|
Chromo high res and frag x - sendout
|
$194.35 |
$194.35 |
$194.35 |
$250.00
|
|
Chromosome analys amniotic
|
$342.55 |
$342.55 |
$342.55 |
$450.00
|
|
Chromosome analysis 15-20 cell count
|
$446.55 |
$446.55 |
$446.55 |
$517.11
|
|
Chromosome analysis 45
|
$382.85 |
$382.85 |
$382.85 |
$382.85
|
|
Chromosome analysis 5
|
$307.45 |
$307.45 |
$307.45 |
$644.80
|
|
Chromosome analys placenta
|
$664.95 |
$664.95 |
$664.95 |
$572.99
|
|
Chromosome count additional
|
$94.90 |
$94.90 |
$94.90 |
$96.50
|
|
Chromosome karyotype study
|
$117.65 |
$117.65 |
$117.65 |
$120.00
|
|
Chronic urticaria - sendout
|
$50.05 |
$50.05 |
$50.05 |
$75.71
|
|
Chylomicron screen, bf - sendout
|
$324.35 |
$324.35 |
$324.35 |
$136.09
|
|
Cidofovir injection
|
$684.83 |
$684.83 |
$684.83 |
$1,352.09
|
|
Cilastatin sodium injection
|
$117.52 |
$117.52 |
$117.52 |
$77.40
|
|
Cine/video x-rays add-on
|
$263.90 |
$263.90 |
$263.90 |
$293.05
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$19.50 |
$19.50 |
$19.50 |
$35.65
|
|
Circumcision (newborn)
|
$1,616.55 |
$1,616.55 |
$1,616.55 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$115.44 |
$115.44 |
$115.44 |
$205.56
|
|
C-kit mutation liquid tumor - sendout
|
$608.40 |
$608.40 |
$608.40 |
$666.60
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$150.65 |
$150.65 |
$150.65 |
$576.60
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$35,349.60 |
$35,349.60 |
$35,349.60 |
$15,560.16
|
|
Clip ligating vesolock lg
|
$8,962.85 |
$8,962.85 |
$8,962.85 |
$4,320.00
|
|
Clofarabine 1 mg/ml intravenous solution
|
$513.96 |
$513.96 |
$513.96 |
$4,784.71
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$15.24 |
$15.24 |
$15.24 |
$85.37
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$724.75 |
$724.75 |
$724.75 |
$520.80
|
|
Closed tx/acetabululm without manip 27220
|
$724.75 |
$724.75 |
$724.75 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$2,291.20
|
|
Closed tx humerus fx w/manip 24505
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$724.75 |
$724.75 |
$724.75 |
$386.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$2,569.28
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$876.85 |
$876.85 |
$876.85 |
$472.50
|
|
Clos txnose fx without stablz 21315
|
$4,117.75 |
$4,117.75 |
$4,117.75 |
$2,392.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$1,641.25 |
$1,641.25 |
$1,641.25 |
$1,259.62
|
|
Closure paravalvlr leak pq
|
$18,421.65 |
$18,421.65 |
$18,421.65 |
$9,434.46
|
|
Clot factor fletcher fact
|
$203.45 |
$203.45 |
$203.45 |
$119.50
|
|
Clot factor viii reltd antgn
|
$360.10 |
$360.10 |
$360.10 |
$140.42
|
|
Clot factor wght kininogen
|
$276.25 |
$276.25 |
$276.25 |
$157.50
|
|
Clot factor xii hageman
|
$139.75 |
$139.75 |
$139.75 |
$138.40
|
|
Clot factor xiii fibrin scrn
|
$52.65 |
$52.65 |
$52.65 |
$56.85
|
|
Clot factor xiii fibrin stab
|
$197.60 |
$197.60 |
$197.60 |
$106.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$760.50 |
$760.50 |
$760.50 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$760.50 |
$760.50 |
$760.50 |
$535.60
|
|
Clsd tx dist fib fx w/manip 27788
|
$760.50 |
$760.50 |
$760.50 |
$676.65
|
|
Clsd tx elbow dislocation child 24640
|
$633.75 |
$633.75 |
$633.75 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$4,176.90 |
$4,176.90 |
$4,176.90 |
$2,211.05
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$811.20 |
$811.20 |
$811.20 |
$464.20
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$4,277.65 |
$4,277.65 |
$4,277.65 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$4,277.65 |
$4,277.65 |
$4,277.65 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$760.50 |
$760.50 |
$760.50 |
$630.00
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$740.35 |
$740.35 |
$740.35 |
$883.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$724.75 |
$724.75 |
$724.75 |
$620.32
|
|
Clsd tx patella disloc without anes 27560
|
$760.50 |
$760.50 |
$760.50 |
$573.52
|
|
Clsd tx pelvic ring fx
|
$724.75 |
$724.75 |
$724.75 |
$424.50
|
|
Clsd tx radius fracture w/manip 24655
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$760.50 |
$760.50 |
$760.50 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$760.50 |
$760.50 |
$760.50 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$760.50 |
$760.50 |
$760.50 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$4,438.20 |
$4,438.20 |
$4,438.20 |
$1,592.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$724.75 |
$724.75 |
$724.75 |
$612.80
|
|
Cltx post ankle fx w/mnpj
|
$4,226.95 |
$4,226.95 |
$4,226.95 |
$1,939.00
|
|
#cms hgb-carboxyhemoglobin
|
$141.70 |
$141.70 |
$141.70 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$55.25 |
$55.25 |
$55.25 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$110.50 |
$110.50 |
$110.50 |
$89.76
|
|
Cmv pcr-sendout
|
$744.25 |
$744.25 |
$744.25 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$7,763.34 |
$7,763.34 |
$7,763.34 |
$11,888.50
|
|
Coagulation time activated teg
|
$84.50 |
$84.50 |
$84.50 |
$52.47
|
|
Cold agglutinin titer
|
$24.70 |
$24.70 |
$24.70 |
$52.00
|
|
Colistimethate sodium inj
|
$164.50 |
$164.50 |
$164.50 |
$82.71
|
|
Collagen based wound filler
|
$9,809.15 |
$9,809.15 |
$9,809.15 |
$1,794.78
|
|
Collagen imp urinary 2.5 ml
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$504.40 |
$504.40 |
$504.40 |
$303.73
|
|
Collar cerv patriot adlt
|
$57.20 |
$57.20 |
$57.20 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$312.00 |
$312.00 |
$312.00 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$312.00 |
$312.00 |
$312.00 |
$155.40
|
|
Compatibility test each unit antiglobulin technique
|
$123.50 |
$123.50 |
$123.50 |
$173.50
|
|
Compatibility test each unit electronic
|
$88.40 |
$88.40 |
$88.40 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$281.45 |
$281.45 |
$281.45 |
$169.52
|
|
Complement antigen each component c3
|
$577.20 |
$577.20 |
$577.20 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,650.35 |
$1,650.35 |
$1,650.35 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,413.75 |
$1,413.75 |
$1,413.75 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,413.75 |
$1,413.75 |
$1,413.75 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,413.75 |
$1,413.75 |
$1,413.75 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$436.15 |
$436.15 |
$436.15 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$927.55 |
$927.55 |
$927.55 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,555.45 |
$1,555.45 |
$1,555.45 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$826.15 |
$826.15 |
$826.15 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$826.15 |
$826.15 |
$826.15 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$3,053.70 |
$3,053.70 |
$3,053.70 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$716.95 |
$716.95 |
$716.95 |
$537.00
|
|
Concentration infection agents any type
|
$271.05 |
$271.05 |
$271.05 |
$51.32
|
|
Condylomata destruction 56420
|
$467.35 |
$467.35 |
$467.35 |
$467.35
|
|
Conform band n/s w>=3"<5"/yd
|
$8.45 |
$8.45 |
$8.45 |
$1.04
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,027.88 |
$1,027.88 |
$1,027.88 |
$860.00
|
|
Connect omega .5mm
|
$1,040.65 |
$1,040.65 |
$1,040.65 |
$1,260.00
|
|
Connector tis 2x10mm
|
$7,079.15 |
$7,079.15 |
$7,079.15 |
$4,024.34
|
|
Consultation pathology during surgery
|
$68.90 |
$68.90 |
$68.90 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,001.65 |
$1,001.65 |
$1,001.65 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$62.40 |
$62.40 |
$62.40 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$423.15 |
$423.15 |
$423.15 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$718.25 |
$718.25 |
$718.25 |
$224.83
|
