|
Brachytx isodose plan simple
|
$3,131.00 |
$3,131.00 |
$3,131.00 |
$817.20
|
|
Braf gene
|
$1,474.00 |
$1,474.00 |
$1,474.00 |
$421.20
|
|
Brain flow imaging only
|
$3,837.00 |
$3,837.00 |
$3,837.00 |
$636.97
|
|
Brain image w/flow < 4 views
|
$4,646.00 |
$4,646.00 |
$4,646.00 |
$828.39
|
|
Brain MRA (blood vessel MRI, with and without contrast)
|
$4,584.00 |
$4,584.00 |
$4,584.00 |
$2,622.87
|
|
Brain MRA (blood vessel MRI, with contrast)
|
$9,777.00 |
$9,777.00 |
$9,777.00 |
$1,998.00
|
|
Brain MRA (blood vessel MRI, without contrast)
|
$5,303.00 |
$5,303.00 |
$5,303.00 |
$1,806.75
|
|
Brain MRI (with and without contrast)
|
$7,893.00 |
$7,893.00 |
$7,893.00 |
$2,854.80
|
|
Brain MRI (with contrast)
|
$5,004.00 |
$5,004.00 |
$5,004.00 |
$2,224.96
|
|
Brain MRI (without contrast)
|
$13,170.00 |
$13,170.00 |
$13,170.00 |
$1,927.04
|
|
Breath test analysis c-14
|
$602.00 |
$602.00 |
$602.00 |
$197.34
|
|
Breath tst attain/anal c-14
|
$70.00 |
$70.00 |
$70.00 |
$60.43
|
|
Bronchial challenge
|
$2,687.00 |
$2,687.00 |
$2,687.00 |
$835.20
|
|
Budesonide non-comp unit
|
$143.00 |
$143.00 |
$143.00 |
$32.78
|
|
Bundled special stain group 1 microorganisms
|
$351.00 |
$351.00 |
$351.00 |
$164.89
|
|
Bundle his recording
|
$41,724.00 |
$41,724.00 |
$41,724.00 |
$5,157.39
|
|
Buprenorphine 2 mg-naloxone 0.5 mg sublingual tablet
|
$59.00 |
$59.00 |
$59.00 |
$12.78
|
|
Buprenorphine 8 mg-naloxone 2 mg sublingual tablet
|
$59.00 |
$59.00 |
$59.00 |
$17.13
|
|
Buprenorphine and metabolite - sendout
|
$124.00 |
$124.00 |
$124.00 |
$99.72
|
|
C1 esterase inhibitor func - sendout
|
$402.00 |
$402.00 |
$402.00 |
$106.60
|
|
Calcium 24 hour urine
|
$265.00 |
$265.00 |
$265.00 |
$52.00
|
|
Calcium ionized
|
$315.00 |
$315.00 |
$315.00 |
$86.35
|
|
Calprotectin fecal
|
$325.00 |
$325.00 |
$325.00 |
$170.00
|
|
Campylobacter antibody
|
$451.00 |
$451.00 |
$451.00 |
$66.61
|
|
Carbamazepine total therapeutic drug level
|
$320.00 |
$320.00 |
$320.00 |
$113.25
|
|
Carbohydrate deficient transf - sendout
|
$1,246.00 |
$1,246.00 |
$1,246.00 |
$113.36
|
|
Carbohydrate urine - sendout
|
$405.00 |
$405.00 |
$405.00 |
$43.51
|
|
Carcinoembryonic ag (cea)
|
$292.00 |
$292.00 |
$292.00 |
$146.90
|
|
Cardiac drug stress test
|
$1,744.00 |
$1,744.00 |
$1,744.00 |
$543.20
|
|
Cardiac perf planar mult/ef/wm
|
$8,704.00 |
$8,704.00 |
$8,704.00 |
$2,544.75
|
|
Cardiac perf planar sgl/ef/wm
|
$4,365.00 |
$4,365.00 |
$4,365.00 |
$1,911.62
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$4,522.00 |
$4,522.00 |
$4,522.00 |
$2,792.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$645.00 |
$645.00 |
$645.00 |
$254.80
|
|
Carotene
|
$320.00 |
$320.00 |
$320.00 |
$46.80
|
|
Catheterization collection of specimen single patient all places of service
|
$139.00 |
$139.00 |
$139.00 |
$48.75
|
|
Cath ext adhere actv m 28mm
|
$240.00 |
$240.00 |
$240.00 |
$1.80
|
|
Cdna analysis for variants
|
$961.00 |
$961.00 |
$961.00 |
$564.86
|
|
Cebpa gene full sequence
|
$443.00 |
$443.00 |
$443.00 |
$485.55
|
|
#celiac hla-dq2
|
$257.00 |
$257.00 |
$257.00 |
$226.28
|
|
#celiac hla-dq8
|
$305.00 |
$305.00 |
$305.00 |
$246.88
|
|
Cell function assay w/stim
|
$221.00 |
$221.00 |
$221.00 |
$335.20
|
|
#cf-97variants
|
$182.00 |
$182.00 |
$182.00 |
$612.26
|
|
Chemo ia push tecnique
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$500.20
|
|
Chest 2 vws w oblique
|
$1,192.00 |
$1,192.00 |
$1,192.00 |
$373.20
|
|
Chest CT scan (with and without contrast)
|
$7,622.00 |
$7,622.00 |
$7,622.00 |
$2,021.80
|
|
Chest CT scan (with contrast)
|
$7,099.00 |
$7,099.00 |
$7,099.00 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$6,994.00 |
$6,994.00 |
$6,994.00 |
$1,350.03
|
|
Chest X-ray
|
$1,026.00 |
$1,026.00 |
$1,026.00 |
$294.06
|
|
Chest X-ray (single view)
|
$964.00 |
$964.00 |
$964.00 |
$229.08
|
|
Chlamydia culture
|
$245.00 |
$245.00 |
$245.00 |
$94.90
|
|
Chlnggrphy intraop addl s&i
|
$855.00 |
$855.00 |
$855.00 |
$280.00
|
|
Chloride
|
$43.00 |
$43.00 |
$43.00 |
$38.50
|
|
Chloride 24 hour urine
|
$139.00 |
$139.00 |
$139.00 |
$46.13
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,777.00 |
$2,777.00 |
$2,777.00 |
$625.60
|
|
Cholesterol
|
$43.00 |
$43.00 |
$43.00 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$284.00 |
$284.00 |
$284.00 |
$115.70
|
|
Cholinesterase
|
$62.00 |
$62.00 |
$62.00 |
$38.69
|
|
Chromatography
|
$383.00 |
$383.00 |
$383.00 |
$80.60
|
|
Chromogenic substrate assay
|
$446.00 |
$446.00 |
$446.00 |
$183.52
|
|
Chromosome karyotype study
|
$201.00 |
$201.00 |
$201.00 |
$102.72
|
|
Chronic urticaria - sendout
|
$296.00 |
$296.00 |
$296.00 |
$89.70
|
|
Chylomicron screen, bf - sendout
|
$749.00 |
$749.00 |
$749.00 |
$123.20
|
|
C-kit mutation liquid tumor - sendout
|
$554.00 |
$554.00 |
$554.00 |
$640.41
|
|
Clot factor viii reltd antgn
|
$1,034.00 |
$1,034.00 |
$1,034.00 |
$95.72
|
|
Clot factor xii hageman
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$125.00
|
|
Clot factor xiii fibrin stab
|
$1,145.00 |
$1,145.00 |
$1,145.00 |
$84.27
|
|
#cmvcul-virus inoculation shell
|
$678.00 |
$678.00 |
$678.00 |
$102.57
|
|
Cmv pcr-sendout
|
$471.00 |
$471.00 |
$471.00 |
$172.25
|
|
Co2 monitor per day
|
$3,351.00 |
$3,351.00 |
$3,351.00 |
$388.85
|
|
Cold agglutinin titer
|
$284.00 |
$284.00 |
$284.00 |
$49.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$384.00 |
$384.00 |
$384.00 |
$163.07
|
|
Compatibility test incubate
|
$561.00 |
$561.00 |
$561.00 |
$143.64
|
|
Consultation pathology during surgery cytological exam initial site
|
$128.00 |
$128.00 |
$128.00 |
$402.05
|
|
Consultation pathology during surgery frozen section each additional block
|
$103.00 |
$103.00 |
$103.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$191.00 |
$191.00 |
$191.00 |
$210.80
|
|
Consultation/report referred material w/preparation of slides
|
$735.00 |
$735.00 |
$735.00 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$168.00 |
$168.00 |
$168.00 |
$176.15
|
|
Contrast exam thoracic aorta
|
$8,328.00 |
$8,328.00 |
$8,328.00 |
$3,648.84
|
|
Contrast exam thoracic aorta 75605-26
|
$12,264.00 |
$12,264.00 |
$12,264.00 |
$3,780.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$117.00 |
$117.00 |
$117.00 |
$100.29
|
|
Copper cu 64 dotatate diag
|
$2,083.00 |
$2,083.00 |
$2,083.00 |
$2,083.80
|
|
Covid-19 lab test non-cdc
|
$88.00 |
$88.00 |
$88.00 |
$56.44
|
|
C-peptide
|
$265.00 |
$265.00 |
$265.00 |
$100.26
|
|
Crbrospnl fld flw imag cistern
|
$9,272.00 |
$9,272.00 |
$9,272.00 |
$1,409.85
|
|
C-reactive protein
|
$402.00 |
$402.00 |
$402.00 |
$61.10
|
|
C-reactive protein high sensitivity
|
$205.00 |
$205.00 |
$205.00 |
$91.20
|
|
Creatine kinase
|
$129.00 |
$129.00 |
$129.00 |
$58.30
|
|
Creatine kinase isoenzymes
|
$292.00 |
$292.00 |
$292.00 |
$49.40
|
|
Creatine kinase mb
|
$350.00 |
$350.00 |
$350.00 |
$105.95
|
|
Creatinine clearance urine
|
$205.00 |
$205.00 |
$205.00 |
$85.80
|
|
Cryofibrinogen qualitative - sendout
|
$187.00 |
$187.00 |
$187.00 |
$50.88
|
|
Cryoprecipitate each unit
|
$369.00 |
$369.00 |
$369.00 |
$190.20
|
|
Crystal identification light microscopy
|
$245.00 |
$245.00 |
$245.00 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$6,296.00 |
$6,296.00 |
$6,296.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$9,678.00 |
$9,678.00 |
$9,678.00 |
$2,092.73
|
|
CT Angiogram of the Chest (for blood clot)
|
$5,400.00 |
$5,400.00 |
$5,400.00 |
$2,017.89
|
|
CT angio pelvis
|
$11,121.00 |
$11,121.00 |
$11,121.00 |
$1,778.40
|
|
CT guid parench tis ablat
|
$4,305.00 |
$4,305.00 |
$4,305.00 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$255.00 |
$255.00 |
$255.00 |
$192.00
|
|
CT neck soft tissue w/contrast
|
$7,246.00 |
$7,246.00 |
$7,246.00 |
$1,667.00
|
