|
Blood typing abo
|
$46.25 |
$46.25 |
$46.25 |
$84.75
|
|
Blood typing ag donor ea ag
|
$122.60 |
$122.60 |
$122.60 |
$204.84
|
|
Blood typing rbc ag non abo/rh ea
|
$133.00 |
$133.00 |
$133.00 |
$206.33
|
|
Blood typing rh (d)
|
$43.00 |
$43.00 |
$43.00 |
$57.14
|
|
Bone Density Scan (DEXA)
|
$237.00 |
$237.00 |
$237.00 |
$398.56
|
|
Borrelia burgdorferi (lyme disease) antibody nonspecific
|
$56.40 |
$56.40 |
$56.40 |
$91.20
|
|
Borrelia miyamotoi amp prb
|
$162.40 |
$162.40 |
$162.40 |
$81.20
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$473.50 |
$473.50 |
$473.50 |
$1,875.25
|
|
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)
|
$5,202.40 |
$5,202.40 |
$5,202.40 |
$2,975.48
|
|
Breast punct aspir cyst, bil
|
$2,043.60 |
$2,043.60 |
$2,043.60 |
$863.10
|
|
Bumetanide in d5w IV syringe 0.04 mg/ml (neo/ped) - cnr
|
$18.40 |
$18.40 |
$18.40 |
$24.08
|
|
Bundled special stain group 1 microorganisms
|
$164.40 |
$164.40 |
$164.40 |
$154.70
|
|
Bundled special stain group 2
|
$192.40 |
$192.40 |
$192.40 |
$170.65
|
|
Bupivacaine 0.1 % epidural pca - 1 hour dose limit
|
$10.20 |
$10.20 |
$10.20 |
$33.08
|
|
Bx breast 1st lesion mr imag
|
$4,769.60 |
$4,769.60 |
$4,769.60 |
$3,256.00
|
|
Bx breast add lesion Ultrasound imag
|
$5,202.40 |
$5,202.40 |
$5,202.40 |
$1,604.40
|
|
Bx breast pq tomo guide
|
$9,758.40 |
$9,758.40 |
$9,758.40 |
$4,428.15
|
|
C1 esterase inhibitor func - sendout
|
$358.60 |
$358.60 |
$358.60 |
$96.72
|
|
Calcium 24 hour urine
|
$88.20 |
$88.20 |
$88.20 |
$52.00
|
|
Calcium ionized
|
$132.60 |
$132.60 |
$132.60 |
$89.88
|
|
Calcium total
|
$52.60 |
$52.60 |
$52.60 |
$50.00
|
|
Calprotectin fecal
|
$545.20 |
$545.20 |
$545.20 |
$170.00
|
|
Carbamazepine free
|
$415.80 |
$415.80 |
$415.80 |
$59.15
|
|
Carbamazepine total therapeutic drug level
|
$312.00 |
$312.00 |
$312.00 |
$122.85
|
|
Carbon dioxide
|
$20.00 |
$20.00 |
$20.00 |
$42.66
|
|
Carboxyhemoglobin quantitative
|
$279.20 |
$279.20 |
$279.20 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$65.00 |
$65.00 |
$65.00 |
$144.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$277.40 |
$277.40 |
$277.40 |
$248.00
|
|
Cardiolipin antibody iga
|
$285.60 |
$285.60 |
$285.60 |
$105.60
|
|
Cardioversion elective electrical conversion arrhythmia external
|
$1,863.20 |
$1,863.20 |
$1,863.20 |
$1,411.50
|
|
Carotid Artery Ultrasound (Duplex)
|
$1,843.20 |
$1,843.20 |
$1,843.20 |
$997.10
|
|
Cath bi-dir df smarttouch
|
$10,598.62 |
$10,598.62 |
$10,598.62 |
$8,528.80
|
|
Cath combo lt&rt heart w/inj/s
|
$6,734.20 |
$6,734.20 |
$6,734.20 |
$9,316.35
|
|
Cath hawkone s directional
|
$9,551.28 |
$9,551.28 |
$9,551.28 |
$7,076.25
|
|
Cath plc art/angio/rt hrt cath
|
$8,399.80 |
$8,399.80 |
$8,399.80 |
$9,974.16
|
|
Cath/saline/contrast/sis/hysteosal 58340
|
$305.60 |
$305.60 |
$305.60 |
$462.80
|
|
Cauterization chemical granulation tissue
|
$877.80 |
$877.80 |
$877.80 |
$340.90
|
|
Cefazolin 10 mg/10 ml (dilution #2) IV desensitization - cnr
|
$7.40 |
$7.40 |
$7.40 |
$40.39
|
|
Cell count body fluid
|
$20.00 |
$20.00 |
$20.00 |
$63.52
|
|
Cell count w differential body fluid
|
$548.80 |
$548.80 |
$548.80 |
$93.23
|
|
Change cystostomy tube simple
|
$717.80 |
$717.80 |
$717.80 |
$473.00
|
|
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
|
$537.60 |
$537.60 |
$537.60 |
$295.03
|
|
Chest X-ray (single view)
|
$475.20 |
$475.20 |
$475.20 |
$241.20
|
|
Chloride
|
$71.20 |
$71.20 |
$71.20 |
$40.95
|
|
Chloride 24 hour urine
|
$52.00 |
$52.00 |
$52.00 |
$50.40
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$602.40
|
|
Cholesterol
|
$62.20 |
$62.20 |
$62.20 |
$45.50
|
|
Cholesterol (Lipid) Test
|
$40.00 |
$40.00 |
$40.00 |
$115.80
|
|
Chromosome analysis 15-20 cell count
|
$2,698.20 |
$2,698.20 |
$2,698.20 |
$512.20
|
|
Circumcision (newborn)
|
$717.40 |
$717.40 |
$717.40 |
$1,358.70
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$3,286.38 |
$3,286.38 |
$3,286.38 |
$15,779.40
|
|
Closed tx humerus fx without manip 23600
|
$952.80 |
$952.80 |
$952.80 |
$494.49
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$1,197.80 |
$1,197.80 |
$1,197.80 |
$657.28
|
|
Clsd tx elbow dislocation child 24640
|
$885.60 |
$885.60 |
$885.60 |
$462.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$5,969.40 |
$5,969.40 |
$5,969.40 |
$1,680.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$685.00 |
$685.00 |
$685.00 |
$613.14
|
|
Clsd tx patella disloc without anes 27560
|
$797.60 |
$797.60 |
$797.60 |
$577.20
|
|
Cmv pcr-sendout
|
$300.40 |
$300.40 |
$300.40 |
$177.50
|
|
Coagulation time activated teg
|
$68.00 |
$68.00 |
$68.00 |
$53.55
|
|
Collection blood specimen from completely implantable venous access device
|
$100.00 |
$100.00 |
$100.00 |
$160.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$100.00 |
$100.00 |
$100.00 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$5.00 |
$5.00 |
$5.00 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$714.80 |
$714.80 |
$714.80 |
$172.00
|
|
Compatibility test each unit electronic
|
$528.00 |
$528.00 |
$528.00 |
$166.26
|
|
Compatibility test each unit immediate spin technique
|
$528.00 |
$528.00 |
$528.00 |
$167.17
|
|
Complement antigen each component c3
|
$167.40 |
$167.40 |
$167.40 |
$110.00
|
|
Concentration infection agents any type
|
$116.60 |
$116.60 |
$116.60 |
$51.32
|
|
Contrast exam abdominl aorta 75625-26
|
$4,233.00 |
$4,233.00 |
$4,233.00 |
$3,480.00
|
|
Control of nosebleed ant comp 30903
|
$684.80 |
$684.80 |
$684.80 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$1,338.60 |
$1,338.60 |
$1,338.60 |
$352.80
|
|
Coombs direct
|
$124.20 |
$124.20 |
$124.20 |
$76.44
|
|
Coronary angio/lv gram/lt heart
|
$6,734.20 |
$6,734.20 |
$6,734.20 |
$10,263.12
|
|
Coronary angio/lv gram/rt< heart
|
$6,734.20 |
$6,734.20 |
$6,734.20 |
$11,280.10
|
|
Coronary art/grft angio s&i
|
$6,734.20 |
$6,734.20 |
$6,734.20 |
$8,200.40
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$6,734.20 |
$6,734.20 |
$6,734.20 |
$7,950.49
|
|
Cortisol acth stimulation test - sendout
|
$1,393.20 |
$1,393.20 |
$1,393.20 |
$146.25
|
|
Cortisol total am
|
$204.60 |
$204.60 |
$204.60 |
$121.20
|
|
C-peptide
|
$232.80 |
$232.80 |
$232.80 |
$93.60
|
|
C-reactive protein
|
$20.00 |
$20.00 |
$20.00 |
$68.38
|
|
C-reactive protein high sensitivity
|
$92.80 |
$92.80 |
$92.80 |
$85.00
|
|
Creatine kinase
|
$158.80 |
$158.80 |
$158.80 |
$65.60
|
|
Creatine kinase mb
|
$181.20 |
$181.20 |
$181.20 |
$113.63
|
|
Creatinine
|
$15.00 |
$15.00 |
$15.00 |
$45.65
|
|
Creatinine 24 hour urine
|
$20.00 |
$20.00 |
$20.00 |
$57.60
|
|
#creutz-prot.,western blot
|
$1,093.40 |
$1,093.40 |
$1,093.40 |
$163.50
|
|
Critical care 30-74 minutes
|
$2,184.40 |
$2,184.40 |
$2,184.40 |
$2,519.00
|
|
Critical care each additional 30 minutes
|
$951.60 |
$951.60 |
$951.60 |
$686.86
|
|
Crystal identification light microscopy
|
$326.80 |
$326.80 |
$326.80 |
$65.50
|
|
CT 3d report other modality w/workstation
|
$664.80 |
$664.80 |
$664.80 |
$637.41
|
|
Cta abdomen without & /or w/contrast
|
$532.50 |
$532.50 |
$532.50 |
$2,002.00
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$397.50 |
$397.50 |
$397.50 |
$1,916.50
|
|
Cta lower extremity without & w/contrast (both sides)
|
$528.50 |
$528.50 |
$528.50 |
$2,002.44
|
|
Cta neck without &/or w/contrast
|
$538.00 |
$538.00 |
$538.00 |
$1,899.75
|
|
CT Angiogram of Abdomen and Pelvis
|
$517.50 |
$517.50 |
$517.50 |
$2,842.40
|
