|
Chest apical lordotic proj
|
$1,438.00 |
$1,438.00 |
$1,438.00 |
$303.21
|
|
Chest CT scan (with and without contrast)
|
$8,531.00 |
$8,531.00 |
$8,531.00 |
$2,014.50
|
|
Chest CT scan (with contrast)
|
$8,531.00 |
$8,531.00 |
$8,531.00 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$8,531.00 |
$8,531.00 |
$8,531.00 |
$1,350.03
|
|
Chest X-ray
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$302.90
|
|
Chest X-ray (single view)
|
$842.00 |
$842.00 |
$842.00 |
$246.94
|
|
Chlamydia culture
|
$603.00 |
$603.00 |
$603.00 |
$94.90
|
|
Chlamydia type
|
$165.00 |
$165.00 |
$165.00 |
$34.80
|
|
Chloride
|
$199.00 |
$199.00 |
$199.00 |
$39.05
|
|
Chloride 24 hour urine
|
$212.00 |
$212.00 |
$212.00 |
$46.13
|
|
Chloroprocaine hcl injection
|
$265.00 |
$265.00 |
$265.00 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$5,114.00 |
$5,114.00 |
$5,114.00 |
$355.99
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$420.00 |
$420.00 |
$420.00 |
$91.92
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$2,364.00 |
$2,364.00 |
$2,364.00 |
$625.60
|
|
Cholesterol
|
$199.00 |
$199.00 |
$199.00 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$580.00 |
$580.00 |
$580.00 |
$115.70
|
|
Chromatography
|
$652.00 |
$652.00 |
$652.00 |
$77.00
|
|
Chromosome karyotype study
|
$1,026.00 |
$1,026.00 |
$1,026.00 |
$102.00
|
|
Cisplatin 1 mg/ml desensitization
|
$287.00 |
$287.00 |
$287.00 |
$175.08
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$165.00 |
$165.00 |
$165.00 |
$62.03
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$2,812.00 |
$2,812.00 |
$2,812.00 |
$81.25
|
|
#cmvcul-virus inoculation shell
|
$525.00 |
$525.00 |
$525.00 |
$102.57
|
|
Cmv pcr-sendout
|
$953.00 |
$953.00 |
$953.00 |
$173.25
|
|
Cocaine 4 % nasal solution
|
$1,691.00 |
$1,691.00 |
$1,691.00 |
$624.58
|
|
Collection of venous blood by venipuncture
|
$9.00 |
$9.00 |
$9.00 |
$22.00
|
|
Compatibility test each unit antiglobulin technique
|
$321.00 |
$321.00 |
$321.00 |
$173.25
|
|
Compatibility test each unit electronic
|
$232.00 |
$232.00 |
$232.00 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$491.00 |
$491.00 |
$491.00 |
$169.52
|
|
Compatibility test incubate
|
$330.00 |
$330.00 |
$330.00 |
$143.65
|
|
Conjugated estrogens 25 mg solution for injection
|
$2,584.00 |
$2,584.00 |
$2,584.00 |
$905.72
|
|
Consultation pathology during surgery cytological exam initial site
|
$612.00 |
$612.00 |
$612.00 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$377.00 |
$377.00 |
$377.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$612.00 |
$612.00 |
$612.00 |
$214.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$926.00 |
$926.00 |
$926.00 |
$94.90
|
|
Coombs indirect titer reference
|
$346.00 |
$346.00 |
$346.00 |
$146.00
|
|
Copper cu 64 dotatate diag
|
$11,736.00 |
$11,736.00 |
$11,736.00 |
$2,083.80
|
|
Cosyntropin 0.25 mg solution for injection
|
$2,453.00 |
$2,453.00 |
$2,453.00 |
$249.41
|
|
C-peptide
|
$713.00 |
$713.00 |
$713.00 |
$100.00
|
|
Cr-51 sodium chromate
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
$2,646.78
|
|
C-reactive protein
|
$457.00 |
$457.00 |
$457.00 |
$63.00
|
|
Creatinine clearance urine
|
$693.00 |
$693.00 |
$693.00 |
$87.50
|
|
Crotalidae poly immune fab
|
$6,214.00 |
$6,214.00 |
$6,214.00 |
$5,654.46
|
|
Crystal identification light microscopy
|
$457.00 |
$457.00 |
$457.00 |
$65.25
|
|
CT 3d report other modality w/workstation
|
$3,245.00 |
$3,245.00 |
$3,245.00 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$9,498.00 |
$9,498.00 |
$9,498.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$11,512.00 |
$11,512.00 |
$11,512.00 |
$2,080.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$16,786.00 |
$16,786.00 |
$16,786.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$9,406.00 |
$9,406.00 |
$9,406.00 |
$1,955.80
|
|
CT angio pelvis
|
$11,488.00 |
$11,488.00 |
$11,488.00 |
$1,775.28
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$1,085.05
|
|
CT heart w/evaluation of calcium without contrast
|
$1,534.00 |
$1,534.00 |
$1,534.00 |
$192.00
|
|
CT neck soft tissue w/contrast
|
$8,137.00 |
$8,137.00 |
$8,137.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$5,843.00 |
$5,843.00 |
$5,843.00 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$8,789.00 |
$8,789.00 |
$8,789.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$9,844.00 |
$9,844.00 |
$9,844.00 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$8,262.00 |
$8,262.00 |
$8,262.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$4,972.00 |
$4,972.00 |
$4,972.00 |
$1,351.20
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$20,098.00 |
$20,098.00 |
$20,098.00 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$16,308.00 |
$16,308.00 |
$16,308.00 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$11,436.00 |
$11,436.00 |
$11,436.00 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$6,104.00 |
$6,104.00 |
$6,104.00 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$6,632.00 |
$6,632.00 |
$6,632.00 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$281.00 |
$281.00 |
$281.00 |
$400.20
|
|
CT t-spine w /wo contrast
|
$6,498.00 |
$6,498.00 |
$6,498.00 |
$2,030.60
|
|
Culture afb any source
|
$763.00 |
$763.00 |
$763.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$469.00 |
$469.00 |
$469.00 |
$77.31
|
|
Culture anaerobic except blood
|
$740.00 |
$740.00 |
$740.00 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$335.00 |
$335.00 |
$335.00 |
$52.80
|
|
Culture fungi definitive id mold
|
$645.00 |
$645.00 |
$645.00 |
$70.00
|
|
Culture fungi definitive id yeast
|
$645.00 |
$645.00 |
$645.00 |
$80.60
|
|
Culture fungi other (except blood)
|
$624.00 |
$624.00 |
$624.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$317.00 |
$317.00 |
$317.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$597.00 |
$597.00 |
$597.00 |
$84.75
|
|
Culture mycoplasma any source
|
$863.00 |
$863.00 |
$863.00 |
$90.37
|
|
Culture quantitative aerobic other source
|
$645.00 |
$645.00 |
$645.00 |
$87.02
|
|
Culture typing immunologic
|
$222.00 |
$222.00 |
$222.00 |
$41.60
|
|
Culture urine each isolate
|
$574.00 |
$574.00 |
$574.00 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$299.00 |
$299.00 |
$299.00 |
$28.00
|
|
Cyclic citrullinated peptide antibody
|
$432.00 |
$432.00 |
$432.00 |
$80.05
|
|
Cyclosporine 2 hour
|
$901.00 |
$901.00 |
$901.00 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$120.00 |
$120.00 |
$120.00 |
$7.48
|
|
Cystatin c
|
$443.00 |
$443.00 |
$443.00 |
$82.26
|
|
Cytarabine 20 mg/ml injection solution
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$104.83
|
|
Cytomegalovirus (cmv) antibody igg
|
$549.00 |
$549.00 |
$549.00 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$610.00 |
$610.00 |
$610.00 |
$96.80
|
|
Cytopathology cellular enhancement technique non-gyn
|
$597.00 |
$597.00 |
$597.00 |
$163.43
|
|
Cytopathology concentration technique smears & interpretation
|
$576.00 |
$576.00 |
$576.00 |
$142.94
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$377.00 |
$377.00 |
$377.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$479.00 |
$479.00 |
$479.00 |
$205.00
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$1,701.00 |
$1,701.00 |
$1,701.00 |
$362.16
|
|
Decalcification
|
$154.00 |
$154.00 |
$154.00 |
$73.60
|
|
Deferoxamine 500 mg solution for injection
|
$1,074.00 |
$1,074.00 |
$1,074.00 |
$96.41
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,599.00 |
$7,599.00 |
$7,599.00 |
$6,508.51
|
|
Desmopressin 4 mcg/ml injection solution
|
$375.00 |
$375.00 |
$375.00 |
$116.22
|
|
Dextran 40 infusion
|
$1,456.00 |
$1,456.00 |
$1,456.00 |
$151.20
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$1,495.00 |
$1,495.00 |
$1,495.00 |
$61.49
|
|
Dextrose 5 % IV bolus
|
$1,361.00 |
$1,361.00 |
$1,361.00 |
$48.58
|
|
Diabetes (HbA1c) Test
|
$438.00 |
$438.00 |
$438.00 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$750.00 |
$750.00 |
$750.00 |
$424.00
|
|
Diatrizoate meglumine 18 % urethral solution
|
$417.00 |
$417.00 |
$417.00 |
$122.25
|
