|
C-reactive protein
|
$1,151.01 |
$1,151.01 |
$1,151.01 |
$61.10
|
|
C-reactive protein high sensitivity
|
$1,151.01 |
$1,151.01 |
$1,151.01 |
$91.20
|
|
Creatine kinase
|
$635.94 |
$635.94 |
$635.94 |
$58.30
|
|
Creatine kinase isoenzymes
|
$3,564.83 |
$3,564.83 |
$3,564.83 |
$49.40
|
|
Creatine kinase mb
|
$2,052.81 |
$2,052.81 |
$2,052.81 |
$105.95
|
|
Creatinine
|
$670.68 |
$670.68 |
$670.68 |
$42.50
|
|
Creatinine clearance urine
|
$990.90 |
$990.90 |
$990.90 |
$85.80
|
|
Critical care each additional 30 minutes
|
$5,600.00 |
$5,600.00 |
$5,600.00 |
$756.00
|
|
Crotalidae poly immune fab
|
$7,192.81 |
$7,192.81 |
$7,192.81 |
$6,208.33
|
|
Cryptococcus abs qn - sendout
|
$1,838.30 |
$1,838.30 |
$1,838.30 |
$80.85
|
|
Crystal identification light microscopy
|
$540.77 |
$540.77 |
$540.77 |
$58.50
|
|
Csf leakage imaging
|
$7,914.89 |
$7,914.89 |
$7,914.89 |
$1,433.25
|
|
CT 3d report other modality w/workstation
|
$4,813.97 |
$4,813.97 |
$4,813.97 |
$613.47
|
|
CT angio hrt w/3d image
|
$30,135.45 |
$30,135.45 |
$30,135.45 |
$1,601.60
|
|
CT bone density axial
|
$2,040.37 |
$2,040.37 |
$2,040.37 |
$338.69
|
|
CT cerebral perf w cont & prcssng
|
$19,001.19 |
$19,001.19 |
$19,001.19 |
$858.00
|
|
CT guidance for needle placement
|
$13,978.69 |
$13,978.69 |
$13,978.69 |
$1,506.04
|
|
CT heart w/evaluation of calcium without contrast
|
$15,226.10 |
$15,226.10 |
$15,226.10 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$24,784.41 |
$24,784.41 |
$24,784.41 |
$1,217.45
|
|
CT hrt w/3d image
|
$24,785.45 |
$24,785.45 |
$24,785.45 |
$1,477.35
|
|
CT limited or localized follow-up study
|
$8,075.92 |
$8,075.92 |
$8,075.92 |
$630.50
|
|
CT thorax low dose for lung screening without contrast
|
$146.06 |
$146.06 |
$146.06 |
$420.60
|
|
Culture anaerobic except blood
|
$1,487.87 |
$1,487.87 |
$1,487.87 |
$120.00
|
|
Culture fungi definitive id mold
|
$1,151.01 |
$1,151.01 |
$1,151.01 |
$70.00
|
|
Culture fungi definitive id yeast
|
$770.36 |
$770.36 |
$770.36 |
$79.00
|
|
Culture fungi skin/hair/nail
|
$1,252.22 |
$1,252.22 |
$1,252.22 |
$76.05
|
|
Culture mycobacteria definitive id each isolate
|
$1,661.57 |
$1,661.57 |
$1,661.57 |
$88.14
|
|
Culture mycoplasma any source
|
$1,705.37 |
$1,705.37 |
$1,705.37 |
$90.37
|
|
Culture typing added method
|
$500.00 |
$500.00 |
$500.00 |
$34.45
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$500.00 |
$500.00 |
$500.00 |
$101.45
|
|
Culture urine each isolate
|
$500.00 |
$500.00 |
$500.00 |
$46.20
|
|
Cv line/pic reposition
|
$1,626.17 |
$1,626.17 |
$1,626.17 |
$1,789.77
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$74.82 |
$74.82 |
$74.82 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$583.06 |
$583.06 |
$583.06 |
$85.03
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$810.90 |
$810.90 |
$810.90 |
$150.79
|
|
Cyclosporine 2 hour
|
$4,483.23 |
$4,483.23 |
$4,483.23 |
$119.40
|
|
Cyclosporine oral 100 mg
|
$37.40 |
$37.40 |
$37.40 |
$42.97
|
|
Cyp3a4 gene common variants
|
$879.12 |
$879.12 |
$879.12 |
$230.01
|
|
Cyp3a5 gene common variants
|
$879.12 |
$879.12 |
$879.12 |
$220.50
|
|
Cystatin c
|
$265.85 |
$265.85 |
$265.85 |
$82.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$8,153.13 |
$8,153.13 |
$8,153.13 |
$527.50
|
|
Cytogenom microarray copy nmbr var
|
$249.23 |
$249.23 |
$249.23 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$271.90 |
$271.90 |
$271.90 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$2,320.15 |
$2,320.15 |
$2,320.15 |
$101.94
|
|
Cytomegalovirus dfa
|
$367.06 |
$367.06 |
$367.06 |
$51.20
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$521.12 |
$521.12 |
$521.12 |
$84.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$225.07 |
$225.07 |
$225.07 |
$185.00
|
|
Cytopath smear other source
|
$1,450.11 |
$1,450.11 |
$1,450.11 |
$85.80
|
|
Cytopath smear oth prep screen & interp
|
$1,450.11 |
$1,450.11 |
$1,450.11 |
$95.00
|
|
Cytp urine 3-5 probes cmptr
|
$2,746.14 |
$2,746.14 |
$2,746.14 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$281.88 |
$281.88 |
$281.88 |
$61.64
|
|
Debridement (>20 cm) charge pt
|
$211.75 |
$211.75 |
$211.75 |
$262.60
|
|
Decalcification
|
$900.28 |
$900.28 |
$900.28 |
$75.38
|
|
Deferoxamine 500 mg solution for injection
|
$86.84 |
$86.84 |
$86.84 |
$112.87
|
|
Degarelix 120 mg subcutaneous solution
|
$1,161.42 |
$1,161.42 |
$1,161.42 |
$1,963.06
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,756.62 |
$7,756.62 |
$7,756.62 |
$7,737.00
|
|
Dermagraft
|
$55.00 |
$55.00 |
$55.00 |
$220.24
|
|
Design mlc device for imrt
|
$582.00 |
$582.00 |
$582.00 |
$1,641.90
|
|
Dextran 40 infusion
|
$2,057.15 |
$2,057.15 |
$2,057.15 |
$173.97
|
|
Dhea-s (dehydroepiand sulfate)
|
$1,549.80 |
$1,549.80 |
$1,549.80 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$646.51 |
$646.51 |
$646.51 |
$78.03
|
|
Diagnostic digital breast tomosynthesis bil
|
$2,028.47 |
$2,028.47 |
$2,028.47 |
$117.94
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$149.62 |
$149.62 |
$149.62 |
$67.89
|
|
Diffusing capacity
|
$2,495.62 |
$2,495.62 |
$2,495.62 |
$357.50
|
|
Digoxin immune fab 40 mg intravenous solution
|
$6,992.23 |
$6,992.23 |
$6,992.23 |
$9,684.65
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$367.38 |
$367.38 |
$367.38 |
$308.90
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$145.63 |
$145.63 |
$145.63 |
$100.80
|
|
Discography cerv/thor spine
|
$4,793.41 |
$4,793.41 |
$4,793.41 |
$2,360.70
|
|
Dissolve clot heart vessel
|
$8,428.59 |
$8,428.59 |
$8,428.59 |
$1,274.40
|
|
Dlyd plmt xtn prosth ea addl
|
$8,332.67 |
$8,332.67 |
$8,332.67 |
$2,001.55
|
|
Dna antibody native/double stranded
|
$2,936.46 |
$2,936.46 |
$2,936.46 |
$101.40
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$22,984.58 |
$22,984.58 |
$22,984.58 |
$712.02
|
|
Doppler intravascular pressure flow initial vessel
|
$5,571.36 |
$5,571.36 |
$5,571.36 |
$3,006.25
|
|
Doxycycline hyclate 100 mg intravenous powder for solution
|
$1,074.29 |
$1,074.29 |
$1,074.29 |
$89.34
|
|
Dpyd gene common variants
|
$879.12 |
$879.12 |
$879.12 |
$380.50
|
|
Drain cath image guided peri/retroperitoneal transvag/transrectal
|
$5,864.46 |
$5,864.46 |
$5,864.46 |
$2,529.45
|
|
Drain cath image guided visceral pq
|
$5,864.46 |
$5,864.46 |
$5,864.46 |
$2,996.80
|
|
Drug admin & hemodynmic meas
|
$1,121.65 |
$1,121.65 |
$1,121.65 |
$542.23
|
|
Drug assay voriconazole
|
$112.00 |
$112.00 |
$112.00 |
$96.75
|
|
Drvvt confirm - quest
|
$320.23 |
$320.23 |
$320.23 |
$102.30
|
|
Dxa bone density axl vrt fx
|
$489.22 |
$489.22 |
$489.22 |
$374.00
|
|
Ecg/1-3 leads/tracing only 93041
|
$1,336.52 |
$1,336.52 |
$1,336.52 |
$129.83
|
|
Ecg external < 48 hours recording
|
$5,259.41 |
$5,259.41 |
$5,259.41 |
$461.76
|
|
Ecg external < 48 hours scanning analysis w/report
|
$5,259.41 |
$5,259.41 |
$5,259.41 |
$567.00
|
|
Echocardiogram (Heart Ultrasound)
|
$17,578.77 |
$17,578.77 |
$17,578.77 |
$2,049.45
|
|
Echo exam uterus 76831-
|
$2,202.15 |
$2,202.15 |
$2,202.15 |
$547.23
|
|
Echo guidance radiotherapy
|
$5,989.43 |
$5,989.43 |
$5,989.43 |
$769.18
|
|
Echo transesophageal
|
$2,838.75 |
$2,838.75 |
$2,838.75 |
$913.33
|
|
Echo transesophageal
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$577.22
|
|
Echo transesophageal intraop
|
$3,989.65 |
$3,989.65 |
$3,989.65 |
$1,571.70
|
|
Eculizumab 300 mg/30 ml intravenous solution
|
$15,216.85 |
$15,216.85 |
$15,216.85 |
$17,641.10
|
|
Eeg/cerebral death evaluation only 95824 -26
|
$4,843.75 |
$4,843.75 |
$4,843.75 |
$1,048.30
|
|
Eeg recording awake and asleep
|
$5,144.85 |
$5,144.85 |
$5,144.85 |
$1,030.27
|
|
Eeg without vid 2-12hr cont mntr
|
$6,102.44 |
$6,102.44 |
$6,102.44 |
$684.75
|
|
Eeg without vid 2-12 hr unmntr
|
$5,155.13 |
$5,155.13 |
$5,155.13 |
$526.57
|
|
Eeg without vid ea 12-26hr cont
|
$7,596.11 |
$7,596.11 |
$7,596.11 |
$1,167.64
|
|
Eeg without vid ea 12-26hr intmt
|
$6,908.75 |
$6,908.75 |
$6,908.75 |
$1,126.20
|
|
Eeg wo vid 2-12hr intmt mntr
|
$12,398.76 |
$12,398.76 |
$12,398.76 |
$593.91
|
|
E equine encephalitis igg
|
$383.68 |
$383.68 |
$383.68 |
$48.73
|
|
Egfr gene com variants
|
$3,245.80 |
$3,245.80 |
$3,245.80 |
$646.75
|
