|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$70.58 |
$70.58 |
$70.58 |
$85.37
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$696.80 |
$696.80 |
$696.80 |
$648.96
|
|
Clsd tx elbow dislocation child 24640
|
$777.60 |
$777.60 |
$777.60 |
$465.21
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,684.00 |
$1,684.00 |
$1,684.00 |
$1,726.01
|
|
Clsd tx patella disloc without anes 27560
|
$365.60 |
$365.60 |
$365.60 |
$573.52
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,690.40 |
$1,690.40 |
$1,690.40 |
$1,592.00
|
|
#cmvcul-virus inoculation shell
|
$163.20 |
$163.20 |
$163.20 |
$89.76
|
|
Cmv pcr-sendout
|
$86.40 |
$86.40 |
$86.40 |
$175.70
|
|
Cold agglutinin titer
|
$68.80 |
$68.80 |
$68.80 |
$52.00
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$337.60 |
$337.60 |
$337.60 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$32.00 |
$32.00 |
$32.00 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$54.40 |
$54.40 |
$54.40 |
$224.11
|
|
Collection blood specimen from completely implantable venous access device
|
$95.20 |
$95.20 |
$95.20 |
$162.00
|
|
Compatibility test each unit antiglobulin technique
|
$148.00 |
$148.00 |
$148.00 |
$173.50
|
|
Compatibility test each unit electronic
|
$107.20 |
$107.20 |
$107.20 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$146.40 |
$146.40 |
$146.40 |
$169.52
|
|
Complement antigen each component c3
|
$74.40 |
$74.40 |
$74.40 |
$110.00
|
|
Complx repair fccmnaxghf 13131
|
$471.20 |
$471.20 |
$471.20 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,518.40 |
$1,518.40 |
$1,518.40 |
$1,107.60
|
|
Concentration infection agents any type
|
$48.00 |
$48.00 |
$48.00 |
$51.32
|
|
Conjugated estrogens 25 mg solution for injection
|
$420.04 |
$420.04 |
$420.04 |
$860.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$88.00 |
$88.00 |
$88.00 |
$430.00
|
|
Consultation pathology during surgery frozen section first tissue block
|
$104.00 |
$104.00 |
$104.00 |
$226.50
|
|
Contrast baths charges
|
$92.80 |
$92.80 |
$92.80 |
$75.60
|
|
Control nosebleed pack+caut 30905
|
$457.60 |
$457.60 |
$457.60 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$420.00 |
$420.00 |
$420.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$390.40 |
$390.40 |
$390.40 |
$352.80
|
|
Coombs direct
|
$61.60 |
$61.60 |
$61.60 |
$76.80
|
|
Coombs indirect titer reference
|
$34.40 |
$34.40 |
$34.40 |
$156.71
|
|
Cortisol total am
|
$144.80 |
$144.80 |
$144.80 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$219.49 |
$219.49 |
$219.49 |
$189.22
|
|
Covid-19 administration immunization im inj 1st/only component
|
$71.20 |
$71.20 |
$71.20 |
$49.13
|
|
#covid19rsv-rsv
|
$171.20 |
$171.20 |
$171.20 |
$145.60
|
|
#coxa-coxsackie a serotype a16
|
$114.40 |
$114.40 |
$114.40 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$413.60 |
$413.60 |
$413.60 |
$584.50
|
|
C-peptide
|
$199.20 |
$199.20 |
$199.20 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,090.40 |
$1,090.40 |
$1,090.40 |
$777.71
|
|
C-reactive protein
|
$45.60 |
$45.60 |
$45.60 |
$69.36
|
|
C-reactive protein high sensitivity
|
$102.40 |
$102.40 |
$102.40 |
$85.50
|
|
Creatine kinase
|
$65.60 |
$65.60 |
$65.60 |
$66.30
|
|
Creatine kinase isoenzymes
|
$105.60 |
$105.60 |
$105.60 |
$56.20
|
|
Creatine kinase mb
|
$79.20 |
$79.20 |
$79.20 |
$113.63
|
|
Creatinine
|
$40.00 |
$40.00 |
$40.00 |
$46.20
|
|
Creatinine 24 hour urine
|
$57.60 |
$57.60 |
$57.60 |
$57.85
|
|
Creatinine clearance urine
|
$87.20 |
$87.20 |
$87.20 |
$90.26
|
|
Critical care each additional 30 minutes
|
$834.40 |
$834.40 |
$834.40 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$3,036.80 |
$3,036.80 |
$3,036.80 |
$2,535.00
|
|
Cryofibrinogen qualitative - sendout
|
$57.60 |
$57.60 |
$57.60 |
$52.50
|
|
Crystal identification light microscopy
|
$52.00 |
$52.00 |
$52.00 |
$66.43
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,990.40 |
$2,990.40 |
$2,990.40 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,946.40 |
$2,946.40 |
$2,946.40 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,946.40 |
$2,946.40 |
$2,946.40 |
$1,881.75
|
|
CT lwr extremity w/o&w/dye
|
$2,727.20 |
$2,727.20 |
$2,727.20 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,310.40 |
$5,310.40 |
$5,310.40 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,703.20 |
$4,703.20 |
$4,703.20 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,067.20 |
$4,067.20 |
$4,067.20 |
$2,272.00
|
|
Culture aerobic additional method definitive id each
|
$57.60 |
$57.60 |
$57.60 |
$72.00
|
|
Culture afb any source
|
$127.20 |
$127.20 |
$127.20 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$55.20 |
$55.20 |
$55.20 |
$84.76
|
|
Culture anaerobic except blood
|
$114.40 |
$114.40 |
$114.40 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$57.60 |
$57.60 |
$57.60 |
$52.50
|
|
Culture body fluid
|
$116.00 |
$116.00 |
$116.00 |
$126.75
|
|
Culture fungi definitive id mold
|
$64.00 |
$64.00 |
$64.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$100.00 |
$100.00 |
$100.00 |
$80.00
|
|
Culture fungi other (except blood)
|
$101.60 |
$101.60 |
$101.60 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$73.60 |
$73.60 |
$73.60 |
$74.75
|
|
Culture mycoplasma any source
|
$153.60 |
$153.60 |
$153.60 |
$83.21
|
|
Culture screening strep group a
|
$58.40 |
$58.40 |
$58.40 |
$84.60
|
|
Culture typing immunologic
|
$44.00 |
$44.00 |
$44.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$604.80 |
$604.80 |
$604.80 |
$408.37
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$164.00 |
$164.00 |
$164.00 |
$140.80
|
|
Culture urine each isolate
|
$50.40 |
$50.40 |
$50.40 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$61.72 |
$61.72 |
$61.72 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$136.00 |
$136.00 |
$136.00 |
$72.36
|
|
Cyclosporine 2 hour
|
$127.20 |
$127.20 |
$127.20 |
$130.40
|
|
Cyp2c19 gene com variants
|
$256.00 |
$256.00 |
$256.00 |
$524.00
|
|
Cystatin c
|
$99.20 |
$99.20 |
$99.20 |
$77.60
|
|
Cystine urine quantitative
|
$148.80 |
$148.80 |
$148.80 |
$100.70
|
|
Cytogenetics 25-99
|
$103.20 |
$103.20 |
$103.20 |
$189.80
|
|
Cytogenetics 3-5
|
$99.20 |
$99.20 |
$99.20 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$70.40 |
$70.40 |
$70.40 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$78.40 |
$78.40 |
$78.40 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$134.40 |
$134.40 |
$134.40 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$115.20 |
$115.20 |
$115.20 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$129.60 |
$129.60 |
$129.60 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$132.00 |
$132.00 |
$132.00 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$246.40 |
$246.40 |
$246.40 |
$213.85
|
|
Cytopath smear other source
|
$134.40 |
$134.40 |
$134.40 |
$92.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$71.87 |
$71.87 |
$71.87 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$1,285.49 |
$1,285.49 |
$1,285.49 |
$6,281.29
|
|
Dch validity tests
|
$32.80 |
$32.80 |
$32.80 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$79.20 |
$79.20 |
$79.20 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$392.80 |
$392.80 |
$392.80 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,257.60 |
$1,257.60 |
$1,257.60 |
$835.20
|
|
Debride nail6 or more 11721
|
$301.60 |
$301.60 |
$301.60 |
$169.80
|
|
Decalcification
|
$29.60 |
$29.60 |
$29.60 |
$68.34
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$208.80 |
$208.80 |
$208.80 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$4,406.88 |
$4,406.88 |
$4,406.88 |
$6,324.98
|
|
Destruction benign lesions < 14 lesions
|
$220.00 |
$220.00 |
$220.00 |
$240.24
|
|
Dexamethasone 4 mg tablet
|
$4.70 |
$4.70 |
$4.70 |
$5.85
|
