|
Cta lower extremity without & w/contrast (both sides)
|
$3,480.00 |
$3,480.00 |
$3,480.00 |
$1,984.00
|
|
Cta neck without &/or w/contrast
|
$1,276.20 |
$1,276.20 |
$1,276.20 |
$1,890.85
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,479.00 |
$1,479.00 |
$1,479.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,298.40 |
$1,298.40 |
$1,298.40 |
$1,912.50
|
|
CT Angiogram of the Head
|
$1,298.40 |
$1,298.40 |
$1,298.40 |
$1,940.00
|
|
CT angio hrt w/3d image
|
$499.20 |
$499.20 |
$499.20 |
$1,501.56
|
|
CT angio pelvis
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,655.17
|
|
CT guidance for needle placement
|
$12,864.78 |
$12,864.78 |
$12,864.78 |
$1,498.20
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$3,620.40 |
$3,620.40 |
$3,620.40 |
$1,134.24
|
|
CT guid cryo ablat intramuscular
|
$45,779.38 |
$45,779.38 |
$45,779.38 |
$1,643.20
|
|
CT guid parench tis ablat
|
$1,148.40 |
$1,148.40 |
$1,148.40 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$213.00 |
$213.00 |
$213.00 |
$174.46
|
|
CT hrt c+ strux cgen hrt ds
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,371.50
|
|
CT hrt w/3d image
|
$450.60 |
$450.60 |
$450.60 |
$1,363.05
|
|
CT limited or localized follow-up study
|
$633.60 |
$633.60 |
$633.60 |
$642.00
|
|
CT lower extremity w/contrast (both sides)
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$1,074.60 |
$1,074.60 |
$1,074.60 |
$1,398.82
|
|
Ctlso a-p-l control molded
|
$4,710.32 |
$4,710.32 |
$4,710.32 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$5,177.93 |
$5,177.93 |
$5,177.93 |
$4,186.78
|
|
Ctlso axilla sling
|
$197.97 |
$197.97 |
$197.97 |
$197.97
|
|
Ctlso milwauke initial model
|
$4,797.91 |
$4,797.91 |
$4,797.91 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,230.60 |
$1,230.60 |
$1,230.60 |
$1,617.00
|
|
CT neck soft tissue without contrast
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,543.00
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,318.20 |
$1,318.20 |
$1,318.20 |
$1,338.60
|
|
Ctrl nosebld postir subsq 30906
|
$528.00 |
$528.00 |
$528.00 |
$422.80
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$3,337.20
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,350.20 |
$2,350.20 |
$2,350.20 |
$2,825.55
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,951.20 |
$1,951.20 |
$1,951.20 |
$2,290.20
|
|
CT thoracic spine w/contrast
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,683.20
|
|
CT thoracic spine without contrast
|
$1,099.80 |
$1,099.80 |
$1,099.80 |
$1,437.75
|
|
CT thorax low dose for lung screening without contrast
|
$230.40 |
$230.40 |
$230.40 |
$331.50
|
|
CT upper extremity w/contrast (both sides)
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,042.20 |
$1,042.20 |
$1,042.20 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$3,097.20 |
$3,097.20 |
$3,097.20 |
$1,841.10
|
|
Cuffs adj lock with active con
|
$2,313.75 |
$2,313.75 |
$2,313.75 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$57.60 |
$57.60 |
$57.60 |
$67.20
|
|
Culture afb any source
|
$111.60 |
$111.60 |
$111.60 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$39.00 |
$39.00 |
$39.00 |
$78.65
|
|
Culture anaerobic except blood
|
$102.60 |
$102.60 |
$102.60 |
$119.20
|
|
Culture bact stool aero addl path ea
|
$54.00 |
$54.00 |
$54.00 |
$52.00
|
|
Culture body fluid
|
$91.20 |
$91.20 |
$91.20 |
$120.44
|
|
Culture fungi definitive id mold
|
$202.20 |
$202.20 |
$202.20 |
$74.97
|
|
Culture fungi definitive id yeast
|
$55.20 |
$55.20 |
$55.20 |
$79.00
|
|
Culture fungi other (except blood)
|
$91.80 |
$91.80 |
$91.80 |
$106.80
|
|
Culture fungi skin/hair/nail
|
$142.20 |
$142.20 |
$142.20 |
$74.88
|
|
Culture mycoplasma any source
|
$42.00 |
$42.00 |
$42.00 |
$85.26
|
|
Culture quantitative aerobic other source
|
$96.60 |
$96.60 |
$96.60 |
$86.40
|
|
Culture screening strep group a
|
$95.40 |
$95.40 |
$95.40 |
$81.60
|
|
Culture typing added method
|
$73.20 |
$73.20 |
$73.20 |
$36.78
|
|
Culture typing immunologic
|
$27.60 |
$27.60 |
$27.60 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$360.60 |
$360.60 |
$360.60 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$94.80 |
$94.80 |
$94.80 |
$124.40
|
|
Culture urine each isolate
|
$86.40 |
$86.40 |
$86.40 |
$52.56
|
|
Cutter lead
|
$9,368.47 |
$9,368.47 |
$9,368.47 |
$6,012.98
|
|
Cv line/pic reposition
|
$1,482.60 |
$1,482.60 |
$1,482.60 |
$1,634.66
|
|
Cyanocobalamin unsat binding capacity
|
$33.60 |
$33.60 |
$33.60 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$35.40 |
$35.40 |
$35.40 |
$72.00
|
|
Cyclophosphamide 25 mg capsule
|
$41.28 |
$41.28 |
$41.28 |
$19.49
|
|
Cyclosporine 2 hour
|
$93.60 |
$93.60 |
$93.60 |
$129.00
|
|
Cyclosporine modified 25 mg capsule
|
$10.62 |
$10.62 |
$10.62 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$1,922.88 |
$1,922.88 |
$1,922.88 |
$34.51
|
|
Cygnus, per sq cm
|
$11,808.99 |
$11,808.99 |
$11,808.99 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$38,237.64 |
$38,237.64 |
$38,237.64 |
$22,803.38
|
|
Cyp2c19 gene com variants
|
$239.40 |
$239.40 |
$239.40 |
$433.00
|
|
Cyp2c9 gene com variants
|
$291.60 |
$291.60 |
$291.60 |
$266.50
|
|
Cyp2d6 gene com variants
|
$508.80 |
$508.80 |
$508.80 |
$525.95
|
|
Cystatin c
|
$72.00 |
$72.00 |
$72.00 |
$75.04
|
|
Cystic fibrosis cftr
|
$1,597.20 |
$1,597.20 |
$1,597.20 |
$1,060.00
|
|
Cystine urine quantitative
|
$121.20 |
$121.20 |
$121.20 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$645.60 |
$645.60 |
$645.60 |
$538.40
|
|
Cysto impl 4 or more
|
$23,981.29 |
$23,981.29 |
$23,981.29 |
$6,900.08
|
|
Cysto, litho, vacuum kidney
|
$30,506.86 |
$30,506.86 |
$30,506.86 |
$10,942.71
|
|
Cystoscopy and treatment
|
$17,710.16 |
$17,710.16 |
$17,710.16 |
$4,081.37
|
|
Cystoscopy and treatment
|
$11,924.52 |
$11,924.52 |
$11,924.52 |
$4,160.10
|
|
Cystoscopy and treatment
|
$19,072.94 |
$19,072.94 |
$19,072.94 |
$5,741.00
|
|
Cystoscopy and treatment
|
$20,205.02 |
$20,205.02 |
$20,205.02 |
$6,015.75
|
|
Cystoscopy and treatment
|
$24,918.55 |
$24,918.55 |
$24,918.55 |
$2,867.70
|
|
Cystoscopy (Bladder Scope)
|
$9,920.22 |
$9,920.22 |
$9,920.22 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$15,743.70 |
$15,743.70 |
$15,743.70 |
$2,424.12
|
|
Cystoscopy & ureter catheter
|
$14,236.69 |
$14,236.69 |
$14,236.69 |
$3,694.00
|
|
Cystouretero & or pyeloscope
|
$17,163.31 |
$17,163.31 |
$17,163.31 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$15,657.23 |
$15,657.23 |
$15,657.23 |
$4,384.91
|
|
Cystouretero w/biopsy
|
$19,759.54 |
$19,759.54 |
$19,759.54 |
$5,650.88
|
|
Cysto/uretero w/lithotripsy
|
$31,520.29 |
$31,520.29 |
$31,520.29 |
$7,372.68
|
|
Cystouretero w/stone remove
|
$12,146.25 |
$12,146.25 |
$12,146.25 |
$4,892.09
|
|
Cystourethroscop/calib/dilat stric 52281
|
$11,543.14 |
$11,543.14 |
$11,543.14 |
$3,015.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$22,502.72 |
$22,502.72 |
$22,502.72 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$90.00
|
|
Cytogenetics 25-99
|
$73.80 |
$73.80 |
$73.80 |
$189.80
|
|
Cytogenomic neo microra alys
|
$4,171.20 |
$4,171.20 |
$4,171.20 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$60.00 |
$60.00 |
$60.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$62.40 |
$62.40 |
$62.40 |
$96.20
|
|
Cytopath c/v index add-on
|
$37.80 |
$37.80 |
$37.80 |
$34.20
|
|
Cytopathology cellular enhancement technique non-gyn
|
$87.60 |
$87.60 |
$87.60 |
$159.90
|
