|
Chlamydia type
|
$15.46 |
$15.46 |
$15.46 |
$34.20
|
|
Chloride 24 hour urine
|
$549.15 |
$549.15 |
$549.15 |
$49.50
|
|
Chloroprocaine hcl injection
|
$297.16 |
$297.16 |
$297.16 |
$61.51
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$834.72 |
$834.72 |
$834.72 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$115.17 |
$115.17 |
$115.17 |
$78.43
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,468.20 |
$2,468.20 |
$2,468.20 |
$602.40
|
|
Chromatography
|
$172.22 |
$172.22 |
$172.22 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$2,294.15 |
$2,294.15 |
$2,294.15 |
$512.20
|
|
Chromosome karyotype study
|
$324.00 |
$324.00 |
$324.00 |
$119.87
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$42.17 |
$42.17 |
$42.17 |
$34.88
|
|
Clozapine, 25 mg
|
$108.68 |
$108.68 |
$108.68 |
$4.87
|
|
#cmvcul-virus inoculation shell
|
$54.28 |
$54.28 |
$54.28 |
$100.80
|
|
Cmv pcr-sendout
|
$147.66 |
$147.66 |
$147.66 |
$177.50
|
|
Cocaine 4 % nasal solution
|
$794.26 |
$794.26 |
$794.26 |
$629.41
|
|
Cocaine hcl nasal (numbrino)
|
$1,830.90 |
$1,830.90 |
$1,830.90 |
$512.30
|
|
Cold agglutinin titer
|
$1,078.83 |
$1,078.83 |
$1,078.83 |
$50.00
|
|
Colistimethate sodium inj
|
$1,367.31 |
$1,367.31 |
$1,367.31 |
$68.47
|
|
Compatibility test each unit antiglobulin technique
|
$1,257.54 |
$1,257.54 |
$1,257.54 |
$170.05
|
|
Compatibility test each unit electronic
|
$1,257.54 |
$1,257.54 |
$1,257.54 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$169.52
|
|
Compatibility test incubate
|
$1,257.54 |
$1,257.54 |
$1,257.54 |
$155.40
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,248.62 |
$1,248.62 |
$1,248.62 |
$871.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$422.42 |
$422.42 |
$422.42 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$422.42 |
$422.42 |
$422.42 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$422.42 |
$422.42 |
$422.42 |
$225.96
|
|
Contrast exam abdominl aorta 75625-26
|
$5,607.61 |
$5,607.61 |
$5,607.61 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$10,322.10 |
$10,322.10 |
$10,322.10 |
$3,728.24
|
|
Coombs indirect qualitative each reagent red cell reference
|
$841.61 |
$841.61 |
$841.61 |
$102.90
|
|
Coombs indirect titer reference
|
$909.86 |
$909.86 |
$909.86 |
$146.40
|
|
Copper intrauterine device
|
$4,428.54 |
$4,428.54 |
$4,428.54 |
$1,953.00
|
|
Cosyntropin 0.25 mg solution for injection
|
$808.74 |
$808.74 |
$808.74 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$83.55 |
$83.55 |
$83.55 |
$55.90
|
|
C-peptide
|
$1,091.84 |
$1,091.84 |
$1,091.84 |
$97.30
|
|
C-reactive protein
|
$721.37 |
$721.37 |
$721.37 |
$68.38
|
|
Creatinine clearance urine
|
$1,017.08 |
$1,017.08 |
$1,017.08 |
$89.50
|
|
Crystal identification light microscopy
|
$717.00 |
$717.00 |
$717.00 |
$62.50
|
|
CT cerebral perf w cont & prcssng
|
$537.60 |
$537.60 |
$537.60 |
$803.40
|
|
CT guidance for needle placement
|
$8,375.70 |
$8,375.70 |
$8,375.70 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,969.36 |
$2,969.36 |
$2,969.36 |
$1,178.52
|
|
CT limited or localized follow-up study
|
$5,499.81 |
$5,499.81 |
$5,499.81 |
$642.75
|
|
Culture afb any source
|
$1,166.57 |
$1,166.57 |
$1,166.57 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$22.42 |
$22.42 |
$22.42 |
$79.00
|
|
Culture anaerobic except blood
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$1,414.13 |
$1,414.13 |
$1,414.13 |
$51.45
|
|
Culture fungi definitive id mold
|
$28.64 |
$28.64 |
$28.64 |
$77.28
|
|
Culture fungi definitive id yeast
|
$126.57 |
$126.57 |
$126.57 |
$79.10
|
|
Culture fungi other (except blood)
|
$1,199.06 |
$1,199.06 |
$1,199.06 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$1,199.06 |
$1,199.06 |
$1,199.06 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$150.01 |
$150.01 |
$150.01 |
$89.70
|
|
Culture quantitative aerobic other source
|
$718.14 |
$718.14 |
$718.14 |
$90.35
|
|
Culture typing added method
|
$21.48 |
$21.48 |
$21.48 |
$38.58
|
|
Culture typing immunologic
|
$207.95 |
$207.95 |
$207.95 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$39.52 |
$39.52 |
$39.52 |
$133.90
|
|
Culture urine each isolate
|
$1,199.06 |
$1,199.06 |
$1,199.06 |
$57.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$33.33 |
$33.33 |
$33.33 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$734.40 |
$734.40 |
$734.40 |
$70.72
|
|
Cyclosporine 2 hour
|
$958.58 |
$958.58 |
$958.58 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$18.58 |
$18.58 |
$18.58 |
$7.48
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,682.43 |
$1,682.43 |
$1,682.43 |
$542.10
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,267.00 |
$1,267.00 |
$1,267.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$1,199.06 |
$1,199.06 |
$1,199.06 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$90.85 |
$90.85 |
$90.85 |
$159.45
|
|
Cytopathology concentration technique smears & interpretation
|
$422.42 |
$422.42 |
$422.42 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$422.42 |
$422.42 |
$422.42 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$422.42 |
$422.42 |
$422.42 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$422.42 |
$422.42 |
$422.42 |
$209.23
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$929.62 |
$929.62 |
$929.62 |
$168.53
|
|
Debridement (>20 cm) charge pt
|
$1,246.77 |
$1,246.77 |
$1,246.77 |
$260.61
|
|
Decalcification
|
$334.69 |
$334.69 |
$334.69 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$458.48 |
$458.48 |
$458.48 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$531.32 |
$531.32 |
$531.32 |
$185.17
|
|
Desmopressin 4 mcg/ml injection solution
|
$82.62 |
$82.62 |
$82.62 |
$89.78
|
|
Device intraute mirena
|
$4,722.57 |
$4,722.57 |
$4,722.57 |
$2,125.00
|
|
Dextrose 5 % IV bolus
|
$30.51 |
$30.51 |
$30.51 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,101.59 |
$1,101.59 |
$1,101.59 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$549.15 |
$549.15 |
$549.15 |
$79.20
|
|
Diagnostic Mammogram (both breasts)
|
$665.94 |
$665.94 |
$665.94 |
$399.30
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$163.61 |
$163.61 |
$163.61 |
$74.76
|
|
Dicyclomine injection
|
$531.46 |
$531.46 |
$531.46 |
$153.29
|
|
Diffusing capacity
|
$1,007.80 |
$1,007.80 |
$1,007.80 |
$332.00
|
|
Digoxin immune fab 40 mg intravenous solution
|
$20,787.30 |
$20,787.30 |
$20,787.30 |
$10,079.82
|
|
Digoxin total therapeutic drug level
|
$633.65 |
$633.65 |
$633.65 |
$102.00
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$287.20 |
$287.20 |
$287.20 |
$297.86
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$163.61 |
$163.61 |
$163.61 |
$17.75
|
|
Disability dlco
|
$641.93 |
$641.93 |
$641.93 |
$282.40
|
|
Dna antibody native/double stranded
|
$1,251.07 |
$1,251.07 |
$1,251.07 |
$97.50
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$597.83 |
$597.83 |
$597.83 |
$65.40
|
|
Doppler echo complete
|
$2,053.00 |
$2,053.00 |
$2,053.00 |
$540.00
|
|
Dornase alfa non-comp unit
|
$470.99 |
$470.99 |
$470.99 |
$446.75
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$938.72 |
$938.72 |
$938.72 |
$84.80
|
|
Droperidol 2.5 mg/ml injection solution
|
$58.59 |
$58.59 |
$58.59 |
$31.07
|
|
Drsg wnd hyalomatrix 10x10cm -cost per sq cm
|
$195.00 |
$195.00 |
$195.00 |
$135.72
|
|
Drug test def 1-7 classes
|
$1,322.54 |
$1,322.54 |
$1,322.54 |
$250.52
|
|
Dup scan/hemodialysis access 93990
|
$3,968.00 |
$3,968.00 |
$3,968.00 |
$489.72
|
|
Ecg 12 lead tracing only
|
$988.38 |
$988.38 |
$988.38 |
$226.50
|
|
Ecg external < 48 hours recording
|
$643.76 |
$643.76 |
$643.76 |
$462.00
|
|
Ecg external < 48 hours scanning analysis w/report
|
$643.76 |
$643.76 |
$643.76 |
$541.20
|
|
Echocardiography doppler color flow mapping
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$469.95
|
|
Echocardiograpy doppler follow up/limited study
|
$1,025.00 |
$1,025.00 |
$1,025.00 |
$362.50
|
|
Echo guide for artery repair
|
$2,656.48 |
$2,656.48 |
$2,656.48 |
$664.00
|