|
Clsd tx fx radius/ulna dist without manip 25600
|
$639.60 |
$639.60 |
$639.60 |
$567.20
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,188.85 |
$1,188.85 |
$1,188.85 |
$1,884.74
|
|
Clsd tx fx radius/ulna without manip 25560
|
$551.20 |
$551.20 |
$551.20 |
$634.40
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,048.45 |
$1,048.45 |
$1,048.45 |
$1,771.43
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$591.50 |
$591.50 |
$591.50 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$914.55 |
$914.55 |
$914.55 |
$685.81
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$499.20 |
$499.20 |
$499.20 |
$519.12
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$634.40 |
$634.40 |
$634.40 |
$688.00
|
|
Clsd tx/metatarsal fx without manip 28470
|
$456.95 |
$456.95 |
$456.95 |
$414.00
|
|
Clsd tx of ankle fracture w/manip 28435
|
$755.30 |
$755.30 |
$755.30 |
$1,815.75
|
|
Clsd tx patella disloc without anes 27560
|
$646.10 |
$646.10 |
$646.10 |
$614.25
|
|
Clsd tx/patellar fx without manip 27520
|
$656.50 |
$656.50 |
$656.50 |
$522.40
|
|
Clsd tx pelvic ring fx
|
$358.15 |
$358.15 |
$358.15 |
$452.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$429.65 |
$429.65 |
$429.65 |
$464.80
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$435.50 |
$435.50 |
$435.50 |
$476.80
|
|
Clsd tx radius fracture w/manip 24655
|
$1,701.70 |
$1,701.70 |
$1,701.70 |
$1,839.77
|
|
Clsd tx shoulder dislc/fx 23665
|
$943.15 |
$943.15 |
$943.15 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,121.90 |
$1,121.90 |
$1,121.90 |
$1,797.83
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,025.05 |
$1,025.05 |
$1,025.05 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$324.35 |
$324.35 |
$324.35 |
$454.40
|
|
Clsd tx toe dislocation without anes28660
|
$303.55 |
$303.55 |
$303.55 |
$400.20
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,125.15 |
$1,125.15 |
$1,125.15 |
$1,632.60
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$542.10 |
$542.10 |
$542.10 |
$473.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$588.25 |
$588.25 |
$588.25 |
$543.23
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$725.40 |
$725.40 |
$725.40 |
$692.03
|
|
Cltx post ankle fx
|
$695.50 |
$695.50 |
$695.50 |
$521.30
|
|
#cmvcul-virus inoculation shell
|
$124.15 |
$124.15 |
$124.15 |
$109.80
|
|
Cmv pcr-sendout
|
$167.05 |
$167.05 |
$167.05 |
$177.50
|
|
Co2 monitor per day
|
$507.65 |
$507.65 |
$507.65 |
$400.00
|
|
Cold agglutinin screen (arc)
|
$47.45 |
$47.45 |
$47.45 |
$48.57
|
|
Cold agglutinin titer
|
$73.45 |
$73.45 |
$73.45 |
$48.57
|
|
Collection blood specimen from completely implantable venous access device
|
$98.80 |
$98.80 |
$98.80 |
$155.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$118.30 |
$118.30 |
$118.30 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$16.90 |
$16.90 |
$16.90 |
$20.30
|
|
Colonoscopy (diagnostic)
|
$3,023.23 |
$3,023.23 |
$3,023.23 |
$1,500.00
|
|
Colonoscopy submucous njx
|
$3,922.91 |
$3,922.91 |
$3,922.91 |
$2,063.25
|
|
Colonoscopy (with biopsy)
|
$3,246.33 |
$3,246.33 |
$3,246.33 |
$2,074.50
|
|
Colonoscopy (with polyp removal)
|
$3,355.45 |
$3,355.45 |
$3,355.45 |
$2,074.50
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$707.85 |
$707.85 |
$707.85 |
$3,615.39
|
|
Compatibility test each unit antiglobulin technique
|
$128.05 |
$128.05 |
$128.05 |
$156.60
|
|
Compatibility test each unit immediate spin technique
|
$113.75 |
$113.75 |
$113.75 |
$156.24
|
|
Compatibility test incubate
|
$96.85 |
$96.85 |
$96.85 |
$140.00
|
|
Complement antigen each component c3
|
$120.90 |
$120.90 |
$120.90 |
$110.00
|
|
Complx repair fccmnaxghf 13131
|
$666.25 |
$666.25 |
$666.25 |
$911.40
|
|
Complx repair fccmnaxghf 13132
|
$980.85 |
$980.85 |
$980.85 |
$1,193.40
|
|
Complx repair fccmnaxghf 13133
|
$306.15 |
$306.15 |
$306.15 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$290.55 |
$290.55 |
$290.55 |
$546.29
|
|
Computed tomographic angiography head and neck with contrast
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$2,544.75
|
|
Concentration infection agents any type
|
$48.75 |
$48.75 |
$48.75 |
$48.00
|
|
Condylomata destruction 56420
|
$371.80 |
$371.80 |
$371.80 |
$472.50
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,169.89 |
$1,169.89 |
$1,169.89 |
$768.50
|
|
Consultation pathology during surgery
|
$78.00 |
$78.00 |
$78.00 |
$89.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$135.85 |
$135.85 |
$135.85 |
$368.46
|
|
Consultation pathology during surgery frozen section each additional block
|
$78.00 |
$78.00 |
$78.00 |
$115.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$172.90 |
$172.90 |
$172.90 |
$200.00
|
|
Consultation/report referred material w/preparation of slides
|
$174.85 |
$174.85 |
$174.85 |
$231.75
|
|
Consultation/report referred slides prepared elsewhere
|
$186.55 |
$186.55 |
$186.55 |
$176.15
|
|
Consult comp w/report rfrd material
|
$285.35 |
$285.35 |
$285.35 |
$365.60
|
|
Contrast baths charges
|
$65.65 |
$65.65 |
$65.65 |
$77.98
|
|
Contrast x-ray gallbladder
|
$254.15 |
$254.15 |
$254.15 |
$260.14
|
|
Contrast x-ray of hip
|
$584.35 |
$584.35 |
$584.35 |
$676.12
|
|
Contrast x-ray of knee joint
|
$617.50 |
$617.50 |
$617.50 |
$623.50
|
|
Control nosebleed pack+caut 30905
|
$481.00 |
$481.00 |
$481.00 |
$457.60
|
|
Control of nosebleed ant comp 30903
|
$441.35 |
$441.35 |
$441.35 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$235.95 |
$235.95 |
$235.95 |
$336.00
|
|
Coombs direct
|
$66.30 |
$66.30 |
$66.30 |
$70.74
|
|
Coombs indirect titer reference
|
$63.70 |
$63.70 |
$63.70 |
$122.85
|
|
Cortisol acth stimulation test - sendout
|
$196.30 |
$196.30 |
$196.30 |
$143.40
|
|
Cortisol total am
|
$150.80 |
$150.80 |
$150.80 |
$117.81
|
|
Cosyntropin 0.25 mg solution for injection
|
$322.14 |
$322.14 |
$322.14 |
$218.95
|
|
Counseling smoke cess interm >10mins
|
$57.20 |
$57.20 |
$57.20 |
$57.85
|
|
Covid-19 administration immunization im inj 1st/only component
|
$41.60 |
$41.60 |
$41.60 |
$64.50
|
|
#covid19rsv-rsv
|
$146.25 |
$146.25 |
$146.25 |
$140.80
|
|
#coxa-coxsackie a serotype a16
|
$59.15 |
$59.15 |
$59.15 |
$65.36
|
|
C-peptide
|
$82.55 |
$82.55 |
$82.55 |
$111.20
|
|
Crbrospnl fld flw imag cistern
|
$1,264.25 |
$1,264.25 |
$1,264.25 |
$1,170.64
|
|
C-reactive protein
|
$88.40 |
$88.40 |
$88.40 |
$54.43
|
|
C-reactive protein high sensitivity
|
$100.10 |
$100.10 |
$100.10 |
$91.65
|
|
C-reactive protein, quantitative
|
$84.50 |
$84.50 |
$84.50 |
$77.50
|
|
Creatine kinase
|
$78.65 |
$78.65 |
$78.65 |
$55.00
|
|
Creatine kinase isoenzymes
|
$78.65 |
$78.65 |
$78.65 |
$66.00
|
|
Creatine kinase mb
|
$126.75 |
$126.75 |
$126.75 |
$100.75
|
|
Creatinine
|
$57.20 |
$57.20 |
$57.20 |
$40.00
|
|
Creatinine 24 hour urine
|
$57.85 |
$57.85 |
$57.85 |
$54.40
|
|
Creatinine clearance urine
|
$101.40 |
$101.40 |
$101.40 |
$73.86
|
|
#creutz-prot.,western blot
|
$200.85 |
$200.85 |
$200.85 |
$178.10
|
|
Critical care 30-74 minutes
|
$1,524.90 |
$1,524.90 |
$1,524.90 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$572.00 |
$572.00 |
$572.00 |
$663.00
|
|
Crotalidae poly immune fab
|
$6,256.89 |
$6,256.89 |
$6,256.89 |
$3,996.74
|
|
Cryofibrinogen qualitative - sendout
|
$34.45 |
$34.45 |
$34.45 |
$52.50
|
|
Crystal identification light microscopy
|
$75.40 |
$75.40 |
$75.40 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$1,937.00 |
$1,937.00 |
$1,937.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,424.50 |
$2,424.50 |
$2,424.50 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,751.75 |
$1,751.75 |
$1,751.75 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,009.50 |
$3,009.50 |
$3,009.50 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,170.35 |
$2,170.35 |
$2,170.35 |
$1,728.80
|
|
CT Angiogram of the Head
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$1,951.50
|
|
CT angio pelvis
|
$2,087.80 |
$2,087.80 |
$2,087.80 |
$1,775.28
|
|
Cta upper extremity w &/or without contrast left
|
$2,033.20 |
$2,033.20 |
$2,033.20 |
$1,650.60
|
