|
#cms hgb-sulfhemoglobin
|
$689.31 |
$689.31 |
$689.31 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$562.42 |
$562.42 |
$562.42 |
$100.20
|
|
Cmv pcr-sendout
|
$2,446.92 |
$2,446.92 |
$2,446.92 |
$177.10
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$27,260.04 |
$27,260.04 |
$27,260.04 |
$8,980.00
|
|
Coagulation time lee & white
|
$450.97 |
$450.97 |
$450.97 |
$11.20
|
|
Cocaine 4 % nasal solution
|
$1,545.32 |
$1,545.32 |
$1,545.32 |
$629.41
|
|
Cold agglutinin screen (arc)
|
$257.51 |
$257.51 |
$257.51 |
$45.00
|
|
Cold agglutinin titer
|
$552.15 |
$552.15 |
$552.15 |
$50.00
|
|
Colistimethate sodium inj
|
$1,188.28 |
$1,188.28 |
$1,188.28 |
$68.47
|
|
Collagen dressing <=16 sq in
|
$343.00 |
$343.00 |
$343.00 |
$42.50
|
|
Collar cerv adlt perfit ace extric
|
$9.00 |
$9.00 |
$9.00 |
$70.00
|
|
Collar extrication adult univ
|
$5,339.00 |
$5,339.00 |
$5,339.00 |
$764.15
|
|
Compatibility test each unit electronic
|
$541.86 |
$541.86 |
$541.86 |
$174.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$6,383.00 |
$6,383.00 |
$6,383.00 |
$1,350.27
|
|
Conivaptan hcl
|
$10,558.75 |
$10,558.75 |
$10,558.75 |
$1,625.08
|
|
Conjugated estrogens 25 mg solution for injection
|
$2,623.95 |
$2,623.95 |
$2,623.95 |
$871.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$3,316.95 |
$3,316.95 |
$3,316.95 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$908.81 |
$908.81 |
$908.81 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$908.81 |
$908.81 |
$908.81 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$1,408.60 |
$1,408.60 |
$1,408.60 |
$224.80
|
|
Contrast exam thoracic aorta 75605-26
|
$7,512.63 |
$7,512.63 |
$7,512.63 |
$3,728.24
|
|
Controler lvad heartmate 3 includes ebb
|
$36,401.00 |
$36,401.00 |
$36,401.00 |
$13,218.75
|
|
Coombs indirect titer reference
|
$366.94 |
$366.94 |
$366.94 |
$146.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$1,795.47 |
$1,795.47 |
$1,795.47 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$105.38 |
$105.38 |
$105.38 |
$55.90
|
|
#covid19rsv-rsv
|
$648.16 |
$648.16 |
$648.16 |
$145.60
|
|
C-peptide
|
$1,210.58 |
$1,210.58 |
$1,210.58 |
$97.30
|
|
Cranial cervical torticollis
|
$3,791.00 |
$3,791.00 |
$3,791.00 |
$483.65
|
|
Crbrospnl fld flw imag cistern
|
$2,039.19 |
$2,039.19 |
$2,039.19 |
$1,240.80
|
|
C-reactive protein high sensitivity
|
$596.73 |
$596.73 |
$596.73 |
$85.00
|
|
Creatine kinase isoenzymes
|
$728.76 |
$728.76 |
$728.76 |
$57.50
|
|
Crotalidae poly immune fab
|
$27,171.61 |
$27,171.61 |
$27,171.61 |
$5,590.35
|
|
Cryofibrinogen qualitative - sendout
|
$2,563.51 |
$2,563.51 |
$2,563.51 |
$52.50
|
|
Cryptococcus abs qn - sendout
|
$720.20 |
$720.20 |
$720.20 |
$89.70
|
|
CT angio pelvis
|
$7,912.56 |
$7,912.56 |
$7,912.56 |
$1,837.80
|
|
CT guidance for needle placement
|
$5,306.52 |
$5,306.52 |
$5,306.52 |
$1,494.00
|
|
CT limited or localized follow-up study
|
$1,318.11 |
$1,318.11 |
$1,318.11 |
$642.75
|
|
Culture bact stool aero addl path ea
|
$33.04 |
$33.04 |
$33.04 |
$51.51
|
|
Culture fungi definitive id mold
|
$848.78 |
$848.78 |
$848.78 |
$76.72
|
|
Culture fungi definitive id yeast
|
$651.60 |
$651.60 |
$651.60 |
$79.10
|
|
Culture fungi skin/hair/nail
|
$26.99 |
$26.99 |
$26.99 |
$74.75
|
|
Culture mycobacteria definitive id each isolate
|
$334.37 |
$334.37 |
$334.37 |
$89.70
|
|
Culture quantitative aerobic other source
|
$34.62 |
$34.62 |
$34.62 |
$90.35
|
|
Culture typing added method
|
$27.09 |
$27.09 |
$27.09 |
$38.58
|
|
Culture typing immunologic
|
$538.43 |
$538.43 |
$538.43 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$122.82 |
$122.82 |
$122.82 |
$133.90
|
|
Culture urine each isolate
|
$514.42 |
$514.42 |
$514.42 |
$57.00
|
|
Cyanocobalamin unsat binding capacity
|
$2,143.42 |
$2,143.42 |
$2,143.42 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$44.53 |
$44.53 |
$44.53 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$543.56 |
$543.56 |
$543.56 |
$70.98
|
|
Cyclophosphamide 25 mg capsule
|
$176.57 |
$176.57 |
$176.57 |
$19.49
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$116.10 |
$116.10 |
$116.10 |
$140.78
|
|
Cyclosporine 2 hour
|
$1,176.30 |
$1,176.30 |
$1,176.30 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$39.30 |
$39.30 |
$39.30 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$108.13 |
$108.13 |
$108.13 |
$34.88
|
|
Cygnus matrix, per sq cm
|
$16,919.00 |
$16,919.00 |
$16,919.00 |
$295.20
|
|
Cyp2c9 gene com variants
|
$564.14 |
$564.14 |
$564.14 |
$275.10
|
|
Cystatin c
|
$373.80 |
$373.80 |
$373.80 |
$77.50
|
|
Cystogram >= 3 views supervision & interpretation
|
$1,582.68 |
$1,582.68 |
$1,582.68 |
$539.55
|
|
Cytomegalovirus (cmv) antibody igg
|
$946.52 |
$946.52 |
$946.52 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$1,191.73 |
$1,191.73 |
$1,191.73 |
$97.50
|
|
Cytopath c/v manual
|
$447.56 |
$447.56 |
$447.56 |
$36.80
|
|
Cytopath fl nongyn filter
|
$324.08 |
$324.08 |
$324.08 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$627.59 |
$627.59 |
$627.59 |
$159.45
|
|
Cytopathology concentration technique smears & interpretation
|
$193.76 |
$193.76 |
$193.76 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$708.19 |
$708.19 |
$708.19 |
$129.28
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$207.49 |
$207.49 |
$207.49 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$252.07 |
$252.07 |
$252.07 |
$208.60
|
|
Cytopath smear other source
|
$133.74 |
$133.74 |
$133.74 |
$88.13
|
|
Cytopath smear other source
|
$193.76 |
$193.76 |
$193.76 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$133.74 |
$133.74 |
$133.74 |
$96.20
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$307.00 |
$307.00 |
$307.00 |
$168.53
|
|
Dch validity tests
|
$411.55 |
$411.55 |
$411.55 |
$24.50
|
|
Decalcification
|
$308.65 |
$308.65 |
$308.65 |
$68.90
|
|
Deferoxamine 500 mg solution for injection
|
$186.69 |
$186.69 |
$186.69 |
$95.85
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$876.21 |
$876.21 |
$876.21 |
$185.40
|
|
Desmopressin 4 mcg/ml injection solution
|
$539.84 |
$539.84 |
$539.84 |
$91.56
|
|
Detect agent nos dna dir
|
$759.62 |
$759.62 |
$759.62 |
$115.20
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$426.42 |
$426.42 |
$426.42 |
$227.15
|
|
Dextran 40 infusion
|
$1,966.51 |
$1,966.51 |
$1,966.51 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$344.47 |
$344.47 |
$344.47 |
$39.60
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$308.09 |
$308.09 |
$308.09 |
$45.80
|
|
Dextrose 5 % IV bolus
|
$344.47 |
$344.47 |
$344.47 |
$48.00
|
|
Dhea-s (dehydroepiand sulfate)
|
$2,285.73 |
$2,285.73 |
$2,285.73 |
$112.00
|
|
Diagnostic digital breast tomosynthesis bil
|
$291.63 |
$291.63 |
$291.63 |
$117.94
|
|
Diagnostic Mammogram (both breasts)
|
$1,548.59 |
$1,548.59 |
$1,548.59 |
$399.30
|
|
Diagnostic radio unlisted proc
|
$399.70 |
$399.70 |
$399.70 |
$214.08
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$258.90 |
$258.90 |
$258.90 |
$74.17
|
|
Dicyclomine injection
|
$331.08 |
$331.08 |
$331.08 |
$153.29
|
|
Digoxin immune fab 40 mg intravenous solution
|
$29,688.15 |
$29,688.15 |
$29,688.15 |
$10,079.82
|
|
Dihydroergotamine 0.05 mg/ml IV syringe - cnr
|
$1,697.24 |
$1,697.24 |
$1,697.24 |
$297.86
|
|
Dilate biliary duct/ampulla
|
$9,008.29 |
$9,008.29 |
$9,008.29 |
$1,866.73
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$39.07 |
$39.07 |
$39.07 |
$17.75
|
|
Diphtheria-tetanus toxoids 0.5 ml (peds)
|
$509.34 |
$509.34 |
$509.34 |
$91.53
|
|
Dna antibody native/double stranded
|
$908.81 |
$908.81 |
$908.81 |
$95.80
|
|
Dna gardnerella
|
$365.23 |
$365.23 |
$365.23 |
$62.50
|
|
Dna trichomonas
|
$365.23 |
$365.23 |
$365.23 |
$67.80
|
|
Doppler echo complete
|
$2,935.65 |
$2,935.65 |
$2,935.65 |
$531.50
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$4,956.19 |
$4,956.19 |
$4,956.19 |
$662.35
|
|
Dorsi & plantar flex ass/res
|
$589.00 |
$589.00 |
$589.00 |
$163.50
|
