|
Chloramphenicol sodium injec
|
$87.57 |
$87.57 |
$87.57 |
$113.84
|
|
Chloride
|
$271.76 |
$271.76 |
$271.76 |
$40.95
|
|
Chloride 24 hour urine
|
$255.00 |
$255.00 |
$255.00 |
$49.50
|
|
Chloroprocaine hcl injection
|
$148.47 |
$148.47 |
$148.47 |
$61.51
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$1,244.93 |
$1,244.93 |
$1,244.93 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$81.27 |
$81.27 |
$81.27 |
$78.43
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,270.30 |
$2,270.30 |
$2,270.30 |
$602.40
|
|
Cholesterol
|
$102.00 |
$102.00 |
$102.00 |
$45.76
|
|
Cholinesterase
|
$445.14 |
$445.14 |
$445.14 |
$38.69
|
|
Chromatography
|
$557.55 |
$557.55 |
$557.55 |
$81.25
|
|
Chromo high res and frag x - sendout
|
$279.50 |
$279.50 |
$279.50 |
$247.59
|
|
Chromosome analysis 15-20 cell count
|
$575.79 |
$575.79 |
$575.79 |
$512.20
|
|
Chromosome karyotype study
|
$189.98 |
$189.98 |
$189.98 |
$119.87
|
|
Chronic urticaria - sendout
|
$200.00 |
$200.00 |
$200.00 |
$75.00
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$1,114.35 |
$1,114.35 |
$1,114.35 |
$34.88
|
|
Clot factor xii hageman
|
$1,256.87 |
$1,256.87 |
$1,256.87 |
$134.39
|
|
#cmvcul-virus inoculation shell
|
$144.00 |
$144.00 |
$144.00 |
$100.80
|
|
Cmv pcr-sendout
|
$30.83 |
$30.83 |
$30.83 |
$177.50
|
|
Cocaine 4 % nasal solution
|
$1,040.83 |
$1,040.83 |
$1,040.83 |
$629.41
|
|
Cocaine hcl nasal (numbrino)
|
$646.20 |
$646.20 |
$646.20 |
$512.30
|
|
Collection of venous blood by venipuncture
|
$61.00 |
$61.00 |
$61.00 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$549.78 |
$549.78 |
$549.78 |
$170.05
|
|
Compatibility test each unit electronic
|
$50.00 |
$50.00 |
$50.00 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$549.00 |
$549.00 |
$549.00 |
$169.52
|
|
Compatibility test incubate
|
$302.12 |
$302.12 |
$302.12 |
$155.40
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$2,545.00 |
$2,545.00 |
$2,545.00 |
$3,322.20
|
|
Conjugated estrogens 25 mg solution for injection
|
$541.64 |
$541.64 |
$541.64 |
$871.08
|
|
Consultation pathology during surgery frozen section each additional block
|
$230.30 |
$230.30 |
$230.30 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$225.00 |
$225.00 |
$225.00 |
$225.96
|
|
Contrast exam abdominl aorta 75625-26
|
$12,464.16 |
$12,464.16 |
$12,464.16 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$16,224.17 |
$16,224.17 |
$16,224.17 |
$3,728.24
|
|
Coombs indirect qualitative each reagent red cell reference
|
$25.74 |
$25.74 |
$25.74 |
$102.90
|
|
Coombs indirect titer reference
|
$23.31 |
$23.31 |
$23.31 |
$146.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$548.53 |
$548.53 |
$548.53 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$571.40 |
$571.40 |
$571.40 |
$110.00
|
|
C-peptide
|
$529.34 |
$529.34 |
$529.34 |
$97.30
|
|
Crbrospnl fld flw imag cistern
|
$1,512.89 |
$1,512.89 |
$1,512.89 |
$1,240.80
|
|
C-reactive protein high sensitivity
|
$232.78 |
$232.78 |
$232.78 |
$85.00
|
|
Creatinine clearance urine
|
$542.37 |
$542.37 |
$542.37 |
$89.50
|
|
Crystal identification light microscopy
|
$280.41 |
$280.41 |
$280.41 |
$62.50
|
|
CT guidance for needle placement
|
$5,911.24 |
$5,911.24 |
$5,911.24 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$3,900.78 |
$3,900.78 |
$3,900.78 |
$1,178.52
|
|
CT heart w/evaluation of calcium without contrast
|
$56.63 |
$56.63 |
$56.63 |
$171.60
|
|
CT limited or localized follow-up study
|
$3,935.66 |
$3,935.66 |
$3,935.66 |
$642.75
|
|
CT thorax low dose for lung screening without contrast
|
$272.85 |
$272.85 |
$272.85 |
$331.50
|
|
Culture aerobic additional method definitive id each
|
$117.00 |
$117.00 |
$117.00 |
$68.64
|
|
Culture afb any source
|
$63.00 |
$63.00 |
$63.00 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$117.00 |
$117.00 |
$117.00 |
$79.00
|
|
Culture anaerobic except blood
|
$1,043.87 |
$1,043.87 |
$1,043.87 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$42.48 |
$42.48 |
$42.48 |
$51.45
|
|
Culture fungi definitive id mold
|
$117.00 |
$117.00 |
$117.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$117.00 |
$117.00 |
$117.00 |
$79.10
|
|
Culture fungi other (except blood)
|
$395.60 |
$395.60 |
$395.60 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$444.52 |
$444.52 |
$444.52 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$117.00 |
$117.00 |
$117.00 |
$89.70
|
|
Culture quantitative aerobic other source
|
$44.51 |
$44.51 |
$44.51 |
$90.35
|
|
Culture typing added method
|
$86.39 |
$86.39 |
$86.39 |
$38.58
|
|
Culture typing immunologic
|
$40.50 |
$40.50 |
$40.50 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$992.95 |
$992.95 |
$992.95 |
$133.90
|
|
Culture urine each isolate
|
$307.69 |
$307.69 |
$307.69 |
$57.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$63.67 |
$63.67 |
$63.67 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$216.49 |
$216.49 |
$216.49 |
$70.72
|
|
Cyclosporine 2 hour
|
$297.44 |
$297.44 |
$297.44 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$17.12 |
$17.12 |
$17.12 |
$7.48
|
|
Cystatin c
|
$217.85 |
$217.85 |
$217.85 |
$77.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$867.19 |
$867.19 |
$867.19 |
$542.10
|
|
Cytomegalovirus (cmv) antibody igg
|
$395.60 |
$395.60 |
$395.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$395.60 |
$395.60 |
$395.60 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$456.00 |
$456.00 |
$456.00 |
$159.45
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$225.33 |
$225.33 |
$225.33 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$225.00 |
$225.00 |
$225.00 |
$209.23
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,616.10 |
$1,616.10 |
$1,616.10 |
$168.53
|
|
Debridement (>20 cm) charge pt
|
$739.67 |
$739.67 |
$739.67 |
$260.61
|
|
Decalcification
|
$172.00 |
$172.00 |
$172.00 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$569.06 |
$569.06 |
$569.06 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$780.78 |
$780.78 |
$780.78 |
$185.17
|
|
Design mlc device for imrt
|
$1,485.69 |
$1,485.69 |
$1,485.69 |
$1,677.86
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$98.55 |
$98.55 |
$98.55 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$91.26 |
$91.26 |
$91.26 |
$45.40
|
|
Dextrose 5 % IV bolus
|
$98.55 |
$98.55 |
$98.55 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$501.50 |
$501.50 |
$501.50 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$474.87 |
$474.87 |
$474.87 |
$79.20
|
|
Diagnostic Mammogram (both breasts)
|
$1,185.49 |
$1,185.49 |
$1,185.49 |
$399.30
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$115.59 |
$115.59 |
$115.59 |
$74.76
|
|
Dicyclomine injection
|
$159.25 |
$159.25 |
$159.25 |
$153.29
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$63.42 |
$63.42 |
$63.42 |
$69.03
|
|
Digoxin immune fab 40 mg intravenous solution
|
$10,921.32 |
$10,921.32 |
$10,921.32 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$590.00 |
$590.00 |
$590.00 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$168.93 |
$168.93 |
$168.93 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$192.90 |
$192.90 |
$192.90 |
$17.75
|
|
Dna antibody native/double stranded
|
$770.82 |
$770.82 |
$770.82 |
$97.50
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$186.94 |
$186.94 |
$186.94 |
$98.43
|
|
Doppler echo complete
|
$2,616.80 |
$2,616.80 |
$2,616.80 |
$540.00
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$135.56 |
$135.56 |
$135.56 |
$84.80
|
|
Dressing wound matrix 2x2in 25sqcm-q4108-cost per sq cm
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$8,131.20
|
|
Droperidol 2.5 mg/ml injection solution
|
$298.93 |
$298.93 |
$298.93 |
$31.07
|
|
Drug of abuse screen urine
|
$56.70 |
$56.70 |
$56.70 |
$63.75
|
|
Drug test def 1-7 classes
|
$855.03 |
$855.03 |
$855.03 |
$250.52
|
|
Dup scan/hemodialysis access 93990
|
$246.70 |
$246.70 |
$246.70 |
$489.72
|
|
Ecg external > 48 hours up to 7 days recording
|
$98.68 |
$98.68 |
$98.68 |
$147.28
|
