|
Crotalidae poly immune fab
|
$16,021.98 |
$16,021.98 |
$16,021.98 |
$5,590.35
|
|
Crystal identification light microscopy
|
$39.60 |
$39.60 |
$39.60 |
$62.50
|
|
CT 3d report other modality w/workstation
|
$298.50 |
$298.50 |
$298.50 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$898.50 |
$898.50 |
$898.50 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$627.30 |
$627.30 |
$627.30 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$872.10 |
$872.10 |
$872.10 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$898.50 |
$898.50 |
$898.50 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$898.50 |
$898.50 |
$898.50 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$718.80 |
$718.80 |
$718.80 |
$1,940.00
|
|
CT Angiogram of the Head
|
$898.50 |
$898.50 |
$898.50 |
$1,996.80
|
|
CT heart w/evaluation of calcium without contrast
|
$305.00 |
$305.00 |
$305.00 |
$171.60
|
|
CT lower extremity w/contrast (both sides)
|
$985.20 |
$985.20 |
$985.20 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$422.70 |
$422.70 |
$422.70 |
$1,421.85
|
|
Ctlso a-p-l control molded
|
$2,969.73 |
$2,969.73 |
$2,969.73 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$3,264.54 |
$3,264.54 |
$3,264.54 |
$4,186.78
|
|
Ctlso axilla sling
|
$124.81 |
$124.81 |
$124.81 |
$197.97
|
|
Ctlso milwauke initial model
|
$3,024.95 |
$3,024.95 |
$3,024.95 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$1,268.40 |
$1,268.40 |
$1,268.40 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$748.50 |
$748.50 |
$748.50 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$422.70 |
$422.70 |
$422.70 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$898.50 |
$898.50 |
$898.50 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$898.50 |
$898.50 |
$898.50 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$863.40 |
$863.40 |
$863.40 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$422.70 |
$422.70 |
$422.70 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$144.60 |
$144.60 |
$144.60 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$898.50 |
$898.50 |
$898.50 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$718.80 |
$718.80 |
$718.80 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$696.30 |
$696.30 |
$696.30 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$871.20 |
$871.20 |
$871.20 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$422.70 |
$422.70 |
$422.70 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$123.60 |
$123.60 |
$123.60 |
$331.50
|
|
CT upper extremity w/contrast (both sides)
|
$899.70 |
$899.70 |
$899.70 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$422.70 |
$422.70 |
$422.70 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$951.30 |
$951.30 |
$951.30 |
$1,845.36
|
|
Cuffs adj lock with active con
|
$1,458.76 |
$1,458.76 |
$1,458.76 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$70.20 |
$70.20 |
$70.20 |
$68.64
|
|
Culture afb any source
|
$124.20 |
$124.20 |
$124.20 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$140.10 |
$140.10 |
$140.10 |
$79.00
|
|
Culture anaerobic except blood
|
$64.20 |
$64.20 |
$64.20 |
$120.00
|
|
Culture body fluid
|
$64.50 |
$64.50 |
$64.50 |
$126.75
|
|
Culture fungi definitive id mold
|
$48.30 |
$48.30 |
$48.30 |
$77.28
|
|
Culture fungi definitive id yeast
|
$96.30 |
$96.30 |
$96.30 |
$79.10
|
|
Culture fungi other (except blood)
|
$129.30 |
$129.30 |
$129.30 |
$108.00
|
|
Culture screening strep group a
|
$18.00 |
$18.00 |
$18.00 |
$81.00
|
|
Culture typing added method
|
$137.10 |
$137.10 |
$137.10 |
$38.58
|
|
Culture typing immunologic
|
$15.00 |
$15.00 |
$15.00 |
$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
|
$89.70 |
$89.70 |
$89.70 |
$133.90
|
|
Culture urine each isolate
|
$47.40 |
$47.40 |
$47.40 |
$57.00
|
|
Cutter lead
|
$5,906.56 |
$5,906.56 |
$5,906.56 |
$6,092.06
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$9.00 |
$9.00 |
$9.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$123.00 |
$123.00 |
$123.00 |
$70.72
|
|
Cygnus, per sq cm
|
$7,445.25 |
$7,445.25 |
$7,445.25 |
$356.54
|
|
Cylinder pump set 20cm titan zero angl
|
$24,107.80 |
$24,107.80 |
$24,107.80 |
$22,803.38
|
|
Cyp3a4 gene common variants
|
$262.20 |
$262.20 |
$262.20 |
$245.31
|
|
Cyp3a5 gene common variants
|
$262.20 |
$262.20 |
$262.20 |
$245.31
|
|
Cystatin c
|
$57.60 |
$57.60 |
$57.60 |
$77.50
|
|
Cystoscopy and treatment
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$2,874.36
|
|
Cystoscopy and treatment
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$3,203.50
|
|
Cystoscopy (Bladder Scope)
|
$434.70 |
$434.70 |
$434.70 |
$1,493.80
|
|
Cystoscopy & ureter catheter
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$3,786.00
|
|
Cystourethroscop/calib/dilat stric 52281
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$3,065.15
|
|
Cytarabine 20 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$89.94
|
|
Cytomegalovirus (cmv) antibody igg
|
$38.40 |
$38.40 |
$38.40 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$59.10 |
$59.10 |
$59.10 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$90.60 |
$90.60 |
$90.60 |
$159.45
|
|
Dacarbazine 100 mg intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$58.22
|
|
Deamidated gliadin antibody iga
|
$20.10 |
$20.10 |
$20.10 |
$43.60
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$403.50 |
$403.50 |
$403.50 |
$668.55
|
|
Debridement bone <= 20 sq cm
|
$1,041.90 |
$1,041.90 |
$1,041.90 |
$2,316.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$14,045.87 |
$14,045.87 |
$14,045.87 |
$810.50
|
|
Debride skin bone at fx site
|
$1,794.30 |
$1,794.30 |
$1,794.30 |
$3,015.00
|
|
Debr musc/fascia 20sq cm/< 11043
|
$403.50 |
$403.50 |
$403.50 |
$1,160.00
|
|
Decalcification
|
$18.00 |
$18.00 |
$18.00 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$378.00 |
$378.00 |
$378.00 |
$543.00
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$148.50 |
$148.50 |
$148.50 |
$185.17
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$9,395.91 |
$9,395.91 |
$9,395.91 |
$6,324.98
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$81.00 |
$81.00 |
$81.00 |
$408.10
|
|
Dermapure 1 square cm
|
$3,300.73 |
$3,300.73 |
$3,300.73 |
$3,822.00
|
|
Desmopressin 4 mcg/ml injection solution
|
$62.70 |
$62.70 |
$62.70 |
$89.78
|
|
Destruction benign lesions < 14 lesions
|
$125.70 |
$125.70 |
$125.70 |
$235.13
|
|
Device ablt adv novasure
|
$8,024.32 |
$8,024.32 |
$8,024.32 |
$6,097.50
|
|
Device hemospray 7frx220cm endo hemostat min access
|
$4,136.25 |
$4,136.25 |
$4,136.25 |
$4,200.00
|
|
Device sut capio slim opn
|
$1,892.75 |
$1,892.75 |
$1,892.75 |
$1,894.50
|
|
Device tiss remov myosure reach
|
$1,532.48 |
$1,532.48 |
$1,532.48 |
$2,541.00
|
|
Dexametha opth insert 0.1 mg
|
$3,667.20 |
$3,667.20 |
$3,667.20 |
$888.47
|
|
Dexamethasone 0.4 mg/0.1 ml intraocular injection - cnr
|
$3,927.00 |
$3,927.00 |
$3,927.00 |
$21.00
|
|
Dexamethasone 4 mg tablet
|
$9.00 |
$9.00 |
$9.00 |
$5.85
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$14.52 |
$14.52 |
$14.52 |
$21.17
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$84.00 |
$84.00 |
$84.00 |
$38.08
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$84.00 |
$84.00 |
$84.00 |
$45.40
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$84.00 |
$84.00 |
$84.00 |
$47.48
|
|
Dhea-s (dehydroepiand sulfate)
|
$105.60 |
$105.60 |
$105.60 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$43.80 |
$43.80 |
$43.80 |
$79.20
|
|
Diagnostic anoscopy spx 46600
|
$81.00 |
$81.00 |
$81.00 |
$190.68
|
|
Diagnostic laryngoscopy 31575
|
$124.50 |
$124.50 |
$124.50 |
$331.58
|
|
Diagnostic Mammogram (both breasts)
|
$180.60 |
$180.60 |
$180.60 |
$399.30
|
|
Diagnostic Mammogram (one breast)
|
$153.00 |
$153.00 |
$153.00 |
$301.55
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$55.54 |
$55.54 |
$55.54 |
$74.76
|
|
Diffusing capacity
|
$240.60 |
$240.60 |
$240.60 |
$332.00
|