|
CT neck soft tissue without contrast
|
$296.00 |
$698.50 |
$1,585.80 |
|
|
CT neck soft tissue without & w/contrast
|
$109.50 |
$1,079.50 |
$2,276.40 |
|
|
CT orbit/sella/fossa w/wo contrast
|
$109.50 |
$1,235.50 |
$2,276.40 |
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$118.00 |
$901.50 |
$1,999.80 |
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$295.00 |
$693.50 |
$1,585.80 |
|
|
Ctrl nosebld postir subsq 30906
|
$227.00 |
$227.00 |
$363.20 |
|
|
CT scan for localization
|
$559.50 |
$1,038.50 |
$1,056.50 |
|
|
CT scan for therapy guide
|
$223.50 |
$370.50 |
$979.50 |
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,001.00 |
$2,012.50 |
$5,362.20 |
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,001.00 |
$1,878.50 |
$4,600.80 |
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$611.00 |
$1,417.00 |
$3,504.00 |
|
|
CT thoracic spine w/contrast
|
$118.00 |
$1,050.00 |
$2,464.20 |
|
|
CT thoracic spine without contrast
|
$296.00 |
$822.50 |
$2,177.40 |
|
|
CT thorax low dose for lung screening without contrast
|
$120.00 |
$120.00 |
$1,919.40 |
|
|
CT t-spine w /wo contrast
|
$729.60 |
$1,383.50 |
$2,025.00 |
|
|
CT upper extremity w/contrast (both sides)
|
$422.00 |
$1,258.50 |
$3,056.00 |
|
|
CT upper extremity without contrast (both sides)
|
$290.50 |
$733.50 |
$2,113.00 |
|
|
CT uppr extremity w/o&w/dye
|
$533.50 |
$1,329.50 |
$2,276.40 |
|
|
Culture aerobic additional method definitive id each
|
$25.00 |
$114.00 |
$249.50 |
|
|
Culture afb any source
|
$169.20 |
$195.00 |
$312.00 |
|
|
Culture anaerobic additional method definitive id each
|
$35.00 |
$70.00 |
$301.50 |
|
|
Culture anaerobic except blood
|
$24.00 |
$82.00 |
$189.60 |
|
|
Culture bacteria anaerobic
|
$80.50 |
$80.50 |
$80.50 |
|
|
Culture bact stool aero addl path ea
|
$30.60 |
$51.00 |
$91.00 |
|
|
Culture body fluid
|
$25.60 |
$75.50 |
$226.00 |
|
|
Culture fungi definitive id mold
|
$34.00 |
$60.50 |
$171.00 |
|
|
Culture fungi definitive id yeast
|
$33.50 |
$53.50 |
$121.00 |
|
|
Culture fungi other (except blood)
|
$34.00 |
$56.50 |
$134.50 |
|
|
Culture fungi skin/hair/nail
|
$19.20 |
$66.50 |
$214.50 |
|
|
Culture mycobacteria definitive id each isolate
|
$140.00 |
$140.00 |
$224.00 |
|
|
Culture mycoplasma any source
|
$95.50 |
$95.50 |
$177.26 |
|
|
Culture quantitative aerobic other source
|
$123.50 |
$145.50 |
$291.00 |
|
|
Culture screening strep group a
|
$14.40 |
$55.00 |
$209.50 |
|
|
Culture typing glc/hplc
|
$129.00 |
$142.50 |
$159.50 |
|
|
Culture typing immunologic
|
$13.00 |
$47.00 |
$139.50 |
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$25.80 |
$352.00 |
$704.00 |
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$202.00 |
$202.00 |
$352.20 |
|
|
Culture urine each isolate
|
$45.00 |
$60.80 |
$73.50 |
|
|
Curette/treat cornea
|
$66.00 |
$105.60 |
$2,313.50 |
|
|
Curette/treat cornea
|
$348.00 |
$370.00 |
$3,996.50 |
|
|
Cutter lead
|
$457.15 |
$603.95 |
$7,609.00 |
|
|
Cv line/pic reposition
|
$61.00 |
$97.60 |
$2,961.00 |
|
|
Cv stress test i&r only 93018
|
$15.00 |
$15.50 |
$174.60 |
|
|
Cv stress test/supervision only 93016
|
$22.50 |
$23.00 |
$115.50 |
|
|
Cyanocobalamin unsat binding capacity
|
$10.50 |
$10.50 |
$92.00 |
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$3.00 |
$5.50 |
$52.72 |
|
|
Cyclic citrullinated peptide antibody
|
$28.00 |
$73.50 |
$193.00 |
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$186.01 |
$608.80 |
$2,944.80 |
|
|
Cyclophosphamide 25 mg capsule
|
$43.91 |
$65.86 |
$280.67 |
|
|
Cyclosporine 2 hour
|
$33.60 |
$115.00 |
$199.80 |
|
|
Cyclosporine modified 25 mg capsule
|
$4.80 |
$4.89 |
$26.49 |
|
|
Cyclosporine oral 100 mg
|
$12.88 |
$15.60 |
$46.47 |
|
|
Cygnus matrix, per sq cm
|
$221.50 |
$221.50 |
$8,648.00 |
|
|
Cylinder pump set 20cm titan zero angl
|
$3,138.00 |
$3,546.00 |
$16,205.64 |
|
|
Cyp2c19 gene com variants
|
$1,175.00 |
$1,175.00 |
$1,175.00 |
|
|
Cyp2c9 gene com variants
|
$200.00 |
$200.00 |
$401.00 |
|
|
Cyp2d6 gene com variants
|
$185.00 |
$185.00 |
$553.80 |
|
|
Cystatin c
|
$27.00 |
$31.00 |
$165.60 |
|
|
Cystic fibrosis cftr
|
$852.50 |
$905.50 |
$2,465.00 |
|
|
Cystine urine quantitative
|
$81.00 |
$129.60 |
$475.50 |
|
|
Cystogram >= 3 views supervision & interpretation
|
$17.00 |
$480.50 |
$978.50 |
|
|
Cysto impl 4 or more
|
$3,014.50 |
$3,193.00 |
$3,818.83 |
|
|
Cysto, litho, vacuum kidney
|
$399.00 |
$399.00 |
$8,555.00 |
|
|
Cystometrogram w/up 51727
|
$109.50 |
$193.60 |
$1,177.50 |
|
|
Cystorrhaphy wound comp 51865
|
$930.50 |
$930.50 |
$1,488.80 |
|
|
Cystorrhaphy wound simple 51860
|
$780.50 |
$783.00 |
$23,466.67 |
|
|
Cysto rx balo cath urtl strx
|
$169.00 |
$169.00 |
$270.40 |
|
|
Cystoscopy and biopsy
|
$170.50 |
$170.50 |
$272.80 |
|
|
Cystoscopy and treatment
|
$177.50 |
$284.00 |
$5,768.50 |
|
|
Cystoscopy and treatment
|
$205.00 |
$328.00 |
$4,083.00 |
|
|
Cystoscopy and treatment
|
$250.50 |
$4,051.50 |
$6,699.00 |
|
|
Cystoscopy and treatment
|
$294.50 |
$2,501.00 |
$7,523.50 |
|
|
Cystoscopy and treatment
|
$399.00 |
$5,251.00 |
$13,613.25 |
|
|
Cystoscopy and treatment
|
$215.00 |
$2,293.00 |
$5,833.63 |
|
|
Cystoscopy and treatment
|
$167.00 |
$2,304.50 |
$2,670.00 |
|
|
Cystoscopy and treatment
|
$270.00 |
$274.50 |
$6,569.00 |
|
|
Cystoscopy and treatment
|
$626.00 |
$801.50 |
$3,828.00 |
|
|
Cystoscopy and treatment
|
$1,387.00 |
$1,387.00 |
$6,384.50 |
|
|
Cystoscopy and treatment
|
$295.50 |
$301.00 |
$4,305.50 |
|
|
Cystoscopy and treatment
|
$155.50 |
$2,403.00 |
$9,309.00 |
|
|
Cystoscopy and treatment
|
$281.00 |
$449.60 |
$5,928.00 |
|
|
Cystoscopy and treatment
|
$250.50 |
$256.50 |
$8,715.00 |
|
|
Cystoscopy and treatment
|
$268.00 |
$273.50 |
$4,083.00 |
|
|
Cystoscopy (Bladder Scope)
|
$571.00 |
$1,019.50 |
$8,483.17 |
|
|
Cystoscopy chemodenervation
|
$173.00 |
$2,417.00 |
$4,433.00 |
|
|
Cystoscopy implant stent
|
$345.00 |
$345.00 |
$552.00 |
|
|
Cystoscopy inject material
|
$2,461.00 |
$2,461.00 |
$2,461.00 |
|
|
Cystoscopy prostatic imp 1-3
|
$1,986.83 |
$1,986.83 |
$3,270.50 |
|
|
Cystoscopy removal of clots
|
$1,296.00 |
$2,881.00 |
$7,293.00 |
|
|
Cystoscopy & revise urethra
|
$253.50 |
$258.50 |
$8,844.50 |
|
|
Cystoscopy stone removal
|
$327.00 |
$332.00 |
$6,824.83 |
|
|
Cystoscopy & ureter catheter
|
$137.00 |
$3,279.50 |
$7,811.00 |
|
|
Cystostomy cystotomy w/drainage 51040
|
$303.50 |
$2,481.00 |
$9,718.50 |
|
|
Cystouretero & or pyeloscope
|
$308.50 |
$2,336.83 |
$7,324.00 |
|
|
Cysto/uretero stricture tx
|
$376.50 |
$3,049.34 |
$14,980.00 |
|
|
Cystouretero w/biopsy
|
$425.50 |
$1,849.75 |
$9,319.00 |
|
|
Cystouretero w/excise tumor
|
$476.00 |
$510.50 |
$5,654.17 |
|
|
Cysto/uretero w/lithotripsy
|
$424.00 |
$7,333.50 |
$27,092.50 |
|
|
Cystouretero w/lithotripsy
|
$399.00 |
$4,189.00 |
$13,649.67 |
|
|
Cystouretero w/renal strict
|
$454.50 |
$454.50 |
$727.20 |
|