|
CT Angiogram of Abdomen and Pelvis
|
$2,910.00 |
$2,910.00 |
$2,910.00 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$1,915.30
|
|
CT Angiogram of the Head
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$1,946.10
|
|
CT angio hrt w/3d image
|
$1,675.00 |
$1,675.00 |
$1,675.00 |
$1,509.00
|
|
CT angio pelvis
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$3,880.00 |
$3,880.00 |
$3,880.00 |
$1,689.80
|
|
CT colonography dx
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$770.90
|
|
CT colonography dx w/dye
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,016.80
|
|
CT colonography screening
|
$500.00 |
$500.00 |
$500.00 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$1,498.20
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$1,113.84
|
|
CT guid cryo ablat intramuscular
|
$2,660.00 |
$2,660.00 |
$2,660.00 |
$1,643.20
|
|
CT guid parench tis ablat
|
$1,135.00 |
$1,135.00 |
$1,135.00 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$24.50 |
$24.50 |
$24.50 |
$187.72
|
|
CT hrt w/3d image
|
$1,675.00 |
$1,675.00 |
$1,675.00 |
$1,373.40
|
|
CT limited or localized follow-up study
|
$945.00 |
$945.00 |
$945.00 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,619.20
|
|
CT lower extremity without contrast (both sides)
|
$2,940.00 |
$2,940.00 |
$2,940.00 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,851.60
|
|
CT neck soft tissue w/contrast
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,630.23
|
|
CT neck soft tissue without contrast
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,318.20
|
|
CT neck soft tissue without & w/contrast
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,940.00
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,705.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,351.20
|
|
CT scan for localization
|
$845.00 |
$845.00 |
$845.00 |
$1,202.37
|
|
CT scan for therapy guide
|
$1,445.00 |
$1,445.00 |
$1,445.00 |
$694.60
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$4,610.00 |
$4,610.00 |
$4,610.00 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,140.00 |
$3,140.00 |
$3,140.00 |
$2,855.63
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,940.00 |
$2,940.00 |
$2,940.00 |
$2,295.00
|
|
CT thoracic spine w/contrast
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,688.40
|
|
CT thoracic spine without contrast
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$445.00 |
$445.00 |
$445.00 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,421.20
|
|
CT uppr extremity w/o&w/dye
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$80.00 |
$80.00 |
$80.00 |
$68.80
|
|
Culture afb any source
|
$80.00 |
$80.00 |
$80.00 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$47.50 |
$47.50 |
$47.50 |
$78.60
|
|
Culture anaerobic except blood
|
$80.00 |
$80.00 |
$80.00 |
$117.45
|
|
Culture bact stool aero addl path ea
|
$80.00 |
$80.00 |
$80.00 |
$51.60
|
|
Culture body fluid
|
$80.00 |
$80.00 |
$80.00 |
$121.80
|
|
Culture fungi definitive id mold
|
$80.00 |
$80.00 |
$80.00 |
$74.83
|
|
Culture fungi definitive id yeast
|
$80.00 |
$80.00 |
$80.00 |
$79.10
|
|
Culture fungi other (except blood)
|
$80.00 |
$80.00 |
$80.00 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$80.00 |
$80.00 |
$80.00 |
$75.40
|
|
Culture mycobacteria definitive id each isolate
|
$80.00 |
$80.00 |
$80.00 |
$88.40
|
|
Culture quantitative aerobic other source
|
$80.00 |
$80.00 |
$80.00 |
$89.10
|
|
Culture screening strep group a
|
$142.50 |
$142.50 |
$142.50 |
$81.25
|
|
Culture type pulse field gel
|
$120.00 |
$120.00 |
$120.00 |
$38.58
|
|
Culture typing immunologic
|
$22.50 |
$22.50 |
$22.50 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$392.50 |
$392.50 |
$392.50 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$235.00 |
$235.00 |
$235.00 |
$130.38
|
|
Culture urine each isolate
|
$80.00 |
$80.00 |
$80.00 |
$52.65
|
|
Cutter lead
|
$856.32 |
$856.32 |
$856.32 |
$5,906.56
|
|
Cv line/pic reposition
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$1,719.44
|
|
Cyanocobalamin unsat binding capacity
|
$100.00 |
$100.00 |
$100.00 |
$64.28
|
|
Cyclic citrullinated peptide antibody
|
$80.00 |
$80.00 |
$80.00 |
$72.00
|
|
Cyclophosphamide 1 gram intravenous powder for solution
|
$5.39 |
$5.39 |
$5.39 |
$1,284.14
|
|
Cyclosporine 2 hour
|
$150.00 |
$150.00 |
$150.00 |
$126.10
|
|
Cylinder pump set 20cm titan zero angl
|
$19,701.80 |
$19,701.80 |
$19,701.80 |
$23,912.22
|
|
Cystatin c
|
$90.00 |
$90.00 |
$90.00 |
$76.41
|
|
Cystic fibrosis cftr
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,060.00
|
|
Cystine urine quantitative
|
$112.50 |
$112.50 |
$112.50 |
$101.60
|
|
Cystogram >= 3 views supervision & interpretation
|
$510.00 |
$510.00 |
$510.00 |
$539.55
|
|
Cystometrogram w/up 51727
|
$775.00 |
$775.00 |
$775.00 |
$857.38
|
|
Cystoscopy and treatment
|
$2,400.00 |
$2,400.00 |
$2,400.00 |
$2,874.36
|
|
Cytogenetics 25-99
|
$265.00 |
$265.00 |
$265.00 |
$189.80
|
|
Cytogenetics 3-5
|
$915.00 |
$915.00 |
$915.00 |
$147.36
|
|
Cytomegalovirus (cmv) antibody igg
|
$95.00 |
$95.00 |
$95.00 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$100.00 |
$100.00 |
$100.00 |
$95.55
|
|
Cytopathology cellular enhancement technique non-gyn
|
$80.00 |
$80.00 |
$80.00 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$95.00 |
$95.00 |
$95.00 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$87.50 |
$87.50 |
$87.50 |
$87.29
|
|
Cytopathology concentration technique smears & interpretation
|
$152.50 |
$152.50 |
$152.50 |
$134.70
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$100.00 |
$100.00 |
$100.00 |
$129.90
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$42.50 |
$42.50 |
$42.50 |
$70.00
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$120.00 |
$120.00 |
$120.00 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$207.50 |
$207.50 |
$207.50 |
$207.50
|
|
Cytopath smear other source
|
$92.50 |
$92.50 |
$92.50 |
$88.13
|
|
Cytopath smear oth prep screen & interp
|
$85.00 |
$85.00 |
$85.00 |
$96.20
|
|
Cytp urine 3-5 probes cmptr
|
$760.00 |
$760.00 |
$760.00 |
$690.00
|
|
Dalbavancin 500 mg intravenous solution
|
$36.30 |
$36.30 |
$36.30 |
$3,493.11
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$125.23 |
$125.23 |
$125.23 |
$21,063.03
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$16.80 |
$16.80 |
$16.80 |
$5,546.48
|
|
Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution
|
$526.40 |
$526.40 |
$526.40 |
$20,196.00
|
|
Dch pulmonary stress test
|
$1,190.00 |
$1,190.00 |
$1,190.00 |
$963.30
|
|
Dch validity tests
|
$15.00 |
$15.00 |
$15.00 |
$24.05
|
|
Dcm pq ndl dsk sgl/mlt lv lmbr w/guide
|
$3,500.00 |
$3,500.00 |
$3,500.00 |
$4,478.50
|
|
Deamidated gliadin antibody iga
|
$85.00 |
$85.00 |
$85.00 |
$44.16
|
|
Debrid ecz/inf skin up tp 10% body 11000
|
$237.50 |
$237.50 |
$237.50 |
$668.55
|
|
Debridement (>20 cm) charge pt
|
$227.50 |
$227.50 |
$227.50 |
$262.60
|
|
Debride nail1-5 11720
|
$67.50 |
$67.50 |
$67.50 |
$148.80
|
|
Debride nail6 or more 11721
|
$90.00 |
$90.00 |
$90.00 |
$166.40
|
|
Decalcification
|
$75.00 |
$75.00 |
$75.00 |
$68.90
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$272.50 |
$272.50 |
$272.50 |
$540.00
|
|
Delivery of placenta 59414
|
$635.00 |
$635.00 |
$635.00 |
$2,917.60
|
|
Delivery transcath fxtn dvc to endogrft w/s&i
|
$3,975.00 |
$3,975.00 |
$3,975.00 |
$6,670.30
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$70.00 |
$70.00 |
$70.00 |
$185.40
|
