|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,565.50 |
$1,565.50 |
$1,565.50 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$1,009.00 |
$1,009.00 |
$1,009.00 |
$1,655.85
|
|
CT thoracic spine without contrast
|
$932.00 |
$932.00 |
$932.00 |
$1,430.20
|
|
CT thorax low dose for lung screening without contrast
|
$64.00 |
$64.00 |
$64.00 |
$332.00
|
|
CT t-spine w /wo contrast
|
$1,052.50 |
$1,052.50 |
$1,052.50 |
$1,968.47
|
|
CT upper extremity w/contrast (both sides)
|
$877.50 |
$877.50 |
$877.50 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$709.00 |
$709.00 |
$709.00 |
$1,404.36
|
|
CT uppr extremity w/o&w/dye
|
$927.00 |
$927.00 |
$927.00 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$147.50 |
$147.50 |
$147.50 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$83.00 |
$83.00 |
$83.00 |
$71.40
|
|
Culture afb any source
|
$157.00 |
$157.00 |
$157.00 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$83.00 |
$83.00 |
$83.00 |
$84.76
|
|
Culture anaerobic except blood
|
$191.50 |
$191.50 |
$191.50 |
$120.54
|
|
Culture bact stool aero addl path ea
|
$74.50 |
$74.50 |
$74.50 |
$52.50
|
|
Culture body fluid
|
$265.00 |
$265.00 |
$265.00 |
$126.00
|
|
Culture fungi definitive id mold
|
$83.00 |
$83.00 |
$83.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$83.00 |
$83.00 |
$83.00 |
$79.50
|
|
Culture fungi other (except blood)
|
$118.50 |
$118.50 |
$118.50 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$95.50 |
$95.50 |
$95.50 |
$74.40
|
|
Culture quantitative aerobic other source
|
$26.00 |
$26.00 |
$26.00 |
$90.35
|
|
Culture screening strep group a
|
$101.00 |
$101.00 |
$101.00 |
$83.16
|
|
Culture typing added method
|
$83.00 |
$83.00 |
$83.00 |
$38.70
|
|
Culture typing immunologic
|
$67.50 |
$67.50 |
$67.50 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$350.00 |
$350.00 |
$350.00 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$617.50 |
$617.50 |
$617.50 |
$138.40
|
|
Culture urine each isolate
|
$23.00 |
$23.00 |
$23.00 |
$54.78
|
|
Curette/treat cornea
|
$435.50 |
$435.50 |
$435.50 |
$1,345.80
|
|
Curette/treat cornea
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$2,818.14
|
|
Cutter lead
|
$26,295.00 |
$26,295.00 |
$26,295.00 |
$6,685.72
|
|
Cv line/pic reposition
|
$702.00 |
$702.00 |
$702.00 |
$1,608.00
|
|
Cyclic citrullinated peptide antibody
|
$93.50 |
$93.50 |
$93.50 |
$72.15
|
|
Cyclosporine 2 hour
|
$114.50 |
$114.50 |
$114.50 |
$129.48
|
|
Cylinder pump set 20cm titan zero angl
|
$25,358.50 |
$25,358.50 |
$25,358.50 |
$24,372.98
|
|
Cymetra injectable
|
$358.50 |
$358.50 |
$358.50 |
$578.24
|
|
Cyp2c19 gene com variants
|
$524.00 |
$524.00 |
$524.00 |
$502.45
|
|
Cyp3a5 gene common variants
|
$551.00 |
$551.00 |
$551.00 |
$245.31
|
|
Cystatin c
|
$48.50 |
$48.50 |
$48.50 |
$76.48
|
|
Cystic fibrosis cftr
|
$837.00 |
$837.00 |
$837.00 |
$1,104.40
|
|
Cystogram >= 3 views supervision & interpretation
|
$236.00 |
$236.00 |
$236.00 |
$564.85
|
|
Cystometrogram w/up 51727
|
$345.50 |
$345.50 |
$345.50 |
$908.59
|
|
Cystoscopy and biopsy
|
$1,792.50 |
$1,792.50 |
$1,792.50 |
$4,081.37
|
|
Cystoscopy and treatment
|
$916.00 |
$916.00 |
$916.00 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,870.00 |
$1,870.00 |
$1,870.00 |
$6,593.60
|
|
Cystoscopy and treatment
|
$663.50 |
$663.50 |
$663.50 |
$2,424.12
|
|
Cystoscopy and treatment
|
$663.50 |
$663.50 |
$663.50 |
$2,850.95
|
|
Cystoscopy and treatment
|
$1,929.50 |
$1,929.50 |
$1,929.50 |
$3,817.53
|
|
Cystoscopy (Bladder Scope)
|
$446.00 |
$446.00 |
$446.00 |
$1,445.41
|
|
Cystoscopy chemodenervation
|
$1,390.00 |
$1,390.00 |
$1,390.00 |
$2,831.92
|
|
Cystoscopy implant stent
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$4,081.37
|
|
Cystoscopy & ureter catheter
|
$1,654.00 |
$1,654.00 |
$1,654.00 |
$3,688.80
|
|
Cysto/uretero w/lithotripsy
|
$3,541.50 |
$3,541.50 |
$3,541.50 |
$7,573.50
|
|
Cystouretero w/stone remove
|
$1,976.50 |
$1,976.50 |
$1,976.50 |
$5,339.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$898.50 |
$898.50 |
$898.50 |
$3,131.20
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$916.00 |
$916.00 |
$916.00 |
$4,045.60
|
|
Cystourethro w/addl implant 52442
|
$7,433.50 |
$7,433.50 |
$7,433.50 |
$2,161.60
|
|
Cystourethro w/implant
|
$3,261.50 |
$3,261.50 |
$3,261.50 |
$2,777.60
|
|
Cysto w/ureter stricture tx
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$4,081.37
|
|
Cytogenetics 25-99
|
$151.50 |
$151.50 |
$151.50 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,219.50 |
$1,219.50 |
$1,219.50 |
$2,156.05
|
|
Cytomegalovirus (cmv) antibody igg
|
$126.50 |
$126.50 |
$126.50 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$134.00 |
$134.00 |
$134.00 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$162.00 |
$162.00 |
$162.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$149.00 |
$149.00 |
$149.00 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$83.50 |
$83.50 |
$83.50 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$83.50 |
$83.50 |
$83.50 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$71.50 |
$71.50 |
$71.50 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$83.50 |
$83.50 |
$83.50 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$162.00 |
$162.00 |
$162.00 |
$209.92
|
|
Cytopath smear other source
|
$56.00 |
$56.00 |
$56.00 |
$91.20
|
|
Cytopath tbs c/v manual
|
$64.50 |
$64.50 |
$64.50 |
$59.28
|
|
Dbrdmt prmlg les w/pdt
|
$338.50 |
$338.50 |
$338.50 |
$468.00
|
|
D&c after delivery 59160
|
$2,373.00 |
$2,373.00 |
$2,373.00 |
$3,827.25
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$2,406.50 |
$2,406.50 |
$2,406.50 |
$3,774.81
|
|
Dch pulmonary stress test
|
$827.50 |
$827.50 |
$827.50 |
$963.30
|
|
Dch validity tests
|
$11.50 |
$11.50 |
$11.50 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$4,022.00 |
$4,022.00 |
$4,022.00 |
$5,110.00
|
|
Deamidated gliadin antibody iga
|
$45.00 |
$45.00 |
$45.00 |
$42.75
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$298.00 |
$298.00 |
$298.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$309.50 |
$309.50 |
$309.50 |
$278.50
|
|
Debridement bone <= 20 sq cm
|
$1,359.00 |
$1,359.00 |
$1,359.00 |
$2,293.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$368.50 |
$368.50 |
$368.50 |
$687.35
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$951.50 |
$951.50 |
$951.50 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$320.50 |
$320.50 |
$320.50 |
$820.15
|
|
Debride nail1-5 11720
|
$79.50 |
$79.50 |
$79.50 |
$149.04
|
|
Debride nail6 or more 11721
|
$119.50 |
$119.50 |
$119.50 |
$167.63
|
|
Debride skin bone at fx site
|
$1,455.50 |
$1,455.50 |
$1,455.50 |
$2,921.60
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$368.50 |
$368.50 |
$368.50 |
$641.52
|
|
Debrid mastoidectomy cavity simple 69220
|
$111.50 |
$111.50 |
$111.50 |
$235.13
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,141.50 |
$1,141.50 |
$1,141.50 |
$1,129.45
|
|
Debr inf skin add-on 11001
|
$96.50 |
$96.50 |
$96.50 |
$124.08
|
|
Debr musc/fascia 20sq cm/< 11043
|
$492.00 |
$492.00 |
$492.00 |
$1,160.00
|
|
Decalcification
|
$60.50 |
$60.50 |
$60.50 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$346.50 |
$346.50 |
$346.50 |
$546.84
|
|
Deep muscle biopsy 20205
|
$2,081.50 |
$2,081.50 |
$2,081.50 |
$3,370.52
|
|
Delay flap eye/nos/ear/lip
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$2,190.24
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$1,101.50 |
$1,101.50 |
$1,101.50 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$125.50 |
$125.50 |
$125.50 |
$182.40
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$264.50 |
$264.50 |
$264.50 |
$399.93
|
|
Dermabrasion other than face
|
$843.50 |
$843.50 |
$843.50 |
$3,214.40
|
|
Descend thora aorta rpr/lt sub art 33880
|
$2,855.00 |
$2,855.00 |
$2,855.00 |
$5,958.60
|
