|
CT thoracic spine w/contrast
|
$1,327.00 |
$1,327.00 |
$1,327.00 |
$1,680.60
|
|
CT thoracic spine without contrast
|
$949.50 |
$949.50 |
$949.50 |
$1,448.04
|
|
CT thorax low dose for lung screening without contrast
|
$120.00 |
$120.00 |
$120.00 |
$345.28
|
|
CT t-spine w /wo contrast
|
$1,568.50 |
$1,568.50 |
$1,568.50 |
$1,982.40
|
|
CT upper extremity w/contrast (both sides)
|
$1,294.50 |
$1,294.50 |
$1,294.50 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$926.50 |
$926.50 |
$926.50 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,531.50 |
$1,531.50 |
$1,531.50 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$114.00 |
$114.00 |
$114.00 |
$70.80
|
|
Culture afb any source
|
$195.00 |
$195.00 |
$195.00 |
$110.00
|
|
Culture anaerobic additional method definitive id each
|
$105.00 |
$105.00 |
$105.00 |
$83.54
|
|
Culture anaerobic except blood
|
$107.00 |
$107.00 |
$107.00 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$51.00 |
$51.00 |
$51.00 |
$51.51
|
|
Culture body fluid
|
$102.00 |
$102.00 |
$102.00 |
$127.40
|
|
Culture fungi definitive id mold
|
$142.00 |
$142.00 |
$142.00 |
$78.40
|
|
Culture fungi definitive id yeast
|
$105.50 |
$105.50 |
$105.50 |
$80.00
|
|
Culture fungi other (except blood)
|
$36.50 |
$36.50 |
$36.50 |
$108.30
|
|
Culture fungi skin/hair/nail
|
$214.50 |
$214.50 |
$214.50 |
$74.40
|
|
Culture mycobacteria definitive id each isolate
|
$140.00 |
$140.00 |
$140.00 |
$96.00
|
|
Culture quantitative aerobic other source
|
$262.00 |
$262.00 |
$262.00 |
$92.30
|
|
Culture screening strep group a
|
$55.00 |
$55.00 |
$55.00 |
$83.16
|
|
Culture typing glc/hplc
|
$159.50 |
$159.50 |
$159.50 |
$54.43
|
|
Culture typing immunologic
|
$61.00 |
$61.00 |
$61.00 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$202.00 |
$202.00 |
$202.00 |
$135.00
|
|
Culture urine each isolate
|
$47.50 |
$47.50 |
$47.50 |
$57.90
|
|
Curette/treat cornea
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$1,345.80
|
|
Curette/treat cornea
|
$2,733.00 |
$2,733.00 |
$2,733.00 |
$2,818.14
|
|
Cutter lead
|
$1,115.63 |
$1,115.63 |
$1,115.63 |
$6,152.59
|
|
Cv line/pic reposition
|
$1,906.00 |
$1,906.00 |
$1,906.00 |
$1,634.66
|
|
Cv stress test i&r only 93018
|
$81.00 |
$81.00 |
$81.00 |
$40.20
|
|
Cv stress test/supervision only 93016
|
$115.50 |
$115.50 |
$115.50 |
$51.20
|
|
Cyanocobalamin unsat binding capacity
|
$10.50 |
$10.50 |
$10.50 |
$58.65
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$5.50 |
$5.50 |
$5.50 |
$25.32
|
|
Cyclic citrullinated peptide antibody
|
$193.00 |
$193.00 |
$193.00 |
$70.98
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$527.01 |
$527.01 |
$527.01 |
$1,305.02
|
|
Cyclophosphamide 25 mg capsule
|
$65.86 |
$65.86 |
$65.86 |
$19.49
|
|
Cyclosporine 2 hour
|
$132.00 |
$132.00 |
$132.00 |
$129.48
|
|
Cyclosporine modified 25 mg capsule
|
$4.89 |
$4.89 |
$4.89 |
$7.48
|
|
Cyclosporine oral 100 mg
|
$12.88 |
$12.88 |
$12.88 |
$34.88
|
|
Cygnus matrix, per sq cm
|
$4,968.00 |
$4,968.00 |
$4,968.00 |
$295.20
|
|
Cylinder pump set 20cm titan zero angl
|
$3,207.50 |
$3,207.50 |
$3,207.50 |
$24,131.60
|
|
Cyp2c19 gene com variants
|
$1,175.00 |
$1,175.00 |
$1,175.00 |
$481.20
|
|
Cyp2c9 gene com variants
|
$200.00 |
$200.00 |
$200.00 |
$275.10
|
|
Cyp2d6 gene com variants
|
$185.00 |
$185.00 |
$185.00 |
$554.00
|
|
Cystatin c
|
$30.00 |
$30.00 |
$30.00 |
$78.60
|
|
Cystic fibrosis cftr
|
$852.50 |
$852.50 |
$852.50 |
$1,100.00
|
|
Cystine urine quantitative
|
$262.50 |
$262.50 |
$262.50 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$684.50 |
$684.50 |
$684.50 |
$564.85
|
|
Cysto, litho, vacuum kidney
|
$4,222.50 |
$4,222.50 |
$4,222.50 |
$10,942.71
|
|
Cystoscopy and treatment
|
$799.34 |
$799.34 |
$799.34 |
$4,081.37
|
|
Cystoscopy and treatment
|
$4,051.50 |
$4,051.50 |
$4,051.50 |
$4,160.10
|
|
Cystoscopy and treatment
|
$4,459.00 |
$4,459.00 |
$4,459.00 |
$5,162.50
|
|
Cystoscopy and treatment
|
$2,501.00 |
$2,501.00 |
$2,501.00 |
$5,995.60
|
|
Cystoscopy and treatment
|
$5,251.00 |
$5,251.00 |
$5,251.00 |
$6,475.26
|
|
Cystoscopy and treatment
|
$2,409.00 |
$2,409.00 |
$2,409.00 |
$3,213.14
|
|
Cystoscopy and treatment
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$2,424.12
|
|
Cystoscopy and treatment
|
$1,596.67 |
$1,596.67 |
$1,596.67 |
$4,045.60
|
|
Cystoscopy and treatment
|
$801.50 |
$801.50 |
$801.50 |
$958.81
|
|
Cystoscopy and treatment
|
$3,127.33 |
$3,127.33 |
$3,127.33 |
$2,867.70
|
|
Cystoscopy and treatment
|
$2,417.00 |
$2,417.00 |
$2,417.00 |
$3,203.50
|
|
Cystoscopy and treatment
|
$4,051.50 |
$4,051.50 |
$4,051.50 |
$3,820.84
|
|
Cystoscopy (Bladder Scope)
|
$1,526.50 |
$1,526.50 |
$1,526.50 |
$1,450.44
|
|
Cystoscopy chemodenervation
|
$2,417.00 |
$2,417.00 |
$2,417.00 |
$2,704.80
|
|
Cystoscopy removal of clots
|
$4,051.50 |
$4,051.50 |
$4,051.50 |
$3,986.00
|
|
Cystoscopy stone removal
|
$4,190.00 |
$4,190.00 |
$4,190.00 |
$5,741.00
|
|
Cystoscopy & ureter catheter
|
$3,743.38 |
$3,743.38 |
$3,743.38 |
$3,684.30
|
|
Cystostomy cystotomy w/drainage 51040
|
$3,026.00 |
$3,026.00 |
$3,026.00 |
$4,129.45
|
|
Cystouretero & or pyeloscope
|
$3,876.00 |
$3,876.00 |
$3,876.00 |
$4,155.20
|
|
Cysto/uretero stricture tx
|
$14,980.00 |
$14,980.00 |
$14,980.00 |
$4,846.99
|
|
Cystouretero w/biopsy
|
$3,820.00 |
$3,820.00 |
$3,820.00 |
$5,971.01
|
|
Cysto/uretero w/lithotripsy
|
$9,430.00 |
$9,430.00 |
$9,430.00 |
$7,372.68
|
|
Cystouretero w/lithotripsy
|
$5,964.00 |
$5,964.00 |
$5,964.00 |
$7,061.60
|
|
Cystouretero w/stone remove
|
$7,395.00 |
$7,395.00 |
$7,395.00 |
$5,014.02
|
|
Cystourethroscop/calib/dilat stric 52281
|
$3,374.50 |
$3,374.50 |
$3,374.50 |
$3,015.50
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$2,403.00 |
$2,403.00 |
$2,403.00 |
$4,045.60
|
|
Cytarabine 20 mg/ml injection solution
|
$2.75 |
$2.75 |
$2.75 |
$89.94
|
|
Cytogenetics 25-99
|
$330.50 |
$330.50 |
$330.50 |
$190.00
|
|
Cytogenetics 3-5
|
$55.00 |
$55.00 |
$55.00 |
$164.90
|
|
Cytomegalovirus (cmv) antibody igg
|
$80.00 |
$80.00 |
$80.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$98.50 |
$98.50 |
$98.50 |
$100.00
|
|
Cyto/molecular report
|
$108.50 |
$108.50 |
$108.50 |
$128.11
|
|
Cytopath fl nongyn filter
|
$107.50 |
$107.50 |
$107.50 |
$93.74
|
|
Cytopathology cellular enhancement technique non-gyn
|
$348.00 |
$348.00 |
$348.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$102.50 |
$102.50 |
$102.50 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$90.50 |
$90.50 |
$90.50 |
$87.29
|
|
Cytopathology concentration technique smears & interpretation
|
$93.50 |
$93.50 |
$93.50 |
$126.00
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$217.50 |
$217.50 |
$217.50 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$48.50 |
$48.50 |
$48.50 |
$67.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$119.50 |
$119.50 |
$119.50 |
$186.08
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$211.00 |
$211.00 |
$211.00 |
$209.92
|
|
Cytopath smear other source
|
$95.00 |
$95.00 |
$95.00 |
$88.13
|
|
Cytopath smear other source
|
$263.00 |
$263.00 |
$263.00 |
$140.00
|
|
Cytopath smear oth prep screen & interp
|
$81.50 |
$81.50 |
$81.50 |
$95.00
|
|
Cytopath tbs c/v manual
|
$95.00 |
$95.00 |
$95.00 |
$59.28
|
|
Cytp urine 3-5 probes cmptr
|
$175.50 |
$175.50 |
$175.50 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$43.56 |
$43.56 |
$43.56 |
$59.15
|
|
Dalbavancin 500 mg intravenous solution
|
$6,201.23 |
$6,201.23 |
$6,201.23 |
$3,469.30
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$40.54 |
$40.54 |
$40.54 |
$169.00
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$19,945.05 |
$19,945.05 |
$19,945.05 |
$21,050.42
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$17.00 |
$17.00 |
$17.00 |
$6,281.29
|
|
Darbepoetin alfa, esrd use
|
$17.00 |
$17.00 |
$17.00 |
$4.48
|
