|
Clsd tx/ulnar shaft fx without manip 25530
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$510.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$716.95
|
|
Clsd tx wrist carpal fx without manip 25630
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$543.23
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$3,346.72 |
$3,346.72 |
$3,346.72 |
$494.40
|
|
Cltx post ankle fx w/mnpj
|
$21,567.36 |
$21,567.36 |
$21,567.36 |
$2,316.80
|
|
Cltx tmprmand dislc comp
|
$4,892.62 |
$4,892.62 |
$4,892.62 |
$3,786.00
|
|
Cmv pcr-sendout
|
$561.44 |
$561.44 |
$561.44 |
$172.25
|
|
Coagulation time activated teg
|
$102.92 |
$102.92 |
$102.92 |
$51.48
|
|
Cocaine 4 % nasal solution
|
$2,096.64 |
$2,096.64 |
$2,096.64 |
$836.06
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$168.80
|
|
Collection of venous blood by venipuncture
|
$45.76 |
$45.76 |
$45.76 |
$22.05
|
|
Compatibility test each unit antiglobulin technique
|
$2,198.56 |
$2,198.56 |
$2,198.56 |
$165.00
|
|
Compatibility test each unit electronic
|
$2,198.56 |
$2,198.56 |
$2,198.56 |
$175.45
|
|
Compatibility test each unit immediate spin technique
|
$671.65 |
$671.65 |
$671.65 |
$163.80
|
|
Complement antigen each component c3
|
$459.68 |
$459.68 |
$459.68 |
$113.30
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$8,298.08 |
$8,298.08 |
$8,298.08 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$8,298.08 |
$8,298.08 |
$8,298.08 |
$1,357.20
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$8,298.08 |
$8,298.08 |
$8,298.08 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$8,298.08 |
$8,298.08 |
$8,298.08 |
$1,252.90
|
|
Complx repair fccmnaxghf 13131
|
$5,598.88 |
$5,598.88 |
$5,598.88 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$8,298.08 |
$8,298.08 |
$8,298.08 |
$1,212.00
|
|
Complx repair fccmnaxghf 13133
|
$1,576.23 |
$1,576.23 |
$1,576.23 |
$797.64
|
|
Complx repair sal addl 5 cm/> 13122
|
$1,873.42 |
$1,873.42 |
$1,873.42 |
$592.69
|
|
Concentration infection agents any type
|
$106.88 |
$106.88 |
$106.88 |
$51.32
|
|
Condylomata destruction 56420
|
$729.47 |
$729.47 |
$729.47 |
$503.67
|
|
Consultation pathology during surgery
|
$552.48 |
$552.48 |
$552.48 |
$118.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$243.00 |
$243.00 |
$243.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$784.44 |
$784.44 |
$784.44 |
$214.00
|
|
Contrast exam abdominl aorta 75625-26
|
$12,241.86 |
$12,241.86 |
$12,241.86 |
$3,391.03
|
|
Contrast x-ray of brain
|
$9,642.56 |
$9,642.56 |
$9,642.56 |
$900.00
|
|
Control nosebleed pack+caut 30905
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$1,651.84 |
$1,651.84 |
$1,651.84 |
$385.45
|
|
Coombs direct
|
$196.49 |
$196.49 |
$196.49 |
$71.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$531.02 |
$531.02 |
$531.02 |
$100.29
|
|
Coombs indirect titer reference
|
$531.02 |
$531.02 |
$531.02 |
$144.00
|
|
Core ndl bx lng/med perq
|
$21,695.04 |
$21,695.04 |
$21,695.04 |
$2,963.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$20,558.56 |
$20,558.56 |
$20,558.56 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$20,118.91 |
$20,118.91 |
$20,118.91 |
$10,281.09
|
|
Coronary angio/lv gram/rt< heart
|
$19,840.70 |
$19,840.70 |
$19,840.70 |
$11,247.60
|
|
Coronary art/grft angio s&i
|
$18,895.94 |
$18,895.94 |
$18,895.94 |
$7,923.88
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$18,895.94 |
$18,895.94 |
$18,895.94 |
$7,697.25
|
|
Cortisol total am
|
$208.18 |
$208.18 |
$208.18 |
$122.20
|
|
Co-treatment - group 15 mins, st
|
$242.36 |
$242.36 |
$242.36 |
$110.00
|
|
Counseling smoke cess interm >10mins
|
$428.96 |
$428.96 |
$428.96 |
$57.60
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$1,653.75 |
$1,653.75 |
$1,653.75 |
$569.31
|
|
C-peptide
|
$72.84 |
$72.84 |
$72.84 |
$100.00
|
|
Crbrospnl fld flw imag cistern
|
$5,579.04 |
$5,579.04 |
$5,579.04 |
$1,410.04
|
|
C-reactive protein
|
$18.13 |
$18.13 |
$18.13 |
$61.20
|
|
C-reactive protein high sensitivity
|
$45.33 |
$45.33 |
$45.33 |
$91.65
|
|
Creatine kinase
|
$377.52 |
$377.52 |
$377.52 |
$58.30
|
|
Creatine kinase isoenzymes
|
$214.24 |
$214.24 |
$214.24 |
$49.02
|
|
Creatine kinase mb
|
$487.10 |
$487.10 |
$487.10 |
$109.20
|
|
Creatine - sendout
|
$74.24 |
$74.24 |
$74.24 |
$39.00
|
|
Creatinine
|
$26.44 |
$26.44 |
$26.44 |
$43.80
|
|
Creatinine 24 hour urine
|
$207.09 |
$207.09 |
$207.09 |
$61.95
|
|
Creatinine clearance urine
|
$151.36 |
$151.36 |
$151.36 |
$85.80
|
|
#creutz-prot.,western blot
|
$467.36 |
$467.36 |
$467.36 |
$179.28
|
|
Critical care 30-74 minutes
|
$6,082.99 |
$6,082.99 |
$6,082.99 |
$2,662.80
|
|
Critical care each additional 30 minutes
|
$1,379.91 |
$1,379.91 |
$1,379.91 |
$784.24
|
|
Cryoprecipitate each unit
|
$343.56 |
$343.56 |
$343.56 |
$195.02
|
|
Crystal identification light microscopy
|
$117.28 |
$117.28 |
$117.28 |
$64.40
|
|
Cta abdomen without & /or w/contrast
|
$2,607.61 |
$2,607.61 |
$2,607.61 |
$2,084.86
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$8,269.87 |
$8,269.87 |
$8,269.87 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,543.46 |
$1,543.46 |
$1,543.46 |
$2,079.00
|
|
Cta neck without &/or w/contrast
|
$2,755.49 |
$2,755.49 |
$2,755.49 |
$1,987.50
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,185.43 |
$3,185.43 |
$3,185.43 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,599.37 |
$1,599.37 |
$1,599.37 |
$2,057.90
|
|
CT Angiogram of the Head
|
$8,338.26 |
$8,338.26 |
$8,338.26 |
$2,080.00
|
|
CT angio hrt w/3d image
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,601.60
|
|
CT angio pelvis
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,802.35
|
|
Cta upper extremity w &/or without contrast left
|
$8,674.31 |
$8,674.31 |
$8,674.31 |
$1,691.30
|
|
CT guidance for needle placement
|
$6,412.52 |
$6,412.52 |
$6,412.52 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,591.36 |
$2,591.36 |
$2,591.36 |
$1,058.40
|
|
CT heart w/evaluation of calcium without contrast
|
$2,583.78 |
$2,583.78 |
$2,583.78 |
$192.00
|
|
CT limited or localized follow-up study
|
$1,301.76 |
$1,301.76 |
$1,301.76 |
$640.48
|
|
CT lower extremity w/contrast (both sides)
|
$8,639.33 |
$8,639.33 |
$8,639.33 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$6,638.73 |
$6,638.73 |
$6,638.73 |
$1,403.73
|
|
CT lwr extremity w/o&w/dye
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,844.52
|
|
CT neck soft tissue w/contrast
|
$8,166.62 |
$8,166.62 |
$8,166.62 |
$1,669.00
|
|
CT neck soft tissue without contrast
|
$7,432.11 |
$7,432.11 |
$7,432.11 |
$1,344.60
|
|
CT neck soft tissue without & w/contrast
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,661.25
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$8,227.88 |
$8,227.88 |
$8,227.88 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$7,405.14 |
$7,405.14 |
$7,405.14 |
$1,365.36
|
|
Ctrl nosebld postir subsq 30906
|
$3,369.28 |
$3,369.28 |
$3,369.28 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$12,644.73 |
$12,644.73 |
$12,644.73 |
$3,472.30
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$13,714.19 |
$13,714.19 |
$13,714.19 |
$2,979.85
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$10,044.97 |
$10,044.97 |
$10,044.97 |
$2,405.40
|
|
CT thoracic spine w/contrast
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$7,563.76 |
$7,563.76 |
$7,563.76 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$1,774.24 |
$1,774.24 |
$1,774.24 |
$420.60
|
|
CT t-spine w /wo contrast
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$8,227.88 |
$8,227.88 |
$8,227.88 |
$1,714.05
|
|
CT upper extremity without contrast (both sides)
|
$7,497.21 |
$7,497.21 |
$7,497.21 |
$1,473.75
|
|
CT uppr extremity w/o&w/dye
|
$9,792.09 |
$9,792.09 |
$9,792.09 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$220.88 |
$220.88 |
$220.88 |
$64.58
|
|
Culture afb any source
|
$172.80 |
$172.80 |
$172.80 |
$108.63
|