|
Culture bact stool aero addl path ea
|
$39.63 |
$39.63 |
$39.63 |
$52.50
|
|
Culture body fluid
|
$70.45 |
$70.45 |
$70.45 |
$126.75
|
|
Culture fungi definitive id mold
|
$86.80 |
$86.80 |
$86.80 |
$80.00
|
|
Culture fungi definitive id yeast
|
$39.00 |
$39.00 |
$39.00 |
$80.00
|
|
Culture fungi other (except blood)
|
$49.06 |
$49.06 |
$49.06 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$37.11 |
$37.11 |
$37.11 |
$74.75
|
|
Culture mycoplasma any source
|
$39.63 |
$39.63 |
$39.63 |
$83.21
|
|
Culture quantitative aerobic other source
|
$38.37 |
$38.37 |
$38.37 |
$87.02
|
|
Culture screening strep group a
|
$41.51 |
$41.51 |
$41.51 |
$84.60
|
|
Culture typing immunologic
|
$53.47 |
$53.47 |
$53.47 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$86.17 |
$86.17 |
$86.17 |
$140.80
|
|
Culture urine each isolate
|
$15.72 |
$15.72 |
$15.72 |
$55.50
|
|
Cutter lead
|
$1,668.54 |
$1,668.54 |
$1,668.54 |
$6,581.45
|
|
Cyanocobalamin unsat binding capacity
|
$40.59 |
$40.59 |
$40.59 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$41.76 |
$41.76 |
$41.76 |
$72.36
|
|
Cyclosporine 2 hour
|
$35.67 |
$35.67 |
$35.67 |
$130.40
|
|
Cyp2c19 gene com variants
|
$939.75 |
$939.75 |
$939.75 |
$524.00
|
|
Cyp2c9 gene com variants
|
$563.85 |
$563.85 |
$563.85 |
$275.10
|
|
Cyp2d6 gene com variants
|
$1,453.12 |
$1,453.12 |
$1,453.12 |
$570.70
|
|
Cyp3a4 gene common variants
|
$563.85 |
$563.85 |
$563.85 |
$241.24
|
|
Cyp3a5 gene common variants
|
$563.85 |
$563.85 |
$563.85 |
$245.31
|
|
Cystatin c
|
$34.44 |
$34.44 |
$34.44 |
$77.60
|
|
Cystic fibrosis cftr
|
$1,607.78 |
$1,607.78 |
$1,607.78 |
$1,104.40
|
|
Cystine urine quantitative
|
$55.96 |
$55.96 |
$55.96 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$379.46 |
$379.46 |
$379.46 |
$586.95
|
|
Cytogenetics 25-99
|
$81.54 |
$81.54 |
$81.54 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$41.76 |
$41.76 |
$41.76 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$42.46 |
$42.46 |
$42.46 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$68.80 |
$68.80 |
$68.80 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$103.19 |
$103.19 |
$103.19 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$50.32 |
$50.32 |
$50.32 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$50.32 |
$50.32 |
$50.32 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$57.33 |
$57.33 |
$57.33 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$219.13 |
$219.13 |
$219.13 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$68.80 |
$68.80 |
$68.80 |
$213.85
|
|
Dch validity tests
|
$6.52 |
$6.52 |
$6.52 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$41.06 |
$41.06 |
$41.06 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$75.22 |
$75.22 |
$75.22 |
$284.00
|
|
Decalcification
|
$17.94 |
$17.94 |
$17.94 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$282.83 |
$282.83 |
$282.83 |
$572.95
|
|
Delivery of placenta 59414
|
$1,460.44 |
$1,460.44 |
$1,460.44 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$142.93 |
$142.93 |
$142.93 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$169.38 |
$169.38 |
$169.38 |
$401.60
|
|
Destroy cervthor facet jnt 64633
|
$2,488.05 |
$2,488.05 |
$2,488.05 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$747.22 |
$747.22 |
$747.22 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$674.32 |
$674.32 |
$674.32 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,465.78 |
$2,465.78 |
$2,465.78 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$127.95 |
$127.95 |
$127.95 |
$142.38
|
|
Device sut capio slim opn
|
$7,492.26 |
$7,492.26 |
$7,492.26 |
$1,860.95
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$332.99 |
$332.99 |
$332.99 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$41.20 |
$41.20 |
$41.20 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$18.45 |
$18.45 |
$18.45 |
$79.30
|
|
Diab manage trn ind/group
|
$34.66 |
$34.66 |
$34.66 |
$54.99
|
|
Diagnostic anoscopy spx 46600
|
$45.56 |
$45.56 |
$45.56 |
$195.50
|
|
Diagnostic Mammogram (both breasts)
|
$323.76 |
$323.76 |
$323.76 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$214.85 |
$214.85 |
$214.85 |
$314.00
|
|
Diffusing capacity
|
$267.15 |
$267.15 |
$267.15 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$32.59 |
$32.59 |
$32.59 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$1,000.85 |
$1,000.85 |
$1,000.85 |
$402.10
|
|
Disability dlco
|
$267.80 |
$267.80 |
$267.80 |
$293.76
|
|
Disaccharidases
|
$222.63 |
$222.63 |
$222.63 |
$230.40
|
|
Dmpk gene detc abnor allele
|
$886.05 |
$886.05 |
$886.05 |
$313.60
|
|
Dna antibody native/double stranded
|
$43.15 |
$43.15 |
$43.15 |
$100.00
|
|
Doppler echo complete
|
$437.28 |
$437.28 |
$437.28 |
$558.00
|
|
Dpyd gene common variants
|
$563.85 |
$563.85 |
$563.85 |
$423.60
|
|
Drainage of kidney lesion
|
$1,826.55 |
$1,826.55 |
$1,826.55 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$34.84 |
$34.84 |
$34.84 |
$182.40
|
|
Drain finger abscess;simple 26010
|
$153.83 |
$153.83 |
$153.83 |
$428.40
|
|
Dress/debride pt-tck burn/5-10% bs 16025
|
$123.28 |
$123.28 |
$123.28 |
$397.65
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$60.57 |
$60.57 |
$60.57 |
$349.50
|
|
Drng of eyelid abscess 67700
|
$190.82 |
$190.82 |
$190.82 |
$655.72
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$5,994.46 |
$5,994.46 |
$5,994.46 |
$1,818.32
|
|
Drug assay caffeine
|
$71.34 |
$71.34 |
$71.34 |
$80.00
|
|
Drug assay posaconazole
|
$72.57 |
$72.57 |
$72.57 |
$96.75
|
|
Drug assay voriconazole
|
$78.11 |
$78.11 |
$78.11 |
$96.75
|
|
Drug of abuse screen urine
|
$23.37 |
$23.37 |
$23.37 |
$67.89
|
|
Drug screening tapentadol
|
$34.44 |
$34.44 |
$34.44 |
$47.03
|
|
Drug test prsmv instrmnt
|
$31.98 |
$31.98 |
$31.98 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$276.14 |
$276.14 |
$276.14 |
$278.85
|
|
Ductogram sgl duct
|
$290.05 |
$290.05 |
$290.05 |
$469.80
|
|
Dup scan/ue art/graft/bilat/comp 93930
|
$859.67 |
$859.67 |
$859.67 |
$904.78
|
|
Dxa bone density axl vrt fx
|
$356.93 |
$356.93 |
$356.93 |
$401.20
|
|
Ear irrigation 69209
|
$23.58 |
$23.58 |
$23.58 |
$154.70
|
|
Ecg/1-3 leads/tracing only 93041
|
$112.93 |
$112.93 |
$112.93 |
$132.08
|
|
Ecg external < 48 hours recording
|
$301.42 |
$301.42 |
$301.42 |
$467.40
|
|
Ecg external < 48 hours scanning analysis w/report
|
$449.97 |
$449.97 |
$449.97 |
$541.20
|
|
Echocardiogram (Heart Ultrasound)
|
$1,906.24 |
$1,906.24 |
$1,906.24 |
$2,024.64
|
|
Echocardiogram (Limited Follow-Up Heart Ultrasound)
|
$430.84 |
$430.84 |
$430.84 |
$720.60
|
|
Echocardiography doppler color flow mapping
|
$345.18 |
$345.18 |
$345.18 |
$511.55
|
|
Echocardiography transthoracic 2d complete w/contrast or without & w/contrast with doppler
|
$2,382.80 |
$2,382.80 |
$2,382.80 |
$1,944.80
|
|
Echocardiograpy doppler follow up/limited study
|
$297.53 |
$297.53 |
$297.53 |
$371.25
|
|
Echo exam of fetal heart
|
$903.96 |
$903.96 |
$903.96 |
$904.80
|
|
Echo exam of fetal heart
|
$415.99 |
$415.99 |
$415.99 |
$538.27
|
|
Echo exam of fetal heart
|
$426.87 |
$426.87 |
$426.87 |
$431.41
|
|
Echo guide for amniocentesis
|
$421.01 |
$421.01 |
$421.01 |
$455.57
|
|
Echo stress
|
$830.12 |
$830.12 |
$830.12 |
$1,609.44
|
|
Echo tte 2d comp wo ctrst wo clr/dplr
|
$606.65 |
$606.65 |
$606.65 |
$1,033.00
|
|
E equine encephalitis igg
|
$45.24 |
$45.24 |
$45.24 |
$51.84
|
|
Egfr gene com variants
|
$1,046.08 |
$1,046.08 |
$1,046.08 |
$672.88
|
|
EKG (Tracing Only)
|
$214.17 |
$214.17 |
$214.17 |
$226.50
|
