|
#cf-97variants
|
$4,715.21 |
$4,715.21 |
$4,715.21 |
$612.26
|
|
Change cystostomy tube; complex 51710
|
$3,864.39 |
$3,864.39 |
$3,864.39 |
$1,645.15
|
|
Change cystostomy tube simple
|
$1,176.28 |
$1,176.28 |
$1,176.28 |
$497.50
|
|
Chemo extend IV infus w/pump
|
$1,866.21 |
$1,866.21 |
$1,866.21 |
$623.70
|
|
Chest 2 vws w oblique
|
$443.67 |
$443.67 |
$443.67 |
$377.06
|
|
Chest apical lordotic proj
|
$696.45 |
$696.45 |
$696.45 |
$291.20
|
|
Chest CT scan (with and without contrast)
|
$5,265.54 |
$5,265.54 |
$5,265.54 |
$2,105.40
|
|
Chest CT scan (with contrast)
|
$4,740.45 |
$4,740.45 |
$4,740.45 |
$1,707.60
|
|
Chest CT scan (without contrast)
|
$3,735.74 |
$3,735.74 |
$3,735.74 |
$1,350.03
|
|
Chest X-ray
|
$573.02 |
$573.02 |
$573.02 |
$295.22
|
|
Chest X-ray (single view)
|
$446.66 |
$446.66 |
$446.66 |
$232.17
|
|
Chlamydia culture
|
$118.46 |
$118.46 |
$118.46 |
$94.90
|
|
Chlamydia type
|
$88.28 |
$88.28 |
$88.28 |
$34.92
|
|
Chloride
|
$207.56 |
$207.56 |
$207.56 |
$39.60
|
|
Chloride 24 hour urine
|
$125.70 |
$125.70 |
$125.70 |
$46.13
|
|
Chloroprocaine hcl injection
|
$67.17 |
$67.17 |
$67.17 |
$78.26
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$115.43 |
$115.43 |
$115.43 |
$333.01
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$216.99 |
$216.99 |
$216.99 |
$89.81
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$1,318.15 |
$1,318.15 |
$1,318.15 |
$625.60
|
|
Cholesterol
|
$61.36 |
$61.36 |
$61.36 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$329.56 |
$329.56 |
$329.56 |
$118.36
|
|
Chromatography
|
$306.97 |
$306.97 |
$306.97 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$1,226.48 |
$1,226.48 |
$1,226.48 |
$479.38
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$55.32 |
$55.32 |
$55.32 |
$45.27
|
|
Circumcision (newborn)
|
$10,461.56 |
$10,461.56 |
$10,461.56 |
$1,549.50
|
|
Cisplatin 1 mg/ml desensitization
|
$721.40 |
$721.40 |
$721.40 |
$127.11
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$5,845.88 |
$5,845.88 |
$5,845.88 |
$581.01
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$103.56 |
$103.56 |
$103.56 |
$61.26
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$39.18 |
$39.18 |
$39.18 |
$81.02
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$3,302.04 |
$3,302.04 |
$3,302.04 |
$423.20
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$1,285.99 |
$1,285.99 |
$1,285.99 |
$487.69
|
|
Clot factor xiii fibrin stab
|
$136.48 |
$136.48 |
$136.48 |
$91.80
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$2,300.33 |
$2,300.33 |
$2,300.33 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$626.40
|
|
Clsd tx elbow dislocation child 24640
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$525.28
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$2,663.55 |
$2,663.55 |
$2,663.55 |
$639.60
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$8,711.83 |
$8,711.83 |
$8,711.83 |
$1,912.80
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$1,790.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$1,445.05 |
$1,445.05 |
$1,445.05 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,445.05 |
$1,445.05 |
$1,445.05 |
$717.75
|
|
Clsd tx patella disloc without anes 27560
|
$1,849.58 |
$1,849.58 |
$1,849.58 |
$707.30
|
|
Clsd tx shoulder dislc/fx 23665
|
$8,711.83 |
$8,711.83 |
$8,711.83 |
$2,066.17
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$10,856.65 |
$10,856.65 |
$10,856.65 |
$2,423.85
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,346.17 |
$1,346.17 |
$1,346.17 |
$666.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$8,794.01 |
$8,794.01 |
$8,794.01 |
$1,704.80
|
|
C motor evoked upr&lwr limbs
|
$3,388.22 |
$3,388.22 |
$3,388.22 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$267.65 |
$267.65 |
$267.65 |
$102.57
|
|
Cmv pcr-sendout
|
$115.76 |
$115.76 |
$115.76 |
$172.25
|
|
Cocaine 4 % nasal solution
|
$558.95 |
$558.95 |
$558.95 |
$781.82
|
|
Cold agglutinin screen (arc)
|
$47.19 |
$47.19 |
$47.19 |
$48.57
|
|
Collection blood specimen from completely implantable venous access device
|
$549.83 |
$549.83 |
$549.83 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$232.41 |
$232.41 |
$232.41 |
$166.94
|
|
Collection of venous blood by venipuncture
|
$52.82 |
$52.82 |
$52.82 |
$22.05
|
|
Compatibility test each unit antiglobulin technique
|
$477.08 |
$477.08 |
$477.08 |
$158.51
|
|
Compatibility test each unit immediate spin technique
|
$82.25 |
$82.25 |
$82.25 |
$158.27
|
|
Complement antigen each component c3
|
$397.35 |
$397.35 |
$397.35 |
$113.30
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$3,552.77 |
$3,552.77 |
$3,552.77 |
$1,247.95
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$3,552.77 |
$3,552.77 |
$3,552.77 |
$1,279.20
|
|
Complx repair fccmnaxghf 13131
|
$2,771.61 |
$2,771.61 |
$2,771.61 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$1,325.91 |
$1,325.91 |
$1,325.91 |
$1,212.00
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,125.35 |
$2,125.35 |
$2,125.35 |
$590.20
|
|
Concentration infection agents any type
|
$99.14 |
$99.14 |
$99.14 |
$51.32
|
|
Condylomata destruction 56420
|
$2,128.69 |
$2,128.69 |
$2,128.69 |
$509.81
|
|
Control of nosebleedantersmpl 30901
|
$940.56 |
$940.56 |
$940.56 |
$385.45
|
|
Coombs direct
|
$90.10 |
$90.10 |
$90.10 |
$72.45
|
|
Coombs indirect qualitative each reagent red cell reference
|
$35.25 |
$35.25 |
$35.25 |
$94.80
|
|
Cortisol total am
|
$269.87 |
$269.87 |
$269.87 |
$122.20
|
|
Counseling smoke cess interm >10mins
|
$102.38 |
$102.38 |
$102.38 |
$57.85
|
|
#coxa-coxsackie a serotype a16
|
$184.75 |
$184.75 |
$184.75 |
$65.36
|
|
C-peptide
|
$485.33 |
$485.33 |
$485.33 |
$101.60
|
|
C-reactive protein
|
$167.71 |
$167.71 |
$167.71 |
$63.50
|
|
C-reactive protein high sensitivity
|
$152.23 |
$152.23 |
$152.23 |
$91.65
|
|
Creatine kinase
|
$127.59 |
$127.59 |
$127.59 |
$59.78
|
|
Creatine kinase isoenzymes
|
$342.04 |
$342.04 |
$342.04 |
$53.00
|
|
Creatine kinase mb
|
$330.36 |
$330.36 |
$330.36 |
$109.20
|
|
Creatine - sendout
|
$106.49 |
$106.49 |
$106.49 |
$41.40
|
|
Creatinine
|
$163.68 |
$163.68 |
$163.68 |
$44.10
|
|
Creatinine 24 hour urine
|
$215.58 |
$215.58 |
$215.58 |
$62.00
|
|
Creatinine clearance urine
|
$324.53 |
$324.53 |
$324.53 |
$86.40
|
|
#creutz-prot.,western blot
|
$236.71 |
$236.71 |
$236.71 |
$189.80
|
|
Critical care 30-74 minutes
|
$2,745.69 |
$2,745.69 |
$2,745.69 |
$2,627.30
|
|
Critical care each additional 30 minutes
|
$1,597.43 |
$1,597.43 |
$1,597.43 |
$756.00
|
|
Crystal identification light microscopy
|
$91.31 |
$91.31 |
$91.31 |
$64.35
|
|
Cta abdomen without & /or w/contrast
|
$2,197.23 |
$2,197.23 |
$2,197.23 |
$2,084.86
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$4,594.14 |
$4,594.14 |
$4,594.14 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,644.62 |
$3,644.62 |
$3,644.62 |
$2,079.00
|
|
Cta neck without &/or w/contrast
|
$4,451.07 |
$4,451.07 |
$4,451.07 |
$1,987.50
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,594.14 |
$4,594.14 |
$4,594.14 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$4,740.45 |
$4,740.45 |
$4,740.45 |
$2,057.90
|
|
CT Angiogram of the Head
|
$4,451.07 |
$4,451.07 |
$4,451.07 |
$2,080.00
|
|
CT angio hrt w/3d image
|
$3,914.56 |
$3,914.56 |
$3,914.56 |
$1,610.08
|
|
Cta upper extremity w &/or without contrast left
|
$3,826.85 |
$3,826.85 |
$3,826.85 |
$1,697.80
|
|
CT guidance for needle placement
|
$3,395.32 |
$3,395.32 |
$3,395.32 |
$1,506.04
|
|
CT heart w/evaluation of calcium without contrast
|
$122.64 |
$122.64 |
$122.64 |
$196.67
|
|
CT lower extremity w/contrast (both sides)
|
$3,886.67 |
$3,886.67 |
$3,886.67 |
$1,693.20
|
|
CT lower extremity without contrast (both sides)
|
$3,368.89 |
$3,368.89 |
$3,368.89 |
$1,403.73
|
|
CT lwr extremity w/o&w/dye
|
$3,841.51 |
$3,841.51 |
$3,841.51 |
$1,844.52
|
|
CT neck soft tissue w/contrast
|
$4,153.95 |
$4,153.95 |
$4,153.95 |
$1,669.00
|
|
CT neck soft tissue without contrast
|
$3,783.07 |
$3,783.07 |
$3,783.07 |
$1,344.60
|
|
CT neck soft tissue without & w/contrast
|
$4,969.88 |
$4,969.88 |
$4,969.88 |
$1,959.75
|
