|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,188.78 |
$2,188.78 |
$2,188.78 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,823.99 |
$1,823.99 |
$1,823.99 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,459.19 |
$1,459.19 |
$1,459.19 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$3,246.08 |
$3,246.08 |
$3,246.08 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,333.05 |
$2,333.05 |
$2,333.05 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$72.31 |
$72.31 |
$72.31 |
$72.00
|
|
Culture afb any source
|
$44.23 |
$44.23 |
$44.23 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$82.84 |
$82.84 |
$82.84 |
$84.76
|
|
Culture anaerobic except blood
|
$20.36 |
$20.36 |
$20.36 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$44.23 |
$44.23 |
$44.23 |
$52.50
|
|
Culture body fluid
|
$78.62 |
$78.62 |
$78.62 |
$126.75
|
|
Culture fungi definitive id mold
|
$96.88 |
$96.88 |
$96.88 |
$80.00
|
|
Culture fungi definitive id yeast
|
$43.52 |
$43.52 |
$43.52 |
$80.00
|
|
Culture fungi other (except blood)
|
$54.76 |
$54.76 |
$54.76 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$41.42 |
$41.42 |
$41.42 |
$74.75
|
|
Culture mycoplasma any source
|
$44.23 |
$44.23 |
$44.23 |
$83.21
|
|
Culture quantitative aerobic other source
|
$42.82 |
$42.82 |
$42.82 |
$87.02
|
|
Culture screening strep group a
|
$46.33 |
$46.33 |
$46.33 |
$84.60
|
|
Culture typing immunologic
|
$59.67 |
$59.67 |
$59.67 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$96.17 |
$96.17 |
$96.17 |
$140.80
|
|
Culture urine each isolate
|
$17.55 |
$17.55 |
$17.55 |
$55.50
|
|
Cutter lead
|
$23,247.59 |
$23,247.59 |
$23,247.59 |
$6,581.45
|
|
Cyanocobalamin unsat binding capacity
|
$43.89 |
$43.89 |
$43.89 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$45.36 |
$45.36 |
$45.36 |
$72.36
|
|
Cyclosporine 2 hour
|
$38.57 |
$38.57 |
$38.57 |
$130.40
|
|
Cylinder pump set 20cm titan zero angl
|
$65,375.48 |
$65,375.48 |
$65,375.48 |
$24,728.89
|
|
Cyp2c19 gene com variants
|
$527.62 |
$527.62 |
$527.62 |
$524.00
|
|
Cyp2c9 gene com variants
|
$316.58 |
$316.58 |
$316.58 |
$275.10
|
|
Cyp2d6 gene com variants
|
$815.86 |
$815.86 |
$815.86 |
$570.70
|
|
Cyp3a4 gene common variants
|
$316.58 |
$316.58 |
$316.58 |
$241.24
|
|
Cyp3a5 gene common variants
|
$316.58 |
$316.58 |
$316.58 |
$245.31
|
|
Cystatin c
|
$37.24 |
$37.24 |
$37.24 |
$77.60
|
|
Cystine urine quantitative
|
$60.52 |
$60.52 |
$60.52 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$408.02 |
$408.02 |
$408.02 |
$586.95
|
|
Cytogenetics 25-99
|
$93.70 |
$93.70 |
$93.70 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$45.36 |
$45.36 |
$45.36 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$46.12 |
$46.12 |
$46.12 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$79.06 |
$79.06 |
$79.06 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$118.58 |
$118.58 |
$118.58 |
$92.40
|
|
Cytopathology concentration technique smears & interpretation
|
$57.83 |
$57.83 |
$57.83 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$57.83 |
$57.83 |
$57.83 |
$127.50
|
|
Cytopathology fna adequacy evaluation each separate additional episode same site
|
$65.88 |
$65.88 |
$65.88 |
$68.06
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$251.81 |
$251.81 |
$251.81 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$79.06 |
$79.06 |
$79.06 |
$213.85
|
|
Dch pulmonary stress test
|
$311.14 |
$311.14 |
$311.14 |
$963.30
|
|
Dch validity tests
|
$7.30 |
$7.30 |
$7.30 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$44.60 |
$44.60 |
$44.60 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$77.04 |
$77.04 |
$77.04 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$77.85 |
$77.85 |
$77.85 |
$835.20
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$352.47 |
$352.47 |
$352.47 |
$1,149.50
|
|
Decalcification
|
$20.77 |
$20.77 |
$20.77 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$290.79 |
$290.79 |
$290.79 |
$572.95
|
|
Delivery of placenta 59414
|
$1,271.88 |
$1,271.88 |
$1,271.88 |
$2,912.46
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$146.91 |
$146.91 |
$146.91 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$193.71 |
$193.71 |
$193.71 |
$401.60
|
|
Destroy cervthor facet jnt 64633
|
$2,414.33 |
$2,414.33 |
$2,414.33 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$725.08 |
$725.08 |
$725.08 |
$1,441.44
|
|
Destruct ben lesion 15/> 17111
|
$103.60 |
$103.60 |
$103.60 |
$235.13
|
|
Destruction benign lesions < 14 lesions
|
$84.59 |
$84.59 |
$84.59 |
$240.24
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$654.34 |
$654.34 |
$654.34 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,392.72 |
$2,392.72 |
$2,392.72 |
$3,296.80
|
|
Device sut capio slim opn
|
$11,522.10 |
$11,522.10 |
$11,522.10 |
$1,860.95
|
|
Device tiss remov myosure reach
|
$10,171.14 |
$10,171.14 |
$10,171.14 |
$2,515.00
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$358.06 |
$358.06 |
$358.06 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$44.56 |
$44.56 |
$44.56 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$19.95 |
$19.95 |
$19.95 |
$79.30
|
|
Diab manage trn ind/group
|
$32.68 |
$32.68 |
$32.68 |
$54.99
|
|
Diagnostic Mammogram (both breasts)
|
$381.05 |
$381.05 |
$381.05 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$252.86 |
$252.86 |
$252.86 |
$314.00
|
|
Diffusing capacity
|
$272.08 |
$272.08 |
$272.08 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$35.25 |
$35.25 |
$35.25 |
$102.07
|
|
Dilator fascial 10fx20cm
|
$1,578.92 |
$1,578.92 |
$1,578.92 |
$402.10
|
|
Disability dlco
|
$272.74 |
$272.74 |
$272.74 |
$293.76
|
|
Disaccharidases
|
$240.73 |
$240.73 |
$240.73 |
$230.40
|
|
#d/lmeth-l-methamphetamine
|
$44.56 |
$44.56 |
$44.56 |
$72.14
|
|
Dna antibody native/double stranded
|
$46.87 |
$46.87 |
$46.87 |
$100.00
|
|
Doppler echo complete
|
$464.44 |
$464.44 |
$464.44 |
$558.00
|
|
Doppler upper/lower extremity arteries complete bilateral
|
$754.72 |
$754.72 |
$754.72 |
$679.64
|
|
Doppler upper/lower extremity arteries limited bilateral
|
$490.82 |
$490.82 |
$490.82 |
$481.65
|
|
Dornhoffer fixed part w/window
|
$217,908.98 |
$217,908.98 |
$217,908.98 |
$34,278.00
|
|
Dpyd gene common variants
|
$316.58 |
$316.58 |
$316.58 |
$423.60
|
|
Drainage absc/cyst/hmtma/vestibule mouth smpl
|
$157.54 |
$157.54 |
$157.54 |
$800.00
|
|
Drainage external ear simple 69000
|
$230.49 |
$230.49 |
$230.49 |
$790.40
|
|
Drainage of arm bursa 23931
|
$296.69 |
$296.69 |
$296.69 |
$2,271.01
|
|
Drainage of kidney lesion
|
$1,877.96 |
$1,877.96 |
$1,877.96 |
$1,506.00
|
|
Drain blood from under nail 11740
|
$39.84 |
$39.84 |
$39.84 |
$182.40
|
|
Drain cerebro spinal fluid 62272
|
$314.72 |
$314.72 |
$314.72 |
$1,044.00
|
|
Drain finger abscess;simple 26010
|
$175.93 |
$175.93 |
$175.93 |
$428.40
|
|
Dress/debride pt-thick burn/<5% bs 16020
|
$69.27 |
$69.27 |
$69.27 |
$349.50
|
|
Dress/debrid prtl-thick burn l 16030
|
$170.41 |
$170.41 |
$170.41 |
$541.00
|
|
Drsg interceed 3x4in adh wnd barr absorb
|
$9,218.67 |
$9,218.67 |
$9,218.67 |
$1,818.32
|
|
Drug assay caffeine
|
$77.14 |
$77.14 |
$77.14 |
$80.00
|
|
Drug assay posaconazole
|
$78.47 |
$78.47 |
$78.47 |
$96.75
|
|
Drug assay vedolizumab
|
$210.80 |
$210.80 |
$210.80 |
$154.00
|
|
Drug assay voriconazole
|
$84.46 |
$84.46 |
$84.46 |
$96.75
|
|
Drug of abuse screen urine
|
$25.27 |
$25.27 |
$25.27 |
$67.89
|
|
Drug screening tapentadol
|
$37.24 |
$37.24 |
$37.24 |
$47.03
|
|
Drug test prsmv instrmnt
|
$34.58 |
$34.58 |
$34.58 |
$83.20
|
|
Drug test(s) presumptive any class instrument chemistry analyzers
|
$298.59 |
$298.59 |
$298.59 |
$278.85
|
|
Drvvt confirm - quest
|
$37.10 |
$37.10 |
$37.10 |
$109.20
|