|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$663.12 |
$663.12 |
$663.12 |
$411.73
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$3,456.72 |
$3,456.72 |
$3,456.72 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$518.40 |
$518.40 |
$518.40 |
$459.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,044.00 |
$1,044.00 |
$1,044.00 |
$630.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$518.40 |
$518.40 |
$518.40 |
$606.00
|
|
Clsd tx patella disloc without anes 27560
|
$518.40 |
$518.40 |
$518.40 |
$566.72
|
|
Clsd tx toe dislocation without anes28660
|
$518.40 |
$518.40 |
$518.40 |
$400.00
|
|
#cmvcul-virus inoculation shell
|
$158.40 |
$158.40 |
$158.40 |
$100.80
|
|
Cmv pcr-sendout
|
$64.80 |
$64.80 |
$64.80 |
$177.50
|
|
Cold agglutinin titer
|
$95.76 |
$95.76 |
$95.76 |
$50.00
|
|
Collection blood specimen from completely implantable venous access device
|
$278.64 |
$278.64 |
$278.64 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$278.64 |
$278.64 |
$278.64 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$17.28 |
$17.28 |
$17.28 |
$21.00
|
|
Compatibility test each unit antiglobulin technique
|
$187.92 |
$187.92 |
$187.92 |
$170.05
|
|
Compatibility test each unit immediate spin technique
|
$196.56 |
$196.56 |
$196.56 |
$169.52
|
|
Complement antigen each component c3
|
$221.76 |
$221.76 |
$221.76 |
$108.55
|
|
Complx repair fccmnaxghf 13132
|
$1,468.80 |
$1,468.80 |
$1,468.80 |
$1,107.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,003.76 |
$2,003.76 |
$2,003.76 |
$502.50
|
|
Condylomata destruction 56420
|
$573.84 |
$573.84 |
$573.84 |
$469.00
|
|
Consultation/report referred slides prepared elsewhere
|
$311.04 |
$311.04 |
$311.04 |
$171.65
|
|
Control nosebleed pack+caut 30905
|
$594.72 |
$594.72 |
$594.72 |
$392.60
|
|
Control of nosebleedantersmpl 30901
|
$594.72 |
$594.72 |
$594.72 |
$355.50
|
|
Coombs direct
|
$82.80 |
$82.80 |
$82.80 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$193.68 |
$193.68 |
$193.68 |
$102.90
|
|
Coombs indirect titer reference
|
$216.00 |
$216.00 |
$216.00 |
$146.40
|
|
Cortisol total am
|
$73.44 |
$73.44 |
$73.44 |
$120.63
|
|
#coxa-coxsackie a serotype a16
|
$262.08 |
$262.08 |
$262.08 |
$60.00
|
|
C-peptide
|
$271.44 |
$271.44 |
$271.44 |
$97.30
|
|
C-reactive protein
|
$110.16 |
$110.16 |
$110.16 |
$68.38
|
|
C-reactive protein high sensitivity
|
$110.16 |
$110.16 |
$110.16 |
$85.00
|
|
C-reactive protein, quantitative
|
$131.76 |
$131.76 |
$131.76 |
$71.06
|
|
Creatine kinase
|
$116.64 |
$116.64 |
$116.64 |
$66.30
|
|
Creatine kinase isoenzymes
|
$269.28 |
$269.28 |
$269.28 |
$56.80
|
|
Creatine kinase mb
|
$193.68 |
$193.68 |
$193.68 |
$114.00
|
|
Creatinine
|
$92.88 |
$92.88 |
$92.88 |
$44.72
|
|
Creatinine 24 hour urine
|
$36.72 |
$36.72 |
$36.72 |
$58.85
|
|
Creatinine clearance urine
|
$197.28 |
$197.28 |
$197.28 |
$89.50
|
|
#creutz-prot.,western blot
|
$211.68 |
$211.68 |
$211.68 |
$166.20
|
|
Crystal identification light microscopy
|
$79.92 |
$79.92 |
$79.92 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$2,521.44 |
$2,521.44 |
$2,521.44 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$5,236.56 |
$5,236.56 |
$5,236.56 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,521.44 |
$2,521.44 |
$2,521.44 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,131.92 |
$2,131.92 |
$2,131.92 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,672.08 |
$4,672.08 |
$4,672.08 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,521.44 |
$2,521.44 |
$2,521.44 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,561.04 |
$2,561.04 |
$2,561.04 |
$1,996.80
|
|
CT angio pelvis
|
$2,715.84 |
$2,715.84 |
$2,715.84 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$2,521.44 |
$2,521.44 |
$2,521.44 |
$1,698.00
|
|
CT bone density axial
|
$473.04 |
$473.04 |
$473.04 |
$387.62
|
|
CT lower extremity w/contrast (both sides)
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,779.12 |
$1,779.12 |
$1,779.12 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$2,494.80 |
$2,494.80 |
$2,494.80 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,668.24 |
$1,668.24 |
$1,668.24 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$1,818.00 |
$1,818.00 |
$1,818.00 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$2,024.64 |
$2,024.64 |
$2,024.64 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,565.28 |
$1,565.28 |
$1,565.28 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$516.96 |
$516.96 |
$516.96 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$5,240.16 |
$5,240.16 |
$5,240.16 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$4,723.20 |
$4,723.20 |
$4,723.20 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$3,879.36 |
$3,879.36 |
$3,879.36 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$2,352.96 |
$2,352.96 |
$2,352.96 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,928.16 |
$1,928.16 |
$1,928.16 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$199.44 |
$199.44 |
$199.44 |
$331.50
|
|
CT t-spine w /wo contrast
|
$2,927.52 |
$2,927.52 |
$2,927.52 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,732.32 |
$1,732.32 |
$1,732.32 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$2,494.80 |
$2,494.80 |
$2,494.80 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$100.80 |
$100.80 |
$100.80 |
$68.64
|
|
Culture afb any source
|
$69.84 |
$69.84 |
$69.84 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$80.64 |
$80.64 |
$80.64 |
$79.00
|
|
Culture anaerobic except blood
|
$208.80 |
$208.80 |
$208.80 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$12.24 |
$12.24 |
$12.24 |
$51.45
|
|
Culture body fluid
|
$158.40 |
$158.40 |
$158.40 |
$126.75
|
|
Culture fungi definitive id mold
|
$108.72 |
$108.72 |
$108.72 |
$77.28
|
|
Culture fungi definitive id yeast
|
$114.48 |
$114.48 |
$114.48 |
$79.10
|
|
Culture fungi other (except blood)
|
$212.40 |
$212.40 |
$212.40 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$179.28 |
$179.28 |
$179.28 |
$74.88
|
|
Culture screening strep group a
|
$120.24 |
$120.24 |
$120.24 |
$81.00
|
|
Culture typing immunologic
|
$43.20 |
$43.20 |
$43.20 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$807.84 |
$807.84 |
$807.84 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$190.08 |
$190.08 |
$190.08 |
$133.90
|
|
Culture urine each isolate
|
$42.48 |
$42.48 |
$42.48 |
$57.00
|
|
Culture virus isolation
|
$97.20 |
$97.20 |
$97.20 |
$163.70
|
|
Cyanocobalamin unsat binding capacity
|
$67.68 |
$67.68 |
$67.68 |
$64.00
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$25.20 |
$25.20 |
$25.20 |
$25.20
|
|
Cyclic citrullinated peptide antibody
|
$124.56 |
$124.56 |
$124.56 |
$70.72
|
|
Cyclosporine 2 hour
|
$244.08 |
$244.08 |
$244.08 |
$129.48
|
|
Cystatin c
|
$95.04 |
$95.04 |
$95.04 |
$77.50
|
|
Cystine urine quantitative
|
$514.08 |
$514.08 |
$514.08 |
$103.35
|
|
Cytomegalovirus (cmv) antibody igg
|
$165.60 |
$165.60 |
$165.60 |
$95.00
|
|
Cytomegalovirus (cmv) antibody igm
|
$165.60 |
$165.60 |
$165.60 |
$97.50
|
|
Cytopath fl nongyn filter
|
$128.16 |
$128.16 |
$128.16 |
$92.63
|
|
Cytopathology cellular enhancement technique non-gyn
|
$118.08 |
$118.08 |
$118.08 |
$159.45
|
|
Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review
|
$132.48 |
$132.48 |
$132.48 |
$91.84
|
|
Cytopathology cervical/vaginal thin layer manual screening
|
$141.84 |
$141.84 |
$141.84 |
$87.50
|
|
Cytopathology concentration technique smears & interpretation
|
$120.24 |
$120.24 |
$120.24 |
$129.60
|
|
Cytopathology fluids/washings/brushings smears with interpretation
|
$131.76 |
$131.76 |
$131.76 |
$129.35
|
|
Cytopathology fna adequacy evaluation first episode each site
|
$246.24 |
$246.24 |
$246.24 |
$187.28
|