|
Consultation pathology during surgery frozen section each additional block
|
$843.00 |
$843.00 |
$843.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$519.00 |
$519.00 |
$519.00 |
$239.85
|
|
Consultation/report referred slides prepared elsewhere
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$176.15
|
|
Contrast x-ray of hip
|
$1,216.00 |
$1,216.00 |
$1,216.00 |
$768.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$47.00 |
$47.00 |
$47.00 |
$94.90
|
|
Coombs indirect titer reference
|
$421.00 |
$421.00 |
$421.00 |
$146.00
|
|
Cortisol total am
|
$406.00 |
$406.00 |
$406.00 |
$122.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$3,454.00 |
$3,454.00 |
$3,454.00 |
$249.41
|
|
Co-treatment - group 15 mins, st
|
$589.00 |
$589.00 |
$589.00 |
$108.81
|
|
Covid-19 lab test non-cdc
|
$76.00 |
$76.00 |
$76.00 |
$58.32
|
|
C-peptide
|
$289.00 |
$289.00 |
$289.00 |
$100.00
|
|
C-reactive protein high sensitivity
|
$473.00 |
$473.00 |
$473.00 |
$91.65
|
|
Creatine kinase isoenzymes
|
$228.00 |
$228.00 |
$228.00 |
$46.34
|
|
Creatine kinase mb
|
$342.00 |
$342.00 |
$342.00 |
$111.00
|
|
Creatine - sendout
|
$146.00 |
$146.00 |
$146.00 |
$39.00
|
|
Creatinine clearance urine
|
$443.00 |
$443.00 |
$443.00 |
$87.50
|
|
Crotalidae poly immune fab
|
$18,422.00 |
$18,422.00 |
$18,422.00 |
$5,654.46
|
|
Cryofibrinogen qualitative - sendout
|
$139.00 |
$139.00 |
$139.00 |
$50.88
|
|
Crystal identification light microscopy
|
$307.00 |
$307.00 |
$307.00 |
$65.25
|
|
Csf leakage imaging
|
$1,935.00 |
$1,935.00 |
$1,935.00 |
$1,446.24
|
|
Cta abdomen without & /or w/contrast
|
$9,622.00 |
$9,622.00 |
$9,622.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$4,142.00 |
$4,142.00 |
$4,142.00 |
$2,080.00
|
|
Cta neck without &/or w/contrast
|
$9,622.00 |
$9,622.00 |
$9,622.00 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$19,237.00 |
$19,237.00 |
$19,237.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$9,622.00 |
$9,622.00 |
$9,622.00 |
$1,955.80
|
|
CT Angiogram of the Head
|
$7,038.00 |
$7,038.00 |
$7,038.00 |
$2,021.40
|
|
CT angio pelvis
|
$9,622.00 |
$9,622.00 |
$9,622.00 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$3,861.00 |
$3,861.00 |
$3,861.00 |
$1,652.25
|
|
CT cerebral perf w cont & prcssng
|
$3,563.00 |
$3,563.00 |
$3,563.00 |
$803.40
|
|
CT heart w/evaluation of calcium without contrast
|
$850.00 |
$850.00 |
$850.00 |
$192.00
|
|
CT hrt c+ strux cgen hrt ds
|
$9,877.00 |
$9,877.00 |
$9,877.00 |
$1,217.45
|
|
CT hrt w/3d image
|
$9,877.00 |
$9,877.00 |
$9,877.00 |
$1,418.60
|
|
CT limited or localized follow-up study
|
$3,641.00 |
$3,641.00 |
$3,641.00 |
$625.63
|
|
CT neck soft tissue w/contrast
|
$7,971.00 |
$7,971.00 |
$7,971.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$6,673.00 |
$6,673.00 |
$6,673.00 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$10,127.00 |
$10,127.00 |
$10,127.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$10,127.00 |
$10,127.00 |
$10,127.00 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$7,971.00 |
$7,971.00 |
$7,971.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$6,673.00 |
$6,673.00 |
$6,673.00 |
$1,351.20
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$21,334.00 |
$21,334.00 |
$21,334.00 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$17,025.00 |
$17,025.00 |
$17,025.00 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$12,973.00 |
$12,973.00 |
$12,973.00 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$8,396.00 |
$8,396.00 |
$8,396.00 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$6,673.00 |
$6,673.00 |
$6,673.00 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$545.00 |
$545.00 |
$545.00 |
$400.20
|
|
CT t-spine w /wo contrast
|
$10,549.00 |
$10,549.00 |
$10,549.00 |
$2,030.60
|
|
Culture afb any source
|
$784.00 |
$784.00 |
$784.00 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$489.00 |
$489.00 |
$489.00 |
$77.31
|
|
Culture anaerobic except blood
|
$839.00 |
$839.00 |
$839.00 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$664.00 |
$664.00 |
$664.00 |
$52.80
|
|
Culture fungi definitive id mold
|
$445.00 |
$445.00 |
$445.00 |
$70.00
|
|
Culture fungi definitive id yeast
|
$601.00 |
$601.00 |
$601.00 |
$80.60
|
|
Culture fungi skin/hair/nail
|
$168.00 |
$168.00 |
$168.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$157.00 |
$157.00 |
$157.00 |
$84.75
|
|
Culture mycoplasma any source
|
$238.00 |
$238.00 |
$238.00 |
$90.37
|
|
Culture quantitative aerobic other source
|
$343.00 |
$343.00 |
$343.00 |
$87.02
|
|
Culture typing added method
|
$23.00 |
$23.00 |
$23.00 |
$34.45
|
|
Culture typing immunologic
|
$318.00 |
$318.00 |
$318.00 |
$41.60
|
|
Culture urine each isolate
|
$419.00 |
$419.00 |
$419.00 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$357.00 |
$357.00 |
$357.00 |
$28.00
|
|
Cyclic citrullinated peptide antibody
|
$617.00 |
$617.00 |
$617.00 |
$80.05
|
|
Cyclosporine 250 mg/5 ml intravenous solution
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$140.78
|
|
Cyclosporine 2 hour
|
$357.00 |
$357.00 |
$357.00 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$47.00 |
$47.00 |
$47.00 |
$7.48
|
|
Cyp2c19 gene com variants
|
$779.00 |
$779.00 |
$779.00 |
$567.75
|
|
Cyp2d6 gene com variants
|
$1,063.00 |
$1,063.00 |
$1,063.00 |
$537.50
|
|
Cystatin c
|
$213.00 |
$213.00 |
$213.00 |
$82.26
|
|
Cystogram >= 3 views supervision & interpretation
|
$2,061.00 |
$2,061.00 |
$2,061.00 |
$539.55
|
|
Cytomegalovirus (cmv) antibody igm
|
$641.00 |
$641.00 |
$641.00 |
$96.80
|
|
Cytomegalovirus dfa
|
$610.00 |
$610.00 |
$610.00 |
$59.59
|
|
Cytopath c/v index add-on
|
$178.00 |
$178.00 |
$178.00 |
$29.60
|
|
Cytopath c/v manual
|
$170.00 |
$170.00 |
$170.00 |
$25.59
|
|
Cytopath fl nongyn filter
|
$141.00 |
$141.00 |
$141.00 |
$73.70
|
|
Cytopathology cellular enhancement technique non-gyn
|
$1,930.00 |
$1,930.00 |
$1,930.00 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$230.00 |
$230.00 |
$230.00 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$394.00 |
$394.00 |
$394.00 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$637.00 |
$637.00 |
$637.00 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$303.00 |
$303.00 |
$303.00 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$382.00 |
$382.00 |
$382.00 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$567.00 |
$567.00 |
$567.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$567.00 |
$567.00 |
$567.00 |
$205.00
|
|
Cytopath smear other source
|
$291.00 |
$291.00 |
$291.00 |
$85.80
|
|
Cytopath smear other source
|
$439.00 |
$439.00 |
$439.00 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$410.00 |
$410.00 |
$410.00 |
$95.89
|
|
Cytp urine 3-5 probes cmptr
|
$2,260.00 |
$2,260.00 |
$2,260.00 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$927.00 |
$927.00 |
$927.00 |
$73.20
|
|
Dactinomycin 0.5 mg intravenous solution
|
$14,506.00 |
$14,506.00 |
$14,506.00 |
$3,019.83
|
|
Dalbavancin 500 mg intravenous solution
|
$7,179.00 |
$7,179.00 |
$7,179.00 |
$3,469.30
|
|
Dalteparin sodium
|
$928.00 |
$928.00 |
$928.00 |
$75.17
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$79.00 |
$79.00 |
$79.00 |
$5,500.25
|
|
Dark field exam without collj
|
$767.00 |
$767.00 |
$767.00 |
$28.80
|
|
Debridement (>20 cm) charge pt
|
$283.00 |
$283.00 |
$283.00 |
$262.60
|
|
Decalcification
|
$250.00 |
$250.00 |
$250.00 |
$73.60
|
|
Deferoxamine 500 mg solution for injection
|
$988.00 |
$988.00 |
$988.00 |
$96.41
|
|
Detect agent nos dna dir
|
$389.00 |
$389.00 |
$389.00 |
$67.15
|
|
Dextran 40 infusion
|
$801.00 |
$801.00 |
$801.00 |
$151.20
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$468.00 |
$468.00 |
$468.00 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$520.00 |
$520.00 |
$520.00 |
$61.49
|
|
Dextrose 5 % IV bolus
|
$506.00 |
$506.00 |
$506.00 |
$48.58
|
