|
Cta neck without &/or w/contrast
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,159.65 |
$3,159.65 |
$3,159.65 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,284.10 |
$2,284.10 |
$2,284.10 |
$1,955.80
|
|
CT Angiogram of the Head
|
$2,265.90 |
$2,265.90 |
$2,265.90 |
$2,021.40
|
|
CT angio hrt w/3d image
|
$3,101.80 |
$3,101.80 |
$3,101.80 |
$1,588.60
|
|
CT angio pelvis
|
$2,512.25 |
$2,512.25 |
$2,512.25 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$2,171.65 |
$2,171.65 |
$2,171.65 |
$1,652.25
|
|
CT colonography dx
|
$1,677.65 |
$1,677.65 |
$1,677.65 |
$770.90
|
|
CT colonography screening
|
$1,677.65 |
$1,677.65 |
$1,677.65 |
$1,084.20
|
|
CT guidance for needle placement
|
$3,389.10 |
$3,389.10 |
$3,389.10 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,151.50 |
$2,151.50 |
$2,151.50 |
$1,085.05
|
|
CT guid parench tis ablat
|
$3,770.65 |
$3,770.65 |
$3,770.65 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$334.10 |
$334.10 |
$334.10 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,616.25 |
$2,616.25 |
$2,616.25 |
$1,217.45
|
|
CT hrt w/3d image
|
$1,821.30 |
$1,821.30 |
$1,821.30 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$2,007.85 |
$2,007.85 |
$2,007.85 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$3,224.00 |
$3,224.00 |
$3,224.00 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$2,932.80 |
$2,932.80 |
$2,932.80 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$3,546.40 |
$3,546.40 |
$3,546.40 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,977.95 |
$1,977.95 |
$1,977.95 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,798.55 |
$1,798.55 |
$1,798.55 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$2,176.85 |
$2,176.85 |
$2,176.85 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,895.40 |
$1,895.40 |
$1,895.40 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,723.15 |
$1,723.15 |
$1,723.15 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,565.20 |
$1,565.20 |
$1,565.20 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$452.40 |
$452.40 |
$452.40 |
$456.00
|
|
CT scan for therapy guide
|
$3,936.40 |
$3,936.40 |
$3,936.40 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,475.55 |
$3,475.55 |
$3,475.55 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,158.35 |
$3,158.35 |
$3,158.35 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,871.05 |
$2,871.05 |
$2,871.05 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,548.30 |
$1,548.30 |
$1,548.30 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,026.35 |
$1,026.35 |
$1,026.35 |
$400.20
|
|
CT t-spine w /wo contrast
|
$1,703.00 |
$1,703.00 |
$1,703.00 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$2,919.80 |
$2,919.80 |
$2,919.80 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$2,657.20 |
$2,657.20 |
$2,657.20 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$3,217.50 |
$3,217.50 |
$3,217.50 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$107.25 |
$107.25 |
$107.25 |
$63.75
|
|
Culture afb any source
|
$224.25 |
$224.25 |
$224.25 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$215.15 |
$215.15 |
$215.15 |
$77.31
|
|
Culture anaerobic except blood
|
$201.50 |
$201.50 |
$201.50 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$87.75 |
$87.75 |
$87.75 |
$52.80
|
|
Culture body fluid
|
$139.75 |
$139.75 |
$139.75 |
$130.50
|
|
Culture fungi definitive id mold
|
$86.45 |
$86.45 |
$86.45 |
$70.00
|
|
Culture fungi definitive id yeast
|
$124.80 |
$124.80 |
$124.80 |
$80.60
|
|
Culture fungi other (except blood)
|
$221.00 |
$221.00 |
$221.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$338.00 |
$338.00 |
$338.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$207.35 |
$207.35 |
$207.35 |
$84.75
|
|
Culture mycoplasma any source
|
$133.25 |
$133.25 |
$133.25 |
$90.37
|
|
Culture quantitative aerobic other source
|
$229.45 |
$229.45 |
$229.45 |
$87.02
|
|
Culture screening strep group a
|
$90.35 |
$90.35 |
$90.35 |
$81.60
|
|
Culture typing immunologic
|
$88.40 |
$88.40 |
$88.40 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,348.75 |
$1,348.75 |
$1,348.75 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$133.90 |
$133.90 |
$133.90 |
$124.40
|
|
Culture urine each isolate
|
$59.80 |
$59.80 |
$59.80 |
$46.20
|
|
Cutter lead
|
$588.80 |
$588.80 |
$588.80 |
$5,538.98
|
|
Cv line/pic reposition
|
$1,376.70 |
$1,376.70 |
$1,376.70 |
$1,829.42
|
|
Cyanocobalamin unsat binding capacity
|
$262.60 |
$262.60 |
$262.60 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$27.09 |
$27.09 |
$27.09 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$141.70 |
$141.70 |
$141.70 |
$80.05
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$329.03 |
$329.03 |
$329.03 |
$1,048.28
|
|
Cyclophosphamide 25 mg capsule
|
$17.06 |
$17.06 |
$17.06 |
$23.49
|
|
Cyclosporine 2 hour
|
$35.10 |
$35.10 |
$35.10 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$11.60 |
$11.60 |
$11.60 |
$9.79
|
|
Cyclosporine oral 100 mg
|
$1,206.60 |
$1,206.60 |
$1,206.60 |
$39.04
|
|
Cyp2c19 gene com variants
|
$1,110.85 |
$1,110.85 |
$1,110.85 |
$567.75
|
|
Cyp2c9 gene com variants
|
$1,500.85 |
$1,500.85 |
$1,500.85 |
$275.10
|
|
Cyp2d6 gene com variants
|
$419.25 |
$419.25 |
$419.25 |
$537.50
|
|
Cyp3a4 gene common variants
|
$1,002.30 |
$1,002.30 |
$1,002.30 |
$230.01
|
|
Cyp3a5 gene common variants
|
$1,170.65 |
$1,170.65 |
$1,170.65 |
$220.50
|
|
Cystatin c
|
$83.85 |
$83.85 |
$83.85 |
$82.26
|
|
Cystic fibrosis cftr
|
$2,349.10 |
$2,349.10 |
$2,349.10 |
$1,041.95
|
|
Cystine urine quantitative
|
$302.90 |
$302.90 |
$302.90 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,204.45 |
$1,204.45 |
$1,204.45 |
$539.55
|
|
Cystoscopy and treatment
|
$4,829.50 |
$4,829.50 |
$4,829.50 |
$3,174.25
|
|
Cystoscopy (Bladder Scope)
|
$2,265.25 |
$2,265.25 |
$2,265.25 |
$1,610.20
|
|
Cystoscopy chemodenervation
|
$1,860.30 |
$1,860.30 |
$1,860.30 |
$2,412.45
|
|
Cystoscopy removal of clots
|
$3,165.50 |
$3,165.50 |
$3,165.50 |
$3,970.98
|
|
Cystostomy cystotomy w/drainage 51040
|
$2,676.05 |
$2,676.05 |
$2,676.05 |
$3,774.40
|
|
Cystouretero & or pyeloscope
|
$4,930.25 |
$4,930.25 |
$4,930.25 |
$4,315.98
|
|
Cytarabine 20 mg/ml injection solution
|
$84.56 |
$84.56 |
$84.56 |
$89.95
|
|
Cytogenetics 25-99
|
$52.65 |
$52.65 |
$52.65 |
$180.32
|
|
Cytogenomic neo microra alys
|
$4,834.70 |
$4,834.70 |
$4,834.70 |
$1,911.78
|
|
Cytogenom microarray copy nmbr var
|
$3,570.45 |
$3,570.45 |
$3,570.45 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$348.40 |
$348.40 |
$348.40 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$168.35 |
$168.35 |
$168.35 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$289.90 |
$289.90 |
$289.90 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$44.20 |
$44.20 |
$44.20 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$40.30 |
$40.30 |
$40.30 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$326.30 |
$326.30 |
$326.30 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$187.20 |
$187.20 |
$187.20 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$232.05 |
$232.05 |
$232.05 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$274.95 |
$274.95 |
$274.95 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$722.15 |
$722.15 |
$722.15 |
$205.00
|
|
Cytopath smear oth prep screen & interp
|
$1,144.65 |
$1,144.65 |
$1,144.65 |
$95.89
|
|
Dacarbazine 100 mg intravenous solution
|
$82.91 |
$82.91 |
$82.91 |
$82.91
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$69.65 |
$69.65 |
$69.65 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$127.03 |
$127.03 |
$127.03 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$3,696.48 |
$3,696.48 |
$3,696.48 |
$5,546.48
|
|
Dch pulmonary stress test
|
$2,542.15 |
$2,542.15 |
$2,542.15 |
$964.41
|