|
Chest CT scan (with and without contrast)
|
$1,587.75 |
$1,587.75 |
$4,379.20 |
$1,975.00
|
|
Chest CT scan (with contrast)
|
$1,412.85 |
$1,412.85 |
$3,763.20 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$1,145.10 |
$1,145.10 |
$2,844.80 |
$1,350.03
|
|
Chest X-ray
|
$188.85 |
$188.85 |
$504.00 |
$294.06
|
|
Chest X-ray (single view)
|
$181.35 |
$181.35 |
$476.00 |
$239.04
|
|
Chg pr pul rehab for copd patients
|
$190.40 |
$190.40 |
$190.40 |
$147.95
|
|
Chg radiologic exam esophagus double contrast
|
$271.80 |
$271.80 |
$1,108.80 |
$511.59
|
|
Chikungunya vaccine live im
|
$483.28 |
$483.28 |
$483.28 |
$483.28
|
|
Chimerism anal no cell selec
|
$31.12 |
$31.12 |
$347.20 |
$347.20
|
|
Chimerism anal w/cell select
|
$39.12 |
$39.12 |
$1,685.60 |
$585.60
|
|
Chiropractic manj 5 regions
|
$117.04 |
$117.04 |
$117.04 |
$93.50
|
|
Chiropract manj 1-2 regions
|
$117.04 |
$117.04 |
$117.04 |
$49.40
|
|
Chiropract manj 3-4 regions
|
$117.04 |
$117.04 |
$117.04 |
$56.99
|
|
Chiropract manj xtrspinl 1/>
|
$65.52 |
$65.52 |
$65.52 |
$65.52
|
|
Chlamydia culture
|
$239.12 |
$239.12 |
$239.12 |
$93.90
|
|
Chlamydia trachomatis ag if
|
$113.12 |
$113.12 |
$113.12 |
$74.88
|
|
Chlamydia type
|
$7.65 |
$7.65 |
$50.96 |
$34.20
|
|
Chlmyd pneum dna dir probe
|
$203.28 |
$203.28 |
$203.28 |
$50.40
|
|
Chlmyd pneum dna quant
|
$431.20 |
$431.20 |
$431.20 |
$59.12
|
|
Chlnggrphy intraop addl s&i
|
$111.30 |
$111.30 |
$644.00 |
$301.40
|
|
Chloramphenicol sodium injec
|
$100.88 |
$100.88 |
$100.88 |
$113.84
|
|
Chloride
|
$23.85 |
$23.85 |
$75.60 |
$40.95
|
|
Chloride 24 hour urine
|
$23.10 |
$23.10 |
$65.52 |
$49.50
|
|
Chloroprocaine (clorotekal)
|
$37.89 |
$37.89 |
$37.89 |
$37.89
|
|
Chloroprocaine hcl injection
|
$58.28 |
$58.28 |
$58.28 |
$61.51
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$522.94 |
$522.94 |
$522.94 |
$377.85
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$78.43 |
$78.43 |
$78.43 |
$78.43
|
|
Chmotx admn plrl cav thrcnts
|
$1,416.80 |
$1,416.80 |
$1,416.80 |
$489.30
|
|
Cholangiogram percutaneous compl
|
$10,752.00 |
$10,752.00 |
$10,752.00 |
$3,495.00
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$262.20 |
$262.20 |
$1,629.60 |
$602.40
|
|
Cholecystostomy complete w/supervision & interpretation
|
$3,469.80 |
$3,469.80 |
$5,269.60 |
$3,690.60
|
|
Cholera vaccine live oral
|
$481.60 |
$481.60 |
$481.60 |
$481.60
|
|
Cholesterol
|
$24.00 |
$24.00 |
$25.76 |
$45.76
|
|
Cholesterol body fluid
|
$53.76 |
$53.76 |
$66.60 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$56.85 |
$56.85 |
$156.24 |
$115.80
|
|
Choline c-11
|
$62.16 |
$62.16 |
$62.16 |
$2,062.94
|
|
Cholinesterase
|
$1.05 |
$1.05 |
$21.28 |
$38.69
|
|
Cholinesterase challenge
|
$868.00 |
$868.00 |
$868.00 |
$366.72
|
|
Chorion biopsy
|
$2,150.40 |
$2,150.40 |
$2,150.40 |
$1,086.00
|
|
Chorionic gonadotropin/1000u
|
$548.36 |
$548.36 |
$548.36 |
$548.36
|
|
Chrom analysis
|
$24.02 |
$24.02 |
$392.00 |
$156.00
|
|
Chromatogram assay sugars
|
$199.36 |
$199.36 |
$199.36 |
$86.42
|
|
Chromatography
|
$4.32 |
$4.32 |
$90.72 |
$81.25
|
|
Chromogenic substrate assay
|
$21.15 |
$21.15 |
$132.16 |
$148.68
|
|
Chromo high res and frag x - sendout
|
$8.56 |
$8.56 |
$130.48 |
$247.59
|
|
Chromosome analys amniotic
|
$29.74 |
$29.74 |
$470.40 |
$450.00
|
|
Chromosome analysis 100
|
$66.15 |
$66.15 |
$1,618.40 |
$434.40
|
|
Chromosome analysis 15-20 cell count
|
$91.43 |
$91.43 |
$324.80 |
$512.20
|
|
Chromosome analysis 20-25
|
$1,226.40 |
$1,226.40 |
$1,226.40 |
$409.20
|
|
Chromosome analysis 45
|
$985.60 |
$985.60 |
$985.60 |
$429.28
|
|
Chromosome analysis 5
|
$16.52 |
$16.52 |
$711.20 |
$644.80
|
|
Chromosome analysis 50-100
|
$1,618.40 |
$1,618.40 |
$1,618.40 |
$405.00
|
|
Chromosome analys placenta
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$618.60
|
|
Chromosome banding study
|
$184.24 |
$184.24 |
$184.24 |
$184.24
|
|
Chromosome count additional
|
$71.68 |
$71.68 |
$71.68 |
$92.45
|
|
Chromosome karyotype study
|
$6.75 |
$6.75 |
$235.76 |
$119.87
|
|
Chromosome study additional
|
$159.04 |
$159.04 |
$159.04 |
$147.03
|
|
Chronic urticaria - sendout
|
$48.72 |
$48.72 |
$48.72 |
$75.00
|
|
Chylomicron screen, bf - sendout
|
$11.25 |
$11.25 |
$436.80 |
$124.15
|
|
Cid ext controller repl
|
$1,546.16 |
$1,546.16 |
$1,546.16 |
$1,546.16
|
|
Cid ext speech process repl
|
$15,422.40 |
$15,422.40 |
$15,422.40 |
$15,422.40
|
|
Cidofovir injection
|
$1,295.73 |
$1,295.73 |
$1,295.73 |
$1,295.73
|
|
Cid transmit coil and cable
|
$213.36 |
$213.36 |
$213.36 |
$292.46
|
|
Cilastatin sodium injection
|
$77.40 |
$77.40 |
$77.40 |
$77.40
|
|
Ciliary transsleral therapy
|
$8,002.40 |
$8,002.40 |
$8,002.40 |
$3,269.14
|
|
Cine/video x-rays
|
$141.15 |
$141.15 |
$784.00 |
$321.64
|
|
Cine/video x-rays add-on
|
$448.00 |
$448.00 |
$448.00 |
$219.00
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$14.84 |
$14.84 |
$18.79 |
$34.88
|
|
Ciprofloxacin otic susp 6 mg
|
$47.27 |
$47.27 |
$47.27 |
$63.31
|
|
Circum 28 days or older
|
$8,377.60 |
$8,377.60 |
$8,377.60 |
$3,860.64
|
|
Circumcise/surg/28 days or < 54160
|
$8,215.20 |
$8,215.20 |
$8,215.20 |
$1,219.20
|
|
Circumcision (newborn)
|
$5,941.60 |
$5,941.60 |
$5,941.60 |
$1,395.20
|
|
Cisplatin 1 mg/ml desensitization
|
$2.49 |
$2.49 |
$898.80 |
$192.66
|
|
C-kit mutation liquid tumor - sendout
|
$37.50 |
$37.50 |
$1,159.20 |
$655.00
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$785.23 |
$785.23 |
$785.23 |
$569.55
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$3,936.30 |
$3,936.30 |
$48,300.00 |
$15,390.00
|
|
Claviculectomy partial
|
$12,908.00 |
$12,908.00 |
$12,908.00 |
$3,594.44
|
|
Claviculectomy total
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,292.06
|
|
Clean out mastoid cavity
|
$3,382.40 |
$3,382.40 |
$3,382.40 |
$1,033.60
|
|
Clearance of airways
|
$403.20 |
$403.20 |
$403.20 |
$208.86
|
|
Clearance of airways
|
$963.20 |
$963.20 |
$963.20 |
$666.23
|
|
Clearance of tear duct
|
$1,657.60 |
$1,657.60 |
$1,657.60 |
$656.38
|
|
C-lens fitg corneosclrl lens
|
$341.60 |
$341.60 |
$341.60 |
$165.50
|
|
C-lens fitg tech aphakia 1
|
$436.80 |
$436.80 |
$436.80 |
$165.50
|
|
C-lens fitg tech aphakia ou
|
$256.48 |
$256.48 |
$256.48 |
$197.60
|
|
C-lens fitg tech corneosclrl
|
$177.52 |
$177.52 |
$177.52 |
$122.20
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$20.20 |
$20.20 |
$40.99 |
$55.20
|
|
Clip ligating vesolock lg
|
$253.35 |
$253.35 |
$48,300.00 |
$4,320.00
|
|
Clip phn wireless f/baha4 proc
|
$374.55 |
$374.55 |
$574.56 |
$538.82
|
|
Clitoroplasty intersex state
|
$7,145.60 |
$7,145.60 |
$7,145.60 |
$3,986.00
|
|
Cllr miami j sm
|
$389.20 |
$389.20 |
$389.20 |
$566.23
|
|
Clofarabine 1 mg/ml intravenous solution
|
$5,152.77 |
$5,152.77 |
$5,152.77 |
$4,784.71
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$308.56 |
$308.56 |
$308.56 |
$81.90
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$508.45
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$1,806.01
|
|
Closed tx/acetabululm without manip 27220
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$5,700.80 |
$5,700.80 |
$5,700.80 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$202.50 |
$202.50 |
$1,125.60 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$398.55 |
$398.55 |
$1,220.80 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$376.96
|
