|
Certolizumab pegol 400 mg (200 mg x 2 vials) subcutaneous kit
|
$18,898.20 |
$18,898.20 |
$18,898.20 |
$10,638.62
|
|
Cervical or vaginal cancer screening g0101
|
$617.00 |
$617.00 |
$617.00 |
$109.46
|
|
Cesarean section delivery only 59514
|
$2,909.00 |
$2,909.00 |
$2,909.00 |
$2,194.65
|
|
Cetuximab 100 mg/50 ml intravenous solution
|
$4,685.70 |
$4,685.70 |
$4,685.70 |
$3,011.40
|
|
#cf-97variants
|
$355.55 |
$355.55 |
$355.55 |
$639.44
|
|
Cftr gene dup/delet variants
|
$302.90 |
$302.90 |
$302.90 |
$757.25
|
|
Change cystostomy tube; complex 51710
|
$430.95 |
$430.95 |
$430.95 |
$1,527.00
|
|
Change cystostomy tube simple
|
$471.00 |
$471.00 |
$471.00 |
$477.60
|
|
Change g-tube to g-j perc
|
$1,515.80 |
$1,515.80 |
$1,515.80 |
$2,198.81
|
|
Change of windpipe airway 31502
|
$257.40 |
$257.40 |
$257.40 |
$401.50
|
|
Chemo adm cns w/lmbr punct
|
$481.00 |
$481.00 |
$481.00 |
$720.20
|
|
Chemodenerv 1 extrem 1-4 ea 64643
|
$176.80 |
$176.80 |
$176.80 |
$617.60
|
|
Chemodenerv 1 extrem 5/> ea 64645
|
$219.05 |
$219.05 |
$219.05 |
$631.80
|
|
Chemodenerv 1 extrem 5/> mus 64644
|
$474.50 |
$474.50 |
$474.50 |
$1,033.63
|
|
Chemodenerv 1 extremity 1-4 64642
|
$474.50 |
$474.50 |
$474.50 |
$988.50
|
|
Chemodenervation/face muscl/unilat 64612
|
$296.40 |
$296.40 |
$296.40 |
$600.00
|
|
Chemodenerv musc migraine 64615
|
$368.00 |
$368.00 |
$368.00 |
$540.80
|
|
Chemodenerv musc neck dyston 64616
|
$296.40 |
$296.40 |
$296.40 |
$719.20
|
|
Chemodenerv saliv glands bilat 64611
|
$196.95 |
$196.95 |
$196.95 |
$477.75
|
|
Chest apical lordotic proj
|
$63.05 |
$63.05 |
$63.05 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$3,938.00 |
$3,938.00 |
$3,938.00 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$2,235.35 |
$2,235.35 |
$2,235.35 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$1,578.20 |
$1,578.20 |
$1,578.20 |
$1,303.15
|
|
Chest Physiotherapy (first session)
|
$110.50 |
$110.50 |
$110.50 |
$160.80
|
|
Chest Physiotherapy (follow-up session)
|
$98.80 |
$98.80 |
$98.80 |
$134.50
|
|
Chest Ultrasound
|
$382.85 |
$382.85 |
$382.85 |
$463.88
|
|
Chest X-ray
|
$896.00 |
$896.00 |
$896.00 |
$294.06
|
|
Chest X-ray (single view)
|
$16,131.14 |
$16,131.14 |
$16,131.14 |
$236.60
|
|
Chg radiologic exam esophagus double contrast
|
$471.25 |
$471.25 |
$471.25 |
$520.80
|
|
Chloride
|
$482.00 |
$482.00 |
$482.00 |
$42.63
|
|
Chloride 24 hour urine
|
$53.30 |
$53.30 |
$53.30 |
$50.88
|
|
Chloroprocaine hcl injection
|
$92.60 |
$92.60 |
$92.60 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$122.35 |
$122.35 |
$122.35 |
$406.36
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$116.50 |
$116.50 |
$116.50 |
$79.74
|
|
Chlorpromazine 100 mg tablet
|
$2.10 |
$2.10 |
$2.10 |
$6.96
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$274.30 |
$274.30 |
$274.30 |
$602.40
|
|
Cholecystostomy complete w/supervision & interpretation
|
$5,762.25 |
$5,762.25 |
$5,762.25 |
$3,856.84
|
|
Cholesterol
|
$34.45 |
$34.45 |
$34.45 |
$45.76
|
|
Cholesterol body fluid
|
$139.10 |
$139.10 |
$139.10 |
$89.28
|
|
Cholesterol (Lipid) Test
|
$92.30 |
$92.30 |
$92.30 |
$115.80
|
|
Cholinesterase
|
$66.30 |
$66.30 |
$66.30 |
$39.48
|
|
Chromatography
|
$80.60 |
$80.60 |
$80.60 |
$84.60
|
|
Chromogenic substrate assay
|
$185.25 |
$185.25 |
$185.25 |
$159.00
|
|
Chromo high res and frag x - sendout
|
$399.75 |
$399.75 |
$399.75 |
$250.00
|
|
Chronic urticaria - sendout
|
$89.70 |
$89.70 |
$89.70 |
$75.71
|
|
Chylomicron screen, bf - sendout
|
$84.50 |
$84.50 |
$84.50 |
$136.09
|
|
Cinacalcet 30 mg tablet
|
$13.00 |
$13.00 |
$13.00 |
$41.25
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$37.00 |
$37.00 |
$37.00 |
$35.65
|
|
Circum 28 days or older
|
$31,044.70 |
$31,044.70 |
$31,044.70 |
$4,074.80
|
|
Circumcision (newborn)
|
$27,716.65 |
$27,716.65 |
$27,716.65 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$379.00 |
$379.00 |
$379.00 |
$205.56
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$1,149.75 |
$1,149.75 |
$1,149.75 |
$576.60
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$15,050.75 |
$15,050.75 |
$15,050.75 |
$15,560.16
|
|
Clearance of airways
|
$367.90 |
$367.90 |
$367.90 |
$213.07
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$20.75 |
$20.75 |
$20.75 |
$55.20
|
|
Clip ligating vesolock lg
|
$8,209.50 |
$8,209.50 |
$8,209.50 |
$4,320.00
|
|
Clip phn wireless f/baha4 proc
|
$538.82 |
$538.82 |
$538.82 |
$449.46
|
|
Cllr miami j sm
|
$607.31 |
$607.31 |
$607.31 |
$536.64
|
|
Clofarabine 1 mg/ml intravenous solution
|
$17,608.50 |
$17,608.50 |
$17,608.50 |
$4,784.71
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$79.35 |
$79.35 |
$79.35 |
$85.37
|
|
Closed tx humerus fx without manip 23600
|
$305.50 |
$305.50 |
$305.50 |
$498.40
|
|
Clot factor xii hageman
|
$100.10 |
$100.10 |
$100.10 |
$138.40
|
|
Clot factor xiii fibrin scrn
|
$81.25 |
$81.25 |
$81.25 |
$56.85
|
|
Clot factor xiii fibrin stab
|
$195.00 |
$195.00 |
$195.00 |
$106.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$1,078.00 |
$1,078.00 |
$1,078.00 |
$535.60
|
|
Clsd tx/clavicular fx without manip 23500
|
$807.00 |
$807.00 |
$807.00 |
$452.40
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$159.25 |
$159.25 |
$159.25 |
$417.90
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$227.50 |
$227.50 |
$227.50 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$350.00 |
$350.00 |
$350.00 |
$465.21
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$239.20 |
$239.20 |
$239.20 |
$373.15
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$18,637.26 |
$18,637.26 |
$18,637.26 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$824.20 |
$824.20 |
$824.20 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$16,620.55 |
$16,620.55 |
$16,620.55 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$234.00 |
$234.00 |
$234.00 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,449.00 |
$1,449.00 |
$1,449.00 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$234.00 |
$234.00 |
$234.00 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$350.35 |
$350.35 |
$350.35 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$78,534.85 |
$78,534.85 |
$78,534.85 |
$883.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$1,197.00 |
$1,197.00 |
$1,197.00 |
$498.85
|
|
Clsd tx/metatarsal fx without manip 28470
|
$721.00 |
$721.00 |
$721.00 |
$429.00
|
|
Clsd tx patella disloc without anes 27560
|
$1,203.00 |
$1,203.00 |
$1,203.00 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$234.00 |
$234.00 |
$234.00 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$156.00 |
$156.00 |
$156.00 |
$424.50
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$668.00 |
$668.00 |
$668.00 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$239.20 |
$239.20 |
$239.20 |
$466.14
|
|
Clsd tx/scapular fx without manip 23570
|
$234.00 |
$234.00 |
$234.00 |
$452.40
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,424.00 |
$1,424.00 |
$1,424.00 |
$2,331.50
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$234.00 |
$234.00 |
$234.00 |
$473.00
|
|
Cmbn ant pst colprhy
|
$54,572.85 |
$54,572.85 |
$54,572.85 |
$4,928.00
|
|
Cmv pcr-sendout
|
$316.55 |
$316.55 |
$316.55 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$17,257.50 |
$17,257.50 |
$17,257.50 |
$11,888.50
|
|
Coagulation time activated teg
|
$85.15 |
$85.15 |
$85.15 |
$52.47
|
|
Coil axium 3d 14mmx40cm qc
|
$2,948.58 |
$2,948.58 |
$2,948.58 |
$308.00
|
|
Cold agglutinin screen (arc)
|
$97.50 |
$97.50 |
$97.50 |
$48.10
|
|
Cold agglutinin titer
|
$54.60 |
$54.60 |
$54.60 |
$52.00
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$272.35 |
$272.35 |
$272.35 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$44.47 |
$44.47 |
$44.47 |
$61.20
|
|
Collar cerv adlt perfit ace extric
|
$34.12 |
$34.12 |
$34.12 |
$67.73
|
