|
CT Angiogram of the Head
|
$559.65 |
$559.65 |
$559.65 |
$1,971.45
|
|
CT angio hrt w/3d image
|
$559.65 |
$559.65 |
$559.65 |
$1,477.35
|
|
CT angio pelvis
|
$617.10 |
$617.10 |
$617.10 |
$1,819.20
|
|
Cta upper extremity w &/or without contrast left
|
$587.70 |
$587.70 |
$587.70 |
$1,689.80
|
|
CT bone density axial
|
$518.25 |
$518.25 |
$518.25 |
$384.80
|
|
CT colonography dx
|
$559.65 |
$559.65 |
$559.65 |
$791.00
|
|
CT colonography dx w/dye
|
$518.25 |
$518.25 |
$518.25 |
$1,018.60
|
|
CT guidance for needle placement
|
$559.65 |
$559.65 |
$559.65 |
$1,476.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$83.10 |
$83.10 |
$83.10 |
$1,146.60
|
|
CT guid parench tis ablat
|
$559.65 |
$559.65 |
$559.65 |
$1,267.50
|
|
CT heart w/evaluation of calcium without contrast
|
$7.35 |
$7.35 |
$7.35 |
$187.72
|
|
CT hrt c+ strux cgen hrt ds
|
$518.25 |
$518.25 |
$518.25 |
$1,344.85
|
|
CT hrt w/3d image
|
$518.25 |
$518.25 |
$518.25 |
$1,375.40
|
|
CT limited or localized follow-up study
|
$559.65 |
$559.65 |
$559.65 |
$640.48
|
|
CT lower extremity w/contrast (both sides)
|
$559.65 |
$559.65 |
$559.65 |
$1,585.20
|
|
CT lower extremity without contrast (both sides)
|
$531.75 |
$531.75 |
$531.75 |
$1,403.73
|
|
CT lwr extremity w/o&w/dye
|
$587.70 |
$587.70 |
$587.70 |
$1,818.96
|
|
CT neck soft tissue w/contrast
|
$559.65 |
$559.65 |
$559.65 |
$1,633.50
|
|
CT neck soft tissue without contrast
|
$531.75 |
$531.75 |
$531.75 |
$1,318.20
|
|
CT neck soft tissue without & w/contrast
|
$587.70 |
$587.70 |
$587.70 |
$1,945.13
|
|
CT orbit/sella/fossa w/wo contrast
|
$587.70 |
$587.70 |
$587.70 |
$1,707.60
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$559.65 |
$559.65 |
$559.65 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$559.65 |
$559.65 |
$559.65 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$96.75 |
$96.75 |
$96.75 |
$437.04
|
|
CT scan for localization
|
$559.65 |
$559.65 |
$559.65 |
$1,202.37
|
|
CT scan for therapy guide
|
$191.40 |
$191.40 |
$191.40 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$587.70 |
$587.70 |
$587.70 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$559.65 |
$559.65 |
$559.65 |
$2,928.00
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$531.75 |
$531.75 |
$531.75 |
$2,325.05
|
|
CT thoracic spine w/contrast
|
$559.65 |
$559.65 |
$559.65 |
$1,686.06
|
|
CT thoracic spine without contrast
|
$531.75 |
$531.75 |
$531.75 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$91.05 |
$91.05 |
$91.05 |
$341.04
|
|
CT t-spine w /wo contrast
|
$587.70 |
$587.70 |
$587.70 |
$2,020.20
|
|
CT upper extremity w/contrast (both sides)
|
$559.65 |
$559.65 |
$559.65 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$531.75 |
$531.75 |
$531.75 |
$1,420.00
|
|
CT uppr extremity w/o&w/dye
|
$587.70 |
$587.70 |
$587.70 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$532.95 |
$532.95 |
$532.95 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$14.25 |
$14.25 |
$14.25 |
$68.64
|
|
Culture afb any source
|
$18.90 |
$18.90 |
$18.90 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$14.25 |
$14.25 |
$14.25 |
$78.60
|
|
Culture anaerobic except blood
|
$16.50 |
$16.50 |
$16.50 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$16.50 |
$16.50 |
$16.50 |
$51.20
|
|
Culture body fluid
|
$15.15 |
$15.15 |
$15.15 |
$125.45
|
|
Culture fungi definitive id mold
|
$18.00 |
$18.00 |
$18.00 |
$75.75
|
|
Culture fungi definitive id yeast
|
$18.00 |
$18.00 |
$18.00 |
$79.00
|
|
Culture fungi other (except blood)
|
$14.70 |
$14.70 |
$14.70 |
$105.95
|
|
Culture fungi skin/hair/nail
|
$13.50 |
$13.50 |
$13.50 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$19.20 |
$19.20 |
$19.20 |
$88.40
|
|
Culture mycoplasma any source
|
$25.95 |
$25.95 |
$25.95 |
$85.26
|
|
Culture quantitative aerobic other source
|
$16.50 |
$16.50 |
$16.50 |
$90.00
|
|
Culture screening strep group a
|
$11.70 |
$11.70 |
$11.70 |
$80.51
|
|
Culture typing added method
|
$9.00 |
$9.00 |
$9.00 |
$38.58
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$294.30 |
$294.30 |
$294.30 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$61.50 |
$61.50 |
$61.50 |
$130.38
|
|
Culture urine each isolate
|
$14.25 |
$14.25 |
$14.25 |
$54.60
|
|
Culture virus isolation
|
$18.75 |
$18.75 |
$18.75 |
$163.70
|
|
Cutter lead
|
$10,030.83 |
$10,030.83 |
$10,030.83 |
$6,092.06
|
|
Cv line/pic reposition
|
$536.55 |
$536.55 |
$536.55 |
$1,719.44
|
|
Cyanocobalamin unsat binding capacity
|
$25.20 |
$25.20 |
$25.20 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$17.09 |
$17.09 |
$17.09 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$12.15 |
$12.15 |
$12.15 |
$70.98
|
|
Cyclosporine 2 hour
|
$31.65 |
$31.65 |
$31.65 |
$128.80
|
|
Cymetra injectable
|
$282.35 |
$282.35 |
$282.35 |
$578.24
|
|
Cyp2c19 gene com variants
|
$419.85 |
$419.85 |
$419.85 |
$487.50
|
|
Cyp2c9 gene com variants
|
$224.70 |
$224.70 |
$224.70 |
$275.10
|
|
Cyp2d6 gene com variants
|
$678.45 |
$678.45 |
$678.45 |
$553.80
|
|
Cystatin c
|
$20.85 |
$20.85 |
$20.85 |
$76.05
|
|
Cystic fibrosis cftr
|
$1,039.65 |
$1,039.65 |
$1,039.65 |
$1,060.00
|
|
Cystine urine quantitative
|
$29.55 |
$29.55 |
$29.55 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$119.55 |
$119.55 |
$119.55 |
$539.55
|
|
Cystoscopy and treatment
|
$1,345.50 |
$1,345.50 |
$1,345.50 |
$2,874.36
|
|
Cystoscopy (Bladder Scope)
|
$271.35 |
$271.35 |
$271.35 |
$1,493.80
|
|
Cystourethroscop/calib/dilat stric 52281
|
$437.10 |
$437.10 |
$437.10 |
$3,220.80
|
|
Cytarabine 20 mg/ml injection solution
|
$17.70 |
$17.70 |
$17.70 |
$89.94
|
|
Cytogenetics 25-99
|
$33.60 |
$33.60 |
$33.60 |
$190.00
|
|
Cytogenetics 3-5
|
$21.90 |
$21.90 |
$21.90 |
$165.00
|
|
Cytogenom microarray copy nmbr var
|
$532.35 |
$532.35 |
$532.35 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$25.20 |
$25.20 |
$25.20 |
$94.50
|
|
Cytomegalovirus (cmv) antibody igm
|
$28.50 |
$28.50 |
$28.50 |
$97.00
|
|
Cytopath c/v index add-on
|
$10.35 |
$10.35 |
$10.35 |
$35.57
|
|
Cytopath fl nongyn filter
|
$74.70 |
$74.70 |
$74.70 |
$96.48
|
|
Cytopathology cellular enhancement technique non-gyn
|
$77.55 |
$77.55 |
$77.55 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$23.40 |
$23.40 |
$23.40 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$35.40 |
$35.40 |
$35.40 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$64.05 |
$64.05 |
$64.05 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$51.45 |
$51.45 |
$51.45 |
$128.00
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$9.75 |
$9.75 |
$9.75 |
$66.60
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$47.40 |
$47.40 |
$47.40 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$86.10 |
$86.10 |
$86.10 |
$207.50
|
|
Cytopath smear other source
|
$43.65 |
$43.65 |
$43.65 |
$88.13
|
|
Cytopath smear other source
|
$64.05 |
$64.05 |
$64.05 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$52.50 |
$52.50 |
$52.50 |
$95.00
|
|
Cytopath tbs c/v manual
|
$18.60 |
$18.60 |
$18.60 |
$59.28
|
|
Cytotoxic antibody screening
|
$31.80 |
$31.80 |
$31.80 |
$96.46
|
|
Dalbavancin 500 mg intravenous solution
|
$1,856.69 |
$1,856.69 |
$1,856.69 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$105.52 |
$105.52 |
$105.52 |
$168.53
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$2,570.80 |
$2,570.80 |
$2,570.80 |
$6,269.40
|
|
Dark field exam spec collj
|
$6.30 |
$6.30 |
$6.30 |
$31.20
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$1,271.85 |
$1,271.85 |
$1,271.85 |
$3,774.81
|
|
Dch pulmonary stress test
|
$247.50 |
$247.50 |
$247.50 |
$963.30
|
