|
CT Angiogram of Abdomen and Pelvis
|
$2,336.50 |
$2,336.50 |
$2,336.50 |
$2,842.40
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,141.00 |
$1,141.00 |
$1,141.00 |
$1,912.50
|
|
CT Angiogram of the Head
|
$1,397.00 |
$1,397.00 |
$1,397.00 |
$1,946.10
|
|
CT angio hrt w/3d image
|
$1,030.00 |
$1,030.00 |
$1,030.00 |
$1,424.40
|
|
CT angio pelvis
|
$1,317.50 |
$1,317.50 |
$1,317.50 |
$1,795.97
|
|
Cta upper extremity w &/or without contrast left
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$1,681.50
|
|
CT cerebral perf w cont & prcssng
|
$1,040.00 |
$1,040.00 |
$1,040.00 |
$1,040.00
|
|
CT colonography dx
|
$575.50 |
$575.50 |
$575.50 |
$797.40
|
|
CT colonography screening
|
$969.50 |
$969.50 |
$969.50 |
$1,079.57
|
|
CT guidance for needle placement
|
$1,329.50 |
$1,329.50 |
$1,329.50 |
$1,498.20
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$3,265.50 |
$3,265.50 |
$3,265.50 |
$1,178.52
|
|
CT guid parench tis ablat
|
$736.50 |
$736.50 |
$736.50 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$189.50 |
$189.50 |
$189.50 |
$156.00
|
|
CT hrt c+ strux cgen hrt ds
|
$1,412.00 |
$1,412.00 |
$1,412.00 |
$1,371.50
|
|
CT hrt w/3d image
|
$899.50 |
$899.50 |
$899.50 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$454.50 |
$454.50 |
$454.50 |
$633.60
|
|
CT lower extremity w/contrast (both sides)
|
$972.00 |
$972.00 |
$972.00 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$876.50 |
$876.50 |
$876.50 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$1,818.96
|
|
CT neck soft tissue w/contrast
|
$1,443.00 |
$1,443.00 |
$1,443.00 |
$1,603.55
|
|
CT neck soft tissue without contrast
|
$1,312.00 |
$1,312.00 |
$1,312.00 |
$1,312.00
|
|
CT neck soft tissue without & w/contrast
|
$1,587.00 |
$1,587.00 |
$1,587.00 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,313.00 |
$1,313.00 |
$1,313.00 |
$1,543.00
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,193.50 |
$1,193.50 |
$1,193.50 |
$1,345.05
|
|
Ctrl nosebld postir subsq 30906
|
$638.00 |
$638.00 |
$638.00 |
$444.50
|
|
CT scan for localization
|
$578.00 |
$578.00 |
$578.00 |
$1,205.14
|
|
CT scan for therapy guide
|
$519.50 |
$519.50 |
$519.50 |
$656.13
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,840.50 |
$2,840.50 |
$2,840.50 |
$3,408.50
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,362.00 |
$2,362.00 |
$2,362.00 |
$2,871.05
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,147.00 |
$2,147.00 |
$2,147.00 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$1,190.50 |
$1,190.50 |
$1,190.50 |
$1,655.85
|
|
CT thoracic spine without contrast
|
$1,082.00 |
$1,082.00 |
$1,082.00 |
$1,430.20
|
|
CT thorax low dose for lung screening without contrast
|
$1,188.00 |
$1,188.00 |
$1,188.00 |
$332.00
|
|
CT t-spine w /wo contrast
|
$1,309.00 |
$1,309.00 |
$1,309.00 |
$1,968.47
|
|
CT upper extremity w/contrast (both sides)
|
$1,099.50 |
$1,099.50 |
$1,099.50 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$993.50 |
$993.50 |
$993.50 |
$1,404.36
|
|
CT uppr extremity w/o&w/dye
|
$1,199.00 |
$1,199.00 |
$1,199.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$170.00 |
$170.00 |
$170.00 |
$71.40
|
|
Culture afb any source
|
$228.50 |
$228.50 |
$228.50 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$134.50 |
$134.50 |
$134.50 |
$84.76
|
|
Culture anaerobic except blood
|
$365.50 |
$365.50 |
$365.50 |
$120.54
|
|
Culture bacteria anaerobic
|
$148.00 |
$148.00 |
$148.00 |
$84.24
|
|
Culture bact stool aero addl path ea
|
$143.00 |
$143.00 |
$143.00 |
$52.50
|
|
Culture body fluid
|
$242.00 |
$242.00 |
$242.00 |
$126.00
|
|
Culture fungi definitive id mold
|
$129.00 |
$129.00 |
$129.00 |
$80.00
|
|
Culture fungi definitive id yeast
|
$118.50 |
$118.50 |
$118.50 |
$79.50
|
|
Culture fungi other (except blood)
|
$240.00 |
$240.00 |
$240.00 |
$109.20
|
|
Culture mycobacteria definitive id each isolate
|
$160.50 |
$160.50 |
$160.50 |
$100.00
|
|
Culture mycoplasma any source
|
$44.00 |
$44.00 |
$44.00 |
$81.62
|
|
Culture quantitative aerobic other source
|
$241.50 |
$241.50 |
$241.50 |
$90.35
|
|
Culture screening strep group a
|
$248.00 |
$248.00 |
$248.00 |
$83.16
|
|
Culture typing immunologic
|
$114.00 |
$114.00 |
$114.00 |
$43.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$339.00 |
$339.00 |
$339.00 |
$138.40
|
|
Culture urine each isolate
|
$181.50 |
$181.50 |
$181.50 |
$54.78
|
|
Cv line/pic reposition
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$1,608.00
|
|
Cyanocobalamin unsat binding capacity
|
$17.00 |
$17.00 |
$17.00 |
$58.65
|
|
Cyclic citrullinated peptide antibody
|
$177.00 |
$177.00 |
$177.00 |
$72.15
|
|
Cyclosporine 2 hour
|
$344.00 |
$344.00 |
$344.00 |
$129.48
|
|
Cyp2c19 gene com variants
|
$130.00 |
$130.00 |
$130.00 |
$502.45
|
|
Cyp2c9 gene com variants
|
$597.00 |
$597.00 |
$597.00 |
$266.50
|
|
Cyp2d6 gene com variants
|
$217.00 |
$217.00 |
$217.00 |
$573.65
|
|
Cyp3a4 gene common variants
|
$120.00 |
$120.00 |
$120.00 |
$241.24
|
|
Cyp3a5 gene common variants
|
$120.00 |
$120.00 |
$120.00 |
$245.31
|
|
Cystatin c
|
$171.50 |
$171.50 |
$171.50 |
$76.48
|
|
Cystic fibrosis cftr
|
$1,900.00 |
$1,900.00 |
$1,900.00 |
$1,104.40
|
|
Cystine urine quantitative
|
$68.00 |
$68.00 |
$68.00 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,281.50 |
$1,281.50 |
$1,281.50 |
$564.85
|
|
Cystoscopy and treatment
|
$1,310.00 |
$1,310.00 |
$1,310.00 |
$2,874.36
|
|
Cystoscopy and treatment
|
$1,199.00 |
$1,199.00 |
$1,199.00 |
$2,850.95
|
|
Cystoscopy (Bladder Scope)
|
$467.50 |
$467.50 |
$467.50 |
$1,445.41
|
|
Cystoscopy implant stent
|
$1,742.50 |
$1,742.50 |
$1,742.50 |
$4,081.37
|
|
Cystoscopy removal of clots
|
$1,660.50 |
$1,660.50 |
$1,660.50 |
$4,051.50
|
|
Cystoscopy & ureter catheter
|
$1,042.50 |
$1,042.50 |
$1,042.50 |
$3,688.80
|
|
Cystostomy cystotomy w/drainage 51040
|
$7,679.00 |
$7,679.00 |
$7,679.00 |
$3,863.60
|
|
Cysto/uretero w/lithotripsy
|
$4,105.00 |
$4,105.00 |
$4,105.00 |
$7,573.50
|
|
Cystourethroscop/calib/dilat stric 52281
|
$767.00 |
$767.00 |
$767.00 |
$3,131.20
|
|
Cytogenom microarray copy nmbr var
|
$1,854.00 |
$1,854.00 |
$1,854.00 |
$1,564.68
|
|
Cytomegalovirus (cmv) antibody igg
|
$217.50 |
$217.50 |
$217.50 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$222.50 |
$222.50 |
$222.50 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$97.00 |
$97.00 |
$97.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$62.00 |
$62.00 |
$62.00 |
$86.86
|
|
Cytopathology concentration technique smears & interpretation
|
$85.50 |
$85.50 |
$85.50 |
$131.36
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$49.50 |
$49.50 |
$49.50 |
$124.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$43.00 |
$43.00 |
$43.00 |
$68.51
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$67.50 |
$67.50 |
$67.50 |
$189.67
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$185.50 |
$185.50 |
$185.50 |
$209.92
|
|
Cytotoxic antibody screening
|
$783.00 |
$783.00 |
$783.00 |
$193.80
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$6,103.00 |
$6,103.00 |
$6,103.00 |
$3,774.81
|
|
Dch validity tests
|
$57.00 |
$57.00 |
$57.00 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$11.00 |
$11.00 |
$11.00 |
$42.75
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$543.00 |
$543.00 |
$543.00 |
$278.50
|
|
Debridement bone <= 20 sq cm
|
$3,872.00 |
$3,872.00 |
$3,872.00 |
$2,293.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$1,455.00 |
$1,455.00 |
$1,455.00 |
$687.35
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$4,344.50 |
$4,344.50 |
$4,344.50 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$1,999.50 |
$1,999.50 |
$1,999.50 |
$820.15
|
|
Debride nail1-5 11720
|
$342.00 |
$342.00 |
$342.00 |
$149.04
|
|
Debride nail6 or more 11721
|
$357.50 |
$357.50 |
$357.50 |
$167.63
|
|
Debride/rmv fb/open fx/skin/sq/musc11011
|
$2,084.50 |
$2,084.50 |
$2,084.50 |
$1,149.50
|
