|
C-reactive protein
|
$143.10 |
$143.10 |
$143.10 |
$68.38
|
|
C-reactive protein high sensitivity
|
$143.10 |
$143.10 |
$143.10 |
$85.00
|
|
Creatine kinase
|
$124.20 |
$124.20 |
$124.20 |
$66.30
|
|
Creatinine
|
$105.00 |
$105.00 |
$105.00 |
$44.72
|
|
Creatinine 24 hour urine
|
$159.60 |
$159.60 |
$159.60 |
$58.85
|
|
Creatinine clearance urine
|
$132.60 |
$132.60 |
$132.60 |
$89.50
|
|
#creutz-prot.,western blot
|
$120.00 |
$120.00 |
$120.00 |
$166.20
|
|
Crisis psychotherapy 90839
|
$296.10 |
$296.10 |
$296.10 |
$313.30
|
|
Crisis psychotherapy additional 30 mins 90840
|
$151.80 |
$151.80 |
$151.80 |
$149.52
|
|
Critical care 30-74 minutes
|
$3,422.40 |
$3,422.40 |
$3,422.40 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$136.80 |
$136.80 |
$136.80 |
$731.40
|
|
Crotalidae poly immune fab
|
$12,664.08 |
$12,664.08 |
$12,664.08 |
$5,590.35
|
|
Crystal identification light microscopy
|
$109.50 |
$109.50 |
$109.50 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$4,437.30 |
$4,437.30 |
$4,437.30 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,826.60 |
$2,826.60 |
$2,826.60 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,453.80 |
$1,453.80 |
$1,453.80 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$4,436.10 |
$4,436.10 |
$4,436.10 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$8,874.90 |
$8,874.90 |
$8,874.90 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$4,437.30 |
$4,437.30 |
$4,437.30 |
$1,940.00
|
|
CT Angiogram of the Head
|
$4,436.10 |
$4,436.10 |
$4,436.10 |
$1,996.80
|
|
CT angio pelvis
|
$847.50 |
$847.50 |
$847.50 |
$1,837.80
|
|
CT lower extremity w/contrast (both sides)
|
$2,656.20 |
$2,656.20 |
$2,656.20 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$2,165.70 |
$2,165.70 |
$2,165.70 |
$1,421.85
|
|
Ctlso a-p-l control molded
|
$4,779.03 |
$4,779.03 |
$4,779.03 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$5,253.46 |
$5,253.46 |
$5,253.46 |
$4,186.78
|
|
Ctlso axilla sling
|
$200.86 |
$200.86 |
$200.86 |
$197.97
|
|
Ctlso milwauke initial model
|
$4,867.90 |
$4,867.90 |
$4,867.90 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$983.10 |
$983.10 |
$983.10 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$3,633.90 |
$3,633.90 |
$3,633.90 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$2,708.10 |
$2,708.10 |
$2,708.10 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$5,454.90 |
$5,454.90 |
$5,454.90 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,016.00 |
$2,016.00 |
$2,016.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$408.00 |
$408.00 |
$408.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,582.80 |
$1,582.80 |
$1,582.80 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$87.00 |
$87.00 |
$87.00 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$6,916.20 |
$6,916.20 |
$6,916.20 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$8,254.20 |
$8,254.20 |
$8,254.20 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,967.70 |
$4,967.70 |
$4,967.70 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$824.10 |
$824.10 |
$824.10 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$3,485.40 |
$3,485.40 |
$3,485.40 |
$1,464.00
|
|
CT t-spine w /wo contrast
|
$595.50 |
$595.50 |
$595.50 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$2,828.10 |
$2,828.10 |
$2,828.10 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$2,502.00 |
$2,502.00 |
$2,502.00 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$495.90 |
$495.90 |
$495.90 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$2,347.50 |
$2,347.50 |
$2,347.50 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$81.90 |
$81.90 |
$81.90 |
$68.64
|
|
Culture afb any source
|
$98.70 |
$98.70 |
$98.70 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$319.80 |
$319.80 |
$319.80 |
$79.00
|
|
Culture anaerobic except blood
|
$213.00 |
$213.00 |
$213.00 |
$120.00
|
|
Culture body fluid
|
$114.90 |
$114.90 |
$114.90 |
$126.75
|
|
Culture fungi definitive id mold
|
$137.10 |
$137.10 |
$137.10 |
$77.28
|
|
Culture fungi definitive id yeast
|
$140.10 |
$140.10 |
$140.10 |
$79.10
|
|
Culture fungi other (except blood)
|
$108.30 |
$108.30 |
$108.30 |
$108.00
|
|
Culture mycobacteria definitive id each isolate
|
$140.10 |
$140.10 |
$140.10 |
$89.70
|
|
Culture typing added method
|
$137.10 |
$137.10 |
$137.10 |
$38.58
|
|
Culture typing immunologic
|
$36.60 |
$36.60 |
$36.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$378.60 |
$378.60 |
$378.60 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$64.20 |
$64.20 |
$64.20 |
$133.90
|
|
Culture urine each isolate
|
$47.40 |
$47.40 |
$47.40 |
$57.00
|
|
Cutter lead
|
$9,505.12 |
$9,505.12 |
$9,505.12 |
$6,092.06
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$48.00 |
$48.00 |
$48.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$46.80 |
$46.80 |
$46.80 |
$70.72
|
|
Cyclosporine modified 25 mg capsule
|
$7.49 |
$7.49 |
$7.49 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$48.00 |
$48.00 |
$48.00 |
$34.88
|
|
Cygnus, per sq cm
|
$11,981.25 |
$11,981.25 |
$11,981.25 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$38,795.42 |
$38,795.42 |
$38,795.42 |
$22,803.38
|
|
Cyp2c9 gene com variants
|
$275.40 |
$275.40 |
$275.40 |
$275.10
|
|
Cyp3a4 gene common variants
|
$262.20 |
$262.20 |
$262.20 |
$245.31
|
|
Cyp3a5 gene common variants
|
$262.20 |
$262.20 |
$262.20 |
$245.31
|
|
Cystoscopy and treatment
|
$773.10 |
$773.10 |
$773.10 |
$2,874.36
|
|
Cystoscopy and treatment
|
$773.10 |
$773.10 |
$773.10 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$3,878.50 |
$3,878.50 |
$3,878.50 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$773.10 |
$773.10 |
$773.10 |
$3,786.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$773.10 |
$773.10 |
$773.10 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$91.44 |
$91.44 |
$91.44 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$75.30 |
$75.30 |
$75.30 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$201.90 |
$201.90 |
$201.90 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$203.40 |
$203.40 |
$203.40 |
$159.45
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$52.80 |
$52.80 |
$52.80 |
$67.20
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$93.90 |
$93.90 |
$93.90 |
$187.28
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$211.50 |
$211.50 |
$211.50 |
$209.23
|
|
Dch validity tests
|
$12.00 |
$12.00 |
$12.00 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$20.10 |
$20.10 |
$20.10 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$242.70 |
$242.70 |
$242.70 |
$668.55
|
|
Debridement bone <= 20 sq cm
|
$625.20 |
$625.20 |
$625.20 |
$2,316.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$155.70 |
$155.70 |
$155.70 |
$810.50
|
|
Debride skin bone at fx site
|
$1,076.70 |
$1,076.70 |
$1,076.70 |
$3,015.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$242.70 |
$242.70 |
$242.70 |
$1,160.00
|
|
Decalcification
|
$68.40 |
$68.40 |
$68.40 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$318.30 |
$318.30 |
$318.30 |
$543.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$92.70 |
$92.70 |
$92.70 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$48.60 |
$48.60 |
$48.60 |
$408.10
|
|
Dermapure 1 square cm
|
$5,311.69 |
$5,311.69 |
$5,311.69 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$129.11 |
$129.11 |
$129.11 |
$89.78
|
|
Destruction benign lesions < 14 lesions
|
$75.30 |
$75.30 |
$75.30 |
$235.13
|
|
Device ablt adv novasure
|
$12,913.12 |
$12,913.12 |
$12,913.12 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$6,656.25 |
$6,656.25 |
$6,656.25 |
$4,200.00
|
|
Device sut capio slim opn
|
$3,045.90 |
$3,045.90 |
$3,045.90 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$2,466.14 |
$2,466.14 |
$2,466.14 |
$2,541.00
|
|
Dexametha opth insert 0.1 mg
|
$7,603.20 |
$7,603.20 |
$7,603.20 |
$888.47
|