|
Clsd tx/metatarsal fx without manip 28470
|
$429.00 |
$429.00 |
$429.00 |
$414.00
|
|
Clsd tx patella disloc without anes 27560
|
$614.25 |
$614.25 |
$614.25 |
$614.25
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$378.95 |
$378.95 |
$378.95 |
$464.80
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$501.80 |
$501.80 |
$501.80 |
$476.80
|
|
Clsd tx temporomandibular dislocat 21480
|
$322.40 |
$322.40 |
$322.40 |
$454.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,042.60 |
$1,042.60 |
$1,042.60 |
$1,632.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$473.20 |
$473.20 |
$473.20 |
$494.40
|
|
#cmvcul-virus inoculation shell
|
$137.80 |
$137.80 |
$137.80 |
$109.80
|
|
Cmv pcr-sendout
|
$262.60 |
$262.60 |
$262.60 |
$177.50
|
|
Coagulation time activated teg
|
$55.25 |
$55.25 |
$55.25 |
$37.05
|
|
Cold agglutinin screen (arc)
|
$57.85 |
$57.85 |
$57.85 |
$48.57
|
|
Cold agglutinin titer
|
$72.15 |
$72.15 |
$72.15 |
$48.57
|
|
Collection blood specimen from completely implantable venous access device
|
$73.45 |
$73.45 |
$73.45 |
$155.40
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$114.40 |
$114.40 |
$114.40 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$16.25 |
$16.25 |
$16.25 |
$20.30
|
|
Colonoscopy (diagnostic)
|
$3,227.54 |
$3,227.54 |
$3,227.54 |
$1,500.00
|
|
Colonoscopy submucous njx
|
$5,264.38 |
$5,264.38 |
$5,264.38 |
$2,063.25
|
|
Colonoscopy w/ablation
|
$991.25 |
$991.25 |
$991.25 |
$2,571.00
|
|
Colonoscopy w/control bleed
|
$1,005.55 |
$1,005.55 |
$1,005.55 |
$2,019.60
|
|
Colonoscopy with ablation
|
$868.40 |
$868.40 |
$868.40 |
$1,740.00
|
|
Colonoscopy (with biopsy)
|
$5,264.38 |
$5,264.38 |
$5,264.38 |
$2,074.50
|
|
Colonoscopy (with polyp removal)
|
$5,547.42 |
$5,547.42 |
$5,547.42 |
$2,074.50
|
|
Compatibility test each unit antiglobulin technique
|
$94.90 |
$94.90 |
$94.90 |
$156.60
|
|
Compatibility test each unit electronic
|
$95.55 |
$95.55 |
$95.55 |
$156.24
|
|
Compatibility test each unit immediate spin technique
|
$94.90 |
$94.90 |
$94.90 |
$156.24
|
|
Compatibility test incubate
|
$94.90 |
$94.90 |
$94.90 |
$140.00
|
|
Complement antigen each component c3
|
$112.45 |
$112.45 |
$112.45 |
$110.00
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$852.80 |
$852.80 |
$852.80 |
$1,193.40
|
|
Complx repair fccmnaxghf 13132
|
$937.30 |
$937.30 |
$937.30 |
$1,193.40
|
|
Complx repair sal addl 5 cm/> 13122
|
$230.75 |
$230.75 |
$230.75 |
$546.29
|
|
Concentration infection agents any type
|
$57.20 |
$57.20 |
$57.20 |
$48.00
|
|
Condylomata destruction 56420
|
$352.95 |
$352.95 |
$352.95 |
$472.50
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,195.05 |
$1,195.05 |
$1,195.05 |
$768.50
|
|
Consultation pathology during surgery
|
$96.20 |
$96.20 |
$96.20 |
$89.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$223.60 |
$223.60 |
$223.60 |
$368.46
|
|
Consultation pathology during surgery frozen section each additional block
|
$92.30 |
$92.30 |
$92.30 |
$115.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$198.90 |
$198.90 |
$198.90 |
$200.00
|
|
Consultation/report referred material w/preparation of slides
|
$181.35 |
$181.35 |
$181.35 |
$231.75
|
|
Consultation/report referred slides prepared elsewhere
|
$195.00 |
$195.00 |
$195.00 |
$176.15
|
|
Consult comp w/report rfrd material
|
$282.75 |
$282.75 |
$282.75 |
$365.60
|
|
Contrast baths charges
|
$53.30 |
$53.30 |
$53.30 |
$77.98
|
|
Control nosebleed pack+caut 30905
|
$497.25 |
$497.25 |
$497.25 |
$457.60
|
|
Control of nosebleed ant comp 30903
|
$401.70 |
$401.70 |
$401.70 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$217.75 |
$217.75 |
$217.75 |
$336.00
|
|
Coombs direct
|
$63.05 |
$63.05 |
$63.05 |
$70.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$102.70 |
$102.70 |
$102.70 |
$76.70
|
|
Coombs indirect titer reference
|
$134.55 |
$134.55 |
$134.55 |
$122.85
|
|
Cortisol acth stimulation test - sendout
|
$252.85 |
$252.85 |
$252.85 |
$143.40
|
|
Cortisol total am
|
$81.90 |
$81.90 |
$81.90 |
$117.81
|
|
Co-treatment - group 15 mins, st
|
$119.60 |
$119.60 |
$119.60 |
$108.81
|
|
Counseling smoke cess interm >10mins
|
$60.45 |
$60.45 |
$60.45 |
$57.85
|
|
Covid-19 administration immunization im inj 1st/only component
|
$41.60 |
$41.60 |
$41.60 |
$64.50
|
|
#covid19rsv-rsv
|
$152.10 |
$152.10 |
$152.10 |
$140.80
|
|
#coxa-coxsackie a serotype a16
|
$70.85 |
$70.85 |
$70.85 |
$65.36
|
|
C-peptide
|
$62.40 |
$62.40 |
$62.40 |
$111.20
|
|
C-reactive protein
|
$53.30 |
$53.30 |
$53.30 |
$54.43
|
|
C-reactive protein high sensitivity
|
$110.50 |
$110.50 |
$110.50 |
$91.65
|
|
C-reactive protein, quantitative
|
$74.10 |
$74.10 |
$74.10 |
$77.50
|
|
Creatine kinase
|
$46.80 |
$46.80 |
$46.80 |
$55.00
|
|
Creatine kinase isoenzymes
|
$92.30 |
$92.30 |
$92.30 |
$66.00
|
|
Creatine kinase mb
|
$100.75 |
$100.75 |
$100.75 |
$100.75
|
|
Creatinine
|
$65.65 |
$65.65 |
$65.65 |
$40.00
|
|
Creatinine 24 hour urine
|
$55.25 |
$55.25 |
$55.25 |
$54.40
|
|
Creatinine clearance urine
|
$85.80 |
$85.80 |
$85.80 |
$73.86
|
|
#creutz-prot.,western blot
|
$247.00 |
$247.00 |
$247.00 |
$178.10
|
|
Critical care 30-74 minutes
|
$1,392.30 |
$1,392.30 |
$1,392.30 |
$2,540.23
|
|
Critical care each additional 30 minutes
|
$351.00 |
$351.00 |
$351.00 |
$663.00
|
|
Crotalidae poly immune fab
|
$6,443.97 |
$6,443.97 |
$6,443.97 |
$3,996.74
|
|
Cryofibrinogen qualitative - sendout
|
$39.00 |
$39.00 |
$39.00 |
$52.50
|
|
Cryoprecipitate each unit
|
$111.80 |
$111.80 |
$111.80 |
$182.25
|
|
Crystal identification light microscopy
|
$55.25 |
$55.25 |
$55.25 |
$56.44
|
|
Cta abdomen without & /or w/contrast
|
$2,002.00 |
$2,002.00 |
$2,002.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,120.30 |
$2,120.30 |
$2,120.30 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$939.25 |
$939.25 |
$939.25 |
$1,899.75
|
|
Cta neck without &/or w/contrast
|
$1,890.85 |
$1,890.85 |
$1,890.85 |
$1,772.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,226.60 |
$3,226.60 |
$3,226.60 |
$2,834.25
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,428.70 |
$1,428.70 |
$1,428.70 |
$1,728.80
|
|
CT Angiogram of the Head
|
$1,047.15 |
$1,047.15 |
$1,047.15 |
$1,951.50
|
|
CT bone density axial
|
$326.30 |
$326.30 |
$326.30 |
$321.75
|
|
CT lower extremity w/contrast (both sides)
|
$842.40 |
$842.40 |
$842.40 |
$1,585.18
|
|
CT lower extremity without contrast (both sides)
|
$788.45 |
$788.45 |
$788.45 |
$1,302.00
|
|
CT lwr extremity w/o&w/dye
|
$920.40 |
$920.40 |
$920.40 |
$1,618.50
|
|
CT neck soft tissue w/contrast
|
$1,383.85 |
$1,383.85 |
$1,383.85 |
$1,577.55
|
|
CT neck soft tissue without contrast
|
$982.80 |
$982.80 |
$982.80 |
$1,151.00
|
|
CT neck soft tissue without & w/contrast
|
$1,600.95 |
$1,600.95 |
$1,600.95 |
$1,752.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$831.35 |
$831.35 |
$831.35 |
$1,647.20
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$813.80 |
$813.80 |
$813.80 |
$1,487.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$771.55 |
$771.55 |
$771.55 |
$1,250.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,636.75 |
$3,636.75 |
$3,636.75 |
$3,133.65
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,020.55 |
$3,020.55 |
$3,020.55 |
$2,737.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,325.05 |
$2,325.05 |
$2,325.05 |
$2,240.40
|
|
CT thoracic spine w/contrast
|
$1,573.00 |
$1,573.00 |
$1,573.00 |
$1,604.85
|
|
CT thoracic spine without contrast
|
$1,399.45 |
$1,399.45 |
$1,399.45 |
$1,381.20
|
|
CT upper extremity w/contrast (both sides)
|
$889.85 |
$889.85 |
$889.85 |
$1,651.65
|
|
CT upper extremity without contrast (both sides)
|
$843.05 |
$843.05 |
$843.05 |
$1,408.54
|
|
CT uppr extremity w/o&w/dye
|
$1,019.20 |
$1,019.20 |
$1,019.20 |
$1,688.20
|
|
Culture aerobic additional method definitive id each
|
$52.00 |
$52.00 |
$52.00 |
$61.03
|
|
Culture afb any source
|
$71.50 |
$71.50 |
$71.50 |
$93.50
|
|
Culture anaerobic additional method definitive id each
|
$65.65 |
$65.65 |
$65.65 |
$73.00
|
|
Culture anaerobic except blood
|
$112.45 |
$112.45 |
$112.45 |
$110.00
|
