|
Brain MRI (without contrast)
|
$1,289.50 |
$1,289.50 |
$1,289.50 |
$1,948.00
|
|
Brcassure comprehensive panel-sendout
|
$5,880.15 |
$5,880.15 |
$5,880.15 |
$2,409.00
|
|
Breast Biopsy (ultrasound-guided, percutaneous)
|
$1,757.70 |
$1,757.70 |
$1,757.70 |
$2,952.00
|
|
Breastbone (Sternum) X-ray
|
$163.33 |
$163.33 |
$163.33 |
$274.65
|
|
Breast punct aspir cyst, bil
|
$332.78 |
$332.78 |
$332.78 |
$871.80
|
|
Br punct aspir ea add, l
|
$96.53 |
$96.53 |
$96.53 |
$357.51
|
|
Bundled special stain group 1 microorganisms
|
$74.52 |
$74.52 |
$74.52 |
$159.00
|
|
Bundled special stain group 2
|
$178.71 |
$178.71 |
$178.71 |
$173.40
|
|
Buprenorphine and metabolite - sendout
|
$79.33 |
$79.33 |
$79.33 |
$80.64
|
|
Bx breast add lesion Ultrasound imag
|
$715.50 |
$715.50 |
$715.50 |
$1,670.79
|
|
Bx thyroid/percutan core needle 60100
|
$695.25 |
$695.25 |
$695.25 |
$963.80
|
|
C1 esterase inhibitor func - sendout
|
$208.80 |
$208.80 |
$208.80 |
$96.72
|
|
Cadd pump refill
|
$188.19 |
$188.19 |
$188.19 |
$386.60
|
|
Calcium 24 hour urine
|
$47.35 |
$47.35 |
$47.35 |
$53.00
|
|
Calcium ionized
|
$79.33 |
$79.33 |
$79.33 |
$90.00
|
|
Calcium total
|
$39.98 |
$39.98 |
$39.98 |
$50.00
|
|
Calprotectin fecal
|
$153.75 |
$153.75 |
$153.75 |
$170.00
|
|
Campylobacter antibody
|
$27.84 |
$27.84 |
$27.84 |
$77.83
|
|
Cannula ercp contour 5-4-3 tip
|
$11,338.03 |
$11,338.03 |
$11,338.03 |
$44,000.00
|
|
Cap nerve 2x15mm
|
$3,160.60 |
$3,160.60 |
$3,160.60 |
$18,466.88
|
|
Cap trach decann 15mm
|
$732.40 |
$732.40 |
$732.40 |
$3,238.70
|
|
Carbamazepine free
|
$55.35 |
$55.35 |
$55.35 |
$60.00
|
|
Carbamazepine free -sendout
|
$55.35 |
$55.35 |
$55.35 |
$49.80
|
|
Carbamazepine total therapeutic drug level
|
$31.98 |
$31.98 |
$31.98 |
$122.85
|
|
Carbohydrate deficient transf - sendout
|
$33.83 |
$33.83 |
$33.83 |
$116.40
|
|
Carbohydrate urine - sendout
|
$140.84 |
$140.84 |
$140.84 |
$66.64
|
|
Carbon dioxide
|
$29.52 |
$29.52 |
$29.52 |
$44.00
|
|
Carboxyhemoglobin quantitative
|
$46.12 |
$46.12 |
$46.12 |
$84.73
|
|
Carcinoembryonic ag (cea)
|
$202.34 |
$202.34 |
$202.34 |
$145.20
|
|
Cardiac perf spect sgl/ef/wm rst/strs
|
$2,619.38 |
$2,619.38 |
$2,619.38 |
$2,917.00
|
|
Cardiac rehabilitation op phase 2 w/continous ecg monitoring
|
$154.44 |
$154.44 |
$154.44 |
$249.60
|
|
Cardiac rehabilitation op phase 2 without continous ecg monitoring
|
$97.68 |
$97.68 |
$97.68 |
$204.54
|
|
Cardiolipin antibody iga
|
$55.68 |
$55.68 |
$55.68 |
$107.25
|
|
Cardioversion (Scheduled Heart Rhythm Shock)
|
$853.30 |
$853.30 |
$853.30 |
$1,431.36
|
|
Caregiver training strategies&tq 1st 30 minutes
|
$136.38 |
$136.38 |
$136.38 |
$97.01
|
|
Caregiver training strategies&tq ea addl 15 min
|
$68.19 |
$68.19 |
$68.19 |
$51.52
|
|
Care mgmt svc bhvl hlth cond
|
$127.74 |
$127.74 |
$127.74 |
$55.09
|
|
Carotene
|
$41.20 |
$41.20 |
$41.20 |
$46.20
|
|
Carotid Artery Ultrasound (Duplex)
|
$978.08 |
$978.08 |
$978.08 |
$1,024.32
|
|
Cath 2lum 14.5frx43cm maxid kt mahurkar
|
$751.22 |
$751.22 |
$751.22 |
$830.58
|
|
Cath acuity innr ic130 6f 63cm
|
$4,298.96 |
$4,298.96 |
$4,298.96 |
$9,931.73
|
|
Cath adherent clot 10mm 6f 10
|
$1,000.85 |
$1,000.85 |
$1,000.85 |
$19,800.55
|
|
Cath cv dl inj 7fx16cm
|
$4,298.96 |
$4,298.96 |
$4,298.96 |
$4,488.99
|
|
Cath epdrl brevi-stf 12in .043
|
$1,250.48 |
$1,250.48 |
$1,250.48 |
$1,928.17
|
|
Catheterization collection of specimen single patient all places of service
|
$56.83 |
$56.83 |
$56.83 |
$40.95
|
|
Cath groshong MRI 8fr plstc port
|
$3,002.73 |
$3,002.73 |
$3,002.73 |
$1,690.71
|
|
Cath imag ivus pv 8.5fx90 .035
|
$3,224.80 |
$3,224.80 |
$3,224.80 |
$4,680.00
|
|
Cath malecot 28fr 4-wing ltx
|
$1,743.66 |
$1,743.66 |
$1,743.66 |
$2,549.50
|
|
Cath uret open tp 6fx70cm
|
$1,311.73 |
$1,311.73 |
$1,311.73 |
$573.88
|
|
Cdna analysis for variants
|
$662.66 |
$662.66 |
$662.66 |
$542.87
|
|
Cebpa gene full sequence
|
$779.72 |
$779.72 |
$779.72 |
$493.21
|
|
Cell count body fluid
|
$11.52 |
$11.52 |
$11.52 |
$63.52
|
|
Cell count w differential body fluid
|
$13.06 |
$13.06 |
$13.06 |
$92.56
|
|
Cell function assay w/stim
|
$283.97 |
$283.97 |
$283.97 |
$325.76
|
|
#cf-97variants
|
$1,793.58 |
$1,793.58 |
$1,793.58 |
$639.44
|
|
Cftr gene dup/delet variants
|
$1,402.64 |
$1,402.64 |
$1,402.64 |
$757.25
|
|
Change cystostomy tube simple
|
$241.65 |
$241.65 |
$241.65 |
$477.60
|
|
Change of windpipe airway 31502
|
$272.70 |
$272.70 |
$272.70 |
$401.50
|
|
Chest 2 vws w oblique
|
$328.18 |
$328.18 |
$328.18 |
$375.60
|
|
Chest apical lordotic proj
|
$290.36 |
$290.36 |
$290.36 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$1,367.40 |
$1,367.40 |
$1,367.40 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$911.40 |
$911.40 |
$911.40 |
$1,303.15
|
|
Chest Physiotherapy (first session)
|
$81.51 |
$81.51 |
$81.51 |
$160.80
|
|
Chest Physiotherapy (follow-up session)
|
$105.62 |
$105.62 |
$105.62 |
$134.50
|
|
Chest Ultrasound
|
$497.18 |
$497.18 |
$497.18 |
$463.88
|
|
Chest X-ray
|
$281.82 |
$281.82 |
$281.82 |
$294.06
|
|
Chest X-ray (single view)
|
$134.20 |
$134.20 |
$134.20 |
$236.60
|
|
Chg pr pul rehab for copd patients
|
$140.97 |
$140.97 |
$140.97 |
$150.40
|
|
Chimerism anal no cell selec
|
$669.10 |
$669.10 |
$669.10 |
$393.74
|
|
Chlamydia culture
|
$44.66 |
$44.66 |
$44.66 |
$91.00
|
|
Chlamydia trachomatis ag if
|
$52.21 |
$52.21 |
$52.21 |
$66.60
|
|
Chlamydia type
|
$35.85 |
$35.85 |
$35.85 |
$34.98
|
|
Chloride
|
$22.75 |
$22.75 |
$22.75 |
$42.63
|
|
Chloride 24 hour urine
|
$11.07 |
$11.07 |
$11.07 |
$50.88
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$457.60 |
$457.60 |
$457.60 |
$602.40
|
|
Cholecystostomy complete w/supervision & interpretation
|
$3,194.78 |
$3,194.78 |
$3,194.78 |
$3,856.84
|
|
Cholesterol
|
$34.44 |
$34.44 |
$34.44 |
$45.76
|
|
Cholesterol body fluid
|
$41.82 |
$41.82 |
$41.82 |
$89.28
|
|
Cholesterol (Lipid) Test
|
$62.73 |
$62.73 |
$62.73 |
$115.80
|
|
Cholinesterase
|
$37.52 |
$37.52 |
$37.52 |
$39.48
|
|
Chromatography
|
$33.83 |
$33.83 |
$33.83 |
$84.60
|
|
Chromo high res and frag x - sendout
|
$184.73 |
$184.73 |
$184.73 |
$250.00
|
|
Chromosome analysis 15-20 cell count
|
$338.88 |
$338.88 |
$338.88 |
$517.11
|
|
Chromosome analysis 5
|
$505.78 |
$505.78 |
$505.78 |
$644.80
|
|
Chronic urticaria - sendout
|
$44.54 |
$44.54 |
$44.54 |
$75.71
|
|
Chylomicron screen, bf - sendout
|
$113.77 |
$113.77 |
$113.77 |
$136.09
|
|
Circumcision (newborn)
|
$386.10 |
$386.10 |
$386.10 |
$1,364.88
|
|
C-kit mutation liquid tumor - sendout
|
$1,062.19 |
$1,062.19 |
$1,062.19 |
$666.60
|
|
Clip ligating vesolock lg
|
$1,395.58 |
$1,395.58 |
$1,395.58 |
$4,320.00
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$578.88 |
$578.88 |
$578.88 |
$520.80
|
|
Closed tx humerus fx w/manip 24505
|
$750.94 |
$750.94 |
$750.94 |
$1,549.52
|
|
Clot factor xii hageman
|
$48.34 |
$48.34 |
$48.34 |
$138.40
|
|
Clot factor xiii fibrin scrn
|
$17.81 |
$17.81 |
$17.81 |
$56.85
|
|
Clot factor xiii fibrin stab
|
$62.33 |
$62.33 |
$62.33 |
$106.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$485.62 |
$485.62 |
$485.62 |
$648.96
|
|
Clsd tx clavicle fracture w/manip 23505
|
$557.98 |
$557.98 |
$557.98 |
$1,893.86
|
|
Clsd tx dist fib fx w/manip 27788
|
$644.27 |
$644.27 |
$644.27 |
$676.65
|
|
Clsd tx elbow dislocation child 24640
|
$131.32 |
$131.32 |
$131.32 |
$465.21
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$158.12 |
$158.12 |
$158.12 |
$464.20
|
