|
Creatinine 24 hour urine
|
$70.40 |
$70.40 |
$70.40 |
$59.80
|
|
Creatinine clearance urine
|
$148.50 |
$148.50 |
$148.50 |
$87.50
|
|
#creutz-prot.,western blot
|
$1,486.65 |
$1,486.65 |
$1,486.65 |
$173.00
|
|
Critical care 30-74 minutes
|
$2,114.20 |
$2,114.20 |
$2,114.20 |
$2,745.69
|
|
Critical care each additional 30 minutes
|
$856.90 |
$856.90 |
$856.90 |
$777.00
|
|
Cryofibrinogen qualitative - sendout
|
$104.50 |
$104.50 |
$104.50 |
$50.88
|
|
Cryoprecipitate each unit
|
$364.65 |
$364.65 |
$364.65 |
$185.64
|
|
Crystal identification light microscopy
|
$116.05 |
$116.05 |
$116.05 |
$65.25
|
|
CT 3d report other modality w/workstation
|
$1,251.25 |
$1,251.25 |
$1,251.25 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$2,544.85 |
$2,544.85 |
$2,544.85 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,698.85 |
$2,698.85 |
$2,698.85 |
$2,080.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,698.95 |
$1,698.95 |
$1,698.95 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$2,576.20 |
$2,576.20 |
$2,576.20 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,509.55 |
$3,509.55 |
$3,509.55 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,698.85 |
$2,698.85 |
$2,698.85 |
$1,955.80
|
|
CT Angiogram of the Head
|
$2,830.85 |
$2,830.85 |
$2,830.85 |
$2,021.40
|
|
CT angio pelvis
|
$2,544.85 |
$2,544.85 |
$2,544.85 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$1,608.75 |
$1,608.75 |
$1,608.75 |
$1,652.25
|
|
CT colonography screening
|
$964.15 |
$964.15 |
$964.15 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,354.10 |
$1,354.10 |
$1,354.10 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$745.25 |
$745.25 |
$745.25 |
$1,085.05
|
|
CT lower extremity w/contrast (both sides)
|
$1,390.40 |
$1,390.40 |
$1,390.40 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$1,045.55 |
$1,045.55 |
$1,045.55 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$1,422.85 |
$1,422.85 |
$1,422.85 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,496.00 |
$1,496.00 |
$1,496.00 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,108.25 |
$1,108.25 |
$1,108.25 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$1,595.00 |
$1,595.00 |
$1,595.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,459.60 |
$2,459.60 |
$2,459.60 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,612.05 |
$1,612.05 |
$1,612.05 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,603.80 |
$1,603.80 |
$1,603.80 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$400.40 |
$400.40 |
$400.40 |
$456.00
|
|
CT scan for therapy guide
|
$771.10 |
$771.10 |
$771.10 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,952.40 |
$2,952.40 |
$2,952.40 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,883.65 |
$2,883.65 |
$2,883.65 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,552.55 |
$2,552.55 |
$2,552.55 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,667.05 |
$1,667.05 |
$1,667.05 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,643.40 |
$1,643.40 |
$1,643.40 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,117.05 |
$1,117.05 |
$1,117.05 |
$400.20
|
|
CT t-spine w /wo contrast
|
$1,778.70 |
$1,778.70 |
$1,778.70 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$1,422.85 |
$1,422.85 |
$1,422.85 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,075.25 |
$1,075.25 |
$1,075.25 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$1,523.50 |
$1,523.50 |
$1,523.50 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$189.20 |
$189.20 |
$189.20 |
$63.75
|
|
Culture afb any source
|
$179.85 |
$179.85 |
$179.85 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$351.45 |
$351.45 |
$351.45 |
$77.31
|
|
Culture anaerobic except blood
|
$190.30 |
$190.30 |
$190.30 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$57.20 |
$57.20 |
$57.20 |
$52.80
|
|
Culture body fluid
|
$169.40 |
$169.40 |
$169.40 |
$130.50
|
|
Culture fungi definitive id mold
|
$41.80 |
$41.80 |
$41.80 |
$70.00
|
|
Culture fungi definitive id yeast
|
$114.40 |
$114.40 |
$114.40 |
$80.60
|
|
Culture fungi other (except blood)
|
$50.05 |
$50.05 |
$50.05 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$121.00 |
$121.00 |
$121.00 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$180.95 |
$180.95 |
$180.95 |
$84.75
|
|
Culture mycoplasma any source
|
$90.75 |
$90.75 |
$90.75 |
$90.37
|
|
Culture screening strep group a
|
$161.15 |
$161.15 |
$161.15 |
$81.60
|
|
Culture typing added method
|
$105.05 |
$105.05 |
$105.05 |
$34.45
|
|
Culture typing immunologic
|
$101.20 |
$101.20 |
$101.20 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$344.30 |
$344.30 |
$344.30 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$121.00 |
$121.00 |
$121.00 |
$124.40
|
|
Culture urine each isolate
|
$138.05 |
$138.05 |
$138.05 |
$46.20
|
|
Cyclic citrullinated peptide antibody
|
$44.55 |
$44.55 |
$44.55 |
$80.05
|
|
Cyclosporine 2 hour
|
$32.45 |
$32.45 |
$32.45 |
$121.80
|
|
Cyp2d6 gene com variants
|
$593.45 |
$593.45 |
$593.45 |
$537.50
|
|
Cystatin c
|
$40.15 |
$40.15 |
$40.15 |
$82.26
|
|
Cystine urine quantitative
|
$84.15 |
$84.15 |
$84.15 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$589.60 |
$589.60 |
$589.60 |
$539.55
|
|
Cytogenetics 25-99
|
$215.05 |
$215.05 |
$215.05 |
$180.32
|
|
Cytogenom microarray copy nmbr var
|
$5,252.50 |
$5,252.50 |
$5,252.50 |
$1,433.77
|
|
Cytomegalovirus (cmv) antibody igg
|
$73.15 |
$73.15 |
$73.15 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$21.45 |
$21.45 |
$21.45 |
$96.80
|
|
Cyto/molecular report
|
$548.35 |
$548.35 |
$548.35 |
$144.75
|
|
Cytopathology cellular enhancement technique non-gyn
|
$240.90 |
$240.90 |
$240.90 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$108.35 |
$108.35 |
$108.35 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$70.40 |
$70.40 |
$70.40 |
$142.94
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$155.65 |
$155.65 |
$155.65 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$500.50 |
$500.50 |
$500.50 |
$205.00
|
|
Cytopath smear other source
|
$177.10 |
$177.10 |
$177.10 |
$85.80
|
|
Cytopath smear oth prep screen & interp
|
$202.40 |
$202.40 |
$202.40 |
$95.89
|
|
Cytopath tbs c/v manual
|
$68.20 |
$68.20 |
$68.20 |
$57.94
|
|
Cytotoxic antibody screening
|
$367.95 |
$367.95 |
$367.95 |
$157.60
|
|
Cytp urine 3-5 probes cmptr
|
$1,370.05 |
$1,370.05 |
$1,370.05 |
$690.00
|
|
Dch glucoscan
|
$6.05 |
$6.05 |
$6.05 |
$24.85
|
|
Dch validity tests
|
$15.40 |
$15.40 |
$15.40 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$17.60 |
$17.60 |
$17.60 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$540.10 |
$540.10 |
$540.10 |
$692.00
|
|
Debridement (>20 cm) charge pt
|
$173.80 |
$173.80 |
$173.80 |
$262.60
|
|
Decalcification
|
$43.45 |
$43.45 |
$43.45 |
$73.60
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$464.20 |
$464.20 |
$464.20 |
$545.90
|
|
Delivery of placenta 59414
|
$2,622.95 |
$2,622.95 |
$2,622.95 |
$3,271.20
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$199.10 |
$199.10 |
$199.10 |
$196.26
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$365.75 |
$365.75 |
$365.75 |
$460.50
|
|
Design mlc device for imrt
|
$2,511.85 |
$2,511.85 |
$2,511.85 |
$1,669.85
|
|
Destroy premlg lesns;1st lesn 17000
|
$215.05 |
$215.05 |
$215.05 |
$220.12
|
|
Developmental screen/score/document 96110
|
$244.75 |
$244.75 |
$244.75 |
$139.10
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$102.30 |
$102.30 |
$102.30 |
$220.43
|
|
Dhea-s (dehydroepiand sulfate)
|
$11.00 |
$11.00 |
$11.00 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$149.60 |
$149.60 |
$149.60 |
$78.03
|
|
Diagnostic anoscopy spx 46600
|
$162.80 |
$162.80 |
$162.80 |
$245.35
|
|
Diagnostic digital breast tomosynthesis bil
|
$26.40 |
$26.40 |
$26.40 |
$117.94
|
|
Diagnostic digital breast tomosynthesis unil
|
$26.40 |
$26.40 |
$26.40 |
$75.93
|
