|
Chest CT scan (with contrast)
|
$943.16 |
$943.16 |
$943.16 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$861.90 |
$861.90 |
$861.90 |
$1,350.03
|
|
Chest X-ray
|
$100.13 |
$100.13 |
$100.13 |
$294.06
|
|
Chest X-ray (single view)
|
$81.77 |
$81.77 |
$81.77 |
$239.04
|
|
Chg pr pul rehab for copd patients
|
$91.97 |
$91.97 |
$91.97 |
$147.95
|
|
Chg radiologic exam esophagus double contrast
|
$115.43 |
$115.43 |
$115.43 |
$511.59
|
|
Chimerism anal no cell selec
|
$35.27 |
$35.27 |
$35.27 |
$347.20
|
|
Chimerism anal w/cell select
|
$44.33 |
$44.33 |
$44.33 |
$585.60
|
|
Chiropractic manj 5 regions
|
$22.10 |
$22.10 |
$22.10 |
$93.50
|
|
Chiropract manj 1-2 regions
|
$11.73 |
$11.73 |
$11.73 |
$49.40
|
|
Chiropract manj 3-4 regions
|
$17.00 |
$17.00 |
$17.00 |
$56.99
|
|
Chlamydia culture
|
$2.87 |
$2.87 |
$2.87 |
$93.90
|
|
Chlamydia type
|
$12.92 |
$12.92 |
$12.92 |
$34.20
|
|
Chlnggrphy intraop addl s&i
|
$155.89 |
$155.89 |
$155.89 |
$301.40
|
|
Chloride
|
$59.50 |
$59.50 |
$59.50 |
$40.95
|
|
Chloride 24 hour urine
|
$66.47 |
$66.47 |
$66.47 |
$49.50
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$592.13 |
$592.13 |
$592.13 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$81.37 |
$81.37 |
$81.37 |
$78.43
|
|
Cholangiogram percutaneous compl
|
$119.17 |
$119.17 |
$119.17 |
$3,495.00
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$334.22 |
$334.22 |
$334.22 |
$602.40
|
|
Cholecystectomy w/cholangiography 47605
|
$641.41 |
$641.41 |
$641.41 |
$1,963.37
|
|
Cholecystostomy complete w/supervision & interpretation
|
$2,261.51 |
$2,261.51 |
$2,261.51 |
$3,690.60
|
|
Cholesterol
|
$61.71 |
$61.71 |
$61.71 |
$45.76
|
|
Cholesterol body fluid
|
$340.00 |
$340.00 |
$340.00 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$165.07 |
$165.07 |
$165.07 |
$115.80
|
|
Cholinesterase
|
$1.19 |
$1.19 |
$1.19 |
$38.69
|
|
Chrnc care mgmt phys 1st 30
|
$89.25 |
$89.25 |
$89.25 |
$156.00
|
|
Chrom analysis
|
$27.22 |
$27.22 |
$27.22 |
$156.00
|
|
Chromatography
|
$31.62 |
$31.62 |
$31.62 |
$81.25
|
|
Chromogenic substrate assay
|
$23.97 |
$23.97 |
$23.97 |
$148.68
|
|
Chromo high res and frag x - sendout
|
$9.70 |
$9.70 |
$9.70 |
$247.59
|
|
Chromosome analys amniotic
|
$57.12 |
$57.12 |
$57.12 |
$450.00
|
|
Chromosome analysis 100
|
$74.97 |
$74.97 |
$74.97 |
$434.40
|
|
Chromosome analysis 15-20 cell count
|
$41.65 |
$41.65 |
$41.65 |
$512.20
|
|
Chromosome analysis 45
|
$44.77 |
$44.77 |
$44.77 |
$429.28
|
|
Chromosome analysis 5
|
$18.72 |
$18.72 |
$18.72 |
$644.80
|
|
Chylomicron screen, bf - sendout
|
$12.75 |
$12.75 |
$12.75 |
$124.15
|
|
Cine/video x-rays
|
$149.43 |
$149.43 |
$149.43 |
$321.64
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$21.23 |
$21.23 |
$21.23 |
$34.88
|
|
Circum 28 days or older
|
$116.45 |
$116.45 |
$116.45 |
$3,860.64
|
|
Circumcise/surg/28 days or < 54160
|
$132.60 |
$132.60 |
$132.60 |
$1,219.20
|
|
Circumcision (newborn)
|
$625.60 |
$625.60 |
$625.60 |
$1,395.20
|
|
Cisplatin 1 mg/ml desensitization
|
$12.93 |
$12.93 |
$12.93 |
$192.66
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$550.80 |
$550.80 |
$550.80 |
$569.55
|
|
C-laminoplasty w/graft/plate
|
$966.28 |
$966.28 |
$966.28 |
$4,108.00
|
|
Claviculectomy partial
|
$354.79 |
$354.79 |
$354.79 |
$3,594.44
|
|
Clean out mastoid cavity
|
$245.31 |
$245.31 |
$245.31 |
$1,033.60
|
|
Clearance of tear duct
|
$150.28 |
$150.28 |
$150.28 |
$656.38
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$8.74 |
$8.74 |
$8.74 |
$55.20
|
|
Clip ligating vesolock lg
|
$790.50 |
$790.50 |
$790.50 |
$4,320.00
|
|
Clip phn wireless f/baha4 proc
|
$424.49 |
$424.49 |
$424.49 |
$538.82
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$11.73 |
$11.73 |
$11.73 |
$81.90
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$238.51 |
$238.51 |
$238.51 |
$508.45
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$425.17 |
$425.17 |
$425.17 |
$1,615.35
|
|
Closed tx humerus fx with manip 23605
|
$291.38 |
$291.38 |
$291.38 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$211.99 |
$211.99 |
$211.99 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$277.61 |
$277.61 |
$277.61 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$66.13 |
$66.13 |
$66.13 |
$376.96
|
|
Closed tx orbit without manipulj
|
$135.66 |
$135.66 |
$135.66 |
$998.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$347.99 |
$347.99 |
$347.99 |
$2,520.60
|
|
Closed tx septal&nose fx
|
$718.08 |
$718.08 |
$718.08 |
$3,624.40
|
|
Closed tx sesamoid fx 28530
|
$65.28 |
$65.28 |
$65.28 |
$445.00
|
|
Closed tx/talus fracture without manip 28430
|
$151.13 |
$151.13 |
$151.13 |
$421.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$137.36 |
$137.36 |
$137.36 |
$481.80
|
|
Close tear duct opening
|
$87.72 |
$87.72 |
$87.72 |
$436.44
|
|
Close tear duct opening
|
$87.38 |
$87.38 |
$87.38 |
$353.74
|
|
Clos txnose fx without stablz 21315
|
$94.35 |
$94.35 |
$94.35 |
$2,326.08
|
|
Closure enterostomy lg/sm intestine 44620
|
$493.51 |
$493.51 |
$493.51 |
$1,641.60
|
|
Closure enterostomy lg/sm intestine anast 44626
|
$895.73 |
$895.73 |
$895.73 |
$2,835.00
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$575.96 |
$575.96 |
$575.96 |
$1,934.40
|
|
Closure intestinal cutaneous fistula 44640
|
$788.12 |
$788.12 |
$788.12 |
$3,443.20
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$122.57 |
$122.57 |
$122.57 |
$1,259.62
|
|
Closure of eyelid by suture
|
$56.78 |
$56.78 |
$56.78 |
$1,613.00
|
|
Closure of windpipe lesion 31820
|
$197.03 |
$197.03 |
$197.03 |
$3,837.72
|
|
Clot factor fletcher fact
|
$19.57 |
$19.57 |
$19.57 |
$119.50
|
|
Clot factor wght kininogen
|
$30.35 |
$30.35 |
$30.35 |
$167.96
|
|
Clot factor xii hageman
|
$2.92 |
$2.92 |
$2.92 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$1.34 |
$1.34 |
$1.34 |
$55.44
|
|
Clot factor xiii fibrin stab
|
$2.47 |
$2.47 |
$2.47 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$209.10 |
$209.10 |
$209.10 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$213.01 |
$213.01 |
$213.01 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$221.00 |
$221.00 |
$221.00 |
$476.80
|
|
Clsd tx clavicle dislocation without manip 23540
|
$149.94 |
$149.94 |
$149.94 |
$419.29
|
|
Clsd tx/clavicular fx without manip 23500
|
$145.35 |
$145.35 |
$145.35 |
$448.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$121.89 |
$121.89 |
$121.89 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$237.15 |
$237.15 |
$237.15 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$197.88 |
$197.88 |
$197.88 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$69.19 |
$69.19 |
$69.19 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$443.36 |
$443.36 |
$443.36 |
$2,184.08
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$333.03 |
$333.03 |
$333.03 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$181.73 |
$181.73 |
$181.73 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$90.44 |
$90.44 |
$90.44 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$103.70 |
$103.70 |
$103.70 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$216.75 |
$216.75 |
$216.75 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$643.11 |
$643.11 |
$643.11 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$185.13 |
$185.13 |
$185.13 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$321.13 |
$321.13 |
$321.13 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$172.38 |
$172.38 |
$172.38 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$254.49 |
$254.49 |
$254.49 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$241.74 |
$241.74 |
$241.74 |
$538.45
|
