|
Creatine kinase mb
|
$106.60 |
$106.60 |
$106.60 |
$100.75
|
|
Creatinine
|
$34.45 |
$34.45 |
$34.45 |
$40.00
|
|
Creatinine 24 hour urine
|
$48.75 |
$48.75 |
$48.75 |
$54.40
|
|
Creatinine clearance urine
|
$92.30 |
$92.30 |
$92.30 |
$73.86
|
|
#creutz-prot.,western blot
|
$189.80 |
$189.80 |
$189.80 |
$178.10
|
|
Critical care 30-74 minutes
|
$1,586.00 |
$1,586.00 |
$1,586.00 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$442.00 |
$442.00 |
$442.00 |
$663.00
|
|
Crotalidae poly immune fab
|
$9,354.15 |
$9,354.15 |
$9,354.15 |
$3,996.74
|
|
Cryofibrinogen qualitative - sendout
|
$43.55 |
$43.55 |
$43.55 |
$52.50
|
|
Cryoprecipitate each unit
|
$130.65 |
$130.65 |
$130.65 |
$182.25
|
|
Cryptosporidium antigen
|
$96.20 |
$96.20 |
$96.20 |
$65.55
|
|
Crystal identification light microscopy
|
$58.50 |
$58.50 |
$58.50 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$2,396.55 |
$2,396.55 |
$2,396.55 |
$2,050.23
|
|
Cta neck without &/or w/contrast
|
$2,017.60 |
$2,017.60 |
$2,017.60 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,069.95 |
$3,069.95 |
$3,069.95 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,869.40 |
$1,869.40 |
$1,869.40 |
$1,728.80
|
|
CT Angiogram of the Head
|
$2,027.35 |
$2,027.35 |
$2,027.35 |
$1,951.50
|
|
CT lower extremity w/contrast (both sides)
|
$2,331.55 |
$2,331.55 |
$2,331.55 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$2,257.45 |
$2,257.45 |
$2,257.45 |
$1,302.00
|
|
CT neck soft tissue w/contrast
|
$1,285.05 |
$1,285.05 |
$1,285.05 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$1,121.25 |
$1,121.25 |
$1,121.25 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$2,132.65 |
$2,132.65 |
$2,132.65 |
$1,752.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$2,206.75 |
$2,206.75 |
$2,206.75 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,656.85 |
$1,656.85 |
$1,656.85 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,286.70 |
$2,286.70 |
$2,286.70 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,136.55 |
$2,136.55 |
$2,136.55 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,977.30 |
$1,977.30 |
$1,977.30 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,784.90 |
$1,784.90 |
$1,784.90 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,097.20 |
$1,097.20 |
$1,097.20 |
$1,381.20
|
|
CT thorax low dose for lung screening without contrast
|
$447.20 |
$447.20 |
$447.20 |
$418.50
|
|
CT upper extremity w/contrast (both sides)
|
$1,442.35 |
$1,442.35 |
$1,442.35 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$1,079.65 |
$1,079.65 |
$1,079.65 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,846.00 |
$1,846.00 |
$1,846.00 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$50.70 |
$50.70 |
$50.70 |
$61.03
|
|
Culture afb any source
|
$120.25 |
$120.25 |
$120.25 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$96.20 |
$96.20 |
$96.20 |
$73.00
|
|
Culture anaerobic except blood
|
$109.85 |
$109.85 |
$109.85 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$50.70 |
$50.70 |
$50.70 |
$49.40
|
|
Culture body fluid
|
$104.00 |
$104.00 |
$104.00 |
$111.15
|
|
Culture fungi definitive id mold
|
$81.90 |
$81.90 |
$81.90 |
$70.00
|
|
Culture fungi definitive id yeast
|
$81.90 |
$81.90 |
$81.90 |
$68.00
|
|
Culture fungi other (except blood)
|
$109.85 |
$109.85 |
$109.85 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$75.40 |
$75.40 |
$75.40 |
$74.75
|
|
Culture mycoplasma any source
|
$154.05 |
$154.05 |
$154.05 |
$94.00
|
|
Culture screening strep group a
|
$72.80 |
$72.80 |
$72.80 |
$76.00
|
|
Culture typing immunologic
|
$46.80 |
$46.80 |
$46.80 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$754.65 |
$754.65 |
$754.65 |
$392.40
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$36.40 |
$36.40 |
$36.40 |
$100.20
|
|
Culture urine each isolate
|
$58.50 |
$58.50 |
$58.50 |
$44.80
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$7.15 |
$7.15 |
$7.15 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$96.85 |
$96.85 |
$96.85 |
$91.20
|
|
Cyclosporine 2 hour
|
$161.20 |
$161.20 |
$161.20 |
$126.10
|
|
Cystatin c
|
$91.65 |
$91.65 |
$91.65 |
$83.20
|
|
Cystic fibrosis cftr
|
$1,190.80 |
$1,190.80 |
$1,190.80 |
$1,041.95
|
|
Cytogenetics 25-99
|
$92.30 |
$92.30 |
$92.30 |
$188.40
|
|
Cytogenom microarray copy nmbr var
|
$906.10 |
$906.10 |
$906.10 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$107.90 |
$107.90 |
$107.90 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$91.00 |
$91.00 |
$91.00 |
$95.00
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$71.50 |
$71.50 |
$71.50 |
$98.00
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$70.20 |
$70.20 |
$70.20 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$146.90 |
$146.90 |
$146.90 |
$142.94
|
|
Cytopath tbs c/v manual
|
$53.30 |
$53.30 |
$53.30 |
$57.94
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$262.47 |
$262.47 |
$262.47 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,358.37 |
$1,358.37 |
$1,358.37 |
$4,542.99
|
|
Dch validity tests
|
$27.95 |
$27.95 |
$27.95 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$95.55 |
$95.55 |
$95.55 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$275.60 |
$275.60 |
$275.60 |
$313.30
|
|
Debridement bone <= 20 sq cm
|
$776.75 |
$776.75 |
$776.75 |
$2,481.05
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$228.15 |
$228.15 |
$228.15 |
$779.35
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$346.45 |
$346.45 |
$346.45 |
$482.35
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$126.75 |
$126.75 |
$126.75 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,313.74 |
$6,313.74 |
$6,313.74 |
$4,681.80
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$337.35 |
$337.35 |
$337.35 |
$460.50
|
|
Desoxycorticosterone
|
$142.35 |
$142.35 |
$142.35 |
$109.28
|
|
Developmental screen/score/document 96110
|
$208.00 |
$208.00 |
$208.00 |
$126.75
|
|
Dexamethasone 4 mg tablet
|
$44.72 |
$44.72 |
$44.72 |
$4.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$13.12 |
$13.12 |
$13.12 |
$8.23
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$42.25 |
$42.25 |
$42.25 |
$37.50
|
|
Dextrose 5 % IV bolus
|
$42.25 |
$42.25 |
$42.25 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$99.45 |
$99.45 |
$99.45 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$63.05 |
$63.05 |
$63.05 |
$70.00
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$13.97 |
$13.97 |
$13.97 |
$42.12
|
|
Dicyclomine injection
|
$53.02 |
$53.02 |
$53.02 |
$153.53
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$7.15 |
$7.15 |
$7.15 |
$29.85
|
|
Digoxin total therapeutic drug level
|
$77.35 |
$77.35 |
$77.35 |
$92.95
|
|
Diltiazem 5 mg/ml intravenous solution
|
$7.15 |
$7.15 |
$7.15 |
$49.92
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$13.17 |
$13.17 |
$13.17 |
$9.29
|
|
Disaccharidases
|
$21.45 |
$21.45 |
$21.45 |
$224.58
|
|
Dna antibody native/double stranded
|
$86.45 |
$86.45 |
$86.45 |
$101.40
|
|
Dna gardnerella
|
$68.25 |
$68.25 |
$68.25 |
$67.68
|
|
Dna probe chlamydia
|
$87.75 |
$87.75 |
$87.75 |
$98.40
|
|
Dna trichomonas
|
$71.50 |
$71.50 |
$71.50 |
$69.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$98.43 |
$98.43 |
$98.43 |
$95.06
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$72.94 |
$72.94 |
$72.94 |
$81.30
|
|
Drainage external ear simple 69000
|
$392.60 |
$392.60 |
$392.60 |
$800.00
|
|
Drainage mouth roof lesion
|
$331.50 |
$331.50 |
$331.50 |
$408.80
|
|
Drain blood from under nail 11740
|
$96.20 |
$96.20 |
$96.20 |
$173.21
|
|
Drain finger abscess;simple 26010
|
$489.45 |
$489.45 |
$489.45 |
$451.20
|
|
Drain thigh/knee lesion 27301
|
$1,474.85 |
$1,474.85 |
$1,474.85 |
$3,620.47
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$294.45 |
$294.45 |
$294.45 |
$387.40
|