|
Creatine kinase
|
$12.84 |
$12.84 |
$12.84 |
$66.30
|
|
Creatine kinase mb
|
$22.47 |
$22.47 |
$22.47 |
$113.63
|
|
Creatinine
|
$28.89 |
$28.89 |
$28.89 |
$46.20
|
|
Creatinine 24 hour urine
|
$51.36 |
$51.36 |
$51.36 |
$57.85
|
|
Creatinine clearance urine
|
$18.62 |
$18.62 |
$18.62 |
$90.26
|
|
#creutz-prot.,western blot
|
$112.99 |
$112.99 |
$112.99 |
$163.50
|
|
Critical care each additional 30 minutes
|
$576.00 |
$576.00 |
$576.00 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$2,535.00
|
|
Cryoprecipitate each unit
|
$54.29 |
$54.29 |
$54.29 |
$144.78
|
|
Cryptosporidium antigen
|
$78.59 |
$78.59 |
$78.59 |
$52.08
|
|
Crystal identification light microscopy
|
$14.67 |
$14.67 |
$14.67 |
$66.43
|
|
CT 3d report other modality w/workstation
|
$748.48 |
$748.48 |
$748.48 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,701.54 |
$1,701.54 |
$1,701.54 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,205.01 |
$2,205.01 |
$2,205.01 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$1,415.53 |
$1,415.53 |
$1,415.53 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$1,828.04 |
$1,828.04 |
$1,828.04 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,576.99 |
$1,576.99 |
$1,576.99 |
$1,915.30
|
|
CT Angiogram of the Head
|
$1,521.13 |
$1,521.13 |
$1,521.13 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$1,671.18 |
$1,671.18 |
$1,671.18 |
$1,881.75
|
|
CT angio hrt w/3d image
|
$1,984.10 |
$1,984.10 |
$1,984.10 |
$1,428.68
|
|
Cta upper extremity w &/or without contrast left
|
$2,349.99 |
$2,349.99 |
$2,349.99 |
$1,691.30
|
|
CT bone density axial
|
$428.35 |
$428.35 |
$428.35 |
$385.15
|
|
CT colonography dx
|
$1,065.49 |
$1,065.49 |
$1,065.49 |
$811.41
|
|
CT colonography dx w/dye
|
$1,332.32 |
$1,332.32 |
$1,332.32 |
$1,069.25
|
|
CT guidance for needle placement
|
$831.10 |
$831.10 |
$831.10 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$744.80 |
$744.80 |
$744.80 |
$1,215.06
|
|
CT heart w/evaluation of calcium without contrast
|
$101.59 |
$101.59 |
$101.59 |
$150.00
|
|
CT hrt w/3d image
|
$1,481.04 |
$1,481.04 |
$1,481.04 |
$1,350.03
|
|
CT limited or localized follow-up study
|
$607.72 |
$607.72 |
$607.72 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$1,620.48 |
$1,620.48 |
$1,620.48 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,099.57 |
$2,099.57 |
$2,099.57 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,749.64 |
$1,749.64 |
$1,749.64 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,399.72 |
$1,399.72 |
$1,399.72 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$3,113.78 |
$3,113.78 |
$3,113.78 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,237.96 |
$2,237.96 |
$2,237.96 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$72.92 |
$72.92 |
$72.92 |
$72.00
|
|
Culture afb any source
|
$44.60 |
$44.60 |
$44.60 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$83.54 |
$83.54 |
$83.54 |
$84.76
|
|
Culture anaerobic except blood
|
$20.53 |
$20.53 |
$20.53 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$44.60 |
$44.60 |
$44.60 |
$52.50
|
|
Culture body fluid
|
$79.30 |
$79.30 |
$79.30 |
$126.75
|
|
Culture fungi definitive id mold
|
$97.70 |
$97.70 |
$97.70 |
$80.00
|
|
Culture fungi definitive id yeast
|
$43.90 |
$43.90 |
$43.90 |
$80.00
|
|
Culture fungi other (except blood)
|
$62.30 |
$62.30 |
$62.30 |
$111.10
|
|
Culture fungi skin/hair/nail
|
$41.77 |
$41.77 |
$41.77 |
$74.75
|
|
Culture mycoplasma any source
|
$44.60 |
$44.60 |
$44.60 |
$83.21
|
|
Culture quantitative aerobic other source
|
$43.19 |
$43.19 |
$43.19 |
$87.02
|
|
Culture screening strep group a
|
$46.73 |
$46.73 |
$46.73 |
$84.60
|
|
Culture typing immunologic
|
$60.18 |
$60.18 |
$60.18 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$97.00 |
$97.00 |
$97.00 |
$140.80
|
|
Culture urine each isolate
|
$17.70 |
$17.70 |
$17.70 |
$55.50
|
|
Cyanocobalamin unsat binding capacity
|
$42.37 |
$42.37 |
$42.37 |
$60.75
|
|
Cyclic citrullinated peptide antibody
|
$70.98 |
$70.98 |
$70.98 |
$72.36
|
|
Cyclosporine 2 hour
|
$37.24 |
$37.24 |
$37.24 |
$130.40
|
|
Cyp2c19 gene com variants
|
$629.12 |
$629.12 |
$629.12 |
$524.00
|
|
Cyp2c9 gene com variants
|
$377.47 |
$377.47 |
$377.47 |
$275.10
|
|
Cyp2d6 gene com variants
|
$972.81 |
$972.81 |
$972.81 |
$570.70
|
|
Cyp3a4 gene common variants
|
$377.47 |
$377.47 |
$377.47 |
$241.24
|
|
Cyp3a5 gene common variants
|
$377.47 |
$377.47 |
$377.47 |
$245.31
|
|
Cystatin c
|
$35.95 |
$35.95 |
$35.95 |
$77.60
|
|
Cystine urine quantitative
|
$58.42 |
$58.42 |
$58.42 |
$100.70
|
|
Cystogram >= 3 views supervision & interpretation
|
$412.87 |
$412.87 |
$412.87 |
$586.95
|
|
Cytogenetics 25-99
|
$54.27 |
$54.27 |
$54.27 |
$189.80
|
|
Cytomegalovirus (cmv) antibody igg
|
$70.98 |
$70.98 |
$70.98 |
$96.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$72.16 |
$72.16 |
$72.16 |
$100.00
|
|
Cytopathology cellular enhancement technique non-gyn
|
$45.79 |
$45.79 |
$45.79 |
$159.90
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$25.86 |
$25.86 |
$25.86 |
$87.45
|
|
Cytopathology concentration technique smears & interpretation
|
$33.50 |
$33.50 |
$33.50 |
$135.20
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$33.50 |
$33.50 |
$33.50 |
$127.50
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$145.86 |
$145.86 |
$145.86 |
$191.66
|
|
Cytopathology fna adequacy evaluation first episode each site interp/rpt
|
$45.79 |
$45.79 |
$45.79 |
$213.85
|
|
Cytopath smear oth prep screen & interp
|
$28.83 |
$28.83 |
$28.83 |
$96.20
|
|
Daptomycin 500 mg/10 ml intravenous solution
|
$0.20 |
$0.20 |
$0.20 |
$171.19
|
|
D&c/diagnostic/therapeutic/non ob 58120
|
$283.93 |
$283.93 |
$283.93 |
$3,774.81
|
|
Dch validity tests
|
$6.98 |
$6.98 |
$6.98 |
$25.00
|
|
Deamidated gliadin antibody iga
|
$69.80 |
$69.80 |
$69.80 |
$43.35
|
|
Debridement (>20 cm) charge pt
|
$84.00 |
$84.00 |
$84.00 |
$284.00
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$76.07 |
$76.07 |
$76.07 |
$835.20
|
|
Debride nail1-5 11720
|
$18.57 |
$18.57 |
$18.57 |
$149.60
|
|
Debrid/rmv fgn bdy/open fx/skin/sq 11010
|
$344.42 |
$344.42 |
$344.42 |
$1,149.50
|
|
Decalcification
|
$14.74 |
$14.74 |
$14.74 |
$68.34
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$310.90 |
$310.90 |
$310.90 |
$572.95
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$143.17 |
$143.17 |
$143.17 |
$185.17
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$189.28 |
$189.28 |
$189.28 |
$401.60
|
|
Desmopressin 4 mcg/ml injection solution
|
$0.93 |
$0.93 |
$0.93 |
$91.84
|
|
Destroy cervthor facet jnt 64633
|
$2,064.16 |
$2,064.16 |
$2,064.16 |
$3,138.15
|
|
Destroy cth facet jnt addl 64634
|
$619.92 |
$619.92 |
$619.92 |
$1,441.44
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides)
|
$559.44 |
$559.44 |
$559.44 |
$1,652.35
|
|
Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides)
|
$2,045.68 |
$2,045.68 |
$2,045.68 |
$3,296.80
|
|
Developmental screen/score/document 96110
|
$118.85 |
$118.85 |
$118.85 |
$142.38
|
|
Dexa bone density study >=1 sites appendicular skeleton (peripheral)
|
$362.32 |
$362.32 |
$362.32 |
$227.25
|
|
Dhea-s (dehydroepiand sulfate)
|
$43.01 |
$43.01 |
$43.01 |
$112.00
|
|
Diabetes (HbA1c) Test
|
$19.26 |
$19.26 |
$19.26 |
$79.30
|
|
Diab manage trn ind/group
|
$21.20 |
$21.20 |
$21.20 |
$54.99
|
|
Diagnostic laryngoscopy 31505
|
$60.50 |
$60.50 |
$60.50 |
$242.14
|
|
Diagnostic laryngoscopy 31575
|
$217.41 |
$217.41 |
$217.41 |
$338.00
|
|
Diagnostic Mammogram (both breasts)
|
$297.72 |
$297.72 |
$297.72 |
$420.35
|
|
Diagnostic Mammogram (one breast)
|
$197.57 |
$197.57 |
$197.57 |
$314.00
|
|
Diffusing capacity
|
$200.57 |
$200.57 |
$200.57 |
$336.80
|
|
Digoxin total therapeutic drug level
|
$34.03 |
$34.03 |
$34.03 |
$102.07
|
