|
Clsd tx temporomandibular dislocat 21480
|
$5,883.28 |
$5,883.28 |
$5,883.28 |
$506.40
|
|
Clsd tx toe dislocation without anes28660
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$415.20
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$4,176.08 |
$4,176.08 |
$4,176.08 |
$494.40
|
|
Cmv pcr-sendout
|
$700.58 |
$700.58 |
$700.58 |
$172.25
|
|
Coagulation time activated teg
|
$85.45 |
$85.45 |
$85.45 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$7,480.58 |
$7,480.58 |
$7,480.58 |
$781.82
|
|
Collection blood specimen from completely implantable venous access device
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$163.07
|
|
Collection of venous blood by venipuncture
|
$34.00 |
$34.00 |
$34.00 |
$21.66
|
|
Compatibility test each unit antiglobulin technique
|
$2,743.40 |
$2,743.40 |
$2,743.40 |
$165.00
|
|
Compatibility test each unit electronic
|
$547.97 |
$547.97 |
$547.97 |
$167.17
|
|
Compatibility test each unit immediate spin technique
|
$547.97 |
$547.97 |
$547.97 |
$159.95
|
|
Complement antigen each component c3
|
$275.30 |
$275.30 |
$275.30 |
$113.13
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$10,354.45 |
$10,354.45 |
$10,354.45 |
$1,252.90
|
|
Complx repair fccmnaxghf 13133
|
$2,097.96 |
$2,097.96 |
$2,097.96 |
$781.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,493.52 |
$2,493.52 |
$2,493.52 |
$590.20
|
|
Concentration infection agents any type
|
$133.36 |
$133.36 |
$133.36 |
$50.70
|
|
Consultation pathology during surgery cytological exam initial site
|
$12,762.43 |
$12,762.43 |
$12,762.43 |
$402.05
|
|
Consultation pathology during surgery frozen section first tissue block
|
$2,743.40 |
$2,743.40 |
$2,743.40 |
$210.80
|
|
Consultation/report referred material w/preparation of slides
|
$1,007.64 |
$1,007.64 |
$1,007.64 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$689.40 |
$689.40 |
$689.40 |
$176.15
|
|
Contrast x-ray gallbladder
|
$2,710.26 |
$2,710.26 |
$2,710.26 |
$276.65
|
|
Control nosebleed pack+caut 30905
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$2,061.19 |
$2,061.19 |
$2,061.19 |
$410.06
|
|
Coombs direct
|
$211.10 |
$211.10 |
$211.10 |
$71.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$547.97 |
$547.97 |
$547.97 |
$100.29
|
|
Cortisol total am
|
$303.27 |
$303.27 |
$303.27 |
$122.00
|
|
Co-treatment - group 15 mins, st
|
$352.28 |
$352.28 |
$352.28 |
$110.00
|
|
Counseling smoke cess interm >10mins
|
$115.58 |
$115.58 |
$115.58 |
$57.60
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$8,994.24 |
$8,994.24 |
$8,994.24 |
$569.31
|
|
#coxa-coxsackie a serotype a16
|
$260.15 |
$260.15 |
$260.15 |
$65.36
|
|
C-peptide
|
$80.12 |
$80.12 |
$80.12 |
$100.26
|
|
C-reactive protein
|
$174.71 |
$174.71 |
$174.71 |
$61.10
|
|
C-reactive protein high sensitivity
|
$258.56 |
$258.56 |
$258.56 |
$91.20
|
|
C-reactive protein, quantitative
|
$212.43 |
$212.43 |
$212.43 |
$63.07
|
|
Creatine kinase
|
$231.14 |
$231.14 |
$231.14 |
$58.30
|
|
Creatine kinase isoenzymes
|
$267.33 |
$267.33 |
$267.33 |
$49.40
|
|
Creatine - sendout
|
$92.64 |
$92.64 |
$92.64 |
$40.59
|
|
Creatinine
|
$256.51 |
$256.51 |
$256.51 |
$42.50
|
|
Creatinine 24 hour urine
|
$142.45 |
$142.45 |
$142.45 |
$59.80
|
|
Creatinine clearance urine
|
$188.87 |
$188.87 |
$188.87 |
$85.80
|
|
#creutz-prot.,western blot
|
$583.19 |
$583.19 |
$583.19 |
$179.28
|
|
Cryofibrinogen qualitative - sendout
|
$282.30 |
$282.30 |
$282.30 |
$50.88
|
|
Cryoprecipitate each unit
|
$1,627.76 |
$1,627.76 |
$1,627.76 |
$190.20
|
|
Crystal identification light microscopy
|
$146.36 |
$146.36 |
$146.36 |
$58.50
|
|
CT guidance for needle placement
|
$7,616.48 |
$7,616.48 |
$7,616.48 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$2,294.51 |
$2,294.51 |
$2,294.51 |
$1,058.40
|
|
CT limited or localized follow-up study
|
$2,158.49 |
$2,158.49 |
$2,158.49 |
$630.50
|
|
CT lower extremity w/contrast (both sides)
|
$6,473.81 |
$6,473.81 |
$6,473.81 |
$1,680.60
|
|
CT lower extremity without contrast (both sides)
|
$8,974.98 |
$8,974.98 |
$8,974.98 |
$1,398.82
|
|
CT neck soft tissue w/contrast
|
$9,465.67 |
$9,465.67 |
$9,465.67 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$8,315.15 |
$8,315.15 |
$8,315.15 |
$1,316.71
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$2,213.93 |
$2,213.93 |
$2,213.93 |
$1,345.05
|
|
Ctrl nosebld postir subsq 30906
|
$4,204.23 |
$4,204.23 |
$4,204.23 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$15,389.43 |
$15,389.43 |
$15,389.43 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$15,296.36 |
$15,296.36 |
$15,296.36 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$15,009.93 |
$15,009.93 |
$15,009.93 |
$2,370.63
|
|
CT thoracic spine without contrast
|
$10,729.19 |
$10,729.19 |
$10,729.19 |
$1,436.50
|
|
CT t-spine w /wo contrast
|
$2,710.26 |
$2,710.26 |
$2,710.26 |
$2,030.60
|
|
CT upper extremity w/contrast (both sides)
|
$5,897.27 |
$5,897.27 |
$5,897.27 |
$1,697.85
|
|
CT upper extremity without contrast (both sides)
|
$8,554.16 |
$8,554.16 |
$8,554.16 |
$1,473.75
|
|
Culture aerobic additional method definitive id each
|
$125.49 |
$125.49 |
$125.49 |
$62.65
|
|
Culture afb any source
|
$321.04 |
$321.04 |
$321.04 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$113.53 |
$113.53 |
$113.53 |
$75.29
|
|
Culture anaerobic except blood
|
$321.04 |
$321.04 |
$321.04 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$188.47 |
$188.47 |
$188.47 |
$52.50
|
|
Culture body fluid
|
$260.83 |
$260.83 |
$260.83 |
$129.21
|
|
Culture fungi definitive id mold
|
$39.73 |
$39.73 |
$39.73 |
$70.00
|
|
Culture fungi definitive id yeast
|
$250.91 |
$250.91 |
$250.91 |
$79.00
|
|
Culture fungi other (except blood)
|
$315.22 |
$315.22 |
$315.22 |
$94.90
|
|
Culture mycobacteria definitive id each isolate
|
$291.70 |
$291.70 |
$291.70 |
$88.14
|
|
Culture quantitative aerobic other source
|
$197.46 |
$197.46 |
$197.46 |
$85.80
|
|
Culture screening strep group a
|
$132.37 |
$132.37 |
$132.37 |
$78.47
|
|
Culture typing added method
|
$154.53 |
$154.53 |
$154.53 |
$34.45
|
|
Culture typing immunologic
|
$103.42 |
$103.42 |
$103.42 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$4,353.57 |
$4,353.57 |
$4,353.57 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$700.58 |
$700.58 |
$700.58 |
$101.45
|
|
Cv line/pic reposition
|
$4,812.94 |
$4,812.94 |
$4,812.94 |
$1,789.77
|
|
Cyanocobalamin unsat binding capacity
|
$285.90 |
$285.90 |
$285.90 |
$60.75
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$116.01 |
$116.01 |
$116.01 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$258.56 |
$258.56 |
$258.56 |
$85.03
|
|
Cyclosporine 2 hour
|
$360.37 |
$360.37 |
$360.37 |
$119.40
|
|
Cyclosporine oral 100 mg
|
$146.53 |
$146.53 |
$146.53 |
$42.97
|
|
Cystatin c
|
$369.75 |
$369.75 |
$369.75 |
$82.50
|
|
Cytarabine 20 mg/ml injection solution
|
$167.74 |
$167.74 |
$167.74 |
$66.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$287.30 |
$287.30 |
$287.30 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$336.41 |
$336.41 |
$336.41 |
$101.94
|
|
Cytopathology cellular enhancement technique non-gyn
|
$1,007.64 |
$1,007.64 |
$1,007.64 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$404.49 |
$404.49 |
$404.49 |
$84.50
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$92,246.12 |
$92,246.12 |
$92,246.12 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$26,375.39 |
$26,375.39 |
$26,375.39 |
$5,500.25
|
|
Deamidated gliadin antibody iga
|
$230.21 |
$230.21 |
$230.21 |
$44.20
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$6,986.36 |
$6,986.36 |
$6,986.36 |
$798.23
|
|
Debride nail1-5 11720
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$173.25
|
|
Debride nail6 or more 11721
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$200.21
|
|
Debr musc/fascia 20sq cm/< 11043
|
$10,354.45 |
$10,354.45 |
$10,354.45 |
$1,193.40
|
|
Decalcification
|
$248.70 |
$248.70 |
$248.70 |
$75.38
|
|
Declotting thrombolytic agent implanted vas access device 36
|
$78.47 |
$78.47 |
$78.47 |
$497.14
|
|
Deferoxamine 500 mg solution for injection
|
$1,413.10 |
$1,413.10 |
$1,413.10 |
$112.87
|
|
Demonstration/evaluation utilization aersol generator/nebulizer/metered dose inhaler/ippb device
|
$894.30 |
$894.30 |
$894.30 |
$182.40
|