|
CT lwr extremity w/o&w/dye
|
$2,785.80 |
$3,316.20 |
$5,112.00 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$2,487.00 |
$2,574.60 |
$3,772.80 |
$422.80
|
|
CT scan for localization
|
$3,509.40 |
$3,509.40 |
$3,509.40 |
$1,216.80
|
|
CT scan for therapy guide
|
$777.00 |
$843.60 |
$1,322.40 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,263.80 |
$5,897.40 |
$8,884.80 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$5,263.80 |
$5,897.40 |
$8,884.80 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,675.60 |
$4,117.20 |
$6,200.40 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,785.80 |
$3,202.80 |
$5,293.80 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,785.80 |
$3,394.80 |
$5,112.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$57.00 |
$76.20 |
$178.20 |
$72.00
|
|
Culture afb any source
|
$68.40 |
$114.60 |
$1,312.80 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$108.60 |
$119.40 |
$466.80 |
$84.76
|
|
Culture anaerobic except blood
|
$80.40 |
$259.20 |
$838.80 |
$121.22
|
|
Culture bacteria anaerobic
|
$67.20 |
$67.20 |
$67.20 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$24.00 |
$38.40 |
$76.80 |
$52.50
|
|
Culture body fluid
|
$121.20 |
$250.20 |
$438.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$102.60 |
$109.80 |
$349.80 |
$80.00
|
|
Culture fungi definitive id yeast
|
$93.60 |
$110.40 |
$254.40 |
$80.00
|
|
Culture fungi other (except blood)
|
$137.40 |
$297.00 |
$520.20 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$79.80 |
$80.40 |
$520.20 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$108.60 |
$127.20 |
$3,052.80 |
$100.00
|
|
Culture mycoplasma any source
|
$115.20 |
$222.00 |
$300.00 |
$83.21
|
|
Culture quantitative aerobic other source
|
$49.80 |
$217.80 |
$300.00 |
$87.02
|
|
Culture screening strep group a
|
$81.00 |
$117.00 |
$126.60 |
$84.60
|
|
Culture typing immunologic
|
$45.60 |
$54.00 |
$80.40 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$334.20 |
$403.80 |
$463.20 |
$140.80
|
|
Culture urine each isolate
|
$70.20 |
$76.20 |
$186.00 |
$55.50
|
|
Curette/treat cornea
|
$748.20 |
$748.20 |
$1,200.60 |
$1,365.60
|
|
Cutter lead
|
$1,882.80 |
$3,284.40 |
$10,158.00 |
$6,581.45
|
|
Cv line/pic reposition
|
$1,025.40 |
$1,127.40 |
$10,446.60 |
$1,681.20
|
|
Cyanocobalamin unsat binding capacity
|
$91.80 |
$134.40 |
$210.00 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$8.20 |
$10.80 |
$18.00 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$85.20 |
$100.20 |
$594.60 |
$72.36
|
|
Cyclophosphamide 100 mg inj
|
$445.20 |
$445.20 |
$607.80 |
$287.88
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1.40 |
$3.75 |
$3.75 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$28.20 |
$67.20 |
$133.20 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$268.20 |
$268.20 |
$268.20 |
$140.78
|
|
Cyclosporine 2 hour
|
$76.80 |
$253.80 |
$490.20 |
$130.40
|
|
Cyclosporine modified 25 mg capsule
|
$10.80 |
$51.45 |
$51.45 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$84.60 |
$198.60 |
$3,460.20 |
$37.31
|
|
Cylinder pump set 20cm titan zero angl
|
$22,476.00 |
$25,255.20 |
$34,293.60 |
$24,728.89
|
|
Cymetra injectable
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$578.24
|
|
Cyp2c19 gene com variants
|
$1,017.60 |
$1,017.60 |
$1,341.60 |
$524.00
|
|
Cyp2c9 gene com variants
|
$845.40 |
$1,870.20 |
$1,870.20 |
$275.10
|
|
Cyp2d6 gene com variants
|
$269.40 |
$269.40 |
$2,536.80 |
$570.70
|
|
Cyp3a4 gene common variants
|
$414.00 |
$438.60 |
$438.60 |
$241.24
|
|
Cyp3a5 gene common variants
|
$414.00 |
$438.60 |
$438.60 |
$245.31
|
|
Cystatin c
|
$102.00 |
$138.00 |
$281.40 |
$77.60
|
|
Cystic fibrosis cftr
|
$4,054.80 |
$4,054.80 |
$8,681.40 |
$1,104.40
|
|
Cystine urine quantitative
|
$117.00 |
$178.20 |
$464.40 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,668.60 |
$1,868.40 |
$2,813.40 |
$586.95
|
|
Cystometrogram w/up 51727
|
$3,349.80 |
$3,349.80 |
$3,349.80 |
$908.59
|
|
Cystoscopy and treatment
|
$3,018.60 |
$3,771.00 |
$4,170.00 |
$2,867.70
|
|
Cystoscopy and treatment
|
$3,045.00 |
$3,045.00 |
$3,769.20 |
$3,817.53
|
|
Cystoscopy (Bladder Scope)
|
$2,580.60 |
$3,145.80 |
$4,303.80 |
$1,493.80
|
|
Cystoscopy chemodenervation
|
$1,871.40 |
$1,871.40 |
$1,871.40 |
$2,874.36
|
|
Cystoscopy prostatic imp 1-3
|
$8,013.60 |
$8,013.60 |
$8,013.60 |
$5,741.40
|
|
Cystoscopy & ureter catheter
|
$3,417.00 |
$3,706.20 |
$5,034.60 |
$3,728.50
|
|
Cystostomy cystotomy w/drainage 51040
|
$4,228.80 |
$4,977.60 |
$6,178.80 |
$4,129.45
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,277.80 |
$3,442.20 |
$4,871.40 |
$3,245.90
|
|
Cytarabine 20 mg/ml injection solution
|
$112.20 |
$320.40 |
$2,244.00 |
$90.00
|
|
Cytarabine liposome inj
|
$1,720.20 |
$1,720.20 |
$3,818.40 |
$4,529.43
|
|
Cytogenetics 25-99
|
$308.40 |
$357.60 |
$401.40 |
$189.80
|
|
Cytogenetics 3-5
|
$366.00 |
$366.00 |
$366.00 |
$147.36
|
|
Cytogenomic neo microra alys
|
$1,343.40 |
$1,343.40 |
$1,416.00 |
$2,198.00
|
|
Cytogenom microarray copy nmbr var
|
$4,206.60 |
$4,206.60 |
$4,206.60 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$192.60 |
$212.40 |
$1,002.00 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$110.40 |
$134.40 |
$1,845.00 |
$100.00
|
|
Cytomegalovirus imm IV /vial
|
$5,413.80 |
$5,413.80 |
$5,413.80 |
$3,072.34
|
|
Cyto/molecular report
|
$34.80 |
$41.40 |
$85.80 |
$144.75
|
|
Cytopath c/v index add-on
|
$63.60 |
$63.60 |
$63.60 |
$34.20
|
|
Cytopath c/v manual
|
$32.40 |
$32.40 |
$32.40 |
$36.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$268.20 |
$322.20 |
$388.80 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$78.00 |
$78.00 |
$90.60 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$61.20 |
$61.20 |
$61.20 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$57.00 |
$128.40 |
$201.00 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$80.40 |
$213.60 |
$1,102.20 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$34.20 |
$40.80 |
$50.40 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$68.40 |
$75.00 |
$213.00 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$85.20 |
$117.00 |
$386.40 |
$213.85
|
|
Cytopath smear other source
|
$67.20 |
$67.20 |
$137.40 |
$92.50
|
|
Cytopath smear oth prep screen & interp
|
$178.80 |
$178.80 |
$178.80 |
$96.20
|
|
Cytopath tbs c/v manual
|
$38.40 |
$38.40 |
$38.40 |
$59.28
|
|
Cytotoxic antibody screening
|
$288.60 |
$288.60 |
$1,555.20 |
$133.25
|
|
Cytp urine 3-5 probes cmptr
|
$963.00 |
$2,238.00 |
$3,282.00 |
$664.80
|
|
Dacarbazine 100 mg intravenous solution
|
$67.40 |
$198.60 |
$198.60 |
$62.41
|
|
Dactinomycin 0.5 mg intravenous solution
|
$166.20 |
$166.20 |
$880.80 |
$3,264.26
|
|
Dalbavancin 500 mg intravenous solution
|
$68.20 |
$68.40 |
$6,856.20 |
$3,493.11
|
|
Dalteparin sodium
|
$126.00 |
$362.40 |
$478.20 |
$469.55
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$2.25 |
$997.80 |
$2,563.20 |
$171.19
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$109.20 |
$134.40 |
$134.40 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$52.50 |
$60.60 |
$12,491.40 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$20.40 |
$20.40 |
$20.40 |
$7.20
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$681.00 |
$681.00 |
$29,942.40 |
$20,196.00
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$808.20 |
$808.20 |
$1,617.60 |
$259.58
|
|
Daunorubicin citrate inj
|
$262.20 |
$262.20 |
$262.20 |
$585.31
|
|
Dbrdmt prmlg les w/pdt
|
$1,000.20 |
$1,000.20 |
$1,253.40 |
$468.00
|
|
D&c after delivery 59160
|
$6,928.80 |
$6,928.80 |
$6,928.80 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$992.40 |
$992.40 |
$992.40 |
$3,774.81
|
|
Dch glucoscan
|
$38.40 |
$38.40 |
$96.00 |
$29.16
|
