|
Creatine kinase isoenzymes
|
$66.17 |
$66.18 |
$66.18 |
|
|
Creatinine
|
$27.32 |
$27.32 |
$34.11 |
|
|
Creatinine 24 hour urine
|
$40.10 |
$40.10 |
$40.10 |
|
|
Creatinine clearance urine
|
$58.38 |
$58.38 |
$58.38 |
|
|
#creutz-prot.,western blot
|
$96.96 |
$96.96 |
$96.96 |
|
|
Critical care 30-74 minutes
|
$976.02 |
$976.02 |
$1,382.76 |
|
|
Critical care each additional 30 minutes
|
$391.38 |
$545.60 |
$545.60 |
|
|
Crotalidae poly immune fab
|
$6,873.14 |
$6,873.14 |
$6,873.14 |
|
|
Cryofibrinogen qualitative - sendout
|
$47.73 |
$47.73 |
$47.73 |
|
|
Cryoprecipitate each unit
|
$397.85 |
$397.86 |
$397.86 |
|
|
Cryptococcus abs qn - sendout
|
$237.50 |
$237.50 |
$237.50 |
|
|
Crystal identification light microscopy
|
$54.47 |
$54.47 |
$54.47 |
|
|
CT 3d report other modality w/workstation
|
$277.94 |
$277.94 |
$277.94 |
|
|
Cta abdomen without & /or w/contrast
|
$856.50 |
$1,409.33 |
$1,479.80 |
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$813.87 |
$1,153.47 |
$1,211.16 |
|
|
Cta lower extremity without & w/contrast (both sides)
|
$731.48 |
$731.76 |
$768.05 |
|
|
Cta neck without &/or w/contrast
|
$779.28 |
$1,045.52 |
$1,097.79 |
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,707.77 |
$1,707.77 |
$1,892.27 |
|
|
CT Angiogram of the Chest (for blood clot)
|
$868.77 |
$1,154.13 |
$1,211.85 |
|
|
CT Angiogram of the Head
|
$779.28 |
$1,045.52 |
$1,097.79 |
|
|
CT angio hrt w/3d image
|
$1,085.27 |
$1,085.27 |
$1,085.27 |
|
|
CT angio pelvis
|
$893.39 |
$893.39 |
$893.39 |
|
|
Cta upper extremity w &/or without contrast left
|
$941.03 |
$941.18 |
$988.25 |
|
|
CT guidance for needle placement
|
$567.44 |
$567.44 |
$567.44 |
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$255.93 |
$588.56 |
$618.00 |
|
|
CT guid parench tis ablat
|
$628.43 |
$628.43 |
$628.43 |
|
|
CT heart w/evaluation of calcium without contrast
|
$101.15 |
$101.15 |
$101.15 |
|
|
CT hrt w/3d image
|
$1,008.18 |
$1,008.18 |
$1,008.18 |
|
|
CT limited or localized follow-up study
|
$235.65 |
$235.65 |
$247.43 |
|
|
CT lower extremity w/contrast (both sides)
|
$687.89 |
$697.83 |
$732.74 |
|
|
CT lower extremity without contrast (both sides)
|
$640.52 |
$667.80 |
$701.21 |
|
|
CT lwr extremity w/o&w/dye
|
$718.02 |
$718.02 |
$753.93 |
|
|
CT neck soft tissue w/contrast
|
$807.06 |
$1,067.58 |
$1,120.97 |
|
|
CT neck soft tissue without contrast
|
$706.80 |
$727.71 |
$764.10 |
|
|
CT neck soft tissue without & w/contrast
|
$826.35 |
$1,128.96 |
$1,185.41 |
|
|
CT orbit/sella/fossa w/wo contrast
|
$704.87 |
$705.11 |
$740.12 |
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$665.75 |
$672.63 |
$699.03 |
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$540.69 |
$612.93 |
$643.59 |
|
|
CT scan for therapy guide
|
$403.28 |
$403.28 |
$403.28 |
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,946.21 |
$2,001.08 |
$2,001.08 |
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,692.89 |
$1,810.25 |
$1,810.25 |
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,409.82 |
$1,721.63 |
$1,721.63 |
|
|
CT thoracic spine w/contrast
|
$745.83 |
$745.83 |
$783.14 |
|
|
CT thoracic spine without contrast
|
$709.85 |
$818.33 |
$859.25 |
|
|
CT t-spine w /wo contrast
|
$834.83 |
$834.83 |
$834.83 |
|
|
CT upper extremity w/contrast (both sides)
|
$668.72 |
$668.72 |
$668.72 |
|
|
CT upper extremity without contrast (both sides)
|
$573.59 |
$691.01 |
$725.55 |
|
|
CT uppr extremity w/o&w/dye
|
$811.20 |
$811.20 |
$811.20 |
|
|
Culture aerobic additional method definitive id each
|
$27.60 |
$27.60 |
$27.60 |
|
|
Culture afb any source
|
$77.37 |
$77.37 |
$77.37 |
|
|
Culture anaerobic additional method definitive id each
|
$54.47 |
$54.47 |
$54.47 |
|
|
Culture anaerobic except blood
|
$254.52 |
$254.52 |
$254.52 |
|
|
Culture bact stool aero addl path ea
|
$105.90 |
$105.90 |
$105.90 |
|
|
Culture body fluid
|
$79.47 |
$79.47 |
$79.49 |
|
|
Culture fungi definitive id mold
|
$83.42 |
$83.42 |
$83.42 |
|
|
Culture fungi definitive id yeast
|
$34.70 |
$34.70 |
$34.70 |
|
|
Culture fungi other (except blood)
|
$77.37 |
$77.37 |
$77.37 |
|
|
Culture fungi skin/hair/nail
|
$77.37 |
$77.37 |
$77.37 |
|
|
Culture mycoplasma any source
|
$122.48 |
$122.48 |
$122.48 |
|
|
Culture quantitative aerobic other source
|
$10.49 |
$10.49 |
$10.49 |
|
|
Culture screening strep group a
|
$120.29 |
$120.29 |
$120.29 |
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$1,093.32 |
$1,093.32 |
$1,093.32 |
|
|
Cv line/pic reposition
|
$1,582.79 |
$1,582.79 |
$1,582.79 |
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$14.87 |
$14.87 |
$14.87 |
|
|
Cyclic citrullinated peptide antibody
|
$99.14 |
$99.14 |
$99.14 |
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$7.88 |
$7.88 |
$7.88 |
|
|
Cyclophosphamide 25 mg capsule
|
$2.67 |
$2.67 |
$2.67 |
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$147.03 |
$147.03 |
$147.03 |
|
|
Cyclosporine modified 25 mg capsule
|
$1.64 |
$1.64 |
$2.48 |
|
|
Cyclosporine oral 100 mg
|
$9.86 |
$9.86 |
$17.00 |
|
|
Cystatin c
|
$175.49 |
$175.49 |
$175.49 |
|
|
Cystogram >= 3 views supervision & interpretation
|
$473.94 |
$473.94 |
$497.66 |
|
|
Cysto, litho, vacuum kidney
|
$7,758.90 |
$7,758.90 |
$7,758.90 |
|
|
Cystoscopy (Bladder Scope)
|
$1,328.63 |
$1,328.63 |
$1,328.63 |
|
|
Cytarabine 20 mg/ml injection solution
|
$13.64 |
$13.64 |
$13.64 |
|
|
Cytomegalovirus (cmv) antibody igg
|
$51.12 |
$51.12 |
$51.12 |
|
|
Cytomegalovirus (cmv) antibody igm
|
$72.51 |
$72.51 |
$72.51 |
|
|
Cytomegalovirus dfa
|
$79.34 |
$79.34 |
$101.58 |
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$121.64 |
$121.64 |
$121.64 |
|
|
Cytopathology concentration technique smears & interpretation
|
$67.86 |
$67.86 |
$71.28 |
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$28.98 |
$28.98 |
$28.98 |
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$31.35 |
$31.35 |
$31.35 |
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$104.07 |
$104.07 |
$104.07 |
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$27.65 |
$27.65 |
$27.65 |
|
|
Cytopath smear other source
|
$26.81 |
$26.81 |
$26.81 |
|
|
Cytopath smear oth prep screen & interp
|
$26.81 |
$26.81 |
$26.81 |
|
|
Dacarbazine 100 mg intravenous solution
|
$13.79 |
$13.79 |
$13.79 |
|
|
Dactinomycin 0.5 mg intravenous solution
|
$3,264.26 |
$3,264.26 |
$3,264.26 |
|
|
Dalbavancin 500 mg intravenous solution
|
$38.24 |
$38.24 |
$38.24 |
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.54 |
$0.54 |
$1.70 |
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$16.64 |
$16.64 |
$16.64 |
|
|
Daunorubicin 5 mg/ml intravenous solution
|
$144.14 |
$144.14 |
$144.14 |
|
|
Deamidated gliadin antibody iga
|
$13.20 |
$13.20 |
$13.20 |
|
|
Debridement (>20 cm) charge pt
|
$188.82 |
$198.27 |
$410.72 |
|
|
Debridement bone <= 20 sq cm
|
$2,147.55 |
$2,147.55 |
$2,147.55 |
|
|
Debridement/bone/20 sq cm or less 11046
|
$471.44 |
$471.44 |
$471.44 |
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$1,264.47 |
$1,264.47 |
$1,264.47 |
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$538.44 |
$538.44 |
$538.44 |
|
|
Debride nail1-5 11720
|
$248.84 |
$248.84 |
$248.84 |
|
|
Debride nail6 or more 11721
|
$248.84 |
$248.84 |
$248.84 |
|