|
CT Angiogram of the Chest (for blood clot)
|
$672.54 |
$672.54 |
$672.54 |
$1,940.00
|
|
CT Angiogram of the Head
|
$646.47 |
$646.47 |
$646.47 |
$2,021.40
|
|
CT angio hrt w/3d image
|
$491.70 |
$491.70 |
$491.70 |
$1,555.00
|
|
CT angio pelvis
|
$680.46 |
$680.46 |
$680.46 |
$1,865.33
|
|
Cta upper extremity w &/or without contrast left
|
$633.93 |
$633.93 |
$633.93 |
$1,698.32
|
|
CT guidance for needle placement
|
$752.73 |
$752.73 |
$752.73 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,731.51 |
$1,731.51 |
$1,731.51 |
$1,113.84
|
|
CT guid parench tis ablat
|
$279.51 |
$279.51 |
$279.51 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$183.48 |
$183.48 |
$183.48 |
$201.29
|
|
CT hrt c+ strux cgen hrt ds
|
$387.42 |
$387.42 |
$387.42 |
$1,395.79
|
|
CT hrt w/3d image
|
$515.13 |
$515.13 |
$515.13 |
$1,399.72
|
|
CT limited or localized follow-up study
|
$344.52 |
$344.52 |
$344.52 |
$648.96
|
|
CT lower extremity w/contrast (both sides)
|
$751.41 |
$751.41 |
$751.41 |
$1,619.25
|
|
CT lower extremity without contrast (both sides)
|
$391.38 |
$391.38 |
$391.38 |
$1,403.73
|
|
CT lwr extremity w/o&w/dye
|
$906.84 |
$906.84 |
$906.84 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$608.52 |
$608.52 |
$608.52 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$471.90 |
$471.90 |
$471.90 |
$1,363.35
|
|
CT neck soft tissue without & w/contrast
|
$617.43 |
$617.43 |
$617.43 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$426.36 |
$426.36 |
$426.36 |
$1,726.50
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$391.71 |
$391.71 |
$391.71 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$331.32 |
$331.32 |
$331.32 |
$1,369.73
|
|
Ctrl nosebld postir subsq 30906
|
$463.32 |
$463.32 |
$463.32 |
$450.77
|
|
CT scan for localization
|
$283.14 |
$283.14 |
$283.14 |
$1,205.14
|
|
CT scan for therapy guide
|
$233.31 |
$233.31 |
$233.31 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$768.57 |
$768.57 |
$768.57 |
$3,575.60
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$756.69 |
$756.69 |
$756.69 |
$2,985.60
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$597.63 |
$597.63 |
$597.63 |
$2,418.75
|
|
CT thoracic spine w/contrast
|
$495.66 |
$495.66 |
$495.66 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$527.01 |
$527.01 |
$527.01 |
$1,468.80
|
|
CT thorax low dose for lung screening without contrast
|
$151.14 |
$151.14 |
$151.14 |
$363.18
|
|
CT t-spine w /wo contrast
|
$582.45 |
$582.45 |
$582.45 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$686.73 |
$686.73 |
$686.73 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$400.62 |
$400.62 |
$400.62 |
$1,468.84
|
|
CT uppr extremity w/o&w/dye
|
$863.28 |
$863.28 |
$863.28 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$232.98 |
$232.98 |
$232.98 |
$67.20
|
|
Culture afb any source
|
$257.07 |
$257.07 |
$257.07 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$282.81 |
$282.81 |
$282.81 |
$76.73
|
|
Culture anaerobic except blood
|
$196.02 |
$196.02 |
$196.02 |
$119.20
|
|
Culture bact stool aero addl path ea
|
$21.12 |
$21.12 |
$21.12 |
$52.50
|
|
Culture body fluid
|
$218.13 |
$218.13 |
$218.13 |
$125.45
|
|
Culture fungi definitive id mold
|
$281.82 |
$281.82 |
$281.82 |
$74.83
|
|
Culture fungi definitive id yeast
|
$24.42 |
$24.42 |
$24.42 |
$79.00
|
|
Culture fungi other (except blood)
|
$66.00 |
$66.00 |
$66.00 |
$105.60
|
|
Culture quantitative aerobic other source
|
$304.92 |
$304.92 |
$304.92 |
$87.02
|
|
Culture screening strep group a
|
$223.08 |
$223.08 |
$223.08 |
$84.81
|
|
Culture typing immunologic
|
$13.53 |
$13.53 |
$13.53 |
$40.32
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$179.85 |
$179.85 |
$179.85 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$788.37 |
$788.37 |
$788.37 |
$123.76
|
|
Cv line/pic reposition
|
$2,704.35 |
$2,704.35 |
$2,704.35 |
$1,742.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$17.75 |
$17.75 |
$17.75 |
$25.86
|
|
Cyclic citrullinated peptide antibody
|
$97.35 |
$97.35 |
$97.35 |
$72.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$1,038.30 |
$1,038.30 |
$1,038.30 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$49.50 |
$49.50 |
$49.50 |
$126.00
|
|
Cyclosporine modified 25 mg capsule
|
$61.16 |
$61.16 |
$61.16 |
$7.48
|
|
Cyp2c19 gene com variants
|
$692.34 |
$692.34 |
$692.34 |
$481.20
|
|
Cystatin c
|
$72.27 |
$72.27 |
$72.27 |
$78.75
|
|
Cystine urine quantitative
|
$52.14 |
$52.14 |
$52.14 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$784.41 |
$784.41 |
$784.41 |
$552.00
|
|
Cystoscopy (Bladder Scope)
|
$1,064.91 |
$1,064.91 |
$1,064.91 |
$1,594.35
|
|
Cytomegalovirus (cmv) antibody igg
|
$170.61 |
$170.61 |
$170.61 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$68.97 |
$68.97 |
$68.97 |
$95.00
|
|
Cytopath fl nongyn filter
|
$59.40 |
$59.40 |
$59.40 |
$82.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$74.91 |
$74.91 |
$74.91 |
$162.50
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$39.27 |
$39.27 |
$39.27 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$68.31 |
$68.31 |
$68.31 |
$141.70
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$52.14 |
$52.14 |
$52.14 |
$132.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$16.17 |
$16.17 |
$16.17 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$223.74 |
$223.74 |
$223.74 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$122.43 |
$122.43 |
$122.43 |
$207.50
|
|
Cytopath tbs c/v redo
|
$24.42 |
$24.42 |
$24.42 |
$76.32
|
|
Dalbavancin 500 mg intravenous solution
|
$23,482.21 |
$23,482.21 |
$23,482.21 |
$3,358.00
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$307.97 |
$307.97 |
$307.97 |
$307.97
|
|
D&c after delivery 59160
|
$2,322.21 |
$2,322.21 |
$2,322.21 |
$3,827.25
|
|
Dch validity tests
|
$6.27 |
$6.27 |
$6.27 |
$25.00
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$1,458.60 |
$1,458.60 |
$1,458.60 |
$4,627.00
|
|
Deamidated gliadin antibody iga
|
$66.99 |
$66.99 |
$66.99 |
$45.31
|
|
Debridement (>20 cm) charge pt
|
$851.40 |
$851.40 |
$851.40 |
$263.90
|
|
Debridement bone <= 20 sq cm
|
$3,525.06 |
$3,525.06 |
$3,525.06 |
$2,436.70
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,026.63 |
$1,026.63 |
$1,026.63 |
$688.80
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$2,430.12 |
$2,430.12 |
$2,430.12 |
$1,418.55
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,459.92 |
$1,459.92 |
$1,459.92 |
$820.15
|
|
Debride nail1-5 11720
|
$27.72 |
$27.72 |
$27.72 |
$170.24
|
|
Debride nail6 or more 11721
|
$45.21 |
$45.21 |
$45.21 |
$179.25
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$933.24 |
$933.24 |
$933.24 |
$663.30
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$1,001.88 |
$1,001.88 |
$1,001.88 |
$1,149.50
|
|
Debr inf skin add-on 11001
|
$180.84 |
$180.84 |
$180.84 |
$169.60
|
|
Debr musc/fascia 20sq cm/< 11043
|
$1,553.31 |
$1,553.31 |
$1,553.31 |
$1,193.40
|
|
Decalcification
|
$40.26 |
$40.26 |
$40.26 |
$70.40
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$2,074.71 |
$2,074.71 |
$2,074.71 |
$540.00
|
|
Delivery of placenta 59414
|
$2,778.27 |
$2,778.27 |
$2,778.27 |
$3,135.14
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$274.89 |
$274.89 |
$274.89 |
$193.05
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$205.59 |
$205.59 |
$205.59 |
$414.78
|
|
Descend thora aorta rpr/lt sub art 33880
|
$12,780.90 |
$12,780.90 |
$12,780.90 |
$5,976.81
|
|
Desmopressin 4 mcg/ml injection solution
|
$1,504.65 |
$1,504.65 |
$1,504.65 |
$93.84
|
|
Des thora aorta rpr without left sub art 33881
|
$7,777.11 |
$7,777.11 |
$7,777.11 |
$5,698.68
|
|
Des thor aorta/prox ext prosth/ini 33883
|
$2,660.79 |
$2,660.79 |
$2,660.79 |
$2,727.20
|
|
Destroy internal hemorrhoids destroy 46930
|
$2,889.48 |
$2,889.48 |
$2,889.48 |
$1,388.56
|
|
Destroy premlg lesns;1st lesn 17000
|
$234.30 |
$234.30 |
$234.30 |
$215.05
|
|
Destruction 2-14 lesions 17003
|
$126.06 |
$126.06 |
$126.06 |
$78.61
|
|
Destruction benign lesions < 14 lesions
|
$115.83 |
$115.83 |
$115.83 |
$248.80
|