|
Cta abdomen without & /or w/contrast
|
$1,567.15 |
$1,567.15 |
$1,567.15 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,647.10 |
$1,647.10 |
$1,647.10 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,207.10 |
$3,207.10 |
$3,207.10 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$1,708.85 |
$1,708.85 |
$1,708.85 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,026.05 |
$2,026.05 |
$2,026.05 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,529.15 |
$2,529.15 |
$2,529.15 |
$2,015.65
|
|
CT Angiogram of the Head
|
$1,474.20 |
$1,474.20 |
$1,474.20 |
$2,032.54
|
|
CT angio hrt w/3d image
|
$2,301.65 |
$2,301.65 |
$2,301.65 |
$1,601.60
|
|
CT angio pelvis
|
$1,977.30 |
$1,977.30 |
$1,977.30 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$1,697.80 |
$1,697.80 |
$1,697.80 |
$1,652.25
|
|
CT colonography dx
|
$1,122.55 |
$1,122.55 |
$1,122.55 |
$770.90
|
|
CT colonography screening
|
$709.80 |
$709.80 |
$709.80 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,251.90 |
$1,251.90 |
$1,251.90 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$600.60 |
$600.60 |
$600.60 |
$1,085.05
|
|
CT guid parench tis ablat
|
$1,004.90 |
$1,004.90 |
$1,004.90 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$112.45 |
$112.45 |
$112.45 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$897.00 |
$897.00 |
$897.00 |
$1,217.45
|
|
CT hrt w/3d image
|
$865.80 |
$865.80 |
$865.80 |
$1,424.40
|
|
CT limited or localized follow-up study
|
$630.50 |
$630.50 |
$630.50 |
$626.07
|
|
CT lower extremity w/contrast (both sides)
|
$2,966.60 |
$2,966.60 |
$2,966.60 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$2,780.70 |
$2,780.70 |
$2,780.70 |
$1,400.00
|
|
CT lwr extremity w/o&w/dye
|
$3,487.90 |
$3,487.90 |
$3,487.90 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,472.90 |
$1,472.90 |
$1,472.90 |
$1,669.00
|
|
CT neck soft tissue without contrast
|
$1,273.35 |
$1,273.35 |
$1,273.35 |
$1,357.54
|
|
CT neck soft tissue without & w/contrast
|
$1,672.45 |
$1,672.45 |
$1,672.45 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,599.00 |
$1,599.00 |
$1,599.00 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,489.15 |
$1,489.15 |
$1,489.15 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,379.95 |
$1,379.95 |
$1,379.95 |
$1,370.85
|
|
Ctrl nosebld postir subsq 30906
|
$471.25 |
$471.25 |
$471.25 |
$470.73
|
|
CT scan for therapy guide
|
$846.30 |
$846.30 |
$846.30 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,555.80 |
$2,555.80 |
$2,555.80 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,190.50 |
$2,190.50 |
$2,190.50 |
$2,855.63
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,649.70 |
$1,649.70 |
$1,649.70 |
$2,299.15
|
|
CT thoracic spine w/contrast
|
$1,786.20 |
$1,786.20 |
$1,786.20 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,718.60 |
$1,718.60 |
$1,718.60 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$311.35 |
$311.35 |
$311.35 |
$420.60
|
|
CT t-spine w /wo contrast
|
$2,236.00 |
$2,236.00 |
$2,236.00 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$2,958.80 |
$2,958.80 |
$2,958.80 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$2,689.70 |
$2,689.70 |
$2,689.70 |
$1,473.75
|
|
CT uppr extremity w/o&w/dye
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$1,841.10
|
|
Culture aerobic additional method definitive id each
|
$42.25 |
$42.25 |
$42.25 |
$63.60
|
|
Culture afb any source
|
$94.90 |
$94.90 |
$94.90 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$64.35 |
$64.35 |
$64.35 |
$77.31
|
|
Culture anaerobic except blood
|
$76.70 |
$76.70 |
$76.70 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$72.15 |
$72.15 |
$72.15 |
$52.80
|
|
Culture body fluid
|
$62.40 |
$62.40 |
$62.40 |
$130.50
|
|
Culture fungi definitive id mold
|
$79.30 |
$79.30 |
$79.30 |
$70.00
|
|
Culture fungi definitive id yeast
|
$70.85 |
$70.85 |
$70.85 |
$79.10
|
|
Culture fungi other (except blood)
|
$94.90 |
$94.90 |
$94.90 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$76.05 |
$76.05 |
$76.05 |
$77.37
|
|
Culture mycobacteria definitive id each isolate
|
$154.05 |
$154.05 |
$154.05 |
$84.80
|
|
Culture mycoplasma any source
|
$111.15 |
$111.15 |
$111.15 |
$90.37
|
|
Culture quantitative aerobic other source
|
$171.60 |
$171.60 |
$171.60 |
$87.02
|
|
Culture screening strep group a
|
$55.25 |
$55.25 |
$55.25 |
$79.20
|
|
Culture typing immunologic
|
$22.10 |
$22.10 |
$22.10 |
$42.12
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,031.55 |
$1,031.55 |
$1,031.55 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$101.40 |
$101.40 |
$101.40 |
$124.02
|
|
Culture urine each isolate
|
$53.95 |
$53.95 |
$53.95 |
$46.20
|
|
Cv line/pic reposition
|
$1,180.40 |
$1,180.40 |
$1,180.40 |
$1,801.20
|
|
Cyanocobalamin unsat binding capacity
|
$186.55 |
$186.55 |
$186.55 |
$58.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$22.10 |
$22.10 |
$22.10 |
$28.08
|
|
Cyclic citrullinated peptide antibody
|
$102.70 |
$102.70 |
$102.70 |
$81.60
|
|
Cyclosporine 2 hour
|
$66.30 |
$66.30 |
$66.30 |
$120.20
|
|
Cyclosporine modified 25 mg capsule
|
$8.97 |
$8.97 |
$8.97 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$30.62 |
$30.62 |
$30.62 |
$43.04
|
|
Cyp2c19 gene com variants
|
$877.50 |
$877.50 |
$877.50 |
$553.00
|
|
Cyp2c9 gene com variants
|
$458.90 |
$458.90 |
$458.90 |
$275.10
|
|
Cyp2d6 gene com variants
|
$370.50 |
$370.50 |
$370.50 |
$537.50
|
|
Cyp3a4 gene common variants
|
$887.90 |
$887.90 |
$887.90 |
$230.01
|
|
Cyp3a5 gene common variants
|
$1,036.75 |
$1,036.75 |
$1,036.75 |
$220.50
|
|
Cystatin c
|
$131.30 |
$131.30 |
$131.30 |
$81.00
|
|
Cystic fibrosis cftr
|
$2,072.85 |
$2,072.85 |
$2,072.85 |
$1,041.95
|
|
Cystine urine quantitative
|
$150.15 |
$150.15 |
$150.15 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$518.05 |
$518.05 |
$518.05 |
$527.50
|
|
Cystoscopy and treatment
|
$4,295.20 |
$4,295.20 |
$4,295.20 |
$3,070.20
|
|
Cystoscopy (Bladder Scope)
|
$2,496.00 |
$2,496.00 |
$2,496.00 |
$1,610.20
|
|
Cystoscopy chemodenervation
|
$1,708.20 |
$1,708.20 |
$1,708.20 |
$2,424.12
|
|
Cystoscopy removal of clots
|
$2,865.85 |
$2,865.85 |
$2,865.85 |
$3,970.98
|
|
Cystostomy cystotomy w/drainage 51040
|
$4,129.45 |
$4,129.45 |
$4,129.45 |
$3,776.04
|
|
Cystouretero & or pyeloscope
|
$4,462.90 |
$4,462.90 |
$4,462.90 |
$4,315.98
|
|
Cytogenetics 25-99
|
$59.15 |
$59.15 |
$59.15 |
$177.45
|
|
Cytogenomic neo microra alys
|
$4,368.00 |
$4,368.00 |
$4,368.00 |
$1,911.78
|
|
Cytogenom microarray copy nmbr var
|
$3,234.40 |
$3,234.40 |
$3,234.40 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$90.35 |
$90.35 |
$90.35 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$95.55 |
$95.55 |
$95.55 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$178.75 |
$178.75 |
$178.75 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$61.75 |
$61.75 |
$61.75 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$48.10 |
$48.10 |
$48.10 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$100.75 |
$100.75 |
$100.75 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$124.80 |
$124.80 |
$124.80 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$169.00 |
$169.00 |
$169.00 |
$75.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$196.30 |
$196.30 |
$196.30 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$7,800.00 |
$7,800.00 |
$7,800.00 |
$205.00
|
|
Cytopath smear oth prep screen & interp
|
$840.45 |
$840.45 |
$840.45 |
$96.20
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$63.64 |
$63.64 |
$63.64 |
$403.57
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$32,891.50 |
$32,891.50 |
$32,891.50 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$7,371.55 |
$7,371.55 |
$7,371.55 |
$5,546.48
|
|
Dch pulmonary stress test
|
$1,927.25 |
$1,927.25 |
$1,927.25 |
$966.00
|
|
Dch validity tests
|
$72.80 |
$72.80 |
$72.80 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$2,592.85 |
$2,592.85 |
$2,592.85 |
$4,021.68
|