|
Clot factor viii reltd antgn
|
$1,288.06 |
$1,288.06 |
$1,288.06 |
$158.20
|
|
Clot factor xii hageman
|
$1,307.56 |
$1,307.56 |
$1,307.56 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$800.88 |
$800.88 |
$800.88 |
$55.44
|
|
Clsd ostomy pouch w/flange
|
$17.00 |
$17.00 |
$17.00 |
$3.53
|
|
#cms hgb-sulfhemoglobin
|
$503.61 |
$503.61 |
$503.61 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$797.45 |
$797.45 |
$797.45 |
$100.80
|
|
Cmv pcr-sendout
|
$1,771.43 |
$1,771.43 |
$1,771.43 |
$177.50
|
|
Coagulation time activated teg
|
$554.42 |
$554.42 |
$554.42 |
$53.72
|
|
Cocaine 4 % nasal solution
|
$613.55 |
$613.55 |
$613.55 |
$629.41
|
|
Coch imp ext proc/contr rplc
|
$38,232.00 |
$38,232.00 |
$38,232.00 |
$20,146.35
|
|
Cold agglutinin screen (arc)
|
$324.79 |
$324.79 |
$324.79 |
$45.00
|
|
Cold agglutinin titer
|
$613.65 |
$613.65 |
$613.65 |
$50.00
|
|
Colistimethate sodium inj
|
$1,547.08 |
$1,547.08 |
$1,547.08 |
$68.47
|
|
Collar extrication adult univ
|
$8,554.00 |
$8,554.00 |
$8,554.00 |
$764.15
|
|
Collection of venous blood by venipuncture
|
$95.17 |
$95.17 |
$95.17 |
$21.00
|
|
Compatibility test each unit immediate spin technique
|
$797.45 |
$797.45 |
$797.45 |
$169.52
|
|
Compatibility test incubate
|
$610.22 |
$610.22 |
$610.22 |
$155.40
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,452.79 |
$1,452.79 |
$1,452.79 |
$871.08
|
|
Connect omega .5mm
|
$4,579.00 |
$4,579.00 |
$4,579.00 |
$1,260.00
|
|
Connector tis 2x10mm
|
$19,025.00 |
$19,025.00 |
$19,025.00 |
$4,091.00
|
|
Consultation pathology during surgery
|
$411.89 |
$411.89 |
$411.89 |
$100.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$769.55 |
$769.55 |
$769.55 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,138.67 |
$1,138.67 |
$1,138.67 |
$225.96
|
|
Consult comp w/report rfrd material
|
$1,019.07 |
$1,019.07 |
$1,019.07 |
$365.60
|
|
Contrast baths charges
|
$353.38 |
$353.38 |
$353.38 |
$70.50
|
|
Contrast exam thoracic aorta 75605-26
|
$17,448.09 |
$17,448.09 |
$17,448.09 |
$3,728.24
|
|
Controler lvad heartmate 3 includes ebb
|
$58,320.00 |
$58,320.00 |
$58,320.00 |
$13,218.75
|
|
Coombs indirect titer reference
|
$902.53 |
$902.53 |
$902.53 |
$146.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$225.35 |
$225.35 |
$225.35 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$582.23 |
$582.23 |
$582.23 |
$110.00
|
|
Covid-19 administration immunization im inj 1st/only component
|
$139.86 |
$139.86 |
$139.86 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$765.28 |
$765.28 |
$765.28 |
$592.49
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$765.28 |
$765.28 |
$765.28 |
$551.64
|
|
Covid-19 lab test non-cdc
|
$85.24 |
$85.24 |
$85.24 |
$80.50
|
|
Cranial cervical torticollis
|
$6,073.00 |
$6,073.00 |
$6,073.00 |
$573.85
|
|
Crbrospnl fld flw imag cistern
|
$8,518.31 |
$8,518.31 |
$8,518.31 |
$1,240.80
|
|
C-reactive protein
|
$449.73 |
$449.73 |
$449.73 |
$68.38
|
|
C-reactive protein high sensitivity
|
$544.87 |
$544.87 |
$544.87 |
$85.00
|
|
Creatine kinase
|
$557.86 |
$557.86 |
$557.86 |
$66.30
|
|
Creatine kinase isoenzymes
|
$853.23 |
$853.23 |
$853.23 |
$56.80
|
|
Creatine kinase mb
|
$1,102.76 |
$1,102.76 |
$1,102.76 |
$114.00
|
|
Creatinine clearance urine
|
$938.44 |
$938.44 |
$938.44 |
$89.50
|
|
Critical care each additional 30 minutes
|
$4,656.60 |
$4,656.60 |
$4,656.60 |
$731.40
|
|
Crotalidae poly immune fab
|
$50,366.52 |
$50,366.52 |
$50,366.52 |
$5,590.35
|
|
Cryofibrinogen qualitative - sendout
|
$682.44 |
$682.44 |
$682.44 |
$52.50
|
|
Cryptococcus abs qn - sendout
|
$749.69 |
$749.69 |
$749.69 |
$89.70
|
|
Crystal identification light microscopy
|
$512.00 |
$512.00 |
$512.00 |
$62.50
|
|
CT 3d report other modality w/workstation
|
$2,484.05 |
$2,484.05 |
$2,484.05 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$8,653.83 |
$8,653.83 |
$8,653.83 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$8,653.83 |
$8,653.83 |
$8,653.83 |
$1,940.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$16,023.88 |
$16,023.88 |
$16,023.88 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$5,006.32 |
$5,006.32 |
$5,006.32 |
$1,940.00
|
|
CT angio pelvis
|
$8,653.83 |
$8,653.83 |
$8,653.83 |
$1,837.80
|
|
CT bone density axial
|
$4.55 |
$4.55 |
$4.55 |
$387.62
|
|
CT colonography dx
|
$10,025.36 |
$10,025.36 |
$10,025.36 |
$791.00
|
|
CT colonography dx w/dye
|
$10,680.70 |
$10,680.70 |
$10,680.70 |
$1,037.00
|
|
CT colonography screening
|
$9,675.75 |
$9,675.75 |
$9,675.75 |
$1,084.20
|
|
CT neck soft tissue w/contrast
|
$5,838.58 |
$5,838.58 |
$5,838.58 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$5,307.80 |
$5,307.80 |
$5,307.80 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$6,392.00 |
$6,392.00 |
$6,392.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$8,724.61 |
$8,724.61 |
$8,724.61 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$6,547.69 |
$6,547.69 |
$6,547.69 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$5,896.61 |
$5,896.61 |
$5,896.61 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$11,999.86 |
$11,999.86 |
$11,999.86 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$10,683.54 |
$10,683.54 |
$10,683.54 |
$2,971.80
|
|
CT thoracic spine w/contrast
|
$5,838.58 |
$5,838.58 |
$5,838.58 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$6,392.00 |
$6,392.00 |
$6,392.00 |
$1,464.00
|
|
CT t-spine w /wo contrast
|
$5,994.28 |
$5,994.28 |
$5,994.28 |
$2,027.52
|
|
CT uppr extremity w/o&w/dye
|
$11,668.66 |
$11,668.66 |
$11,668.66 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$547.94 |
$547.94 |
$547.94 |
$68.64
|
|
Culture afb any source
|
$949.90 |
$949.90 |
$949.90 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$687.40 |
$687.40 |
$687.40 |
$79.00
|
|
Culture anaerobic except blood
|
$1,012.57 |
$1,012.57 |
$1,012.57 |
$120.00
|
|
Culture fungi definitive id mold
|
$626.64 |
$626.64 |
$626.64 |
$77.28
|
|
Culture fungi definitive id yeast
|
$436.36 |
$436.36 |
$436.36 |
$79.10
|
|
Culture fungi other (except blood)
|
$1,019.07 |
$1,019.07 |
$1,019.07 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$1,077.91 |
$1,077.91 |
$1,077.91 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$428.34 |
$428.34 |
$428.34 |
$89.70
|
|
Culture mycoplasma any source
|
$273.97 |
$273.97 |
$273.97 |
$85.26
|
|
Culture typing immunologic
|
$238.06 |
$238.06 |
$238.06 |
$44.00
|
|
Culture urine each isolate
|
$557.86 |
$557.86 |
$557.86 |
$57.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$107.51 |
$107.51 |
$107.51 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$670.98 |
$670.98 |
$670.98 |
$70.72
|
|
Cyclosporine 2 hour
|
$1,202.87 |
$1,202.87 |
$1,202.87 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$63.00 |
$63.00 |
$63.00 |
$7.48
|
|
Cytogenetics 25-99
|
$721.78 |
$721.78 |
$721.78 |
$190.00
|
|
Cytomegalovirus ag ia
|
$238.06 |
$238.06 |
$238.06 |
$38.58
|
|
Cytomegalovirus (cmv) antibody igm
|
$853.23 |
$853.23 |
$853.23 |
$97.50
|
|
Cytomeg dna dir probe
|
$1,411.11 |
$1,411.11 |
$1,411.11 |
$178.88
|
|
Cytopath fl nongyn filter
|
$521.95 |
$521.95 |
$521.95 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$600.67 |
$600.67 |
$600.67 |
$159.45
|
|
Cytopathology concentration technique smears & interpretation
|
$600.67 |
$600.67 |
$600.67 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$753.12 |
$753.12 |
$753.12 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$631.61 |
$631.61 |
$631.61 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$992.71 |
$992.71 |
$992.71 |
$209.23
|
|
Cytopath smear other source
|
$326.70 |
$326.70 |
$326.70 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$424.91 |
$424.91 |
$424.91 |
$96.20
|
|
Cytopath tbs c/v manual
|
$283.91 |
$283.91 |
$283.91 |
$59.28
|
|
Dalbavancin 500 mg intravenous solution
|
$9,178.63 |
$9,178.63 |
$9,178.63 |
$3,480.35
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$5,437.80 |
$5,437.80 |
$5,437.80 |
$6,072.48
|
