|
Clsd tx hip disloc without anes 27265
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$716.95
|
|
Clsd tx humeral fract without manip 24530
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$623.93
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$529.08
|
|
Clsd tx patella disloc without anes 27560
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$665.50
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$23,406.48 |
$23,406.48 |
$23,406.48 |
$1,707.42
|
|
Clsd tx wrist carpal fx without manip 25630
|
$3,632.11 |
$3,632.11 |
$3,632.11 |
$476.00
|
|
Coagulation time activated teg
|
$75.05 |
$75.05 |
$75.05 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$2,155.76 |
$2,155.76 |
$2,155.76 |
$781.82
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$163.07
|
|
Collection of venous blood by venipuncture
|
$50.21 |
$50.21 |
$50.21 |
$21.66
|
|
Compatibility test each unit antiglobulin technique
|
$455.16 |
$455.16 |
$455.16 |
$165.00
|
|
Compatibility test each unit electronic
|
$455.16 |
$455.16 |
$455.16 |
$167.17
|
|
Compatibility test each unit immediate spin technique
|
$455.16 |
$455.16 |
$455.16 |
$159.95
|
|
Complement antigen each component c3
|
$41.67 |
$41.67 |
$41.67 |
$113.13
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$9,005.68 |
$9,005.68 |
$9,005.68 |
$1,252.90
|
|
Complx repair fccmnaxghf 13131
|
$6,076.32 |
$6,076.32 |
$6,076.32 |
$911.40
|
|
Complx repair fccmnaxghf 13132
|
$9,005.68 |
$9,005.68 |
$9,005.68 |
$1,212.00
|
|
Complx repair fccmnaxghf 13133
|
$1,824.68 |
$1,824.68 |
$1,824.68 |
$781.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,168.71 |
$2,168.71 |
$2,168.71 |
$590.20
|
|
Concentration infection agents any type
|
$85.06 |
$85.06 |
$85.06 |
$50.70
|
|
Condylomata destruction 56420
|
$2,234.51 |
$2,234.51 |
$2,234.51 |
$503.67
|
|
Control of nosebleed ant comp 30903
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$385.45
|
|
Coombs direct
|
$172.73 |
$172.73 |
$172.73 |
$71.74
|
|
Cortisol total am
|
$222.89 |
$222.89 |
$222.89 |
$122.00
|
|
Co-treatment - group 15 mins, st
|
$189.95 |
$189.95 |
$189.95 |
$110.00
|
|
Counseling smoke cess interm >10mins
|
$465.54 |
$465.54 |
$465.54 |
$57.60
|
|
#covid19rsv-rsv
|
$429.94 |
$429.94 |
$429.94 |
$140.80
|
|
C-peptide
|
$72.27 |
$72.27 |
$72.27 |
$100.26
|
|
C-reactive protein
|
$149.94 |
$149.94 |
$149.94 |
$61.10
|
|
C-reactive protein high sensitivity
|
$166.28 |
$166.28 |
$166.28 |
$91.20
|
|
Creatine kinase
|
$238.37 |
$238.37 |
$238.37 |
$58.30
|
|
Creatine kinase isoenzymes
|
$249.20 |
$249.20 |
$249.20 |
$49.40
|
|
Creatinine
|
$144.74 |
$144.74 |
$144.74 |
$42.50
|
|
Creatinine 24 hour urine
|
$190.38 |
$190.38 |
$190.38 |
$59.80
|
|
#creutz-prot.,western blot
|
$371.96 |
$371.96 |
$371.96 |
$179.28
|
|
Critical care 30-74 minutes
|
$4,973.12 |
$4,973.12 |
$4,973.12 |
$2,595.34
|
|
Critical care each additional 30 minutes
|
$1,597.43 |
$1,597.43 |
$1,597.43 |
$756.00
|
|
Crystal identification light microscopy
|
$132.97 |
$132.97 |
$132.97 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$7,070.78 |
$7,070.78 |
$7,070.78 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$7,781.07 |
$7,781.07 |
$7,781.07 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$5,755.17 |
$5,755.17 |
$5,755.17 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$7,367.07 |
$7,367.07 |
$7,367.07 |
$1,944.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$15,221.87 |
$15,221.87 |
$15,221.87 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$7,683.51 |
$7,683.51 |
$7,683.51 |
$2,017.89
|
|
CT Angiogram of the Head
|
$7,036.91 |
$7,036.91 |
$7,036.91 |
$2,041.78
|
|
CT angio pelvis
|
$2,357.21 |
$2,357.21 |
$2,357.21 |
$1,778.40
|
|
Cta upper extremity w &/or without contrast left
|
$2,357.21 |
$2,357.21 |
$2,357.21 |
$1,652.95
|
|
CT lower extremity w/contrast (both sides)
|
$5,841.38 |
$5,841.38 |
$5,841.38 |
$1,680.60
|
|
CT lower extremity without contrast (both sides)
|
$5,312.42 |
$5,312.42 |
$5,312.42 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$2,357.21 |
$2,357.21 |
$2,357.21 |
$1,817.40
|
|
CT neck soft tissue w/contrast
|
$6,496.89 |
$6,496.89 |
$6,496.89 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$5,304.97 |
$5,304.97 |
$5,304.97 |
$1,316.71
|
|
CT neck soft tissue without & w/contrast
|
$2,357.21 |
$2,357.21 |
$2,357.21 |
$1,959.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$6,084.02 |
$6,084.02 |
$6,084.02 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$5,733.05 |
$5,733.05 |
$5,733.05 |
$1,345.05
|
|
Ctrl nosebld postir subsq 30906
|
$3,656.59 |
$3,656.59 |
$3,656.59 |
$456.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$16,386.70 |
$16,386.70 |
$16,386.70 |
$3,328.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$13,470.99 |
$13,470.99 |
$13,470.99 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$11,071.81 |
$11,071.81 |
$11,071.81 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$2,357.21 |
$2,357.21 |
$2,357.21 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$6,134.47 |
$6,134.47 |
$6,134.47 |
$1,436.50
|
|
CT upper extremity w/contrast (both sides)
|
$6,047.53 |
$6,047.53 |
$6,047.53 |
$1,697.85
|
|
CT upper extremity without contrast (both sides)
|
$4,097.95 |
$4,097.95 |
$4,097.95 |
$1,473.75
|
|
Culture aerobic additional method definitive id each
|
$347.69 |
$347.69 |
$347.69 |
$62.65
|
|
Culture afb any source
|
$137.53 |
$137.53 |
$137.53 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$25.45 |
$25.45 |
$25.45 |
$75.29
|
|
Culture anaerobic except blood
|
$120.59 |
$120.59 |
$120.59 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$120.20 |
$120.20 |
$120.20 |
$52.50
|
|
Culture body fluid
|
$493.99 |
$493.99 |
$493.99 |
$129.21
|
|
Culture fungi definitive id mold
|
$131.42 |
$131.42 |
$131.42 |
$70.00
|
|
Culture fungi definitive id yeast
|
$143.82 |
$143.82 |
$143.82 |
$79.00
|
|
Culture fungi other (except blood)
|
$29.00 |
$29.00 |
$29.00 |
$94.90
|
|
Culture mycobacteria definitive id each isolate
|
$186.05 |
$186.05 |
$186.05 |
$88.14
|
|
Culture screening strep group a
|
$202.47 |
$202.47 |
$202.47 |
$78.47
|
|
Culture typing added method
|
$98.56 |
$98.56 |
$98.56 |
$34.45
|
|
Culture typing immunologic
|
$65.96 |
$65.96 |
$65.96 |
$41.19
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$1,149.56 |
$1,149.56 |
$1,149.56 |
$408.75
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$446.83 |
$446.83 |
$446.83 |
$101.45
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$110.34 |
$110.34 |
$110.34 |
$26.73
|
|
Cyclic citrullinated peptide antibody
|
$44.97 |
$44.97 |
$44.97 |
$85.03
|
|
Cyclosporine 2 hour
|
$56.86 |
$56.86 |
$56.86 |
$119.40
|
|
Cyclosporine oral 100 mg
|
$71.31 |
$71.31 |
$71.31 |
$42.97
|
|
Cystatin c
|
$235.84 |
$235.84 |
$235.84 |
$82.50
|
|
Cytarabine 20 mg/ml injection solution
|
$86.50 |
$86.50 |
$86.50 |
$66.95
|
|
Cytomegalovirus (cmv) antibody igg
|
$183.24 |
$183.24 |
$183.24 |
$101.25
|
|
Cytomegalovirus (cmv) antibody igm
|
$214.57 |
$214.57 |
$214.57 |
$101.94
|
|
Cytopathology cellular enhancement technique non-gyn
|
$876.38 |
$876.38 |
$876.38 |
$163.43
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$257.99 |
$257.99 |
$257.99 |
$84.50
|
|
Daratumumab 1,800 mg-hyaluronidase-fihj 30,000 unit/15 ml subcut soln
|
$36,768.81 |
$36,768.81 |
$36,768.81 |
$28,415.40
|
|
Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe
|
$23,095.96 |
$23,095.96 |
$23,095.96 |
$5,500.25
|
|
Deamidated gliadin antibody iga
|
$40.05 |
$40.05 |
$40.05 |
$44.20
|
|
Debridement subcutaneous tissue <= 20 sq cm
|
$6,076.32 |
$6,076.32 |
$6,076.32 |
$798.23
|
|
Deferoxamine 500 mg solution for injection
|
$1,452.23 |
$1,452.23 |
$1,452.23 |
$112.87
|
|
Denosumab 120 mg/1.7 ml (70 mg/ml) subcutaneous solution
|
$36,522.66 |
$36,522.66 |
$36,522.66 |
$7,737.00
|
|
Dentoalveolar/drain abs/cyst/hema 41800
|
$1,792.70 |
$1,792.70 |
$1,792.70 |
$448.50
|
|
Desmopressin 4 mcg/ml injection solution
|
$2,572.46 |
$2,572.46 |
$2,572.46 |
$172.46
|
|
Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr
|
$66.16 |
$66.16 |
$66.16 |
$23.27
|
|
Dextrose 5 % and 0.9 % sodium chloride intravenous solution
|
$386.35 |
$386.35 |
$386.35 |
$43.65
|
|
Dextrose 5 % and lactated ringers intravenous solution
|
$386.35 |
$386.35 |
$386.35 |
$68.25
|