|
Clsd tx patella disloc without anes 27560
|
$358.56 |
$358.56 |
$358.56 |
$566.72
|
|
Clsd tx radius fracture w/manip 24655
|
$3,954.24 |
$3,954.24 |
$3,954.24 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$4,001.04 |
$4,001.04 |
$4,001.04 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$3,922.56 |
$3,922.56 |
$3,922.56 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$425.52 |
$425.52 |
$425.52 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$623.52 |
$623.52 |
$623.52 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$591.84 |
$591.84 |
$591.84 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$4,083.12 |
$4,083.12 |
$4,083.12 |
$1,565.74
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$4,001.76 |
$4,001.76 |
$4,001.76 |
$2,317.60
|
|
Cltx humrl cndylr fx w/mnpj
|
$4,001.76 |
$4,001.76 |
$4,001.76 |
$1,815.75
|
|
Cltx lunate dislc w/mnpj
|
$4,001.04 |
$4,001.04 |
$4,001.04 |
$2,437.00
|
|
#cmvcul-virus inoculation shell
|
$114.48 |
$114.48 |
$114.48 |
$100.80
|
|
Cmv pcr-sendout
|
$645.84 |
$645.84 |
$645.84 |
$177.50
|
|
Cochlear implt f/up exam <7
|
$379.44 |
$379.44 |
$379.44 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$386.64 |
$386.64 |
$386.64 |
$423.87
|
|
Cold agglutinin titer
|
$193.68 |
$193.68 |
$193.68 |
$50.00
|
|
Collection blood specimen from completely implantable venous access device
|
$147.60 |
$147.60 |
$147.60 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$347.76 |
$347.76 |
$347.76 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$27.36 |
$27.36 |
$27.36 |
$21.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$6,810.48 |
$6,810.48 |
$6,810.48 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$216.00 |
$216.00 |
$216.00 |
$170.05
|
|
Compatibility test each unit immediate spin technique
|
$216.00 |
$216.00 |
$216.00 |
$169.52
|
|
Complement antigen each component c3
|
$148.32 |
$148.32 |
$148.32 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$660.96 |
$660.96 |
$660.96 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$660.96 |
$660.96 |
$660.96 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$660.96 |
$660.96 |
$660.96 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$660.96 |
$660.96 |
$660.96 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$470.16 |
$470.16 |
$470.16 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$513.36 |
$513.36 |
$513.36 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$660.96 |
$660.96 |
$660.96 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$470.16 |
$470.16 |
$470.16 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$388.08 |
$388.08 |
$388.08 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$660.96 |
$660.96 |
$660.96 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$470.16 |
$470.16 |
$470.16 |
$537.00
|
|
Comprehensive hearing test
|
$329.04 |
$329.04 |
$329.04 |
$255.00
|
|
Concentration infection agents any type
|
$61.20 |
$61.20 |
$61.20 |
$49.95
|
|
Conditioning play audiometry 92582
|
$169.20 |
$169.20 |
$169.20 |
$189.15
|
|
Condylomata destruction 56420
|
$396.72 |
$396.72 |
$396.72 |
$469.00
|
|
Consultation pathology during surgery
|
$76.32 |
$76.32 |
$76.32 |
$100.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$144.00 |
$144.00 |
$144.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$216.00 |
$216.00 |
$216.00 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$370.80 |
$370.80 |
$370.80 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$351.36 |
$351.36 |
$351.36 |
$171.65
|
|
Consult comp w/report rfrd material
|
$216.00 |
$216.00 |
$216.00 |
$365.60
|
|
Cont gluc mntr analysis i&r 95251
|
$76.32 |
$76.32 |
$76.32 |
$65.70
|
|
Contrast x-ray of ankle
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$612.30
|
|
Contrast x-ray of elbow
|
$1,095.12 |
$1,095.12 |
$1,095.12 |
$649.80
|
|
Contrast x-ray of hip
|
$1,149.84 |
$1,149.84 |
$1,149.84 |
$771.12
|
|
Contrast x-ray of knee joint
|
$1,334.88 |
$1,334.88 |
$1,334.88 |
$769.88
|
|
Contrast x-ray of wrist
|
$1,334.88 |
$1,334.88 |
$1,334.88 |
$637.00
|
|
Control nosebleed pack+caut 30905
|
$465.12 |
$465.12 |
$465.12 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$414.72 |
$414.72 |
$414.72 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$329.76 |
$329.76 |
$329.76 |
$355.50
|
|
Coombs direct
|
$94.32 |
$94.32 |
$94.32 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$216.00 |
$216.00 |
$216.00 |
$102.90
|
|
Coombs indirect titer reference
|
$224.64 |
$224.64 |
$224.64 |
$146.40
|
|
Core ndl bx lng/med perq
|
$4,042.80 |
$4,042.80 |
$4,042.80 |
$2,678.00
|
|
Cortisol total am
|
$93.60 |
$93.60 |
$93.60 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$368.35 |
$368.35 |
$368.35 |
$189.22
|
|
#coxa-coxsackie a serotype a16
|
$27.36 |
$27.36 |
$27.36 |
$60.00
|
|
C-peptide
|
$81.36 |
$81.36 |
$81.36 |
$97.30
|
|
C-reactive protein
|
$126.00 |
$126.00 |
$126.00 |
$68.38
|
|
C-reactive protein high sensitivity
|
$154.08 |
$154.08 |
$154.08 |
$85.00
|
|
Creatine kinase
|
$110.16 |
$110.16 |
$110.16 |
$66.30
|
|
Creatine kinase isoenzymes
|
$38.88 |
$38.88 |
$38.88 |
$56.80
|
|
Creatine kinase mb
|
$148.32 |
$148.32 |
$148.32 |
$114.00
|
|
Creatinine
|
$72.00 |
$72.00 |
$72.00 |
$44.72
|
|
Creatinine 24 hour urine
|
$84.96 |
$84.96 |
$84.96 |
$58.85
|
|
Creatinine clearance urine
|
$35.28 |
$35.28 |
$35.28 |
$89.50
|
|
#creutz-prot.,western blot
|
$92.88 |
$92.88 |
$92.88 |
$166.20
|
|
Critical care 30-74 minutes
|
$2,072.16 |
$2,072.16 |
$2,072.16 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$846.72 |
$846.72 |
$846.72 |
$731.40
|
|
Cryoprecipitate each unit
|
$177.84 |
$177.84 |
$177.84 |
$144.78
|
|
Cryptococcus abs qn - sendout
|
$18.00 |
$18.00 |
$18.00 |
$89.70
|
|
Crystal identification light microscopy
|
$68.40 |
$68.40 |
$68.40 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$2,413.44 |
$2,413.44 |
$2,413.44 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,203.20 |
$2,203.20 |
$2,203.20 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,280.24 |
$2,280.24 |
$2,280.24 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,259.36 |
$2,259.36 |
$2,259.36 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,681.44 |
$4,681.44 |
$4,681.44 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,839.68 |
$2,839.68 |
$2,839.68 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,175.12 |
$2,175.12 |
$2,175.12 |
$1,996.80
|
|
CT angio pelvis
|
$2,558.88 |
$2,558.88 |
$2,558.88 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$2,306.88 |
$2,306.88 |
$2,306.88 |
$1,698.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,290.24 |
$1,290.24 |
$1,290.24 |
$1,178.52
|
|
CT limited or localized follow-up study
|
$1,955.52 |
$1,955.52 |
$1,955.52 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,815.12 |
$1,815.12 |
$1,815.12 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$2,230.56 |
$2,230.56 |
$2,230.56 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$2,136.96 |
$2,136.96 |
$2,136.96 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,504.08 |
$1,504.08 |
$1,504.08 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,095.92 |
$2,095.92 |
$2,095.92 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,804.32 |
$1,804.32 |
$1,804.32 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,625.76 |
$1,625.76 |
$1,625.76 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,447.20 |
$1,447.20 |
$1,447.20 |
$1,360.00
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,340.96 |
$5,340.96 |
$5,340.96 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,451.04 |
$4,451.04 |
$4,451.04 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,755.52 |
$3,755.52 |
$3,755.52 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$3,029.76 |
$3,029.76 |
$3,029.76 |
$1,690.32
|
