|
CT lower extremity without contrast (both sides)
|
$1,443.00 |
$1,443.00 |
$1,443.00 |
$1,421.85
|
|
Ctlso a-p-l control molded
|
$4,746.61 |
$4,746.61 |
$4,746.61 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$5,217.82 |
$5,217.82 |
$5,217.82 |
$4,186.78
|
|
Ctlso axilla sling
|
$353.73 |
$353.73 |
$353.73 |
$197.97
|
|
Ctlso milwauke initial model
|
$4,834.88 |
$4,834.88 |
$4,834.88 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$2,994.00 |
$2,994.00 |
$2,994.00 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,312.80 |
$1,312.80 |
$1,312.80 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,411.80 |
$1,411.80 |
$1,411.80 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,562.00 |
$2,562.00 |
$2,562.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,367.00 |
$2,367.00 |
$2,367.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,873.20 |
$1,873.20 |
$1,873.20 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,336.20 |
$1,336.20 |
$1,336.20 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$405.60 |
$405.60 |
$405.60 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,210.20 |
$4,210.20 |
$4,210.20 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$6,379.20 |
$6,379.20 |
$6,379.20 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$5,445.00 |
$5,445.00 |
$5,445.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,950.60 |
$1,950.60 |
$1,950.60 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$127.80 |
$127.80 |
$127.80 |
$331.50
|
|
CT t-spine w /wo contrast
|
$4,303.80 |
$4,303.80 |
$4,303.80 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$2,430.60 |
$2,430.60 |
$2,430.60 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$2,212.20 |
$2,212.20 |
$2,212.20 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,994.00 |
$2,994.00 |
$2,994.00 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$2,331.58 |
$2,331.58 |
$2,331.58 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$67.80 |
$67.80 |
$67.80 |
$68.64
|
|
Culture afb any source
|
$163.80 |
$163.80 |
$163.80 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$76.80 |
$76.80 |
$76.80 |
$79.00
|
|
Culture anaerobic except blood
|
$113.40 |
$113.40 |
$113.40 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$31.80 |
$31.80 |
$31.80 |
$51.45
|
|
Culture body fluid
|
$99.60 |
$99.60 |
$99.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$96.00 |
$96.00 |
$96.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$70.80 |
$70.80 |
$70.80 |
$79.10
|
|
Culture fungi other (except blood)
|
$126.00 |
$126.00 |
$126.00 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$141.00 |
$141.00 |
$141.00 |
$74.88
|
|
Culture mycoplasma any source
|
$250.80 |
$250.80 |
$250.80 |
$85.26
|
|
Culture quantitative aerobic other source
|
$100.80 |
$100.80 |
$100.80 |
$90.35
|
|
Culture screening strep group a
|
$147.60 |
$147.60 |
$147.60 |
$81.00
|
|
Culture typing added method
|
$99.60 |
$99.60 |
$99.60 |
$38.58
|
|
Culture typing immunologic
|
$52.20 |
$52.20 |
$52.20 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$33.60 |
$33.60 |
$33.60 |
$133.90
|
|
Culture urine each isolate
|
$45.60 |
$45.60 |
$45.60 |
$57.00
|
|
Cutter lead
|
$9,440.65 |
$9,440.65 |
$9,440.65 |
$6,092.06
|
|
Cyanocobalamin unsat binding capacity
|
$204.00 |
$204.00 |
$204.00 |
$64.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$85.20 |
$85.20 |
$85.20 |
$70.72
|
|
Cyclosporine 2 hour
|
$192.00 |
$192.00 |
$192.00 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$14.28 |
$14.28 |
$14.28 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$17.70 |
$17.70 |
$17.70 |
$34.88
|
|
Cygnus, per sq cm
|
$11,899.98 |
$11,899.98 |
$11,899.98 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$38,532.27 |
$38,532.27 |
$38,532.27 |
$22,803.38
|
|
Cyp2c19 gene com variants
|
$297.00 |
$297.00 |
$297.00 |
$504.00
|
|
Cyp2c9 gene com variants
|
$143.40 |
$143.40 |
$143.40 |
$275.10
|
|
Cyp2d6 gene com variants
|
$363.00 |
$363.00 |
$363.00 |
$554.00
|
|
Cyp3a4 gene common variants
|
$132.60 |
$132.60 |
$132.60 |
$245.31
|
|
Cyp3a5 gene common variants
|
$104.40 |
$104.40 |
$104.40 |
$245.31
|
|
Cystatin c
|
$175.20 |
$175.20 |
$175.20 |
$77.50
|
|
Cystic fibrosis cftr
|
$1,098.60 |
$1,098.60 |
$1,098.60 |
$1,100.00
|
|
Cystine urine quantitative
|
$212.40 |
$212.40 |
$212.40 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$768.60 |
$768.60 |
$768.60 |
$542.10
|
|
Cystoscopy and treatment
|
$10,536.29 |
$10,536.29 |
$10,536.29 |
$5,995.60
|
|
Cystoscopy and treatment
|
$21,424.01 |
$21,424.01 |
$21,424.01 |
$4,045.60
|
|
Cystoscopy and treatment
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,874.36
|
|
Cystoscopy and treatment
|
$3,291.60 |
$3,291.60 |
$3,291.60 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$3,581.40 |
$3,581.40 |
$3,581.40 |
$3,786.00
|
|
Cysto/uretero w/lithotripsy
|
$18,416.14 |
$18,416.14 |
$18,416.14 |
$9,002.88
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,220.80 |
$3,220.80 |
$3,220.80 |
$3,065.15
|
|
Cytogenetics 25-99
|
$194.40 |
$194.40 |
$194.40 |
$190.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$164.40 |
$164.40 |
$164.40 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$192.00 |
$192.00 |
$192.00 |
$97.50
|
|
Cytopath c/v thin layer redo
|
$132.60 |
$132.60 |
$132.60 |
$61.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$303.60 |
$303.60 |
$303.60 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$203.40 |
$203.40 |
$203.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$222.60 |
$222.60 |
$222.60 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$612.60 |
$612.60 |
$612.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$304.80 |
$304.80 |
$304.80 |
$129.35
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$183.60 |
$183.60 |
$183.60 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$471.60 |
$471.60 |
$471.60 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$193.80 |
$193.80 |
$193.80 |
$209.23
|
|
Cytopath smear other source
|
$213.60 |
$213.60 |
$213.60 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$188.40 |
$188.40 |
$188.40 |
$96.20
|
|
Cytopath tbs c/v manual
|
$107.40 |
$107.40 |
$107.40 |
$59.28
|
|
Cytotoxic antibody screening
|
$258.60 |
$258.60 |
$258.60 |
$189.00
|
|
Dacarbazine 100 mg intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$58.22
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$32,793.96 |
$32,793.96 |
$32,793.96 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$6,966.00 |
$6,966.00 |
$6,966.00 |
$6,072.48
|
|
Dch glucoscan
|
$39.00 |
$39.00 |
$39.00 |
$28.10
|
|
Dch validity tests
|
$27.60 |
$27.60 |
$27.60 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$30.00 |
$30.00 |
$30.00 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$347.40 |
$347.40 |
$347.40 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$2,316.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$648.00 |
$648.00 |
$648.00 |
$810.50
|
|
Debride skin bone at fx site
|
$4,909.80 |
$4,909.80 |
$4,909.80 |
$3,015.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$1,160.00
|
|
Decalcification
|
$96.00 |
$96.00 |
$96.00 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$143.88 |
$143.88 |
$143.88 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$807.00 |
$807.00 |
$807.00 |
$543.00
|
|
Degarelix 120 mg subcutaneous solution
|
$2,364.06 |
$2,364.06 |
$2,364.06 |
$1,807.08
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$146.40 |
$146.40 |
$146.40 |
$185.17
|
