|
Change cystostomy tube simple
|
$728.75 |
$728.75 |
$728.75 |
$479.00
|
|
Change nephroureteral cath
|
$5,559.71 |
$5,559.71 |
$5,559.71 |
$2,969.25
|
|
Chest apical lordotic proj
|
$1,291.86 |
$1,291.86 |
$1,291.86 |
$288.81
|
|
Chest CT scan (with and without contrast)
|
$8,409.14 |
$8,409.14 |
$8,409.14 |
$2,021.80
|
|
Chest CT scan (with contrast)
|
$7,880.57 |
$7,880.57 |
$7,880.57 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$7,303.94 |
$7,303.94 |
$7,303.94 |
$1,350.03
|
|
Chest X-ray
|
$1,158.09 |
$1,158.09 |
$1,158.09 |
$294.06
|
|
Chest X-ray (single view)
|
$865.98 |
$865.98 |
$865.98 |
$229.08
|
|
Chg pr pul rehab for copd patients
|
$350.07 |
$350.07 |
$350.07 |
$150.00
|
|
Chlamydia type
|
$105.27 |
$105.27 |
$105.27 |
$34.75
|
|
Chloride
|
$141.99 |
$141.99 |
$141.99 |
$38.50
|
|
Chloride 24 hour urine
|
$115.24 |
$115.24 |
$115.24 |
$46.13
|
|
Chloroprocaine hcl injection
|
$144.82 |
$144.82 |
$144.82 |
$78.26
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$299.70 |
$299.70 |
$299.70 |
$333.01
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$588.56 |
$588.56 |
$588.56 |
$89.81
|
|
Cholesterol
|
$325.46 |
$325.46 |
$325.46 |
$46.15
|
|
Cholesterol body fluid
|
$550.21 |
$550.21 |
$550.21 |
$92.80
|
|
Cholesterol (Lipid) Test
|
$595.51 |
$595.51 |
$595.51 |
$115.70
|
|
Chromatography
|
$278.75 |
$278.75 |
$278.75 |
$80.60
|
|
Chromosome analysis 15-20 cell count
|
$618.65 |
$618.65 |
$618.65 |
$448.80
|
|
Chromosome karyotype study
|
$122.93 |
$122.93 |
$122.93 |
$102.72
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$149.44 |
$149.44 |
$149.44 |
$45.27
|
|
Circumcise/surg/28 days or < 54160
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$1,995.50
|
|
Cisplatin 1 mg/ml desensitization
|
$712.46 |
$712.46 |
$712.46 |
$127.11
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$4,706.52 |
$4,706.52 |
$4,706.52 |
$576.60
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$235.94 |
$235.94 |
$235.94 |
$61.26
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$74.75 |
$74.75 |
$74.75 |
$81.02
|
|
Closed tx humerus fx without manip 23600
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$498.40
|
|
Closed tx humerus fx w/manip 24505
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,592.00
|
|
Clos txnose fx without stablz 21315
|
$15,514.83 |
$15,514.83 |
$15,514.83 |
$2,587.20
|
|
Clotting assay whole blood
|
$495.92 |
$495.92 |
$495.92 |
$105.95
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$625.13
|
|
Clsd tx clavicle dislocation without manip 23540
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$498.05
|
|
Clsd tx/clavicular fx without manip 23500
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$488.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$728.00
|
|
Clsd tx elbow dislocation child 24640
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$525.28
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$392.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$2,263.78 |
$2,263.78 |
$2,263.78 |
$469.10
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$597.60
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$5,023.06 |
$5,023.06 |
$5,023.06 |
$1,893.86
|
|
Clsd tx fx radius/ulna without manip 25560
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$547.20
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$5,023.06 |
$5,023.06 |
$5,023.06 |
$1,827.71
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$476.00
|
|
Clsd tx hip disloc without anes 27265
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$716.95
|
|
Clsd tx humeral fract without manip 24530
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$623.93
|
|
Clsd tx humerus fract without manip 24500
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$546.86
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$2,976.33 |
$2,976.33 |
$2,976.33 |
$1,014.00
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$519.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$716.95
|
|
Clsd tx/metatarsal fx without manip 28470
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$418.20
|
|
Clsd tx patella disloc without anes 27560
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$665.50
|
|
Clsd tx/patellar fx without manip 27520
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$544.80
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,370.40
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$501.80
|
|
Clsd tx radius fracture w/manip 24655
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,868.38
|
|
Clsd tx shoulder dislc/fx 23665
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,055.00
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,423.85
|
|
Clsd tx temporomandibular dislocat 21480
|
$5,105.33 |
$5,105.33 |
$5,105.33 |
$506.40
|
|
Clsd tx toe dislocation without anes28660
|
$1,486.13 |
$1,486.13 |
$1,486.13 |
$415.20
|
|
Clsd tx trimall ankle fx without manip 27816
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$597.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$510.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$2,757.88 |
$2,757.88 |
$2,757.88 |
$730.08
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$543.23
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$494.40
|
|
Cltx carpl scphd fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,368.00
|
|
Cltx lunate dislc w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,884.30
|
|
Cltx post ankle fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,316.80
|
|
C motor evoked upr&lwr limbs
|
$11,386.02 |
$11,386.02 |
$11,386.02 |
$1,273.61
|
|
#cmvcul-virus inoculation shell
|
$301.91 |
$301.91 |
$301.91 |
$102.57
|
|
Cmv pcr-sendout
|
$541.61 |
$541.61 |
$541.61 |
$172.25
|
|
Coagulation time activated teg
|
$113.47 |
$113.47 |
$113.47 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$1,459.75 |
$1,459.75 |
$1,459.75 |
$781.82
|
|
Cold agglutinin screen (arc)
|
$44.94 |
$44.94 |
$44.94 |
$47.19
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$163.07
|
|
Collection of venous blood by venipuncture
|
$37.92 |
$37.92 |
$37.92 |
$21.66
|
|
Colonoscopy (with biopsy)
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,538.00
|
|
Colonoscopy (with polyp removal)
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,472.75
|
|
Compatibility test each unit antiglobulin technique
|
$498.15 |
$498.15 |
$498.15 |
$165.00
|
|
Compatibility test each unit electronic
|
$498.15 |
$498.15 |
$498.15 |
$167.17
|
|
Compatibility test each unit immediate spin technique
|
$498.15 |
$498.15 |
$498.15 |
$159.95
|
|
Comp cystometrogram/void presssure 51728
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$958.81
|
|
Complement antigen each component c3
|
$67.40 |
$67.40 |
$67.40 |
$113.13
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$913.68
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,193.40
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,252.90
|
|
Complx repair fccmnaxghf 13131
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$911.40
|
|
Complx repair fccmnaxghf 13132
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,212.00
|
|
Complx repair fccmnaxghf 13133
|
$1,703.05 |
$1,703.05 |
$1,703.05 |
$781.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,024.14 |
$2,024.14 |
$2,024.14 |
$590.20
|
|
Concentration infection agents any type
|
$103.11 |
$103.11 |
$103.11 |
$50.70
|
|
Condylomata destruction 56420
|
$3,266.79 |
$3,266.79 |
$3,266.79 |
$503.67
|
|
Consultation pathology during surgery
|
$331.57 |
$331.57 |
$331.57 |
$112.45
|