|
Chest 2 vws w oblique
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$377.06
|
|
Chest apical lordotic proj
|
$990.30 |
$990.30 |
$990.30 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$6,120.56 |
$6,120.56 |
$6,120.56 |
$1,975.00
|
|
Chest CT scan (with contrast)
|
$5,594.00 |
$5,594.00 |
$5,594.00 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$6,094.49 |
$6,094.49 |
$6,094.49 |
$1,350.03
|
|
Chest X-ray
|
$588.36 |
$588.36 |
$588.36 |
$294.06
|
|
Chest X-ray (single view)
|
$501.36 |
$501.36 |
$501.36 |
$239.04
|
|
Chg pr pul rehab for copd patients
|
$463.22 |
$463.22 |
$463.22 |
$147.95
|
|
Chlamydia type
|
$15.12 |
$15.12 |
$15.12 |
$34.20
|
|
Chloride
|
$105.09 |
$105.09 |
$105.09 |
$40.95
|
|
Chloride 24 hour urine
|
$111.06 |
$111.06 |
$111.06 |
$49.50
|
|
Cholesterol
|
$414.46 |
$414.46 |
$414.46 |
$45.76
|
|
Cholesterol (Lipid) Test
|
$317.29 |
$317.29 |
$317.29 |
$115.80
|
|
Chromatography
|
$394.63 |
$394.63 |
$394.63 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$2,657.31 |
$2,657.31 |
$2,657.31 |
$512.20
|
|
Chromosome karyotype study
|
$385.05 |
$385.05 |
$385.05 |
$119.87
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$33.25 |
$33.25 |
$33.25 |
$34.88
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$82.08 |
$82.08 |
$82.08 |
$55.20
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$438.57 |
$438.57 |
$438.57 |
$81.90
|
|
Clozapine, 25 mg
|
$157.96 |
$157.96 |
$157.96 |
$4.87
|
|
#cmvcul-virus inoculation shell
|
$137.16 |
$137.16 |
$137.16 |
$100.80
|
|
Cmv pcr-sendout
|
$216.00 |
$216.00 |
$216.00 |
$177.50
|
|
Colistimethate sodium inj
|
$1,961.79 |
$1,961.79 |
$1,961.79 |
$68.47
|
|
Collection of venous blood by venipuncture
|
$105.00 |
$105.00 |
$105.00 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$663.12 |
$663.12 |
$663.12 |
$170.05
|
|
Compatibility test each unit electronic
|
$556.20 |
$556.20 |
$556.20 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$965.76 |
$965.76 |
$965.76 |
$169.52
|
|
Compatibility test incubate
|
$556.20 |
$556.20 |
$556.20 |
$155.40
|
|
Computed tomographic angiography head and neck with contrast
|
$8,510.04 |
$8,510.04 |
$8,510.04 |
$2,237.25
|
|
Consultation pathology during surgery cytological exam initial site
|
$2,272.60 |
$2,272.60 |
$2,272.60 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$113.03 |
$113.03 |
$113.03 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,421.86 |
$1,421.86 |
$1,421.86 |
$225.96
|
|
Contrast exam abdominl aorta 75625-26
|
$9,349.00 |
$9,349.00 |
$9,349.00 |
$3,458.54
|
|
Coombs indirect qualitative each reagent red cell reference
|
$663.12 |
$663.12 |
$663.12 |
$102.90
|
|
Coombs indirect titer reference
|
$556.20 |
$556.20 |
$556.20 |
$146.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$1,186.83 |
$1,186.83 |
$1,186.83 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$132.39 |
$132.39 |
$132.39 |
$55.90
|
|
C-peptide
|
$442.22 |
$442.22 |
$442.22 |
$97.30
|
|
C-reactive protein
|
$372.81 |
$372.81 |
$372.81 |
$68.38
|
|
Creatine kinase
|
$321.26 |
$321.26 |
$321.26 |
$66.30
|
|
Creatine - sendout
|
$839.43 |
$839.43 |
$839.43 |
$39.00
|
|
Creatinine
|
$214.16 |
$214.16 |
$214.16 |
$44.72
|
|
Creatinine clearance urine
|
$196.31 |
$196.31 |
$196.31 |
$89.50
|
|
Crystal identification light microscopy
|
$321.26 |
$321.26 |
$321.26 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$4,608.67 |
$4,608.67 |
$4,608.67 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$4,608.67 |
$4,608.67 |
$4,608.67 |
$1,940.00
|
|
Cta neck without &/or w/contrast
|
$4,608.67 |
$4,608.67 |
$4,608.67 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,903.11 |
$3,903.11 |
$3,903.11 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$4,608.67 |
$4,608.67 |
$4,608.67 |
$1,940.00
|
|
CT Angiogram of the Head
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$5,300.31 |
$5,300.31 |
$5,300.31 |
$1,500.38
|
|
CT cerebral perf w cont & prcssng
|
$537.60 |
$537.60 |
$537.60 |
$803.40
|
|
CT guidance for needle placement
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$5,385.46 |
$5,385.46 |
$5,385.46 |
$1,178.52
|
|
CT heart w/evaluation of calcium without contrast
|
$45.00 |
$45.00 |
$45.00 |
$171.60
|
|
CT limited or localized follow-up study
|
$8,709.84 |
$8,709.84 |
$8,709.84 |
$642.75
|
|
CT neck soft tissue w/contrast
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$2,787.44 |
$2,787.44 |
$2,787.44 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$4,615.61 |
$4,615.61 |
$4,615.61 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$4,615.61 |
$4,615.61 |
$4,615.61 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$3,901.37 |
$3,901.37 |
$3,901.37 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$12,242.84 |
$12,242.84 |
$12,242.84 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$11,194.96 |
$11,194.96 |
$11,194.96 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$9,495.37 |
$9,495.37 |
$9,495.37 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$7,825.33 |
$7,825.33 |
$7,825.33 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$5,317.69 |
$5,317.69 |
$5,317.69 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$910.60 |
$910.60 |
$910.60 |
$331.50
|
|
CT t-spine w /wo contrast
|
$15,690.67 |
$15,690.67 |
$15,690.67 |
$2,027.52
|
|
Culture afb any source
|
$233.99 |
$233.99 |
$233.99 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$347.04 |
$347.04 |
$347.04 |
$79.00
|
|
Culture anaerobic except blood
|
$277.62 |
$277.62 |
$277.62 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$1,292.37 |
$1,292.37 |
$1,292.37 |
$51.45
|
|
Culture fungi definitive id mold
|
$168.56 |
$168.56 |
$168.56 |
$77.28
|
|
Culture fungi definitive id yeast
|
$224.08 |
$224.08 |
$224.08 |
$79.10
|
|
Culture fungi other (except blood)
|
$1,166.40 |
$1,166.40 |
$1,166.40 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$167.00 |
$167.00 |
$167.00 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$131.76 |
$131.76 |
$131.76 |
$89.70
|
|
Culture quantitative aerobic other source
|
$501.82 |
$501.82 |
$501.82 |
$90.35
|
|
Culture typing added method
|
$191.16 |
$191.16 |
$191.16 |
$38.58
|
|
Culture typing immunologic
|
$203.04 |
$203.04 |
$203.04 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$611.19 |
$611.19 |
$611.19 |
$133.90
|
|
Culture urine each isolate
|
$455.53 |
$455.53 |
$455.53 |
$57.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$155.89 |
$155.89 |
$155.89 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$214.16 |
$214.16 |
$214.16 |
$70.72
|
|
Cystatin c
|
$144.76 |
$144.76 |
$144.76 |
$77.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$542.10
|
|
Cytomegalovirus (cmv) antibody igg
|
$1,501.75 |
$1,501.75 |
$1,501.75 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$1,420.86 |
$1,420.86 |
$1,420.86 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$458.09 |
$458.09 |
$458.09 |
$159.45
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$408.52 |
$408.52 |
$408.52 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$418.44 |
$418.44 |
$418.44 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$705.97 |
$705.97 |
$705.97 |
$209.23
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$10.39 |
$10.39 |
$10.39 |
$168.53
|
|
Debridement (>20 cm) charge pt
|
$706.22 |
$706.22 |
$706.22 |
$260.61
|
|
Decalcification
|
$81.31 |
$81.31 |
$81.31 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$657.82 |
$657.82 |
$657.82 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$648.32 |
$648.32 |
$648.32 |
$185.17
|
|
Desmopressin 4 mcg/ml injection solution
|
$56.12 |
$56.12 |
$56.12 |
$89.78
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$259.82 |
$259.82 |
$259.82 |
$38.08
|
