|
Creatine kinase mb
|
$183.00 |
$183.00 |
$183.00 |
$114.00
|
|
Creatine - sendout
|
$12.00 |
$12.00 |
$12.00 |
$39.00
|
|
Creatinine
|
$88.20 |
$88.20 |
$88.20 |
$44.72
|
|
Creatinine 24 hour urine
|
$253.20 |
$253.20 |
$253.20 |
$58.85
|
|
Creatinine clearance urine
|
$186.00 |
$186.00 |
$186.00 |
$89.50
|
|
#creutz-prot.,western blot
|
$1,077.60 |
$1,077.60 |
$1,077.60 |
$166.20
|
|
Critical care 30-74 minutes
|
$280.20 |
$280.20 |
$280.20 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$181.20 |
$181.20 |
$181.20 |
$731.40
|
|
Crotalidae poly immune fab
|
$10,873.20 |
$10,873.20 |
$10,873.20 |
$5,590.35
|
|
Cryoprecipitate each unit
|
$45.60 |
$45.60 |
$45.60 |
$144.78
|
|
Cryptosporidium antigen
|
$165.60 |
$165.60 |
$165.60 |
$52.08
|
|
Crystal identification light microscopy
|
$115.20 |
$115.20 |
$115.20 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$4,552.20 |
$4,552.20 |
$4,552.20 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$5,247.00 |
$5,247.00 |
$5,247.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,918.40 |
$2,918.40 |
$2,918.40 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$1,500.38
|
|
Cta upper extremity w &/or without contrast left
|
$4,552.20 |
$4,552.20 |
$4,552.20 |
$1,698.00
|
|
CT guidance for needle placement
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$1,494.00
|
|
CT heart w/evaluation of calcium without contrast
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$171.60
|
|
CT hrt w/3d image
|
$1,644.60 |
$1,644.60 |
$1,644.60 |
$1,383.06
|
|
CT lower extremity w/contrast (both sides)
|
$3,999.00 |
$3,999.00 |
$3,999.00 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$3,171.60 |
$3,171.60 |
$3,171.60 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$4,552.20 |
$4,552.20 |
$4,552.20 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,999.80 |
$1,999.80 |
$1,999.80 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,999.80 |
$1,999.80 |
$1,999.80 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,362.20 |
$5,362.20 |
$5,362.20 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,600.80 |
$4,600.80 |
$4,600.80 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,504.00 |
$3,504.00 |
$3,504.00 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$2,464.20 |
$2,464.20 |
$2,464.20 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$2,177.40 |
$2,177.40 |
$2,177.40 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,919.40 |
$1,919.40 |
$1,919.40 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,025.00 |
$2,025.00 |
$2,025.00 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,999.80 |
$1,999.80 |
$1,999.80 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,276.40 |
$2,276.40 |
$2,276.40 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$110.40 |
$110.40 |
$110.40 |
$68.64
|
|
Culture afb any source
|
$169.20 |
$169.20 |
$169.20 |
$109.20
|
|
Culture anaerobic except blood
|
$186.00 |
$186.00 |
$186.00 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$30.60 |
$30.60 |
$30.60 |
$51.45
|
|
Culture body fluid
|
$169.20 |
$169.20 |
$169.20 |
$126.75
|
|
Culture fungi skin/hair/nail
|
$25.20 |
$25.20 |
$25.20 |
$74.88
|
|
Culture screening strep group a
|
$14.40 |
$14.40 |
$14.40 |
$81.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$25.80 |
$25.80 |
$25.80 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$352.20 |
$352.20 |
$352.20 |
$133.90
|
|
Cutter lead
|
$2,116.80 |
$2,116.80 |
$2,116.80 |
$6,092.06
|
|
Cv stress test i&r only 93018
|
$174.60 |
$174.60 |
$174.60 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$102.00 |
$102.00 |
$102.00 |
$51.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$24.00 |
$24.00 |
$24.00 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$135.00 |
$135.00 |
$135.00 |
$70.72
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$2,944.80 |
$2,944.80 |
$2,944.80 |
$1,305.02
|
|
Cyclosporine 2 hour
|
$196.20 |
$196.20 |
$196.20 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$4.80 |
$4.80 |
$4.80 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$15.60 |
$15.60 |
$15.60 |
$34.88
|
|
Cyp2d6 gene com variants
|
$553.80 |
$553.80 |
$553.80 |
$554.00
|
|
Cystatin c
|
$139.80 |
$139.80 |
$139.80 |
$77.50
|
|
Cytogenetics 25-99
|
$334.20 |
$334.20 |
$334.20 |
$190.00
|
|
Cytomegalovirus (cmv) antibody igg
|
$87.00 |
$87.00 |
$87.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$108.00 |
$108.00 |
$108.00 |
$97.50
|
|
Cytopathology cellular enhancement technique non-gyn
|
$116.40 |
$116.40 |
$116.40 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$39.00 |
$39.00 |
$39.00 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$118.20 |
$118.20 |
$118.20 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$84.60 |
$84.60 |
$84.60 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$60.00 |
$60.00 |
$60.00 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$101.40 |
$101.40 |
$101.40 |
$187.28
|
|
Cytopath smear other source
|
$28.80 |
$28.80 |
$28.80 |
$88.13
|
|
Dacarbazine 100 mg intravenous solution
|
$55.80 |
$55.80 |
$55.80 |
$58.22
|
|
Dalbavancin 500 mg intravenous solution
|
$5,117.40 |
$5,117.40 |
$5,117.40 |
$3,480.35
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$116.40 |
$116.40 |
$116.40 |
$168.53
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$26,504.40 |
$26,504.40 |
$26,504.40 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$12,903.60 |
$12,903.60 |
$12,903.60 |
$6,072.48
|
|
Darbepoetin alfa, esrd use
|
$1,137.60 |
$1,137.60 |
$1,137.60 |
$4.48
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$534.60 |
$534.60 |
$534.60 |
$3,774.81
|
|
Dch glucoscan
|
$30.00 |
$30.00 |
$30.00 |
$28.10
|
|
Dch pulmonary stress test
|
$424.80 |
$424.80 |
$424.80 |
$963.30
|
|
Dch validity tests
|
$36.00 |
$36.00 |
$36.00 |
$24.50
|
|
Deamidated gliadin antibody iga
|
$11.40 |
$11.40 |
$11.40 |
$43.60
|
|
Debridement (>20 cm) charge pt
|
$40.20 |
$40.20 |
$40.20 |
$260.61
|
|
Debridement bone <= 20 sq cm
|
$427.80 |
$427.80 |
$427.80 |
$2,316.00
|
|
Debridement/bone/20 sq cm or less 11046
|
$93.00 |
$93.00 |
$93.00 |
$663.00
|
|
Debridement/bone/ea add 20 sq cm 11047
|
$153.00 |
$153.00 |
$153.00 |
$1,373.46
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$145.80 |
$145.80 |
$145.80 |
$810.50
|
|
Debride nail1-5 11720
|
$265.80 |
$265.80 |
$265.80 |
$148.80
|
|
Debride/subq tissue/ea add 20sq cm 11045
|
$243.00 |
$243.00 |
$243.00 |
$639.60
|
|
Debrid mastoidectomy cavity simple 69220
|
$75.00 |
$75.00 |
$75.00 |
$235.13
|
|
Debr musc/fascia 20sq cm/< 11043
|
$335.40 |
$335.40 |
$335.40 |
$1,160.00
|
|
Decalcification
|
$28.20 |
$28.20 |
$28.20 |
$68.90
|
|
Decitabine 50 mg intravenous solution
|
$385.80 |
$385.80 |
$385.80 |
$1,073.52
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$452.40 |
$452.40 |
$452.40 |
$543.00
|
|
Decomp forearm 1 space 25020
|
$894.00 |
$894.00 |
$894.00 |
$3,137.60
|
|
Denervation of hip joint
|
$2,038.80 |
$2,038.80 |
$2,038.80 |
$5,741.00
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$7,392.60 |
$7,392.60 |
$7,392.60 |
$6,324.98
|
|
Desmopressin 4 mcg/ml injection solution
|
$265.80 |
$265.80 |
$265.80 |
$89.78
|
