|
Coombs indirect titer reference
|
$66.40 |
$66.40 |
$66.40 |
$156.71
|
|
Cortisol total am
|
$227.20 |
$227.20 |
$227.20 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$74.84 |
$74.84 |
$74.84 |
$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
|
$80.80 |
$80.80 |
$80.80 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$372.00 |
$372.00 |
$372.00 |
$584.50
|
|
C-peptide
|
$101.60 |
$101.60 |
$101.60 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,254.40 |
$1,254.40 |
$1,254.40 |
$777.71
|
|
C-reactive protein
|
$53.60 |
$53.60 |
$53.60 |
$69.36
|
|
C-reactive protein high sensitivity
|
$124.00 |
$124.00 |
$124.00 |
$85.50
|
|
Creatine kinase
|
$48.00 |
$48.00 |
$48.00 |
$66.30
|
|
Creatine kinase mb
|
$151.20 |
$151.20 |
$151.20 |
$113.63
|
|
Creatinine
|
$58.40 |
$58.40 |
$58.40 |
$46.20
|
|
Creatinine 24 hour urine
|
$54.40 |
$54.40 |
$54.40 |
$57.85
|
|
Creatinine clearance urine
|
$71.20 |
$71.20 |
$71.20 |
$90.26
|
|
Critical care each additional 30 minutes
|
$620.80 |
$620.80 |
$620.80 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$2,535.00
|
|
Crystal identification light microscopy
|
$44.00 |
$44.00 |
$44.00 |
$66.43
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,180.00 |
$4,180.00 |
$4,180.00 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$3,272.00 |
$3,272.00 |
$3,272.00 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$2,968.00 |
$2,968.00 |
$2,968.00 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,992.00 |
$2,992.00 |
$2,992.00 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,936.80 |
$2,936.80 |
$2,936.80 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,936.80 |
$2,936.80 |
$2,936.80 |
$1,881.75
|
|
Cta upper extremity w &/or without contrast left
|
$2,544.00 |
$2,544.00 |
$2,544.00 |
$1,691.30
|
|
CT lwr extremity w/o&w/dye
|
$2,832.00 |
$2,832.00 |
$2,832.00 |
$1,818.96
|
|
Ctrl nosebld postir subsq 30906
|
$333.60 |
$333.60 |
$333.60 |
$422.80
|
|
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)
|
$4,458.40 |
$4,458.40 |
$4,458.40 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,744.00 |
$3,744.00 |
$3,744.00 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$3,301.60 |
$3,301.60 |
$3,301.60 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,586.40 |
$2,586.40 |
$2,586.40 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Culture afb any source
|
$64.00 |
$64.00 |
$64.00 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$50.40 |
$50.40 |
$50.40 |
$84.76
|
|
Culture anaerobic except blood
|
$130.40 |
$130.40 |
$130.40 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$55.20 |
$55.20 |
$55.20 |
$52.50
|
|
Culture body fluid
|
$81.60 |
$81.60 |
$81.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$78.40 |
$78.40 |
$78.40 |
$80.00
|
|
Culture fungi definitive id yeast
|
$72.00 |
$72.00 |
$72.00 |
$80.00
|
|
Culture fungi other (except blood)
|
$96.00 |
$96.00 |
$96.00 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$92.80 |
$92.80 |
$92.80 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$66.40 |
$66.40 |
$66.40 |
$100.00
|
|
Culture screening strep group a
|
$68.00 |
$68.00 |
$68.00 |
$84.60
|
|
Culture typing immunologic
|
$40.80 |
$40.80 |
$40.80 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$576.00 |
$576.00 |
$576.00 |
$408.37
|
|
Culture urine each isolate
|
$58.40 |
$58.40 |
$58.40 |
$55.50
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$61.72 |
$61.72 |
$61.72 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$170.40 |
$170.40 |
$170.40 |
$72.36
|
|
Cyclosporine 2 hour
|
$186.40 |
$186.40 |
$186.40 |
$130.40
|
|
Cystatin c
|
$160.00 |
$160.00 |
$160.00 |
$77.60
|
|
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
|
$113.60 |
$113.60 |
$113.60 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$113.60 |
$113.60 |
$113.60 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$130.40 |
$130.40 |
$130.40 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$91.20 |
$91.20 |
$91.20 |
$92.40
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$140.80 |
$140.80 |
$140.80 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$237.60 |
$237.60 |
$237.60 |
$213.85
|
|
Cytopath smear other source
|
$116.00 |
$116.00 |
$116.00 |
$92.50
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$71.88 |
$71.88 |
$71.88 |
$171.19
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,156.00 |
$2,156.00 |
$2,156.00 |
$6,281.29
|
|
Dch validity tests
|
$36.00 |
$36.00 |
$36.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$54.40 |
$54.40 |
$54.40 |
$43.35
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$684.80 |
$684.80 |
$684.80 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$395.20 |
$395.20 |
$395.20 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,055.20 |
$1,055.20 |
$1,055.20 |
$835.20
|
|
Decalcification
|
$50.40 |
$50.40 |
$50.40 |
$68.34
|
|
Delivery of placenta 59414
|
$3,419.20 |
$3,419.20 |
$3,419.20 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$224.00 |
$224.00 |
$224.00 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$2,709.22 |
$2,709.22 |
$2,709.22 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$348.00 |
$348.00 |
$348.00 |
$401.60
|
|
Destruction benign lesions < 14 lesions
|
$170.40 |
$170.40 |
$170.40 |
$240.24
|
|
Developmental screen/score/document 96110
|
$251.20 |
$251.20 |
$251.20 |
$142.38
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$339.20 |
$339.20 |
$339.20 |
$227.25
|
|
Dexamethasone 4 mg tablet
|
$5.50 |
$5.50 |
$5.50 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$62.08 |
$62.08 |
$62.08 |
$20.76
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$36.05
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$42.25
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$48.00 |
$48.00 |
$48.00 |
$46.35
|
|
Dextrose 5 % IV bolus
|
$40.00 |
$40.00 |
$40.00 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$145.60 |
$145.60 |
$145.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$79.20 |
$79.20 |
$79.20 |
$79.30
|
|
Diagnostic laryngoscopy 31505
|
$280.80 |
$280.80 |
$280.80 |
$242.14
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$69.15 |
$69.15 |
$69.15 |
$79.71
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$60.53 |
$60.53 |
$60.53 |
$65.84
|
|
Digoxin total therapeutic drug level
|
$121.60 |
$121.60 |
$121.60 |
$102.07
|
|
Diltiazem 5 mg/ml intravenous solution
|
$60.62 |
$60.62 |
$60.62 |
$45.60
|
|
Diphenhydramine 12.5 mg/5 ml oral elixir
|
$1.20 |
$1.20 |
$1.20 |
$1.20
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$60.44 |
$60.44 |
$60.44 |
$18.32
|
|
Dna antibody native/double stranded
|
$81.60 |
$81.60 |
$81.60 |
$100.00
|
|
Dna gardnerella
|
$90.40 |
$90.40 |
$90.40 |
$61.83
|
|
Dna probe chlamydia
|
$78.40 |
$78.40 |
$78.40 |
$82.20
|
|
Dna probe gc
|
$84.80 |
$84.80 |
$84.80 |
$79.38
|
|
Dna trichomonas
|
$90.40 |
$90.40 |
$90.40 |
$63.00
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$128.04 |
$128.04 |
$128.04 |
$95.06
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$99.24 |
$99.24 |
$99.24 |
$65.40
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$771.20 |
$771.20 |
$771.20 |
$481.65
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$72.25 |
$72.25 |
$72.25 |
$89.34
|
