|
Chest CT scan (without contrast)
|
$524.70 |
$524.70 |
$524.70 |
$1,350.03
|
|
Chest X-ray
|
$81.84 |
$81.84 |
$81.84 |
$294.06
|
|
Chest X-ray (single view)
|
$53.46 |
$53.46 |
$53.46 |
$239.04
|
|
Chg radiologic exam esophagus double contrast
|
$107.58 |
$107.58 |
$107.58 |
$511.59
|
|
Chlamydia culture
|
$14.52 |
$14.52 |
$14.52 |
$93.90
|
|
Chlamydia type
|
$3.96 |
$3.96 |
$3.96 |
$34.20
|
|
Chloride
|
$14.52 |
$14.52 |
$14.52 |
$40.95
|
|
Chloride 24 hour urine
|
$16.83 |
$16.83 |
$16.83 |
$49.50
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$60.73 |
$60.73 |
$60.73 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$63.45 |
$63.45 |
$63.45 |
$78.43
|
|
Cholangiogram percutaneous compl
|
$1,810.71 |
$1,810.71 |
$1,810.71 |
$3,495.00
|
|
Cholesterol
|
$14.52 |
$14.52 |
$14.52 |
$45.76
|
|
Cholesterol body fluid
|
$1,484.01 |
$1,484.01 |
$1,484.01 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$44.55 |
$44.55 |
$44.55 |
$115.80
|
|
Cholinesterase
|
$17.16 |
$17.16 |
$17.16 |
$38.69
|
|
Cholinesterase challenge
|
$154.11 |
$154.11 |
$154.11 |
$366.72
|
|
Chromatography
|
$16.50 |
$16.50 |
$16.50 |
$81.25
|
|
Chromogenic substrate assay
|
$226.38 |
$226.38 |
$226.38 |
$148.68
|
|
Chromo high res and frag x - sendout
|
$192.06 |
$192.06 |
$192.06 |
$247.59
|
|
Chronic urticaria - sendout
|
$8.25 |
$8.25 |
$8.25 |
$75.00
|
|
Chylomicron screen, bf - sendout
|
$38.61 |
$38.61 |
$38.61 |
$124.15
|
|
Cidofovir injection
|
$832.23 |
$832.23 |
$832.23 |
$1,295.73
|
|
Cilastatin sodium injection
|
$57.46 |
$57.46 |
$57.46 |
$77.40
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$16.17 |
$16.17 |
$16.17 |
$34.88
|
|
Cisplatin 1 mg/ml desensitization
|
$562.32 |
$562.32 |
$562.32 |
$192.66
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$833.74 |
$833.74 |
$833.74 |
$569.55
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$15.43 |
$15.43 |
$15.43 |
$55.20
|
|
Clofarabine 1 mg/ml intravenous solution
|
$4,008.78 |
$4,008.78 |
$4,008.78 |
$4,784.71
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$101.76 |
$101.76 |
$101.76 |
$81.90
|
|
Clot factor xii hageman
|
$73.59 |
$73.59 |
$73.59 |
$134.39
|
|
Cmv pcr-sendout
|
$58.41 |
$58.41 |
$58.41 |
$177.50
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$15,791.82 |
$15,791.82 |
$15,791.82 |
$8,980.00
|
|
Cold agglutinin titer
|
$47.85 |
$47.85 |
$47.85 |
$50.00
|
|
Collagenase, clost hist inj
|
$7,993.96 |
$7,993.96 |
$7,993.96 |
$12,906.28
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$19.87 |
$19.87 |
$19.87 |
$60.84
|
|
Collar cerv ascend 172 reg
|
$26.67 |
$26.67 |
$26.67 |
$213.89
|
|
Collar extrication adult univ
|
$1,309.03 |
$1,309.03 |
$1,309.03 |
$764.15
|
|
Collection blood specimen from completely implantable venous access device
|
$67.32 |
$67.32 |
$67.32 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$67.32 |
$67.32 |
$67.32 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$4.95 |
$4.95 |
$4.95 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$59.73 |
$59.73 |
$59.73 |
$170.05
|
|
Compatibility test each unit electronic
|
$59.73 |
$59.73 |
$59.73 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$59.73 |
$59.73 |
$59.73 |
$169.52
|
|
Complement antigen each component c3
|
$39.93 |
$39.93 |
$39.93 |
$108.55
|
|
Computed tomographic angiography head and neck with contrast
|
$862.29 |
$862.29 |
$862.29 |
$2,237.25
|
|
Concentration infection agents any type
|
$22.11 |
$22.11 |
$22.11 |
$49.95
|
|
Conjugated estrogens 25 mg solution for injection
|
$423.86 |
$423.86 |
$423.86 |
$871.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$32.34 |
$32.34 |
$32.34 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$23.76 |
$23.76 |
$23.76 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$41.91 |
$41.91 |
$41.91 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$30.03 |
$30.03 |
$30.03 |
$224.80
|
|
Contrast baths charges
|
$11.22 |
$11.22 |
$11.22 |
$70.50
|
|
Contrast x-ray of hip
|
$372.24 |
$372.24 |
$372.24 |
$771.12
|
|
Contrast x-ray of knee joint
|
$372.24 |
$372.24 |
$372.24 |
$769.88
|
|
Contrast x-ray of wrist
|
$186.12 |
$186.12 |
$186.12 |
$637.00
|
|
Convert nephrostomy catheter
|
$2,411.64 |
$2,411.64 |
$2,411.64 |
$2,777.60
|
|
Coombs direct
|
$29.70 |
$29.70 |
$29.70 |
$75.00
|
|
Core ndl bx lng/med perq
|
$1,918.62 |
$1,918.62 |
$1,918.62 |
$2,678.00
|
|
Cortisol acth stimulation test - sendout
|
$75.24 |
$75.24 |
$75.24 |
$146.25
|
|
Cortisol total am
|
$54.12 |
$54.12 |
$54.12 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$153.71 |
$153.71 |
$153.71 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$27.72 |
$27.72 |
$27.72 |
$110.00
|
|
Cover wrist
|
$155.76 |
$155.76 |
$155.76 |
$225.00
|
|
Covid-19 administration immunization im inj 1st/only component
|
$33.99 |
$33.99 |
$33.99 |
$49.13
|
|
#covid19rsv-rsv
|
$162.03 |
$162.03 |
$162.03 |
$145.60
|
|
C-peptide
|
$11.88 |
$11.88 |
$11.88 |
$97.30
|
|
Crbrospnl fld flw imag cistern
|
$312.84 |
$312.84 |
$312.84 |
$1,240.80
|
|
C-reactive protein
|
$17.16 |
$17.16 |
$17.16 |
$68.38
|
|
C-reactive protein high sensitivity
|
$42.90 |
$42.90 |
$42.90 |
$85.00
|
|
Creatine kinase
|
$21.78 |
$21.78 |
$21.78 |
$66.30
|
|
Creatine kinase mb
|
$38.28 |
$38.28 |
$38.28 |
$114.00
|
|
Creatinine
|
$16.83 |
$16.83 |
$16.83 |
$44.72
|
|
Creatinine 24 hour urine
|
$17.16 |
$17.16 |
$17.16 |
$58.85
|
|
Creatinine clearance urine
|
$31.35 |
$31.35 |
$31.35 |
$89.50
|
|
#creutz-prot.,western blot
|
$198.00 |
$198.00 |
$198.00 |
$166.20
|
|
Critical care 30-74 minutes
|
$435.60 |
$435.60 |
$435.60 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$93.39 |
$93.39 |
$93.39 |
$731.40
|
|
Crizanlizumab-tmca 10 mg/ml intravenous solution
|
$2,758.67 |
$2,758.67 |
$2,758.67 |
$4,288.58
|
|
Crotalidae poly immune fab
|
$3,596.60 |
$3,596.60 |
$3,596.60 |
$5,590.35
|
|
Cryoprecipitate each unit
|
$87.78 |
$87.78 |
$87.78 |
$144.78
|
|
Cta abdomen without & /or w/contrast
|
$862.29 |
$862.29 |
$862.29 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$960.30 |
$960.30 |
$960.30 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,149.06 |
$1,149.06 |
$1,149.06 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$749.76 |
$749.76 |
$749.76 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,724.25 |
$1,724.25 |
$1,724.25 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$862.29 |
$862.29 |
$862.29 |
$1,940.00
|
|
CT Angiogram of the Head
|
$862.29 |
$862.29 |
$862.29 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$357.72 |
$357.72 |
$357.72 |
$1,500.38
|
|
CT angio pelvis
|
$862.29 |
$862.29 |
$862.29 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$1,149.06 |
$1,149.06 |
$1,149.06 |
$1,698.00
|
|
CT cerebral perf w cont & prcssng
|
$267.63 |
$267.63 |
$267.63 |
$803.40
|
|
CT guidance for needle placement
|
$447.15 |
$447.15 |
$447.15 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$277.86 |
$277.86 |
$277.86 |
$1,178.52
|
|
CT heart w/evaluation of calcium without contrast
|
$39.60 |
$39.60 |
$39.60 |
$171.60
|
|
CT hrt w/3d image
|
$357.72 |
$357.72 |
$357.72 |
$1,383.06
|
|
CT limited or localized follow-up study
|
$232.98 |
$232.98 |
$232.98 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$966.24 |
$966.24 |
$966.24 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$906.84 |
$906.84 |
$906.84 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$1,238.82 |
$1,238.82 |
$1,238.82 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$371.25 |
$371.25 |
$371.25 |
$1,652.00
|