|
Crystal identification light microscopy
|
$90.91 |
$90.91 |
$90.91 |
$65.25
|
|
Cta abdomen without & /or w/contrast
|
$6,323.51 |
$6,323.51 |
$6,323.51 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$6,323.51 |
$6,323.51 |
$6,323.51 |
$2,080.00
|
|
Cta neck without &/or w/contrast
|
$6,323.51 |
$6,323.51 |
$6,323.51 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$6,323.51 |
$6,323.51 |
$6,323.51 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$5,555.61 |
$5,555.61 |
$5,555.61 |
$1,955.80
|
|
CT Angiogram of the Head
|
$6,323.51 |
$6,323.51 |
$6,323.51 |
$2,021.40
|
|
CT lower extremity w/contrast (both sides)
|
$2,267.00 |
$2,267.00 |
$2,267.00 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$2,845.58 |
$2,845.58 |
$2,845.58 |
$1,398.82
|
|
CT neck soft tissue w/contrast
|
$3,161.76 |
$3,161.76 |
$3,161.76 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$2,845.58 |
$2,845.58 |
$2,845.58 |
$1,332.50
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$3,616.25 |
$3,616.25 |
$3,616.25 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$2,845.58 |
$2,845.58 |
$2,845.58 |
$1,351.20
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$6,442.34 |
$6,442.34 |
$6,442.34 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$5,871.84 |
$5,871.84 |
$5,871.84 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$4,968.48 |
$4,968.48 |
$4,968.48 |
$2,284.15
|
|
CT thoracic spine without contrast
|
$2,845.58 |
$2,845.58 |
$2,845.58 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,355.78 |
$1,355.78 |
$1,355.78 |
$400.20
|
|
CT upper extremity w/contrast (both sides)
|
$2,954.91 |
$2,954.91 |
$2,954.91 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$2,845.58 |
$2,845.58 |
$2,845.58 |
$1,468.83
|
|
Culture aerobic additional method definitive id each
|
$204.76 |
$204.76 |
$204.76 |
$63.75
|
|
Culture afb any source
|
$206.88 |
$206.88 |
$206.88 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$182.01 |
$182.01 |
$182.01 |
$77.31
|
|
Culture anaerobic except blood
|
$301.43 |
$301.43 |
$301.43 |
$123.20
|
|
Culture body fluid
|
$213.41 |
$213.41 |
$213.41 |
$130.50
|
|
Culture fungi definitive id yeast
|
$245.03 |
$245.03 |
$245.03 |
$80.60
|
|
Culture fungi other (except blood)
|
$219.47 |
$219.47 |
$219.47 |
$105.60
|
|
Culture screening strep group a
|
$427.30 |
$427.30 |
$427.30 |
$81.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,783.10 |
$1,783.10 |
$1,783.10 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$364.06 |
$364.06 |
$364.06 |
$124.40
|
|
Culture urine each isolate
|
$118.56 |
$118.56 |
$118.56 |
$46.20
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$35.06 |
$35.06 |
$35.06 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$371.50 |
$371.50 |
$371.50 |
$80.05
|
|
Cyclosporine oral 100 mg
|
$55.68 |
$55.68 |
$55.68 |
$39.04
|
|
Cystatin c
|
$227.16 |
$227.16 |
$227.16 |
$82.26
|
|
Cytarabine 20 mg/ml injection solution
|
$75.65 |
$75.65 |
$75.65 |
$89.95
|
|
Cytopathology cellular enhancement technique non-gyn
|
$354.98 |
$354.98 |
$354.98 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$446.58 |
$446.58 |
$446.58 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$236.78 |
$236.78 |
$236.78 |
$84.50
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$29,754.93 |
$29,754.93 |
$29,754.93 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$4,278.64 |
$4,278.64 |
$4,278.64 |
$5,546.48
|
|
Dch validity tests
|
$56.41 |
$56.41 |
$56.41 |
$25.20
|
|
Deamidated gliadin antibody iga
|
$258.57 |
$258.57 |
$258.57 |
$44.16
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$2,328.63 |
$2,328.63 |
$2,328.63 |
$810.50
|
|
Deferoxamine 500 mg solution for injection
|
$387.16 |
$387.16 |
$387.16 |
$110.82
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$305.14 |
$305.14 |
$305.14 |
$196.26
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$6,758.73 |
$6,758.73 |
$6,758.73 |
$7,933.81
|
|
Desmopressin 4 mcg/ml injection solution
|
$487.68 |
$487.68 |
$487.68 |
$102.32
|
|
Destroy premlg lesns;1st lesn 17000
|
$614.50 |
$614.50 |
$614.50 |
$220.12
|
|
Destruction 2-14 lesions 17003
|
$119.79 |
$119.79 |
$119.79 |
$72.60
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$30.22 |
$30.22 |
$30.22 |
$30.00
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$62.45 |
$62.45 |
$62.45 |
$60.00
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$62.45 |
$62.45 |
$62.45 |
$68.93
|
|
Dextrose 5 % in water (d5w) intravenous solution (non-pvc)
|
$23.25 |
$23.25 |
$23.25 |
$49.75
|
|
Dextrose 5 % IV bolus
|
$62.45 |
$62.45 |
$62.45 |
$68.93
|
|
Dhea-s (dehydroepiand sulfate)
|
$95.33 |
$95.33 |
$95.33 |
$107.50
|
|
Diabetes (HbA1c) Test
|
$193.18 |
$193.18 |
$193.18 |
$78.03
|
|
Diagnostic Mammogram (both breasts)
|
$616.54 |
$616.54 |
$616.54 |
$424.00
|
|
Diagnostic Mammogram (one breast)
|
$436.63 |
$436.63 |
$436.63 |
$301.55
|
|
Diatrizoate meglumine 18 % urethral solution
|
$510.98 |
$510.98 |
$510.98 |
$100.03
|
|
Diazepam 5 mg/ml injection solution (wrapper)
|
$41.81 |
$41.81 |
$41.81 |
$72.34
|
|
Dicyclomine injection
|
$162.67 |
$162.67 |
$162.67 |
$211.81
|
|
Digoxin 250 mcg/ml (0.25 mg/ml) injection solution
|
$29.68 |
$29.68 |
$29.68 |
$69.79
|
|
Digoxin total therapeutic drug level
|
$284.57 |
$284.57 |
$284.57 |
$102.00
|
|
Dilate esophagus 1/mult pass
|
$8,583.78 |
$8,583.78 |
$8,583.78 |
$1,484.17
|
|
Diphenhydramine 50 mg/ml injection (wrapper)
|
$25.14 |
$25.14 |
$25.14 |
$26.87
|
|
Dna antibody native/double stranded
|
$160.60 |
$160.60 |
$160.60 |
$102.60
|
|
Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution
|
$228.85 |
$228.85 |
$228.85 |
$101.04
|
|
Docetaxel 20 mg/ml intravenous solution (wrapper)
|
$609.69 |
$609.69 |
$609.69 |
$712.02
|
|
Dopamine 40 mg/ml intravenous solution (wrapper)
|
$92.23 |
$92.23 |
$92.23 |
$84.30
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$1,103.90 |
$1,103.90 |
$1,103.90 |
$482.03
|
|
Dostarlimab-gxly 50 mg/ml intravenous solution
|
$32,375.09 |
$32,375.09 |
$32,375.09 |
$32,490.15
|
|
Doxorubicin 2 mg/ml intravenous solution (wrapper)
|
$171.92 |
$171.92 |
$171.92 |
$299.52
|
|
Doxorubicin, pegylated liposomal 2 mg/ml intravenous suspension
|
$6,157.46 |
$6,157.46 |
$6,157.46 |
$2,417.38
|
|
Drainage external ear simple 69000
|
$380.80 |
$380.80 |
$380.80 |
$809.25
|
|
Drain blood from under nail 11740
|
$123.18 |
$123.18 |
$123.18 |
$190.33
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$948.08 |
$948.08 |
$948.08 |
$365.60
|
|
Dress/debrid prtl-thick burn l 16030
|
$128.03 |
$128.03 |
$128.03 |
$554.40
|
|
Droperidol 2.5 mg/ml injection solution
|
$33.23 |
$33.23 |
$33.23 |
$39.60
|
|
Drug test prsmv instrmnt
|
$437.66 |
$437.66 |
$437.66 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$1,189.51 |
$1,189.51 |
$1,189.51 |
$278.85
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$1,911.34 |
$1,911.34 |
$1,911.34 |
$903.00
|
|
Durvalumab 50 mg/ml intravenous solution
|
$35,545.38 |
$35,545.38 |
$35,545.38 |
$10,021.12
|
|
Ear irrigation 69209
|
$461.34 |
$461.34 |
$461.34 |
$165.42
|
|
Ecg 12 lead tracing only
|
$265.61 |
$265.61 |
$265.61 |
$245.00
|
|
Ecg external < 48 hours recording
|
$949.92 |
$949.92 |
$949.92 |
$461.76
|
|
Echocardiogram (Heart Ultrasound)
|
$3,636.02 |
$3,636.02 |
$3,636.02 |
$2,049.45
|
|
Echocardiography transthoracic 2d followup/limited
|
$3,636.02 |
$3,636.02 |
$3,636.02 |
$724.20
|
|
Echo stress
|
$1,645.97 |
$1,645.97 |
$1,645.97 |
$1,582.75
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$2,851.91 |
$2,851.91 |
$2,851.91 |
$1,014.01
|
|
Ehrlicha chaffeensis amp prb
|
$184.50 |
$184.50 |
$184.50 |
$105.00
|
|
Electrical stimulation/unattended 97014
|
$109.40 |
$109.40 |
$109.40 |
$81.75
|
|
Electrolyte panel
|
$265.88 |
$265.88 |
$265.88 |
$86.33
|
|
Enoxaparin 30 mg/0.3 ml subcutaneous syringe
|
$146.84 |
$146.84 |
$146.84 |
$121.63
|
|
Epoetin alfa-epbx 40,000 unit/ml injection solution
|
$428.16 |
$428.16 |
$428.16 |
$918.00
|
|
Epoetin alfa in ns IV syringe 100 unit/ml (neo/ped) - cnr
|
$663.76 |
$663.76 |
$663.76 |
$950.55
|
|
Epstein barr nuclear antigen antibody
|
$302.22 |
$302.22 |
$302.22 |
$81.81
|
|
Epstein barr viral capsid antigen antibody igm
|
$262.49 |
$262.49 |
$262.49 |
$95.04
|
|
Eptifibatide 0.75 mg/ml intravenous solution
|
$238.02 |
$238.02 |
$238.02 |
$363.57
|
|
Eptinezumab-jjmr 100 mg/ml intravenous solution
|
$3,810.14 |
$3,810.14 |
$3,810.14 |
$6,313.52
|