|
Calcitonin (salmon) 200 unit/ml injection solution
|
$347.76 |
$347.76 |
$347.76 |
$2,802.31
|
|
Calcium 24 hour urine
|
$336.96 |
$336.96 |
$336.96 |
$51.75
|
|
Calcium chloride 100 mg/ml (10 %) intravenous syringe
|
$129.60 |
$129.60 |
$129.60 |
$55.47
|
|
Calcium gluconate 2 gram/100 ml in sodium chloride,iso-osm IV solution
|
$233.28 |
$233.28 |
$233.28 |
$92.91
|
|
Calcium ionized
|
$576.72 |
$576.72 |
$576.72 |
$88.40
|
|
Calprotectin fecal
|
$709.56 |
$709.56 |
$709.56 |
$169.20
|
|
Carbamazepine total therapeutic drug level
|
$585.36 |
$585.36 |
$585.36 |
$117.74
|
|
Carboprost tromethamine 250 mcg/ml intramuscular solution
|
$465.00 |
$465.00 |
$465.00 |
$455.00
|
|
Carboxyhemoglobin quantitative
|
$401.76 |
$401.76 |
$401.76 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$555.12 |
$555.12 |
$555.12 |
$146.25
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$4,597.56 |
$4,597.56 |
$4,597.56 |
$2,752.20
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$95.04 |
$95.04 |
$95.04 |
$129.60
|
|
Carotid Artery Ultrasound (Duplex)
|
$3,624.48 |
$3,624.48 |
$3,624.48 |
$1,068.06
|
|
Ceftazidime and avibactam
|
$1,040.04 |
$1,040.04 |
$1,040.04 |
$995.91
|
|
Cefuroxime in ns IV syringe 30 mg/ml (neo/ped) - cnr
|
$105.84 |
$105.84 |
$105.84 |
$27.18
|
|
Chest 2 vws w oblique
|
$921.44 |
$921.44 |
$921.44 |
$377.06
|
|
Chest apical lordotic proj
|
$958.88 |
$958.88 |
$958.88 |
$303.21
|
|
Chest CT scan (with and without contrast)
|
$5,550.48 |
$5,550.48 |
$5,550.48 |
$2,014.50
|
|
Chest CT scan (with contrast)
|
$4,987.84 |
$4,987.84 |
$4,987.84 |
$1,701.60
|
|
Chest X-ray
|
$933.92 |
$933.92 |
$933.92 |
$302.90
|
|
Chest X-ray (single view)
|
$847.60 |
$847.60 |
$847.60 |
$246.94
|
|
Chlamydia culture
|
$933.12 |
$933.12 |
$933.12 |
$94.90
|
|
Chlamydia type
|
$749.52 |
$749.52 |
$749.52 |
$34.80
|
|
Chloride
|
$162.00 |
$162.00 |
$162.00 |
$39.05
|
|
Chloride 24 hour urine
|
$127.44 |
$127.44 |
$127.44 |
$46.13
|
|
Chloroprocaine hcl injection
|
$268.92 |
$268.92 |
$268.92 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$105.84 |
$105.84 |
$105.84 |
$355.99
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$447.12 |
$447.12 |
$447.12 |
$91.92
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,096.64 |
$2,096.64 |
$2,096.64 |
$625.60
|
|
Cholesterol
|
$382.32 |
$382.32 |
$382.32 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$867.24 |
$867.24 |
$867.24 |
$115.70
|
|
Chromatography
|
$657.72 |
$657.72 |
$657.72 |
$77.00
|
|
Chromosome karyotype study
|
$1,041.12 |
$1,041.12 |
$1,041.12 |
$102.00
|
|
Cilastatin sodium injection
|
$370.44 |
$370.44 |
$370.44 |
$87.44
|
|
Cine/video x-rays
|
$393.12 |
$393.12 |
$393.12 |
$229.44
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$1.08 |
$1.08 |
$1.08 |
$62.03
|
|
Clot factor xiii fibrin stab
|
$592.92 |
$592.92 |
$592.92 |
$84.27
|
|
#cmvcul-virus inoculation shell
|
$411.48 |
$411.48 |
$411.48 |
$102.57
|
|
Cmv pcr-sendout
|
$962.28 |
$962.28 |
$962.28 |
$173.25
|
|
Cocaine hcl nasal (numbrino)
|
$2,725.09 |
$2,725.09 |
$2,725.09 |
$512.30
|
|
Cold agglutinin titer
|
$374.76 |
$374.76 |
$374.76 |
$48.57
|
|
Colistimethate sodium inj
|
$139.32 |
$139.32 |
$139.32 |
$90.35
|
|
Collection of venous blood by venipuncture
|
$65.40 |
$65.40 |
$65.40 |
$22.00
|
|
Compatibility test each unit antiglobulin technique
|
$298.08 |
$298.08 |
$298.08 |
$173.25
|
|
Compatibility test each unit electronic
|
$206.28 |
$206.28 |
$206.28 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$488.16 |
$488.16 |
$488.16 |
$169.52
|
|
Compatibility test incubate
|
$178.20 |
$178.20 |
$178.20 |
$143.65
|
|
Conjugated estrogens 25 mg solution for injection
|
$538.92 |
$538.92 |
$538.92 |
$905.72
|
|
Consultation pathology during surgery cytological exam initial site
|
$617.76 |
$617.76 |
$617.76 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$694.44 |
$694.44 |
$694.44 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$984.96 |
$984.96 |
$984.96 |
$214.00
|
|
Contrast exam thoracic aorta 75605-26
|
$6,309.68 |
$6,309.68 |
$6,309.68 |
$4,178.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$925.56 |
$925.56 |
$925.56 |
$94.90
|
|
Coombs indirect titer reference
|
$885.60 |
$885.60 |
$885.60 |
$146.00
|
|
Cosyntropin 0.25 mg solution for injection
|
$222.48 |
$222.48 |
$222.48 |
$249.41
|
|
C-peptide
|
$923.40 |
$923.40 |
$923.40 |
$100.00
|
|
C-reactive protein
|
$399.60 |
$399.60 |
$399.60 |
$63.00
|
|
Creatine kinase
|
$476.28 |
$476.28 |
$476.28 |
$59.78
|
|
Creatinine clearance urine
|
$615.60 |
$615.60 |
$615.60 |
$87.50
|
|
Cryptococcus abs qn - sendout
|
$162.00 |
$162.00 |
$162.00 |
$70.00
|
|
Crystal identification light microscopy
|
$66.96 |
$66.96 |
$66.96 |
$65.25
|
|
Cta abdomen without & /or w/contrast
|
$3,923.92 |
$3,923.92 |
$3,923.92 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$3,923.92 |
$3,923.92 |
$3,923.92 |
$2,080.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,960.40 |
$1,960.40 |
$1,960.40 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$12,345.84 |
$12,345.84 |
$12,345.84 |
$1,955.80
|
|
CT angio hrt w/3d image
|
$13,085.28 |
$13,085.28 |
$13,085.28 |
$1,588.60
|
|
CT angio pelvis
|
$3,923.92 |
$3,923.92 |
$3,923.92 |
$1,775.28
|
|
CT bone density axial
|
$2,864.16 |
$2,864.16 |
$2,864.16 |
$326.30
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$3,600.48 |
$3,600.48 |
$3,600.48 |
$1,085.05
|
|
CT heart w/evaluation of calcium without contrast
|
$1,336.40 |
$1,336.40 |
$1,336.40 |
$192.00
|
|
CT hrt w/3d image
|
$13,085.28 |
$13,085.28 |
$13,085.28 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$2,440.88 |
$2,440.88 |
$2,440.88 |
$625.63
|
|
CT neck soft tissue w/contrast
|
$5,046.08 |
$5,046.08 |
$5,046.08 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$3,836.56 |
$3,836.56 |
$3,836.56 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$6,087.12 |
$6,087.12 |
$6,087.12 |
$1,959.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$5,766.80 |
$5,766.80 |
$5,766.80 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$4,010.24 |
$4,010.24 |
$4,010.24 |
$1,351.20
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$7,104.24 |
$7,104.24 |
$7,104.24 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$5,869.76 |
$5,869.76 |
$5,869.76 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,229.68 |
$4,229.68 |
$4,229.68 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$6,840.08 |
$6,840.08 |
$6,840.08 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$6,677.84 |
$6,677.84 |
$6,677.84 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,118.00 |
$1,118.00 |
$1,118.00 |
$400.20
|
|
CT t-spine w /wo contrast
|
$6,377.28 |
$6,377.28 |
$6,377.28 |
$2,030.60
|
|
Culture afb any source
|
$592.92 |
$592.92 |
$592.92 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$302.40 |
$302.40 |
$302.40 |
$77.31
|
|
Culture anaerobic except blood
|
$702.00 |
$702.00 |
$702.00 |
$123.20
|
|
Culture fungi definitive id mold
|
$271.08 |
$271.08 |
$271.08 |
$70.00
|
|
Culture fungi definitive id yeast
|
$185.76 |
$185.76 |
$185.76 |
$80.60
|
|
Culture fungi other (except blood)
|
$625.32 |
$625.32 |
$625.32 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$592.92 |
$592.92 |
$592.92 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$592.92 |
$592.92 |
$592.92 |
$84.75
|
|
Culture quantitative aerobic other source
|
$555.12 |
$555.12 |
$555.12 |
$87.02
|
|
Culture typing immunologic
|
$221.40 |
$221.40 |
$221.40 |
$41.60
|
|
Culture urine each isolate
|
$581.04 |
$581.04 |
$581.04 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$48.60 |
$48.60 |
$48.60 |
$28.00
|
|
Cyclic citrullinated peptide antibody
|
$513.00 |
$513.00 |
$513.00 |
$80.05
|
|
Cyclophosphamide 25 mg capsule
|
$178.14 |
$178.14 |
$178.14 |
$20.45
|
|
Cyclosporine 2 hour
|
$765.72 |
$765.72 |
$765.72 |
$121.80
|
|
Cystatin c
|
$437.40 |
$437.40 |
$437.40 |
$82.26
|
