|
Chest CT scan (with contrast)
|
$2,444.40 |
$2,444.40 |
$2,444.40 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$1,788.00 |
$1,788.00 |
$1,788.00 |
$1,350.03
|
|
Chest X-ray
|
$251.40 |
$251.40 |
$251.40 |
$294.06
|
|
Chest X-ray (single view)
|
$214.20 |
$214.20 |
$214.20 |
$239.04
|
|
Chloride 24 hour urine
|
$92.40 |
$92.40 |
$92.40 |
$49.50
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$84.00 |
$84.00 |
$84.00 |
$78.43
|
|
Cholesterol
|
$111.00 |
$111.00 |
$111.00 |
$45.76
|
|
Cholesterol (Lipid) Test
|
$214.20 |
$214.20 |
$214.20 |
$115.80
|
|
Chromatography
|
$198.00 |
$198.00 |
$198.00 |
$81.25
|
|
Chromosome analysis 15-20 cell count
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$512.20
|
|
Circumcise/surg/28 days or < 54160
|
$366.00 |
$366.00 |
$366.00 |
$1,219.20
|
|
Cisplatin 1 mg/ml desensitization
|
$135.00 |
$135.00 |
$135.00 |
$192.66
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$58.80 |
$58.80 |
$58.80 |
$55.20
|
|
Clip ligating vesolock lg
|
$398.23 |
$398.23 |
$398.23 |
$4,320.00
|
|
Closed tx humerus fx with manip 23605
|
$3,543.60 |
$3,543.60 |
$3,543.60 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$278.40 |
$278.40 |
$278.40 |
$494.15
|
|
Closed tx septal&nose fx
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$3,624.40
|
|
Clos txnose fx without stablz 21315
|
$2,946.00 |
$2,946.00 |
$2,946.00 |
$2,326.08
|
|
Clot factor xii hageman
|
$554.40 |
$554.40 |
$554.40 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$183.00 |
$183.00 |
$183.00 |
$55.44
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$267.60 |
$267.60 |
$267.60 |
$641.90
|
|
Clsd tx coccygeal fracture 27200
|
$267.60 |
$267.60 |
$267.60 |
$388.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$162.00 |
$162.00 |
$162.00 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$267.60 |
$267.60 |
$267.60 |
$653.60
|
|
Clsd tx elbow dislocation child 24640
|
$267.60 |
$267.60 |
$267.60 |
$462.80
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$267.60 |
$267.60 |
$267.60 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$288.00 |
$288.00 |
$288.00 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,976.40 |
$1,976.40 |
$1,976.40 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$213.00 |
$213.00 |
$213.00 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$935.40 |
$935.40 |
$935.40 |
$1,571.25
|
|
Clsd tx humeral fract without manip 24530
|
$295.20 |
$295.20 |
$295.20 |
$538.45
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$2,643.60 |
$2,643.60 |
$2,643.60 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$607.20 |
$607.20 |
$607.20 |
$987.60
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$231.60 |
$231.60 |
$231.60 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$267.60 |
$267.60 |
$267.60 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$267.60 |
$267.60 |
$267.60 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$182.40 |
$182.40 |
$182.40 |
$418.20
|
|
Clsd tx patella disloc without anes 27560
|
$267.60 |
$267.60 |
$267.60 |
$566.72
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$518.40 |
$518.40 |
$518.40 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$200.40 |
$200.40 |
$200.40 |
$445.80
|
|
Clsd tx shoulder dislc/fx 23665
|
$935.40 |
$935.40 |
$935.40 |
$1,839.54
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,643.60 |
$2,643.60 |
$2,643.60 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$303.60 |
$303.60 |
$303.60 |
$394.40
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$264.60 |
$264.60 |
$264.60 |
$452.40
|
|
Clsd tx wrist carpal fx without manip 25630
|
$326.40 |
$326.40 |
$326.40 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$232.80 |
$232.80 |
$232.80 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$267.60 |
$267.60 |
$267.60 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$185.40 |
$185.40 |
$185.40 |
$474.50
|
|
Cltx scap fx w/mnpj +-tractj
|
$935.40 |
$935.40 |
$935.40 |
$2,021.04
|
|
Cmv pcr-sendout
|
$277.80 |
$277.80 |
$277.80 |
$177.50
|
|
Collection blood specimen from completely implantable venous access device
|
$178.80 |
$178.80 |
$178.80 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$178.80 |
$178.80 |
$178.80 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$18.00 |
$18.00 |
$18.00 |
$21.00
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$109.20 |
$109.20 |
$109.20 |
$312.90
|
|
Compatibility test each unit antiglobulin technique
|
$124.20 |
$124.20 |
$124.20 |
$170.05
|
|
Complement antigen each component c3
|
$404.40 |
$404.40 |
$404.40 |
$108.55
|
|
Complx repair fccmnaxghf 13131
|
$394.20 |
$394.20 |
$394.20 |
$810.40
|
|
Complx repair sal addl 5 cm/> 13122
|
$422.40 |
$422.40 |
$422.40 |
$502.50
|
|
Concentration infection agents any type
|
$114.00 |
$114.00 |
$114.00 |
$49.95
|
|
Condylomata destruction 56420
|
$333.00 |
$333.00 |
$333.00 |
$469.00
|
|
Contrast baths charges
|
$126.00 |
$126.00 |
$126.00 |
$70.50
|
|
Contrast exam abdominl aorta 75625-26
|
$2,695.80 |
$2,695.80 |
$2,695.80 |
$3,458.54
|
|
Control nosebleed pack+caut 30905
|
$261.60 |
$261.60 |
$261.60 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$323.40 |
$323.40 |
$323.40 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$758.40 |
$758.40 |
$758.40 |
$355.50
|
|
Coombs direct
|
$75.00 |
$75.00 |
$75.00 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$33.60 |
$33.60 |
$33.60 |
$102.90
|
|
Copper intrauterine device
|
$2,695.80 |
$2,695.80 |
$2,695.80 |
$1,953.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$15,282.00 |
$15,282.00 |
$15,282.00 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$14,478.60 |
$14,478.60 |
$14,478.60 |
$10,246.32
|
|
Coronary art/grft angio s&i
|
$10,004.40 |
$10,004.40 |
$10,004.40 |
$8,194.20
|
|
Cortisol total am
|
$169.20 |
$169.20 |
$169.20 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$392.40 |
$392.40 |
$392.40 |
$189.22
|
|
Counseling visit to discuss need for ldct g0296
|
$54.00 |
$54.00 |
$54.00 |
$98.14
|
|
Coveredge 32 lead kit 40cm 48
|
$5,911.16 |
$5,911.16 |
$5,911.16 |
$3,908.16
|
|
Covid-19 lab test non-cdc
|
$93.00 |
$93.00 |
$93.00 |
$80.50
|
|
C-peptide
|
$171.60 |
$171.60 |
$171.60 |
$97.30
|
|
C-reactive protein
|
$90.60 |
$90.60 |
$90.60 |
$68.38
|
|
C-reactive protein high sensitivity
|
$97.80 |
$97.80 |
$97.80 |
$85.00
|
|
Creatine kinase
|
$82.20 |
$82.20 |
$82.20 |
$66.30
|
|
Creatine kinase isoenzymes
|
$27.00 |
$27.00 |
$27.00 |
$56.80
|
|
Creatine kinase mb
|
$170.40 |
$170.40 |
$170.40 |
$114.00
|
|
Creatinine
|
$78.00 |
$78.00 |
$78.00 |
$44.72
|
|
Creatinine 24 hour urine
|
$224.40 |
$224.40 |
$224.40 |
$58.85
|
|
Creatinine clearance urine
|
$164.40 |
$164.40 |
$164.40 |
$89.50
|
|
Critical care 30-74 minutes
|
$280.20 |
$280.20 |
$280.20 |
$2,505.60
|
|
Crotalidae poly immune fab
|
$10,873.20 |
$10,873.20 |
$10,873.20 |
$5,590.35
|
|
Cryofibrinogen qualitative - sendout
|
$16.80 |
$16.80 |
$16.80 |
$52.50
|
|
Crystal identification light microscopy
|
$100.80 |
$100.80 |
$100.80 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$4,230.60 |
$4,230.60 |
$4,230.60 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,881.00 |
$4,881.00 |
$4,881.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$1,996.80
|
|
CT angio pelvis
|
$2,764.80 |
$2,764.80 |
$2,764.80 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$2,115.00 |
$2,115.00 |
$2,115.00 |
$1,698.00
|
|
CT lower extremity w/contrast (both sides)
|
$1,861.80 |
$1,861.80 |
$1,861.80 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$2,947.80 |
$2,947.80 |
$2,947.80 |
$1,421.85
|
