|
Chg radiologic exam esophagus double contrast
|
$91.28 |
$91.28 |
$91.28 |
$511.59
|
|
Chloride
|
$3.92 |
$3.92 |
$3.92 |
$40.95
|
|
Chloride 24 hour urine
|
$9.80 |
$9.80 |
$9.80 |
$49.50
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$9.80 |
$9.80 |
$9.80 |
$78.43
|
|
Cholesterol
|
$8.68 |
$8.68 |
$8.68 |
$45.76
|
|
Cholesterol body fluid
|
$18.76 |
$18.76 |
$18.76 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$26.88 |
$26.88 |
$26.88 |
$115.80
|
|
Cholinesterase
|
$8.96 |
$8.96 |
$8.96 |
$38.69
|
|
Chromosome analysis 15-20 cell count
|
$146.72 |
$146.72 |
$146.72 |
$512.20
|
|
Chronic urticaria - sendout
|
$66.92 |
$66.92 |
$66.92 |
$75.00
|
|
Cilastatin sodium injection
|
$30.80 |
$30.80 |
$30.80 |
$77.40
|
|
C-kit mutation liquid tumor - sendout
|
$154.00 |
$154.00 |
$154.00 |
$655.00
|
|
Clearance of airways
|
$94.08 |
$94.08 |
$94.08 |
$208.86
|
|
Clip ligating vesolock lg
|
$508.20 |
$508.20 |
$508.20 |
$4,320.00
|
|
Cllr miami j sm
|
$67.84 |
$67.84 |
$67.84 |
$566.23
|
|
Clot factor xii hageman
|
$23.80 |
$23.80 |
$23.80 |
$134.39
|
|
#cmvcul-virus inoculation shell
|
$74.48 |
$74.48 |
$74.48 |
$100.80
|
|
Cold agglutinin titer
|
$3.64 |
$3.64 |
$3.64 |
$50.00
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$29.12 |
$29.12 |
$29.12 |
$60.84
|
|
Collar cerv ascend 172 reg
|
$22.63 |
$22.63 |
$22.63 |
$213.89
|
|
Collection blood specimen from completely implantable venous access device
|
$57.12 |
$57.12 |
$57.12 |
$159.60
|
|
Collection of venous blood by venipuncture
|
$4.20 |
$4.20 |
$4.20 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$36.12 |
$36.12 |
$36.12 |
$170.05
|
|
Compatibility test each unit immediate spin technique
|
$36.12 |
$36.12 |
$36.12 |
$169.52
|
|
Complement antigen each component c3
|
$40.60 |
$40.60 |
$40.60 |
$108.55
|
|
Complement fixation each
|
$12.32 |
$12.32 |
$12.32 |
$29.12
|
|
Computed tomographic angiography head and neck with contrast
|
$731.64 |
$731.64 |
$731.64 |
$2,237.25
|
|
Conjugated estrogens 25 mg solution for injection
|
$127.59 |
$127.59 |
$127.59 |
$871.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$27.44 |
$27.44 |
$27.44 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$20.16 |
$20.16 |
$20.16 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$35.56 |
$35.56 |
$35.56 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$86.80 |
$86.80 |
$86.80 |
$224.80
|
|
Contrast x-ray of knee joint
|
$157.92 |
$157.92 |
$157.92 |
$769.88
|
|
Coombs direct
|
$73.92 |
$73.92 |
$73.92 |
$75.00
|
|
Core ndl bx lng/med perq
|
$1,627.92 |
$1,627.92 |
$1,627.92 |
$2,678.00
|
|
Cortisol acth stimulation test - sendout
|
$17.92 |
$17.92 |
$17.92 |
$146.25
|
|
Cortisol total am
|
$12.32 |
$12.32 |
$12.32 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$43.68 |
$43.68 |
$43.68 |
$189.22
|
|
C-peptide
|
$17.64 |
$17.64 |
$17.64 |
$97.30
|
|
C-reactive protein
|
$5.04 |
$5.04 |
$5.04 |
$68.38
|
|
C-reactive protein high sensitivity
|
$26.88 |
$26.88 |
$26.88 |
$85.00
|
|
Creatine kinase
|
$13.16 |
$13.16 |
$13.16 |
$66.30
|
|
Creatine kinase isoenzymes
|
$8.96 |
$8.96 |
$8.96 |
$56.80
|
|
Creatine kinase mb
|
$23.24 |
$23.24 |
$23.24 |
$114.00
|
|
Creatinine
|
$4.48 |
$4.48 |
$4.48 |
$44.72
|
|
Creatinine 24 hour urine
|
$4.76 |
$4.76 |
$4.76 |
$58.85
|
|
Creatinine clearance urine
|
$6.16 |
$6.16 |
$6.16 |
$89.50
|
|
Critical care 30-74 minutes
|
$369.60 |
$369.60 |
$369.60 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$79.24 |
$79.24 |
$79.24 |
$731.40
|
|
Crotalidae poly immune fab
|
$1,235.08 |
$1,235.08 |
$1,235.08 |
$5,590.35
|
|
Cryofibrinogen qualitative - sendout
|
$4.48 |
$4.48 |
$4.48 |
$52.50
|
|
Cryoprecipitate each unit
|
$47.32 |
$47.32 |
$47.32 |
$144.78
|
|
Cryptococcus abs qn - sendout
|
$21.84 |
$21.84 |
$21.84 |
$89.70
|
|
Crystal identification light microscopy
|
$14.28 |
$14.28 |
$14.28 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$731.64 |
$731.64 |
$731.64 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$814.80 |
$814.80 |
$814.80 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$974.96 |
$974.96 |
$974.96 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$636.16 |
$636.16 |
$636.16 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,463.00 |
$1,463.00 |
$1,463.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$731.64 |
$731.64 |
$731.64 |
$1,940.00
|
|
CT Angiogram of the Head
|
$731.64 |
$731.64 |
$731.64 |
$1,996.80
|
|
CT angio pelvis
|
$731.64 |
$731.64 |
$731.64 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$974.96 |
$974.96 |
$974.96 |
$1,698.00
|
|
CT cerebral perf w cont & prcssng
|
$227.08 |
$227.08 |
$227.08 |
$803.40
|
|
CT guidance for needle placement
|
$379.40 |
$379.40 |
$379.40 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$235.76 |
$235.76 |
$235.76 |
$1,178.52
|
|
CT lower extremity w/contrast (both sides)
|
$819.84 |
$819.84 |
$819.84 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$769.44 |
$769.44 |
$769.44 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$1,051.12 |
$1,051.12 |
$1,051.12 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$315.00 |
$315.00 |
$315.00 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$299.60 |
$299.60 |
$299.60 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$461.16 |
$461.16 |
$461.16 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$414.68 |
$414.68 |
$414.68 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$315.00 |
$315.00 |
$315.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$348.60 |
$348.60 |
$348.60 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,108.24 |
$1,108.24 |
$1,108.24 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$739.20 |
$739.20 |
$739.20 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$739.20 |
$739.20 |
$739.20 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$507.92 |
$507.92 |
$507.92 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$507.92 |
$507.92 |
$507.92 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$445.20 |
$445.20 |
$445.20 |
$331.50
|
|
CT t-spine w /wo contrast
|
$761.88 |
$761.88 |
$761.88 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$733.04 |
$733.04 |
$733.04 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$614.32 |
$614.32 |
$614.32 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$837.20 |
$837.20 |
$837.20 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$16.24 |
$16.24 |
$16.24 |
$68.64
|
|
Culture afb any source
|
$21.84 |
$21.84 |
$21.84 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$16.24 |
$16.24 |
$16.24 |
$79.00
|
|
Culture anaerobic except blood
|
$19.04 |
$19.04 |
$19.04 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$4.76 |
$4.76 |
$4.76 |
$51.45
|
|
Culture body fluid
|
$17.36 |
$17.36 |
$17.36 |
$126.75
|
|
Culture fungi definitive id yeast
|
$20.72 |
$20.72 |
$20.72 |
$79.10
|
|
Culture fungi other (except blood)
|
$16.80 |
$16.80 |
$16.80 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$15.40 |
$15.40 |
$15.40 |
$74.88
|
|
Culture mycoplasma any source
|
$14.00 |
$14.00 |
$14.00 |
$85.26
|
|
Culture screening strep group a
|
$35.56 |
$35.56 |
$35.56 |
$81.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$305.20 |
$305.20 |
$305.20 |
$392.50
|
|
Cyclic citrullinated peptide antibody
|
$34.16 |
$34.16 |
$34.16 |
$70.72
|
|
Cyclosporine 2 hour
|
$18.76 |
$18.76 |
$18.76 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$1.68 |
$1.68 |
$1.68 |
$7.48
|
