|
Brain MRI (with and without contrast)
|
$701.50 |
$701.50 |
$701.50 |
$2,837.12
|
|
Brain MRI (with contrast)
|
$635.50 |
$635.50 |
$635.50 |
$2,264.60
|
|
Brain MRI (without contrast)
|
$455.00 |
$455.00 |
$455.00 |
$1,932.50
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$2,720.80 |
$2,720.80 |
$2,720.80 |
$2,975.48
|
|
Breast punct aspir cyst, bil
|
$1,594.40 |
$1,594.40 |
$1,594.40 |
$863.10
|
|
Bronchial allergy tests
|
$873.60 |
$873.60 |
$873.60 |
$734.40
|
|
Bronchial challenge
|
$873.60 |
$873.60 |
$873.60 |
$805.90
|
|
Br punct aspir ea add, l
|
$303.20 |
$303.20 |
$303.20 |
$356.50
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$50.00 |
$50.00 |
$50.00 |
$24.08
|
|
Bundled special stain group 1 microorganisms
|
$195.20 |
$195.20 |
$195.20 |
$154.70
|
|
Bundled special stain group 2
|
$143.20 |
$143.20 |
$143.20 |
$170.65
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$66.00 |
$66.00 |
$66.00 |
$33.08
|
|
Butorphanol tartrate 1 mg
|
$153.80 |
$153.80 |
$153.80 |
$41.79
|
|
Bx bone trocar/ndl deep
|
$2,640.80 |
$2,640.80 |
$2,640.80 |
$2,347.69
|
|
Bx breast 1st lesion mr imag
|
$1,585.60 |
$1,585.60 |
$1,585.60 |
$3,256.00
|
|
Bx breast 1st lesion strtctc
|
$2,720.80 |
$2,720.80 |
$2,720.80 |
$3,570.00
|
|
Bx breast add lesion mr imag
|
$910.40 |
$910.40 |
$910.40 |
$1,649.29
|
|
Bx breast add lesion strtctc
|
$867.20 |
$867.20 |
$867.20 |
$1,698.00
|
|
Bx breast add lesion Ultrasound imag
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$1,604.40
|
|
Bx breast pq tomo guide
|
$2,471.20 |
$2,471.20 |
$2,471.20 |
$4,428.15
|
|
Bx pancreas pq ndl
|
$2,881.60 |
$2,881.60 |
$2,881.60 |
$1,585.20
|
|
Bx pleura pq ndl
|
$2,664.00 |
$2,664.00 |
$2,664.00 |
$1,608.00
|
|
Bypass temp external fem-fem
|
$5,223.20 |
$5,223.20 |
$5,223.20 |
$1,830.64
|
|
C-1 esterase, berinert
|
$13,986.60 |
$13,986.60 |
$13,986.60 |
$7,815.00
|
|
C1 esterase inhibitor func - sendout
|
$49.60 |
$49.60 |
$49.60 |
$96.72
|
|
Calcitonin (salmon) 200 unit/ml injection solution
|
$3,445.00 |
$3,445.00 |
$3,445.00 |
$2,177.05
|
|
Calcium 24 hour urine
|
$24.80 |
$24.80 |
$24.80 |
$52.00
|
|
Calcium gluconate 100 mg/ml (10 %) intravenous solution
|
$123.80 |
$123.80 |
$123.80 |
$64.49
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$222.80 |
$222.80 |
$222.80 |
$91.60
|
|
Calcium ionized
|
$56.80 |
$56.80 |
$56.80 |
$89.88
|
|
Calcium total
|
$21.60 |
$21.60 |
$21.60 |
$50.00
|
|
Calprotectin fecal
|
$81.60 |
$81.60 |
$81.60 |
$170.00
|
|
Carbamazepine free
|
$55.20 |
$55.20 |
$55.20 |
$59.15
|
|
Carbamazepine free -sendout
|
$77.60 |
$77.60 |
$77.60 |
$49.80
|
|
Carbamazepine total therapeutic drug level
|
$60.80 |
$60.80 |
$60.80 |
$122.85
|
|
Carbon dioxide
|
$20.00 |
$20.00 |
$20.00 |
$42.66
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$1,921.80 |
$1,921.80 |
$1,921.80 |
$460.80
|
|
Carboxyhemoglobin quantitative
|
$61.60 |
$61.60 |
$61.60 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$65.00 |
$65.00 |
$65.00 |
$144.00
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$4,720.00 |
$4,720.00 |
$4,720.00 |
$2,880.48
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$296.00 |
$296.00 |
$296.00 |
$248.00
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$304.00 |
$304.00 |
$304.00 |
$203.34
|
|
Cardiolipin antibody iga
|
$105.60 |
$105.60 |
$105.60 |
$105.60
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$1,771.20 |
$1,771.20 |
$1,771.20 |
$1,411.50
|
|
Carotene
|
$38.40 |
$38.40 |
$38.40 |
$46.20
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,346.40 |
$1,346.40 |
$1,346.40 |
$997.10
|
|
Car seat/bed test 60 minutes
|
$137.60 |
$137.60 |
$137.60 |
$110.40
|
|
Catheter stripping venous
|
$5,223.20 |
$5,223.20 |
$5,223.20 |
$3,193.94
|
|
Cath place 1st order venous 36011
|
$896.00 |
$896.00 |
$896.00 |
$1,357.20
|
|
Cath plc art ang/grft lt/rt hr
|
$13,621.60 |
$13,621.60 |
$13,621.60 |
$11,689.44
|
|
Cath plc art/angio/rt hrt cath
|
$13,621.60 |
$13,621.60 |
$13,621.60 |
$9,974.16
|
|
Cath plc art/grft/angio right hrt
|
$13,621.60 |
$13,621.60 |
$13,621.60 |
$10,600.47
|
|
Cath right heart w/o2 sat & card
|
$13,621.60 |
$13,621.60 |
$13,621.60 |
$6,356.90
|
|
Cath/saline/contrast/sis/hysteosal 58340
|
$275.20 |
$275.20 |
$275.20 |
$462.80
|
|
Cath segmntl pulm art
|
$497.60 |
$497.60 |
$497.60 |
$1,250.25
|
|
Cauterization chemical granulation tissue
|
$187.20 |
$187.20 |
$187.20 |
$340.90
|
|
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr
|
$52.40 |
$52.40 |
$52.40 |
$40.39
|
|
Cefepime 1 gram solution for injection
|
$117.80 |
$117.80 |
$117.80 |
$44.99
|
|
Ceftaroline fosamil 600 mg intravenous solution
|
$1,825.40 |
$1,825.40 |
$1,825.40 |
$602.45
|
|
Ceftazidime 4.5 mg/0.2 ml intraocular injection - cnr
|
$69.20 |
$69.20 |
$69.20 |
$59.79
|
|
Ceftazidime and avibactam
|
$2,988.00 |
$2,988.00 |
$2,988.00 |
$904.66
|
|
Ceftriaxone 1 gram solution for injection
|
$52.40 |
$52.40 |
$52.40 |
$84.15
|
|
Cell count body fluid
|
$20.00 |
$20.00 |
$20.00 |
$63.52
|
|
Cell count w differential body fluid
|
$23.20 |
$23.20 |
$23.20 |
$93.23
|
|
Cell function assay w/stim
|
$564.80 |
$564.80 |
$564.80 |
$318.58
|
|
Change cystostomy tube; complex 51710
|
$1,457.60 |
$1,457.60 |
$1,457.60 |
$1,484.16
|
|
Change cystostomy tube simple
|
$564.80 |
$564.80 |
$564.80 |
$473.00
|
|
Change g-tube to g-j perc
|
$2,888.00 |
$2,888.00 |
$2,888.00 |
$2,198.40
|
|
Change nephroureteral cath
|
$3,511.20 |
$3,511.20 |
$3,511.20 |
$3,000.00
|
|
Change of ureter tube/stent
|
$3,307.20 |
$3,307.20 |
$3,307.20 |
$2,424.12
|
|
Change of windpipe airway 31502
|
$595.20 |
$595.20 |
$595.20 |
$398.43
|
|
Chest 2 vws w oblique
|
$501.60 |
$501.60 |
$501.60 |
$373.60
|
|
Chest apical lordotic proj
|
$416.00 |
$416.00 |
$416.00 |
$309.65
|
|
Chest CT scan (with and without contrast)
|
$562.00 |
$562.00 |
$562.00 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$470.00 |
$470.00 |
$470.00 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$285.00 |
$285.00 |
$285.00 |
$1,350.03
|
|
Chest X-ray
|
$322.40 |
$322.40 |
$322.40 |
$295.03
|
|
Chest X-ray (single view)
|
$292.80 |
$292.80 |
$292.80 |
$241.20
|
|
Chg radiologic exam esophagus double contrast
|
$479.20 |
$479.20 |
$479.20 |
$512.00
|
|
Chloride
|
$19.20 |
$19.20 |
$19.20 |
$40.95
|
|
Chloride 24 hour urine
|
$24.00 |
$24.00 |
$24.00 |
$50.40
|
|
Chloroprocaine hcl injection
|
$223.80 |
$223.80 |
$223.80 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$294.00 |
$294.00 |
$294.00 |
$369.74
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$250.40 |
$250.40 |
$250.40 |
$78.43
|
|
Cholangiogram percutaneous compl
|
$6,234.40 |
$6,234.40 |
$6,234.40 |
$3,384.15
|
|
Cholecystostomy complete w/supervision & interpretation
|
$8,569.60 |
$8,569.60 |
$8,569.60 |
$3,739.81
|
|
Cholesterol
|
$18.40 |
$18.40 |
$18.40 |
$45.50
|
|
Cholesterol (Lipid) Test
|
$40.00 |
$40.00 |
$40.00 |
$115.80
|
|
Chromo high res and frag x - sendout
|
$284.80 |
$284.80 |
$284.80 |
$250.00
|
|
Chromosome analysis 15-20 cell count
|
$626.40 |
$626.40 |
$626.40 |
$512.20
|
|
Chromosome karyotype study
|
$140.00 |
$140.00 |
$140.00 |
$120.00
|
|
Cilastatin sodium injection
|
$156.60 |
$156.60 |
$156.60 |
$77.40
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$98.00 |
$98.00 |
$98.00 |
$36.23
|
|
Circumcise/surg/28 days or < 54160
|
$433.60 |
$433.60 |
$433.60 |
$1,219.20
|
|
Circumcision (newborn)
|
$412.80 |
$412.80 |
$412.80 |
$1,358.70
|
|
Clearance of airways
|
$309.60 |
$309.60 |
$309.60 |
$208.00
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$156.80 |
$156.80 |
$156.80 |
$55.20
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$177.00 |
$177.00 |
$177.00 |
$83.14
|
|
Closed tx humerus fx with manip 23605
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$2,269.80
|
|
Closed tx humerus fx without manip 23600
|
$952.80 |
$952.80 |
$952.80 |
$494.49
|
