|
Cryoprecipitate each unit
|
$182.25 |
$182.25 |
$182.25 |
$144.78
|
|
Cryosurgery penis lesion(s) 54056
|
$192.00 |
$192.00 |
$192.00 |
$271.20
|
|
Cryptococcus abs qn - sendout
|
$184.50 |
$184.50 |
$184.50 |
$89.70
|
|
Crystal identification light microscopy
|
$39.75 |
$39.75 |
$39.75 |
$66.43
|
|
Csf leakage imaging
|
$1,371.75 |
$1,371.75 |
$1,371.75 |
$1,564.11
|
|
CT 3d report other modality w/workstation
|
$775.50 |
$775.50 |
$775.50 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,652.50 |
$3,652.50 |
$3,652.50 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,915.30
|
|
CT Angiogram of the Head
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$1,899.75 |
$1,899.75 |
$1,899.75 |
$1,881.75
|
|
CT angio hrt w/3d image
|
$2,749.50 |
$2,749.50 |
$2,749.50 |
$1,428.68
|
|
CT angio pelvis
|
$2,965.50 |
$2,965.50 |
$2,965.50 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,025.75 |
$2,025.75 |
$2,025.75 |
$1,691.30
|
|
CT cerebral perf w cont & prcssng
|
$775.50 |
$775.50 |
$775.50 |
$1,040.00
|
|
CT colonography dx
|
$2,616.00 |
$2,616.00 |
$2,616.00 |
$811.41
|
|
CT guidance for needle placement
|
$1,476.00 |
$1,476.00 |
$1,476.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,377.75 |
$1,377.75 |
$1,377.75 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$879.75 |
$879.75 |
$879.75 |
$2,039.76
|
|
CT guid parench tis ablat
|
$1,573.50 |
$1,573.50 |
$1,573.50 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$2,514.75 |
$2,514.75 |
$2,514.75 |
$150.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,965.50 |
$2,965.50 |
$2,965.50 |
$1,395.79
|
|
CT hrt w/3d image
|
$3,534.00 |
$3,534.00 |
$3,534.00 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$787.50 |
$787.50 |
$787.50 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$1,983.75 |
$1,983.75 |
$1,983.75 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$226.50 |
$226.50 |
$226.50 |
$422.80
|
|
CT scan for localization
|
$1,661.25 |
$1,661.25 |
$1,661.25 |
$1,216.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,610.50 |
$3,610.50 |
$3,610.50 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,180.75 |
$3,180.75 |
$3,180.75 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,865.75 |
$2,865.75 |
$2,865.75 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,228.25 |
$2,228.25 |
$2,228.25 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,726.25 |
$2,726.25 |
$2,726.25 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$81.00 |
$81.00 |
$81.00 |
$72.00
|
|
Culture afb any source
|
$159.00 |
$159.00 |
$159.00 |
$110.60
|
|
Culture anaerobic except blood
|
$182.25 |
$182.25 |
$182.25 |
$121.22
|
|
Culture body fluid
|
$126.00 |
$126.00 |
$126.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$66.00 |
$66.00 |
$66.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$46.50 |
$46.50 |
$46.50 |
$80.00
|
|
Culture fungi other (except blood)
|
$130.50 |
$130.50 |
$130.50 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$90.75 |
$90.75 |
$90.75 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$84.75 |
$84.75 |
$84.75 |
$100.00
|
|
Culture mycoplasma any source
|
$130.50 |
$130.50 |
$130.50 |
$83.21
|
|
Culture quantitative aerobic other source
|
$82.50 |
$82.50 |
$82.50 |
$87.02
|
|
Culture screening strep group a
|
$108.00 |
$108.00 |
$108.00 |
$84.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$408.75 |
$408.75 |
$408.75 |
$408.37
|
|
Cutter lead
|
$22,020.89 |
$22,020.89 |
$22,020.89 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,629.75 |
$1,629.75 |
$1,629.75 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$60.75 |
$60.75 |
$60.75 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$25.86 |
$25.86 |
$25.86 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$178.50 |
$178.50 |
$178.50 |
$72.36
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$4,143.90 |
$4,143.90 |
$4,143.90 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$2,769.06 |
$2,769.06 |
$2,769.06 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$243.99 |
$243.99 |
$243.99 |
$140.78
|
|
Cyclosporine 2 hour
|
$96.00 |
$96.00 |
$96.00 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$470.55 |
$470.55 |
$470.55 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$2,865.39 |
$2,865.39 |
$2,865.39 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$42,849.57 |
$42,849.57 |
$42,849.57 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$613.50 |
$613.50 |
$613.50 |
$524.00
|
|
Cyp2c9 gene com variants
|
$368.25 |
$368.25 |
$368.25 |
$275.10
|
|
Cyp2d6 gene com variants
|
$949.50 |
$949.50 |
$949.50 |
$570.70
|
|
Cyp3a4 gene common variants
|
$328.50 |
$328.50 |
$328.50 |
$241.24
|
|
Cyp3a5 gene common variants
|
$328.50 |
$328.50 |
$328.50 |
$245.31
|
|
Cystatin c
|
$61.50 |
$61.50 |
$61.50 |
$77.60
|
|
Cystic fibrosis cftr
|
$6,271.50 |
$6,271.50 |
$6,271.50 |
$1,104.40
|
|
Cystine urine quantitative
|
$171.75 |
$171.75 |
$171.75 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$633.00 |
$633.00 |
$633.00 |
$586.95
|
|
Cystoscopy and treatment
|
$1,579.50 |
$1,579.50 |
$1,579.50 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$2,335.50 |
$2,335.50 |
$2,335.50 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$322.50 |
$322.50 |
$322.50 |
$2,874.36
|
|
Cystoscopy & ureter catheter
|
$1,997.25 |
$1,997.25 |
$1,997.25 |
$3,728.50
|
|
Cysto/uretero w/lithotripsy
|
$17,490.00 |
$17,490.00 |
$17,490.00 |
$9,430.00
|
|
Cystouretero w/lithotripsy
|
$11,789.25 |
$11,789.25 |
$11,789.25 |
$7,372.68
|
|
Cytarabine 20 mg/ml injection solution
|
$64.71 |
$64.71 |
$64.71 |
$90.00
|
|
Cytogenetics 25-99
|
$188.25 |
$188.25 |
$188.25 |
$189.80
|
|
Cytog genom-wid alys hem mal
|
$2,368.50 |
$2,368.50 |
$2,368.50 |
$1,263.53
|
|
Cytomegalovirus (cmv) antibody igg
|
$100.50 |
$100.50 |
$100.50 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$113.25 |
$113.25 |
$113.25 |
$100.00
|
|
Cytomegalovirus imm IV /vial
|
$6,333.64 |
$6,333.64 |
$6,333.64 |
$3,072.34
|
|
Cytopathology cellular enhancement technique non-gyn
|
$240.75 |
$240.75 |
$240.75 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$153.00 |
$153.00 |
$153.00 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$195.75 |
$195.75 |
$195.75 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$67.50 |
$67.50 |
$67.50 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$111.00 |
$111.00 |
$111.00 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$141.00 |
$141.00 |
$141.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$163.50 |
$163.50 |
$163.50 |
$213.85
|
|
Cytopath smear other source
|
$82.50 |
$82.50 |
$82.50 |
$92.50
|
|
Cytopath tbs c/v manual
|
$168.75 |
$168.75 |
$168.75 |
$59.28
|
|
Cytotoxic antibody screening
|
$363.75 |
$363.75 |
$363.75 |
$133.25
|
|
Cytp urine 3-5 probes cmptr
|
$907.50 |
$907.50 |
$907.50 |
$664.80
|
|
Dacarbazine 100 mg intravenous solution
|
$53.55 |
$53.55 |
$53.55 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$10,014.84 |
$10,014.84 |
$10,014.84 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$6,061.91 |
$6,061.91 |
$6,061.91 |
$3,493.11
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$38,894.03 |
$38,894.03 |
$38,894.03 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$5,546.48 |
$5,546.48 |
$5,546.48 |
$6,281.29
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$38,568.63 |
$38,568.63 |
$38,568.63 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$300.73 |
$300.73 |
$300.73 |
$259.58
|
|
D&c after delivery 59160
|
$792.00 |
$792.00 |
$792.00 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$358.50 |
$358.50 |
$358.50 |
$3,774.81
|
