|
Complex repair trunk 2.6-7.5cm 13101
|
$416.76 |
$416.76 |
$416.76 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$433.32 |
$433.32 |
$433.32 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$464.83 |
$464.83 |
$464.83 |
$1,193.40
|
|
Complx repair enel addl 5cm/< 13153
|
$409.40 |
$409.40 |
$409.40 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$420.90 |
$420.90 |
$420.90 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$422.28 |
$422.28 |
$422.28 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$307.05 |
$307.05 |
$307.05 |
$527.52
|
|
Complx repair sal addl 5 cm/> 13122
|
$379.96 |
$379.96 |
$379.96 |
$498.60
|
|
Complx repair trunk addl 5cm/< 13102
|
$379.96 |
$379.96 |
$379.96 |
$537.00
|
|
Concentration infection agents any type
|
$11.27 |
$11.27 |
$11.27 |
$49.40
|
|
Condylomata destruction 56420
|
$218.27 |
$218.27 |
$218.27 |
$469.00
|
|
Consultation pathology during surgery
|
$51.06 |
$51.06 |
$51.06 |
$100.00
|
|
Consultation/report referred material w/preparation of slides
|
$63.94 |
$63.94 |
$63.94 |
$215.63
|
|
Consult comp w/report rfrd material
|
$132.48 |
$132.48 |
$132.48 |
$345.71
|
|
Controller infinity pt dbs
|
$3,339.46 |
$3,339.46 |
$3,339.46 |
$4,494.00
|
|
Control nosebleed pack+caut 30905
|
$241.50 |
$241.50 |
$241.50 |
$385.45
|
|
Control of nosebleed ant comp 30903
|
$207.92 |
$207.92 |
$207.92 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$76.13 |
$76.13 |
$76.13 |
$342.24
|
|
Control oropharyngeal hemorr/simp 42960
|
$207.92 |
$207.92 |
$207.92 |
$624.78
|
|
Coombs direct
|
$16.33 |
$16.33 |
$16.33 |
$73.50
|
|
Coombs indirect titer reference
|
$43.93 |
$43.93 |
$43.93 |
$146.00
|
|
Coronary thrombolysis/iv infusion 92977
|
$386.63 |
$386.63 |
$386.63 |
$476.00
|
|
Cortisol acth stimulation test - sendout
|
$29.90 |
$29.90 |
$29.90 |
$146.25
|
|
Cortisol total am
|
$28.29 |
$28.29 |
$28.29 |
$121.20
|
|
Covid-19 administration immunization im inj 1st/only component
|
$17.48 |
$17.48 |
$17.48 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$127.65 |
$127.65 |
$127.65 |
$553.80
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$127.65 |
$127.65 |
$127.65 |
$548.79
|
|
Covid-19 lab test non-cdc
|
$14.72 |
$14.72 |
$14.72 |
$79.50
|
|
#coxa-coxsackie a serotype a16
|
$22.31 |
$22.31 |
$22.31 |
$60.00
|
|
C-peptide
|
$35.65 |
$35.65 |
$35.65 |
$94.40
|
|
C-reactive protein
|
$8.97 |
$8.97 |
$8.97 |
$66.79
|
|
C-reactive protein high sensitivity
|
$22.31 |
$22.31 |
$22.31 |
$83.20
|
|
Creatine kinase
|
$11.04 |
$11.04 |
$11.04 |
$66.30
|
|
Creatine kinase isoenzymes
|
$11.04 |
$11.04 |
$11.04 |
$49.80
|
|
Creatine kinase mb
|
$19.78 |
$19.78 |
$19.78 |
$113.75
|
|
Creatine - sendout
|
$8.05 |
$8.05 |
$8.05 |
$39.00
|
|
Creatinine
|
$8.97 |
$8.97 |
$8.97 |
$44.72
|
|
Creatinine 24 hour urine
|
$8.97 |
$8.97 |
$8.97 |
$61.95
|
|
Creatinine clearance urine
|
$16.10 |
$16.10 |
$16.10 |
$87.50
|
|
#creutz-prot.,western blot
|
$30.82 |
$30.82 |
$30.82 |
$168.64
|
|
Crotalidae poly immune fab
|
$5,429.02 |
$5,429.02 |
$5,429.02 |
$5,590.35
|
|
Cryoprecipitate each unit
|
$106.26 |
$106.26 |
$106.26 |
$144.78
|
|
Cryptosporidium antigen
|
$19.78 |
$19.78 |
$19.78 |
$52.08
|
|
Crystal identification light microscopy
|
$12.42 |
$12.42 |
$12.42 |
$62.00
|
|
Cstb gene full gene sequence
|
$212.06 |
$212.06 |
$212.06 |
$288.21
|
|
Cta abdomen without & /or w/contrast
|
$576.61 |
$576.61 |
$576.61 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$507.84 |
$507.84 |
$507.84 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$549.24 |
$549.24 |
$549.24 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$549.24 |
$549.24 |
$549.24 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$614.33 |
$614.33 |
$614.33 |
$2,848.80
|
|
CT Angiogram of the Chest (for blood clot)
|
$576.61 |
$576.61 |
$576.61 |
$1,940.00
|
|
CT Angiogram of the Head
|
$549.24 |
$549.24 |
$549.24 |
$1,971.45
|
|
Cta upper extremity w &/or without contrast left
|
$549.24 |
$549.24 |
$549.24 |
$1,689.80
|
|
CT heart w/evaluation of calcium without contrast
|
$7.13 |
$7.13 |
$7.13 |
$171.69
|
|
CT limited or localized follow-up study
|
$549.24 |
$549.24 |
$549.24 |
$640.48
|
|
CT lower extremity w/contrast (both sides)
|
$549.24 |
$549.24 |
$549.24 |
$1,619.25
|
|
CT lower extremity without contrast (both sides)
|
$521.87 |
$521.87 |
$521.87 |
$1,403.73
|
|
CT lwr extremity w/o&w/dye
|
$576.61 |
$576.61 |
$576.61 |
$1,844.52
|
|
CT neck soft tissue w/contrast
|
$549.24 |
$549.24 |
$549.24 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$521.87 |
$521.87 |
$521.87 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$576.61 |
$576.61 |
$576.61 |
$1,945.13
|
|
CT orbit/sella/fossa w/wo contrast
|
$576.61 |
$576.61 |
$576.61 |
$1,707.60
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$549.24 |
$549.24 |
$549.24 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$549.24 |
$549.24 |
$549.24 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$576.61 |
$576.61 |
$576.61 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$549.24 |
$549.24 |
$549.24 |
$2,928.00
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$521.87 |
$521.87 |
$521.87 |
$2,325.05
|
|
CT thoracic spine w/contrast
|
$549.24 |
$549.24 |
$549.24 |
$1,689.80
|
|
CT thoracic spine without contrast
|
$521.87 |
$521.87 |
$521.87 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$89.47 |
$89.47 |
$89.47 |
$345.28
|
|
CT t-spine w /wo contrast
|
$576.61 |
$576.61 |
$576.61 |
$2,025.00
|
|
CT upper extremity w/contrast (both sides)
|
$549.24 |
$549.24 |
$549.24 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$521.87 |
$521.87 |
$521.87 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$576.61 |
$576.61 |
$576.61 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$14.03 |
$14.03 |
$14.03 |
$69.55
|
|
Culture afb any source
|
$18.63 |
$18.63 |
$18.63 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$14.03 |
$14.03 |
$14.03 |
$78.82
|
|
Culture anaerobic except blood
|
$16.10 |
$16.10 |
$16.10 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$16.10 |
$16.10 |
$16.10 |
$51.20
|
|
Culture body fluid
|
$14.72 |
$14.72 |
$14.72 |
$120.50
|
|
Culture fungi definitive id mold
|
$17.94 |
$17.94 |
$17.94 |
$74.97
|
|
Culture fungi definitive id yeast
|
$17.94 |
$17.94 |
$17.94 |
$79.10
|
|
Culture fungi other (except blood)
|
$14.49 |
$14.49 |
$14.49 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$13.34 |
$13.34 |
$13.34 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$18.86 |
$18.86 |
$18.86 |
$88.40
|
|
Culture quantitative aerobic other source
|
$16.10 |
$16.10 |
$16.10 |
$87.02
|
|
Culture screening strep group a
|
$11.27 |
$11.27 |
$11.27 |
$81.00
|
|
Culture typing added method
|
$8.97 |
$8.97 |
$8.97 |
$36.78
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$289.11 |
$289.11 |
$289.11 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$60.03 |
$60.03 |
$60.03 |
$130.38
|
|
Culture urine each isolate
|
$14.03 |
$14.03 |
$14.03 |
$52.00
|
|
Cutter lead
|
$15,380.61 |
$15,380.61 |
$15,380.61 |
$5,790.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$26.21 |
$26.21 |
$26.21 |
$25.16
|
|
Cyclic citrullinated peptide antibody
|
$11.73 |
$11.73 |
$11.73 |
$72.36
|
|
Cyclosporine 2 hour
|
$30.82 |
$30.82 |
$30.82 |
$129.48
|
|
Cymetra injectable
|
$432.94 |
$432.94 |
$432.94 |
$578.24
|
|
Cyp2c9 gene com variants
|
$220.80 |
$220.80 |
$220.80 |
$266.50
|
|
Cyp2d6 gene com variants
|
$634.11 |
$634.11 |
$634.11 |
$525.95
|
|
Cystatin c
|
$20.47 |
$20.47 |
$20.47 |
$78.60
|
|
Cystic fibrosis cftr
|
$1,020.28 |
$1,020.28 |
$1,020.28 |
$1,060.00
|
