|
Cta abdomen without & /or w/contrast
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,100.00 |
$2,100.00 |
$2,100.00 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$1,940.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,474.20 |
$1,474.20 |
$1,474.20 |
$2,856.70
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,274.40 |
$1,274.40 |
$1,274.40 |
$1,940.00
|
|
CT Angiogram of the Head
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$2,002.00
|
|
CT angio pelvis
|
$2,100.00 |
$2,100.00 |
$2,100.00 |
$1,865.02
|
|
Cta upper extremity w &/or without contrast left
|
$2,100.00 |
$2,100.00 |
$2,100.00 |
$1,698.00
|
|
CT guidance for needle placement
|
$2,434.80 |
$2,434.80 |
$2,434.80 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$886.20 |
$886.20 |
$886.20 |
$1,113.84
|
|
CT guid parench tis ablat
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$1,281.75
|
|
CT heart w/evaluation of calcium without contrast
|
$227.00 |
$227.00 |
$227.00 |
$192.00
|
|
CT limited or localized follow-up study
|
$777.00 |
$777.00 |
$777.00 |
$642.00
|
|
CT lower extremity w/contrast (both sides)
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,612.00
|
|
CT lower extremity without contrast (both sides)
|
$1,360.80 |
$1,360.80 |
$1,360.80 |
$1,398.82
|
|
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
|
$1,995.00 |
$1,995.00 |
$1,995.00 |
$1,857.80
|
|
CT neck soft tissue w/contrast
|
$1,545.60 |
$1,545.60 |
$1,545.60 |
$1,652.30
|
|
CT neck soft tissue without contrast
|
$1,374.60 |
$1,374.60 |
$1,374.60 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$1,951.60
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,545.60 |
$1,545.60 |
$1,545.60 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,374.60 |
$1,374.60 |
$1,374.60 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$386.40 |
$386.40 |
$386.40 |
$450.77
|
|
CT scan for localization
|
$550.20 |
$550.20 |
$550.20 |
$1,205.14
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,833.80 |
$2,833.80 |
$2,833.80 |
$3,475.55
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,721.60 |
$2,721.60 |
$2,721.60 |
$2,883.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,419.20 |
$2,419.20 |
$2,419.20 |
$2,376.00
|
|
CT thoracic spine w/contrast
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$267.60 |
$267.60 |
$267.60 |
$350.26
|
|
CT t-spine w /wo contrast
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,440.00
|
|
CT uppr extremity w/o&w/dye
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$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
|
$106.20 |
$106.20 |
$106.20 |
$67.05
|
|
Culture afb any source
|
$193.20 |
$193.20 |
$193.20 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$163.80 |
$163.80 |
$163.80 |
$76.80
|
|
Culture anaerobic except blood
|
$120.00 |
$120.00 |
$120.00 |
$117.45
|
|
Culture bacteria anaerobic
|
$202.80 |
$202.80 |
$202.80 |
$43.55
|
|
Culture bact stool aero addl path ea
|
$142.80 |
$142.80 |
$142.80 |
$52.00
|
|
Culture body fluid
|
$116.40 |
$116.40 |
$116.40 |
$125.45
|
|
Culture fungi definitive id mold
|
$160.20 |
$160.20 |
$160.20 |
$74.83
|
|
Culture fungi definitive id yeast
|
$25.80 |
$25.80 |
$25.80 |
$79.00
|
|
Culture fungi other (except blood)
|
$740.40 |
$740.40 |
$740.40 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$163.80 |
$163.80 |
$163.80 |
$76.80
|
|
Culture mycoplasma any source
|
$118.80 |
$118.80 |
$118.80 |
$81.62
|
|
Culture quantitative aerobic other source
|
$181.20 |
$181.20 |
$181.20 |
$87.02
|
|
Culture screening strep group a
|
$64.20 |
$64.20 |
$64.20 |
$84.60
|
|
Culture typing added method
|
$97.20 |
$97.20 |
$97.20 |
$34.45
|
|
Culture typing immunologic
|
$24.60 |
$24.60 |
$24.60 |
$40.80
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$378.60 |
$378.60 |
$378.60 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$78.60 |
$78.60 |
$78.60 |
$123.76
|
|
Culture urine each isolate
|
$71.40 |
$71.40 |
$71.40 |
$51.52
|
|
Cutter lead
|
$9,368.47 |
$9,368.47 |
$9,368.47 |
$5,790.00
|
|
Cyanocobalamin unsat binding capacity
|
$185.40 |
$185.40 |
$185.40 |
$64.28
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.50 |
$7.50 |
$7.50 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$374.40 |
$374.40 |
$374.40 |
$68.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$941.16 |
$941.16 |
$941.16 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$175.80 |
$175.80 |
$175.80 |
$126.10
|
|
Cyclosporine modified 25 mg capsule
|
$13.62 |
$13.62 |
$13.62 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$54.30 |
$54.30 |
$54.30 |
$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 |
$24,131.60
|
|
Cyp2c19 gene com variants
|
$481.20 |
$481.20 |
$481.20 |
$419.85
|
|
Cyp2c9 gene com variants
|
$289.80 |
$289.80 |
$289.80 |
$266.50
|
|
Cyp2d6 gene com variants
|
$505.80 |
$505.80 |
$505.80 |
$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
|
$37.20 |
$37.20 |
$37.20 |
$78.75
|
|
Cystic fibrosis cftr
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,060.00
|
|
Cystine urine quantitative
|
$228.00 |
$228.00 |
$228.00 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$986.40 |
$986.40 |
$986.40 |
$543.40
|
|
Cytogenetics 25-99
|
$160.20 |
$160.20 |
$160.20 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$158.40 |
$158.40 |
$158.40 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$147.00 |
$147.00 |
$147.00 |
$95.55
|
|
Cytopath c/v thin layer redo
|
$61.80 |
$61.80 |
$61.80 |
$50.40
|
|
Cytopathology cellular enhancement technique non-gyn
|
$274.80 |
$274.80 |
$274.80 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$92.40 |
$92.40 |
$92.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$211.20 |
$211.20 |
$211.20 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$366.00 |
$366.00 |
$366.00 |
$141.25
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$288.00 |
$288.00 |
$288.00 |
$132.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$67.80 |
$67.80 |
$67.80 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$260.40 |
$260.40 |
$260.40 |
$186.08
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$477.00 |
$477.00 |
$477.00 |
$207.50
|
|
Cytopath smear other source
|
$179.40 |
$179.40 |
$179.40 |
$88.13
|
|
Cytopath smear other source
|
$361.20 |
$361.20 |
$361.20 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$235.80 |
$235.80 |
$235.80 |
$96.20
|
|
Cytopath tbs c/v manual
|
$87.60 |
$87.60 |
$87.60 |
$59.15
|
|
Cytotoxic antibody screening
|
$223.20 |
$223.20 |
$223.20 |
$184.63
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$184.38 |
$184.38 |
$184.38 |
$232.95
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$39,327.36 |
$39,327.36 |
$39,327.36 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$14,558.94 |
$14,558.94 |
$14,558.94 |
$5,546.48
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$98.58 |
$98.58 |
$98.58 |
$259.58
|
|
Dch validity tests
|
$37.80 |
$37.80 |
$37.80 |
$24.50
|
