|
CT limited or localized follow-up study
|
$493.43 |
$493.43 |
$493.43 |
$625.63
|
|
CT lower extremity w/contrast (both sides)
|
$1,243.38 |
$1,243.38 |
$1,243.38 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$1,195.15 |
$1,195.15 |
$1,195.15 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$1,547.60 |
$1,547.60 |
$1,547.60 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$1,470.75 |
$1,470.75 |
$1,470.75 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$1,138.44 |
$1,138.44 |
$1,138.44 |
$1,332.50
|
|
CT neck soft tissue without & w/contrast
|
$2,060.64 |
$2,060.64 |
$2,060.64 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,777.62 |
$1,777.62 |
$1,777.62 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,335.07 |
$1,335.07 |
$1,335.07 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,162.29 |
$1,162.29 |
$1,162.29 |
$1,351.20
|
|
Ctrl nosebld postir subsq 30906
|
$299.98 |
$299.98 |
$299.98 |
$456.00
|
|
CT scan for therapy guide
|
$1,699.18 |
$1,699.18 |
$1,699.18 |
$729.40
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,848.22 |
$2,848.22 |
$2,848.22 |
$3,301.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,898.46 |
$1,898.46 |
$1,898.46 |
$2,847.65
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,981.67 |
$1,981.67 |
$1,981.67 |
$2,284.15
|
|
CT thoracic spine w/contrast
|
$1,331.36 |
$1,331.36 |
$1,331.36 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$1,230.13 |
$1,230.13 |
$1,230.13 |
$1,443.00
|
|
CT thorax low dose for lung screening without contrast
|
$328.60 |
$328.60 |
$328.60 |
$400.20
|
|
CT t-spine w /wo contrast
|
$1,816.31 |
$1,816.31 |
$1,816.31 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$1,129.43 |
$1,129.43 |
$1,129.43 |
$1,700.00
|
|
CT upper extremity without contrast (both sides)
|
$1,102.40 |
$1,102.40 |
$1,102.40 |
$1,468.83
|
|
CT uppr extremity w/o&w/dye
|
$1,212.11 |
$1,212.11 |
$1,212.11 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$57.77 |
$57.77 |
$57.77 |
$63.75
|
|
Culture afb any source
|
$115.01 |
$115.01 |
$115.01 |
$110.50
|
|
Culture anaerobic additional method definitive id each
|
$74.73 |
$74.73 |
$74.73 |
$77.31
|
|
Culture anaerobic except blood
|
$87.98 |
$87.98 |
$87.98 |
$123.20
|
|
Culture bact stool aero addl path ea
|
$71.55 |
$71.55 |
$71.55 |
$52.80
|
|
Culture body fluid
|
$91.69 |
$91.69 |
$91.69 |
$130.50
|
|
Culture fungi definitive id mold
|
$58.83 |
$58.83 |
$58.83 |
$70.00
|
|
Culture fungi definitive id yeast
|
$59.89 |
$59.89 |
$59.89 |
$80.60
|
|
Culture fungi other (except blood)
|
$77.91 |
$77.91 |
$77.91 |
$105.60
|
|
Culture fungi skin/hair/nail
|
$71.55 |
$71.55 |
$71.55 |
$77.40
|
|
Culture mycobacteria definitive id each isolate
|
$115.54 |
$115.54 |
$115.54 |
$84.75
|
|
Culture mycoplasma any source
|
$83.21 |
$83.21 |
$83.21 |
$90.37
|
|
Culture quantitative aerobic other source
|
$66.78 |
$66.78 |
$66.78 |
$87.02
|
|
Culture screening strep group a
|
$61.48 |
$61.48 |
$61.48 |
$81.60
|
|
Culture typing added method
|
$49.29 |
$49.29 |
$49.29 |
$34.45
|
|
Culture typing immunologic
|
$43.46 |
$43.46 |
$43.46 |
$41.60
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$124.02 |
$124.02 |
$124.02 |
$124.40
|
|
Culture urine each isolate
|
$66.78 |
$66.78 |
$66.78 |
$46.20
|
|
Culture virus isolation
|
$144.16 |
$144.16 |
$144.16 |
$39.20
|
|
Cv line/pic reposition
|
$948.70 |
$948.70 |
$948.70 |
$1,829.42
|
|
Cyanocobalamin unsat binding capacity
|
$100.17 |
$100.17 |
$100.17 |
$60.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$15.10 |
$15.10 |
$15.10 |
$33.37
|
|
Cyclic citrullinated peptide antibody
|
$88.51 |
$88.51 |
$88.51 |
$80.05
|
|
Cyclosporine 2 hour
|
$151.05 |
$151.05 |
$151.05 |
$121.80
|
|
Cyclosporine modified 25 mg capsule
|
$1.99 |
$1.99 |
$1.99 |
$9.79
|
|
Cyp2d6 gene com variants
|
$806.66 |
$806.66 |
$806.66 |
$537.50
|
|
Cystatin c
|
$266.59 |
$266.59 |
$266.59 |
$82.26
|
|
Cystic fibrosis cftr
|
$3,733.32 |
$3,733.32 |
$3,733.32 |
$1,041.95
|
|
Cystine urine quantitative
|
$142.04 |
$142.04 |
$142.04 |
$103.35
|
|
Cystogram >= 3 views supervision & interpretation
|
$471.70 |
$471.70 |
$471.70 |
$539.55
|
|
Cystometrogram w/up 51727
|
$486.54 |
$486.54 |
$486.54 |
$857.38
|
|
Cystoscopy and biopsy
|
$788.64 |
$788.64 |
$788.64 |
$4,061.71
|
|
Cystoscopy and treatment
|
$1,718.26 |
$1,718.26 |
$1,718.26 |
$4,081.37
|
|
Cystoscopy and treatment
|
$1,706.07 |
$1,706.07 |
$1,706.07 |
$4,081.37
|
|
Cystoscopy and treatment
|
$546.43 |
$546.43 |
$546.43 |
$2,424.12
|
|
Cystoscopy and treatment
|
$176.49 |
$176.49 |
$176.49 |
$2,358.72
|
|
Cystoscopy and treatment
|
$225.78 |
$225.78 |
$225.78 |
$802.40
|
|
Cystoscopy and treatment
|
$231.61 |
$231.61 |
$231.61 |
$3,174.25
|
|
Cystoscopy and treatment
|
$385.84 |
$385.84 |
$385.84 |
$3,219.80
|
|
Cystoscopy and treatment
|
$1,075.37 |
$1,075.37 |
$1,075.37 |
$3,986.00
|
|
Cystoscopy chemodenervation
|
$331.25 |
$331.25 |
$331.25 |
$2,412.45
|
|
Cystoscopy & duct catheter
|
$513.04 |
$513.04 |
$513.04 |
$822.50
|
|
Cystoscopy & revise urethra
|
$462.69 |
$462.69 |
$462.69 |
$2,412.45
|
|
Cystoscopy & revise urethra
|
$625.93 |
$625.93 |
$625.93 |
$2,424.12
|
|
Cystoscopy & ureter catheter
|
$390.61 |
$390.61 |
$390.61 |
$3,416.48
|
|
Cystourethroscop/calib/dilat stric 52281
|
$348.74 |
$348.74 |
$348.74 |
$2,874.36
|
|
Cystourethroscopy w/biopsy(s) 52204
|
$681.58 |
$681.58 |
$681.58 |
$3,970.98
|
|
Cytarabine 20 mg/ml injection solution
|
$0.53 |
$0.53 |
$0.53 |
$89.95
|
|
Cytogenetics 25-99
|
$645.01 |
$645.01 |
$645.01 |
$180.32
|
|
Cytogenomic neo microra alys
|
$2,074.95 |
$2,074.95 |
$2,074.95 |
$1,911.78
|
|
Cytomegalovirus (cmv) antibody igg
|
$104.94 |
$104.94 |
$104.94 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$61.48 |
$61.48 |
$61.48 |
$96.80
|
|
Cytomegalovirus imm IV /vial
|
$1,681.16 |
$1,681.16 |
$1,681.16 |
$3,113.07
|
|
Cytopath c/v index add-on
|
$45.58 |
$45.58 |
$45.58 |
$29.60
|
|
Cytopathology cellular enhancement technique non-gyn
|
$195.57 |
$195.57 |
$195.57 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$185.50 |
$185.50 |
$185.50 |
$90.75
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$33.92 |
$33.92 |
$33.92 |
$84.50
|
|
Cytopathology concentration technique smears & interpretation
|
$193.45 |
$193.45 |
$193.45 |
$142.94
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$101.76 |
$101.76 |
$101.76 |
$124.80
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$133.56 |
$133.56 |
$133.56 |
$73.45
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$161.12 |
$161.12 |
$161.12 |
$185.00
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$266.06 |
$266.06 |
$266.06 |
$205.00
|
|
Cytopath smear other source
|
$116.07 |
$116.07 |
$116.07 |
$85.80
|
|
Cytopath smear other source
|
$179.14 |
$179.14 |
$179.14 |
$122.19
|
|
Cytopath smear oth prep screen & interp
|
$106.53 |
$106.53 |
$106.53 |
$95.89
|
|
Cytopath tbs c/v manual
|
$84.80 |
$84.80 |
$84.80 |
$57.94
|
|
Cytotoxic antibody screening
|
$128.26 |
$128.26 |
$128.26 |
$157.60
|
|
Cytotoxic antibody screening
|
$96.46 |
$96.46 |
$96.46 |
$75.20
|
|
Cytp urine 3-5 probes cmptr
|
$592.54 |
$592.54 |
$592.54 |
$690.00
|
|
Dacarbazine 100 mg intravenous solution
|
$12.94 |
$12.94 |
$12.94 |
$82.91
|
|
Dactinomycin 0.5 mg intravenous solution
|
$1,197.80 |
$1,197.80 |
$1,197.80 |
$2,526.62
|
|
Dalbavancin 500 mg intravenous solution
|
$29.22 |
$29.22 |
$29.22 |
$3,469.30
|
|
Dalteparin sodium
|
$12.19 |
$12.19 |
$12.19 |
$124.09
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.41 |
$0.41 |
$0.41 |
$315.32
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$77.35 |
$77.35 |
$77.35 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$13.46 |
$13.46 |
$13.46 |
$5,546.48
|
|
Darbepoetin alfa, esrd use
|
$4.24 |
$4.24 |
$4.24 |
$3.04
|
|
Dch glucoscan
|
$9.54 |
$9.54 |
$9.54 |
$24.85
|