|
Creatinine clearance urine
|
$58.38 |
$58.38 |
$58.38 |
$73.86
|
|
#creutz-prot.,western blot
|
$96.96 |
$96.96 |
$96.96 |
$178.10
|
|
Critical care 30-74 minutes
|
$1,382.76 |
$1,382.76 |
$1,382.76 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$391.38 |
$391.38 |
$391.38 |
$663.00
|
|
Cryofibrinogen qualitative - sendout
|
$47.73 |
$47.73 |
$47.73 |
$52.50
|
|
Cryoprecipitate each unit
|
$397.86 |
$397.86 |
$397.86 |
$182.25
|
|
Cryptococcus abs qn - sendout
|
$237.50 |
$237.50 |
$237.50 |
$89.70
|
|
Crystal identification light microscopy
|
$54.47 |
$54.47 |
$54.47 |
$56.44
|
|
CT 3d report other modality w/workstation
|
$277.94 |
$277.94 |
$277.94 |
$607.80
|
|
Cta abdomen without & /or w/contrast
|
$1,409.33 |
$1,409.33 |
$1,409.33 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,153.47 |
$1,153.47 |
$1,153.47 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$731.76 |
$731.76 |
$731.76 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,045.52 |
$1,045.52 |
$1,045.52 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,707.77 |
$1,707.77 |
$1,707.77 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,154.13 |
$1,154.13 |
$1,154.13 |
$1,728.80
|
|
CT Angiogram of the Head
|
$1,045.52 |
$1,045.52 |
$1,045.52 |
$1,951.50
|
|
CT angio hrt w/3d image
|
$1,085.27 |
$1,085.27 |
$1,085.27 |
$1,618.00
|
|
Cta upper extremity w &/or without contrast left
|
$941.18 |
$941.18 |
$941.18 |
$1,650.60
|
|
CT guidance for needle placement
|
$567.44 |
$567.44 |
$567.44 |
$1,425.85
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$588.56 |
$588.56 |
$588.56 |
$1,007.29
|
|
CT heart w/evaluation of calcium without contrast
|
$101.15 |
$101.15 |
$101.15 |
$176.89
|
|
CT hrt w/3d image
|
$1,008.18 |
$1,008.18 |
$1,008.18 |
$1,513.20
|
|
CT limited or localized follow-up study
|
$235.65 |
$235.65 |
$235.65 |
$624.60
|
|
CT lower extremity w/contrast (both sides)
|
$697.83 |
$697.83 |
$697.83 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$667.80 |
$667.80 |
$667.80 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$718.02 |
$718.02 |
$718.02 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,067.58 |
$1,067.58 |
$1,067.58 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$727.71 |
$727.71 |
$727.71 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,128.96 |
$1,128.96 |
$1,128.96 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$704.87 |
$704.87 |
$704.87 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$665.75 |
$665.75 |
$665.75 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$612.93 |
$612.93 |
$612.93 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,001.08 |
$2,001.08 |
$2,001.08 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,810.25 |
$1,810.25 |
$1,810.25 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,721.63 |
$1,721.63 |
$1,721.63 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$745.83 |
$745.83 |
$745.83 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$818.33 |
$818.33 |
$818.33 |
$1,381.20
|
|
CT t-spine w /wo contrast
|
$834.83 |
$834.83 |
$834.83 |
$1,817.25
|
|
CT upper extremity w/contrast (both sides)
|
$668.72 |
$668.72 |
$668.72 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$691.01 |
$691.01 |
$691.01 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$811.20 |
$811.20 |
$811.20 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$27.60 |
$27.60 |
$27.60 |
$61.03
|
|
Culture afb any source
|
$77.37 |
$77.37 |
$77.37 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$54.47 |
$54.47 |
$54.47 |
$73.00
|
|
Culture anaerobic except blood
|
$254.52 |
$254.52 |
$254.52 |
$110.00
|
|
Culture bact stool aero addl path ea
|
$105.90 |
$105.90 |
$105.90 |
$49.40
|
|
Culture body fluid
|
$79.49 |
$79.49 |
$79.49 |
$111.15
|
|
Culture fungi definitive id mold
|
$83.42 |
$83.42 |
$83.42 |
$70.00
|
|
Culture fungi definitive id yeast
|
$34.70 |
$34.70 |
$34.70 |
$68.00
|
|
Culture fungi other (except blood)
|
$77.37 |
$77.37 |
$77.37 |
$92.95
|
|
Culture fungi skin/hair/nail
|
$77.37 |
$77.37 |
$77.37 |
$74.75
|
|
Culture mycoplasma any source
|
$122.48 |
$122.48 |
$122.48 |
$94.00
|
|
Culture quantitative aerobic other source
|
$10.49 |
$10.49 |
$10.49 |
$63.45
|
|
Culture screening strep group a
|
$120.29 |
$120.29 |
$120.29 |
$76.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$14.87 |
$14.87 |
$14.87 |
$17.58
|
|
Cyclic citrullinated peptide antibody
|
$99.14 |
$99.14 |
$99.14 |
$91.20
|
|
Cyclosporine modified 25 mg capsule
|
$2.48 |
$2.48 |
$2.48 |
$4.42
|
|
Cyclosporine oral 100 mg
|
$9.86 |
$9.86 |
$9.86 |
$19.50
|
|
Cystatin c
|
$175.49 |
$175.49 |
$175.49 |
$83.20
|
|
Cystogram >= 3 views supervision & interpretation
|
$473.94 |
$473.94 |
$473.94 |
$487.04
|
|
Cytomegalovirus (cmv) antibody igg
|
$51.12 |
$51.12 |
$51.12 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$72.51 |
$72.51 |
$72.51 |
$95.00
|
|
Cytomegalovirus dfa
|
$101.58 |
$101.58 |
$101.58 |
$101.58
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$121.64 |
$121.64 |
$121.64 |
$90.88
|
|
Cytopathology concentration technique smears & interpretation
|
$67.86 |
$67.86 |
$67.86 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$28.98 |
$28.98 |
$28.98 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$31.35 |
$31.35 |
$31.35 |
$71.25
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$104.07 |
$104.07 |
$104.07 |
$179.44
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$27.65 |
$27.65 |
$27.65 |
$205.00
|
|
Cytopath smear other source
|
$26.81 |
$26.81 |
$26.81 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$26.81 |
$26.81 |
$26.81 |
$95.00
|
|
Dalbavancin 500 mg intravenous solution
|
$38.24 |
$38.24 |
$38.24 |
$3,480.61
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.54 |
$0.54 |
$0.54 |
$1.80
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$16.64 |
$16.64 |
$16.64 |
$4,542.99
|
|
Deamidated gliadin antibody iga
|
$13.20 |
$13.20 |
$13.20 |
$53.95
|
|
Debridement (>20 cm) charge pt
|
$188.82 |
$188.82 |
$188.82 |
$313.30
|
|
Decalcification
|
$51.62 |
$51.62 |
$51.62 |
$72.15
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$359.58 |
$359.58 |
$359.58 |
$482.35
|
|
Deferoxamine 500 mg solution for injection
|
$20.33 |
$20.33 |
$20.33 |
$47.62
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$128.94 |
$128.94 |
$128.94 |
$165.60
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$67.19 |
$67.19 |
$67.19 |
$4,681.80
|
|
Desmopressin 4 mcg/ml injection solution
|
$43.59 |
$43.59 |
$43.59 |
$37.26
|
|
Detect agnt mult dna direc
|
$166.77 |
$166.77 |
$166.77 |
$115.50
|
|
Developmental screen/score/document 96110
|
$189.75 |
$189.75 |
$189.75 |
$126.75
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$3,262.37 |
$3,262.37 |
$3,262.37 |
$4,298.87
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$0.53 |
$0.53 |
$0.53 |
$8.23
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$46.35 |
$46.35 |
$46.35 |
$48.56
|
|
Dextrose 5 % IV bolus
|
$46.35 |
$46.35 |
$46.35 |
$46.35
|
|
Dhea-s (dehydroepiand sulfate)
|
$71.87 |
$71.87 |
$71.87 |
$110.50
|
|
Diabetes (HbA1c) Test
|
$41.99 |
$41.99 |
$41.99 |
$70.00
|
|
Diagnostic anoscopy spx 46600
|
$426.99 |
$426.99 |
$426.99 |
$252.00
|
|
Diagnostic Mammogram (both breasts)
|
$244.26 |
$244.26 |
$244.26 |
$381.60
|
|
Diagnostic Mammogram (one breast)
|
$215.58 |
$215.58 |
$215.58 |
$276.60
|
|
Dialysis one evaluation
|
$855.18 |
$855.18 |
$855.18 |
$920.00
|
|
Diffusing capacity
|
$263.46 |
$263.46 |
$263.46 |
$336.80
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$296.01 |
$296.01 |
$296.01 |
$29.85
|
|
Digoxin immune fab 40 mg intravenous solution
|
$10,279.62 |
$10,279.62 |
$10,279.62 |
$6,815.78
|
|
Digoxin total therapeutic drug level
|
$44.45 |
$44.45 |
$44.45 |
$92.95
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$321.30 |
$321.30 |
$321.30 |
$297.86
|
|
Dilate esophagus
|
$758.39 |
$758.39 |
$758.39 |
$2,003.04
|