|
Cta neck without &/or w/contrast
|
$1,426.80 |
$1,426.80 |
$1,426.80 |
$1,940.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,637.40 |
$1,637.40 |
$1,637.40 |
$2,910.00
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,296.00 |
$1,296.00 |
$1,296.00 |
$1,940.00
|
|
CT Angiogram of the Head
|
$1,562.40 |
$1,562.40 |
$1,562.40 |
$2,021.40
|
|
CT angio hrt w/3d image
|
$518.40 |
$518.40 |
$518.40 |
$1,543.85
|
|
CT angio pelvis
|
$1,926.60 |
$1,926.60 |
$1,926.60 |
$1,865.02
|
|
Cta upper extremity w &/or without contrast left
|
$1,926.60 |
$1,926.60 |
$1,926.60 |
$1,698.32
|
|
CT guidance for needle placement
|
$1,769.40 |
$1,769.40 |
$1,769.40 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$835.80 |
$835.80 |
$835.80 |
$1,113.84
|
|
CT guid parench tis ablat
|
$1,202.40 |
$1,202.40 |
$1,202.40 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$458.00 |
$458.00 |
$458.00 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$453.60 |
$453.60 |
$453.60 |
$1,371.50
|
|
CT hrt w/3d image
|
$450.60 |
$450.60 |
$450.60 |
$1,376.92
|
|
CT limited or localized follow-up study
|
$642.00 |
$642.00 |
$642.00 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,817.40 |
$1,817.40 |
$1,817.40 |
$1,619.25
|
|
CT lower extremity without contrast (both sides)
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$1,403.73
|
|
Ctlso a-p-l control molded
|
$4,710.32 |
$4,710.32 |
$4,710.32 |
$3,381.32
|
|
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
|
$1,714.80 |
$1,714.80 |
$1,714.80 |
$1,887.84
|
|
CT neck soft tissue w/contrast
|
$1,463.40 |
$1,463.40 |
$1,463.40 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$1,344.60
|
|
CT neck soft tissue without & w/contrast
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,707.60
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,463.40 |
$1,463.40 |
$1,463.40 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$1,360.00
|
|
CT scan for localization
|
$592.20 |
$592.20 |
$592.20 |
$1,205.14
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,703.80 |
$3,703.80 |
$3,703.80 |
$3,543.57
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,201.00 |
$3,201.00 |
$3,201.00 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,845.20 |
$2,845.20 |
$2,845.20 |
$2,405.40
|
|
CT thoracic spine w/contrast
|
$1,777.80 |
$1,777.80 |
$1,777.80 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$229.20 |
$229.20 |
$229.20 |
$356.50
|
|
CT t-spine w /wo contrast
|
$1,926.60 |
$1,926.60 |
$1,926.60 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$1,817.40 |
$1,817.40 |
$1,817.40 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,579.80 |
$1,579.80 |
$1,579.80 |
$1,449.20
|
|
CT uppr extremity w/o&w/dye
|
$2,089.80 |
$2,089.80 |
$2,089.80 |
$1,845.36
|
|
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
|
$124.20 |
$124.20 |
$124.20 |
$67.80
|
|
Culture afb any source
|
$193.20 |
$193.20 |
$193.20 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$190.20 |
$190.20 |
$190.20 |
$76.80
|
|
Culture anaerobic except blood
|
$126.00 |
$126.00 |
$126.00 |
$117.45
|
|
Culture bacteria anaerobic
|
$181.20 |
$181.20 |
$181.20 |
$43.55
|
|
Culture bact stool aero addl path ea
|
$165.60 |
$165.60 |
$165.60 |
$52.50
|
|
Culture body fluid
|
$135.00 |
$135.00 |
$135.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$186.00 |
$186.00 |
$186.00 |
$74.83
|
|
Culture fungi definitive id yeast
|
$29.40 |
$29.40 |
$29.40 |
$79.00
|
|
Culture fungi other (except blood)
|
$139.20 |
$139.20 |
$139.20 |
$105.81
|
|
Culture fungi skin/hair/nail
|
$129.60 |
$129.60 |
$129.60 |
$77.37
|
|
Culture mycoplasma any source
|
$180.00 |
$180.00 |
$180.00 |
$83.21
|
|
Culture quantitative aerobic other source
|
$157.80 |
$157.80 |
$157.80 |
$89.10
|
|
Culture screening strep group a
|
$74.40 |
$74.40 |
$74.40 |
$84.81
|
|
Culture typing added method
|
$97.20 |
$97.20 |
$97.20 |
$36.78
|
|
Culture typing immunologic
|
$28.20 |
$28.20 |
$28.20 |
$40.86
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$397.80 |
$397.80 |
$397.80 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$82.80 |
$82.80 |
$82.80 |
$123.76
|
|
Culture urine each isolate
|
$83.40 |
$83.40 |
$83.40 |
$51.30
|
|
Cutter lead
|
$9,368.47 |
$9,368.47 |
$9,368.47 |
$5,999.07
|
|
Cv line/pic reposition
|
$1,942.20 |
$1,942.20 |
$1,942.20 |
$1,720.93
|
|
Cyanocobalamin unsat binding capacity
|
$159.00 |
$159.00 |
$159.00 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.50 |
$7.50 |
$7.50 |
$25.30
|
|
Cyclic citrullinated peptide antibody
|
$570.60 |
$570.60 |
$570.60 |
$68.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,015.50 |
$1,015.50 |
$1,015.50 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$30.36 |
$30.36 |
$30.36 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$337.38 |
$337.38 |
$337.38 |
$140.78
|
|
Cyclosporine 2 hour
|
$139.20 |
$139.20 |
$139.20 |
$126.00
|
|
Cyclosporine modified 25 mg capsule
|
$14.34 |
$14.34 |
$14.34 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$73.98 |
$73.98 |
$73.98 |
$34.88
|
|
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 |
$24,131.60
|
|
Cyp2c19 gene com variants
|
$481.20 |
$481.20 |
$481.20 |
$425.25
|
|
Cyp2c9 gene com variants
|
$289.80 |
$289.80 |
$289.80 |
$266.50
|
|
Cyp2d6 gene com variants
|
$505.80 |
$505.80 |
$505.80 |
$554.00
|
|
Cyp3a4 gene common variants
|
$289.80 |
$289.80 |
$289.80 |
$241.24
|
|
Cyp3a5 gene common variants
|
$289.80 |
$289.80 |
$289.80 |
$237.90
|
|
Cystatin c
|
$36.00 |
$36.00 |
$36.00 |
$78.75
|
|
Cystic fibrosis cftr
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,060.00
|
|
Cystine urine quantitative
|
$205.80 |
$205.80 |
$205.80 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,002.60 |
$1,002.60 |
$1,002.60 |
$546.00
|
|
Cysto rx balo cath urtl strx
|
$14,671.40 |
$14,671.40 |
$14,671.40 |
$6,015.75
|
|
Cystoscopy and treatment
|
$12,492.47 |
$12,492.47 |
$12,492.47 |
$5,304.00
|
|
Cystoscopy and treatment
|
$10,260.84 |
$10,260.84 |
$10,260.84 |
$5,855.00
|
|
Cystoscopy (Bladder Scope)
|
$11,124.84 |
$11,124.84 |
$11,124.84 |
$1,594.35
|
|
Cystouretero & or pyeloscope
|
$34,152.61 |
$34,152.61 |
$34,152.61 |
$4,315.98
|
|
Cysto/uretero w/lithotripsy
|
$19,605.82 |
$19,605.82 |
$19,605.82 |
$7,372.68
|
|
Cystouretero w/lithotripsy
|
$15,756.94 |
$15,756.94 |
$15,756.94 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$17,143.34 |
$17,143.34 |
$17,143.34 |
$4,892.09
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$11,949.32 |
$11,949.32 |
$11,949.32 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$111.78 |
$111.78 |
$111.78 |
$89.94
|
|
Cytogenetics 25-99
|
$196.20 |
$196.20 |
$196.20 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$241.20 |
$241.20 |
$241.20 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$223.80 |
$223.80 |
$223.80 |
$95.00
|
|
Cytopath c/v thin layer redo
|
$67.80 |
$67.80 |
$67.80 |
$50.40
|
|
Cytopathology cellular enhancement technique non-gyn
|
$338.40 |
$338.40 |
$338.40 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$97.20 |
$97.20 |
$97.20 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$258.60 |
$258.60 |
$258.60 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$449.40 |
$449.40 |
$449.40 |
$137.54
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$352.20 |
$352.20 |
$352.20 |
$132.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$71.40 |
$71.40 |
$71.40 |
$70.00
|
