|
CT heart w/evaluation of calcium without contrast
|
$65.00 |
$65.00 |
$65.00 |
$156.00
|
|
CT hrt c+ strux cgen hrt ds
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$1,371.50
|
|
CT hrt w/3d image
|
$499.50 |
$499.50 |
$499.50 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$731.00 |
$731.00 |
$731.00 |
$633.60
|
|
CT lower extremity w/contrast (both sides)
|
$1,793.00 |
$1,793.00 |
$1,793.00 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$1,715.00 |
$1,715.00 |
$1,715.00 |
$1,398.82
|
|
Ctlso a-p-l control molded
|
$4,466.50 |
$4,466.50 |
$4,466.50 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$4,204.00 |
$4,204.00 |
$4,204.00 |
$4,186.78
|
|
CT lwr extremity w/o&w/dye
|
$1,793.00 |
$1,793.00 |
$1,793.00 |
$1,818.96
|
|
CT neck soft tissue w/contrast
|
$1,789.50 |
$1,789.50 |
$1,789.50 |
$1,603.55
|
|
CT neck soft tissue without contrast
|
$1,567.50 |
$1,567.50 |
$1,567.50 |
$1,312.00
|
|
CT neck soft tissue without & w/contrast
|
$3,065.00 |
$3,065.00 |
$3,065.00 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,976.50 |
$1,976.50 |
$1,976.50 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,976.50 |
$1,976.50 |
$1,976.50 |
$1,543.00
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,779.00 |
$1,779.00 |
$1,779.00 |
$1,345.05
|
|
CT scan for therapy guide
|
$916.50 |
$916.50 |
$916.50 |
$656.13
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,415.50 |
$5,415.50 |
$5,415.50 |
$3,408.50
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,439.50 |
$4,439.50 |
$4,439.50 |
$2,871.05
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,208.00 |
$3,208.00 |
$3,208.00 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$2,016.50 |
$2,016.50 |
$2,016.50 |
$1,655.85
|
|
CT thoracic spine without contrast
|
$1,971.50 |
$1,971.50 |
$1,971.50 |
$1,430.20
|
|
CT thorax low dose for lung screening without contrast
|
$36.00 |
$36.00 |
$36.00 |
$332.00
|
|
CT t-spine w /wo contrast
|
$2,016.50 |
$2,016.50 |
$2,016.50 |
$1,968.47
|
|
CT upper extremity w/contrast (both sides)
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,529.00 |
$1,529.00 |
$1,529.00 |
$1,404.36
|
|
CT uppr extremity w/o&w/dye
|
$1,983.50 |
$1,983.50 |
$1,983.50 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$92.50 |
$92.50 |
$92.50 |
$71.40
|
|
Culture afb any source
|
$320.00 |
$320.00 |
$320.00 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$92.50 |
$92.50 |
$92.50 |
$84.76
|
|
Culture anaerobic except blood
|
$215.00 |
$215.00 |
$215.00 |
$120.54
|
|
Culture bact stool aero addl path ea
|
$88.00 |
$88.00 |
$88.00 |
$52.50
|
|
Culture body fluid
|
$262.00 |
$262.00 |
$262.00 |
$126.00
|
|
Culture fungi definitive id mold
|
$126.50 |
$126.50 |
$126.50 |
$80.00
|
|
Culture fungi definitive id yeast
|
$110.00 |
$110.00 |
$110.00 |
$79.50
|
|
Culture fungi other (except blood)
|
$306.00 |
$306.00 |
$306.00 |
$109.20
|
|
Culture fungi skin/hair/nail
|
$155.50 |
$155.50 |
$155.50 |
$74.40
|
|
Culture quantitative aerobic other source
|
$230.00 |
$230.00 |
$230.00 |
$90.35
|
|
Culture screening strep group a
|
$90.00 |
$90.00 |
$90.00 |
$83.16
|
|
Culture typing added method
|
$112.00 |
$112.00 |
$112.00 |
$38.70
|
|
Culture typing immunologic
|
$75.50 |
$75.50 |
$75.50 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$393.00 |
$393.00 |
$393.00 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$839.00 |
$839.00 |
$839.00 |
$138.40
|
|
Culture urine each isolate
|
$163.00 |
$163.00 |
$163.00 |
$54.78
|
|
Cutter lead
|
$26,295.00 |
$26,295.00 |
$26,295.00 |
$6,685.72
|
|
Cv line/pic reposition
|
$4,842.00 |
$4,842.00 |
$4,842.00 |
$1,608.00
|
|
Cyclic citrullinated peptide antibody
|
$126.00 |
$126.00 |
$126.00 |
$72.15
|
|
Cyclosporine 2 hour
|
$154.50 |
$154.50 |
$154.50 |
$129.48
|
|
Cylinder pump set 20cm titan zero angl
|
$25,358.50 |
$25,358.50 |
$25,358.50 |
$24,372.98
|
|
Cyp2c19 gene com variants
|
$524.00 |
$524.00 |
$524.00 |
$502.45
|
|
Cyp3a5 gene common variants
|
$559.00 |
$559.00 |
$559.00 |
$245.31
|
|
Cystatin c
|
$125.50 |
$125.50 |
$125.50 |
$76.48
|
|
Cystogram >= 3 views supervision & interpretation
|
$634.50 |
$634.50 |
$634.50 |
$564.85
|
|
Cystoscopy and treatment
|
$1,773.00 |
$1,773.00 |
$1,773.00 |
$2,850.95
|
|
Cystostomy cystotomy w/drainage 51040
|
$1,786.00 |
$1,786.00 |
$1,786.00 |
$3,863.60
|
|
Cysto/uretero w/lithotripsy
|
$4,592.00 |
$4,592.00 |
$4,592.00 |
$7,573.50
|
|
Cytogenetics 25-99
|
$168.50 |
$168.50 |
$168.50 |
$189.80
|
|
Cytogenomic neo microra alys
|
$1,886.50 |
$1,886.50 |
$1,886.50 |
$2,156.05
|
|
Cytomegalovirus (cmv) antibody igg
|
$195.00 |
$195.00 |
$195.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$195.00 |
$195.00 |
$195.00 |
$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
|
$144.50 |
$144.50 |
$144.50 |
$92.40
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$55.00 |
$55.00 |
$55.00 |
$86.86
|
|
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
|
$0.50 |
$0.50 |
$0.50 |
$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
|
$53.50 |
$53.50 |
$53.50 |
$91.20
|
|
Cytopath tbs c/v manual
|
$83.50 |
$83.50 |
$83.50 |
$59.28
|
|
Dch glucoscan
|
$15.50 |
$15.50 |
$15.50 |
$29.16
|
|
Dch pulmonary stress test
|
$347.50 |
$347.50 |
$347.50 |
$963.30
|
|
Dch validity tests
|
$38.00 |
$38.00 |
$38.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$100.00 |
$100.00 |
$100.00 |
$42.75
|
|
Debridement (>20 cm) charge pt
|
$654.50 |
$654.50 |
$654.50 |
$278.50
|
|
Debridement bone <= 20 sq cm
|
$5,154.00 |
$5,154.00 |
$5,154.00 |
$2,293.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$687.35
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$5,154.00 |
$5,154.00 |
$5,154.00 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$820.15
|
|
Debride nail1-5 11720
|
$755.50 |
$755.50 |
$755.50 |
$149.04
|
|
Debride nail6 or more 11721
|
$755.50 |
$755.50 |
$755.50 |
$167.63
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$653.00 |
$653.00 |
$653.00 |
$1,149.50
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$641.52
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,301.00 |
$1,301.00 |
$1,301.00 |
$1,160.00
|
|
Decalcification
|
$60.50 |
$60.50 |
$60.50 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$733.00 |
$733.00 |
$733.00 |
$546.84
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$209.50 |
$209.50 |
$209.50 |
$182.40
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$553.00 |
$553.00 |
$553.00 |
$399.93
|
|
Dermagraft
|
$62.50 |
$62.50 |
$62.50 |
$85.00
|
|
Design mlc device for imrt
|
$4,319.00 |
$4,319.00 |
$4,319.00 |
$1,739.10
|
|
Destruction benign lesions < 14 lesions
|
$401.00 |
$401.00 |
$401.00 |
$235.13
|
|
Detect agnt mult dna direc
|
$133.00 |
$133.00 |
$133.00 |
$166.77
|
|
Device ablt adv novasure
|
$11,418.50 |
$11,418.50 |
$11,418.50 |
$6,237.48
|
|
Device sut capio slim opn
|
$1,127.50 |
$1,127.50 |
$1,127.50 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$10,966.00 |
$10,966.00 |
$10,966.00 |
$2,466.14
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$272.50 |
$272.50 |
$272.50 |
$227.15
|
|
Dhea-s (dehydroepiand sulfate)
|
$636.00 |
$636.00 |
$636.00 |
$111.60
|
|
Diabetes (HbA1c) Test
|
$205.00 |
$205.00 |
$205.00 |
$79.20
|
|
Diagnostic digital breast tomosynthesis bil
|
$468.50 |
$468.50 |
$468.50 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$413.50 |
$413.50 |
$413.50 |
$75.93
|
|
Diagnostic laryngoscopy 31575
|
$527.50 |
$527.50 |
$527.50 |
$334.95
|
