|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,668.60 |
$1,668.60 |
$1,668.60 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,441.20 |
$1,441.20 |
$1,441.20 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,599.00 |
$4,599.00 |
$4,599.00 |
$3,475.55
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,555.20 |
$4,555.20 |
$4,555.20 |
$2,883.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,290.20 |
$2,290.20 |
$2,290.20 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,897.80 |
$1,897.80 |
$1,897.80 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,636.80 |
$1,636.80 |
$1,636.80 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$192.00 |
$192.00 |
$192.00 |
$350.26
|
|
CT t-spine w /wo contrast
|
$2,320.80 |
$2,320.80 |
$2,320.80 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$1,897.80 |
$1,897.80 |
$1,897.80 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,636.80 |
$1,636.80 |
$1,636.80 |
$1,440.00
|
|
CT uppr extremity w/o&w/dye
|
$2,320.80 |
$2,320.80 |
$2,320.80 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$6,948.02 |
$6,948.02 |
$6,948.02 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$67.20 |
$67.20 |
$67.20 |
$67.05
|
|
Culture afb any source
|
$101.40 |
$101.40 |
$101.40 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$118.20 |
$118.20 |
$118.20 |
$76.80
|
|
Culture anaerobic except blood
|
$124.20 |
$124.20 |
$124.20 |
$117.45
|
|
Culture bact stool aero addl path ea
|
$40.20 |
$40.20 |
$40.20 |
$52.00
|
|
Culture body fluid
|
$86.40 |
$86.40 |
$86.40 |
$125.16
|
|
Culture fungi definitive id mold
|
$142.20 |
$142.20 |
$142.20 |
$74.83
|
|
Culture fungi definitive id yeast
|
$74.40 |
$74.40 |
$74.40 |
$79.00
|
|
Culture fungi other (except blood)
|
$91.20 |
$91.20 |
$91.20 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$135.00 |
$135.00 |
$135.00 |
$76.80
|
|
Culture mycoplasma any source
|
$42.00 |
$42.00 |
$42.00 |
$81.62
|
|
Culture screening strep group a
|
$84.60 |
$84.60 |
$84.60 |
$84.60
|
|
Culture typing added method
|
$55.20 |
$55.20 |
$55.20 |
$34.45
|
|
Culture typing immunologic
|
$49.20 |
$49.20 |
$49.20 |
$40.70
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$202.20 |
$202.20 |
$202.20 |
$123.76
|
|
Culture urine each isolate
|
$69.60 |
$69.60 |
$69.60 |
$51.35
|
|
Cutter lead
|
$12,620.24 |
$12,620.24 |
$12,620.24 |
$5,790.00
|
|
Cv line/pic reposition
|
$1,894.80 |
$1,894.80 |
$1,894.80 |
$1,719.44
|
|
Cyanocobalamin unsat binding capacity
|
$39.60 |
$39.60 |
$39.60 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$164.40 |
$164.40 |
$164.40 |
$68.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,027.86 |
$1,027.86 |
$1,027.86 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$20.94 |
$20.94 |
$20.94 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$832.80 |
$832.80 |
$832.80 |
$140.78
|
|
Cyclosporine 2 hour
|
$102.60 |
$102.60 |
$102.60 |
$126.00
|
|
Cyclosporine modified 25 mg capsule
|
$9.90 |
$9.90 |
$9.90 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$1,788.30 |
$1,788.30 |
$1,788.30 |
$34.51
|
|
Cygnus, per sq cm
|
$15,907.86 |
$15,907.86 |
$15,907.86 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$34,548.34 |
$34,548.34 |
$34,548.34 |
$24,131.60
|
|
Cyp2c19 gene com variants
|
$540.00 |
$540.00 |
$540.00 |
$419.85
|
|
Cyp2c9 gene com variants
|
$289.80 |
$289.80 |
$289.80 |
$257.36
|
|
Cyp2d6 gene com variants
|
$373.20 |
$373.20 |
$373.20 |
$537.50
|
|
Cyp3a4 gene common variants
|
$289.80 |
$289.80 |
$289.80 |
$231.00
|
|
Cyp3a5 gene common variants
|
$289.80 |
$289.80 |
$289.80 |
$231.00
|
|
Cystatin c
|
$278.40 |
$278.40 |
$278.40 |
$78.75
|
|
Cystic fibrosis cftr
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,060.00
|
|
Cystine urine quantitative
|
$84.60 |
$84.60 |
$84.60 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$752.40 |
$752.40 |
$752.40 |
$542.10
|
|
Cysto impl 4 or more
|
$42,590.19 |
$42,590.19 |
$42,590.19 |
$6,900.08
|
|
Cysto rx balo cath urtl strx
|
$23,484.70 |
$23,484.70 |
$23,484.70 |
$6,015.75
|
|
Cystoscopy and treatment
|
$14,633.16 |
$14,633.16 |
$14,633.16 |
$4,160.10
|
|
Cystoscopy and treatment
|
$18,858.64 |
$18,858.64 |
$18,858.64 |
$5,110.00
|
|
Cystoscopy and treatment
|
$22,645.60 |
$22,645.60 |
$22,645.60 |
$5,769.46
|
|
Cystoscopy and treatment
|
$24,112.48 |
$24,112.48 |
$24,112.48 |
$6,015.75
|
|
Cystoscopy and treatment
|
$22,204.74 |
$22,204.74 |
$22,204.74 |
$3,171.41
|
|
Cystoscopy and treatment
|
$23,732.22 |
$23,732.22 |
$23,732.22 |
$2,424.12
|
|
Cystoscopy and treatment
|
$25,489.20 |
$25,489.20 |
$25,489.20 |
$3,786.00
|
|
Cystoscopy and treatment
|
$91,433.24 |
$91,433.24 |
$91,433.24 |
$2,896.40
|
|
Cystoscopy (Bladder Scope)
|
$2,381.40 |
$2,381.40 |
$2,381.40 |
$1,525.60
|
|
Cystoscopy chemodenervation
|
$20,566.54 |
$20,566.54 |
$20,566.54 |
$2,424.12
|
|
Cystoscopy removal of clots
|
$15,352.74 |
$15,352.74 |
$15,352.74 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$14,246.19 |
$14,246.19 |
$14,246.19 |
$3,787.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$17,470.25 |
$17,470.25 |
$17,470.25 |
$3,875.56
|
|
Cystouretero & or pyeloscope
|
$23,634.26 |
$23,634.26 |
$23,634.26 |
$4,315.98
|
|
Cysto/uretero stricture tx
|
$24,855.29 |
$24,855.29 |
$24,855.29 |
$4,384.91
|
|
Cystouretero w/biopsy
|
$28,838.29 |
$28,838.29 |
$28,838.29 |
$5,650.88
|
|
Cysto/uretero w/lithotripsy
|
$31,601.92 |
$31,601.92 |
$31,601.92 |
$6,839.00
|
|
Cystouretero w/lithotripsy
|
$30,499.79 |
$30,499.79 |
$30,499.79 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$23,853.43 |
$23,853.43 |
$23,853.43 |
$4,892.09
|
|
Cystourethroscop/calib/dilat stric 52281
|
$16,153.60 |
$16,153.60 |
$16,153.60 |
$3,015.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$25,342.04 |
$25,342.04 |
$25,342.04 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$89.94
|
|
Cytogenetics 25-99
|
$141.60 |
$141.60 |
$141.60 |
$189.80
|
|
Cytogenomic neo microra alys
|
$4,146.60 |
$4,146.60 |
$4,146.60 |
$2,020.20
|
|
Cytomegalovirus (cmv) antibody igg
|
$89.40 |
$89.40 |
$89.40 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$75.60 |
$75.60 |
$75.60 |
$95.00
|
|
Cyto/molecular report
|
$127.80 |
$127.80 |
$127.80 |
$140.25
|
|
Cytopath c/v thin layer redo
|
$64.80 |
$64.80 |
$64.80 |
$50.40
|
|
Cytopathology cellular enhancement technique non-gyn
|
$126.00 |
$126.00 |
$126.00 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$82.20 |
$82.20 |
$82.20 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$75.00 |
$75.00 |
$75.00 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$291.00 |
$291.00 |
$291.00 |
$137.54
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$252.00 |
$252.00 |
$252.00 |
$132.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$158.40 |
$158.40 |
$158.40 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$174.60 |
$174.60 |
$174.60 |
$185.64
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$291.00 |
$291.00 |
$291.00 |
$207.50
|
|
Cytopath smear other source
|
$162.00 |
$162.00 |
$162.00 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$180.00 |
$180.00 |
$180.00 |
$96.20
|
|
Cytopath tbs c/v manual
|
$67.80 |
$67.80 |
$67.80 |
$59.01
|
|
Cytotoxic antibody screening
|
$193.20 |
$193.20 |
$193.20 |
$184.63
|
|
Cytp urine 3-5 probes cmptr
|
$622.20 |
$622.20 |
$622.20 |
$708.18
|
|
Dacarbazine 100 mg intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$62.70
|
|
Dalbavancin 500 mg intravenous solution
|
$6,885.24 |
$6,885.24 |
$6,885.24 |
$3,410.61
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$42,181.80 |
$42,181.80 |
$42,181.80 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$14,976.90 |
$14,976.90 |
$14,976.90 |
$5,546.48
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$105.72 |
$105.72 |
$105.72 |
$259.58
|
|
D&c after delivery 59160
|
$14,937.96 |
$14,937.96 |
$14,937.96 |
$3,827.25
|
