
|
|
Cutter lead
|
$2,154.87 |
$2,154.87 |
$2,154.87 |
$6,092.06
|
|
Cv line/pic reposition
|
$1,100.50 |
$1,100.50 |
$1,100.50 |
$1,720.93
|
|
Cyanocobalamin unsat binding capacity
|
$109.00 |
$109.00 |
$109.00 |
$64.00
|
|
Cyclic citrullinated peptide antibody
|
$171.50 |
$171.50 |
$171.50 |
$70.72
|
|
Cyclosporine 2 hour
|
$129.00 |
$129.00 |
$129.00 |
$129.48
|
|
Cyp2c19 gene com variants
|
$475.00 |
$475.00 |
$475.00 |
$504.00
|
|
Cyp2c9 gene com variants
|
$133.00 |
$133.00 |
$133.00 |
$275.10
|
|
Cyp2d6 gene com variants
|
$607.00 |
$607.00 |
$607.00 |
$554.00
|
|
Cystatin c
|
$215.00 |
$215.00 |
$215.00 |
$77.50
|
|
Cystine urine quantitative
|
$56.00 |
$56.00 |
$56.00 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$301.50 |
$301.50 |
$301.50 |
$542.10
|
|
Cystoscopy and treatment
|
$2,673.00 |
$2,673.00 |
$2,673.00 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$951.00 |
$951.00 |
$951.00 |
$1,493.80
|
|
Cystoscopy removal of clots
|
$4,371.50 |
$4,371.50 |
$4,371.50 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$4,371.50 |
$4,371.50 |
$4,371.50 |
$3,786.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$2,711.50 |
$2,711.50 |
$2,711.50 |
$3,065.15
|
|
Cysto w/ureter stricture tx
|
$5,022.00 |
$5,022.00 |
$5,022.00 |
$4,081.37
|
|
Cytomegalovirus (cmv) antibody igg
|
$96.00 |
$96.00 |
$96.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$15.50 |
$15.50 |
$15.50 |
$97.50
|
|
Cytopath c/v auto in fluid
|
$20.00 |
$20.00 |
$20.00 |
$56.00
|
|
Cytopath c/v manual
|
$22.00 |
$22.00 |
$22.00 |
$36.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$190.00 |
$190.00 |
$190.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$15.50 |
$15.50 |
$15.50 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$142.00 |
$142.00 |
$142.00 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$300.50 |
$300.50 |
$300.50 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$238.50 |
$238.50 |
$238.50 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$117.00 |
$117.00 |
$117.00 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$218.00 |
$218.00 |
$218.00 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$207.00 |
$207.00 |
$207.00 |
$209.23
|
|
Cytopath smear other source
|
$141.00 |
$141.00 |
$141.00 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$63.00 |
$63.00 |
$63.00 |
$96.20
|
|
Cytp urine 3-5 probes cmptr
|
$872.50 |
$872.50 |
$872.50 |
$690.00
|
|
D&c after delivery 59160
|
$2,497.00 |
$2,497.00 |
$2,497.00 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$3,774.81
|
|
Dch pulmonary stress test
|
$270.00 |
$270.00 |
$270.00 |
$963.30
|
|
Dch validity tests
|
$18.00 |
$18.00 |
$18.00 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$77.00 |
$77.00 |
$77.00 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$295.50 |
$295.50 |
$295.50 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$325.00 |
$325.00 |
$325.00 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$2,353.50 |
$2,353.50 |
$2,353.50 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$576.50 |
$576.50 |
$576.50 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,782.50 |
$1,782.50 |
$1,782.50 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$755.00 |
$755.00 |
$755.00 |
$810.50
|
|
Debride nail1-5 11720
|
$266.00 |
$266.00 |
$266.00 |
$148.80
|
|
Debride nail6 or more 11721
|
$163.00 |
$163.00 |
$163.00 |
$169.60
|
