|
Chest CT scan (without contrast)
|
$633.65 |
$633.65 |
$633.65 |
$1,350.03
|
|
Chest X-ray
|
$211.46 |
$211.46 |
$211.46 |
$295.22
|
|
Chest X-ray (single view)
|
$157.96 |
$157.96 |
$157.96 |
$232.17
|
|
Chg radiologic exam esophagus double contrast
|
$254.34 |
$254.34 |
$254.34 |
$541.82
|
|
Chlamydia culture
|
$70.74 |
$70.74 |
$70.74 |
$94.90
|
|
Chlamydia trachomatis ag if
|
$45.82 |
$45.82 |
$45.82 |
$30.40
|
|
Chlamydia type
|
$45.45 |
$45.45 |
$45.45 |
$34.92
|
|
Chlnggrphy intraop addl s&i
|
$89.06 |
$89.06 |
$89.06 |
$280.00
|
|
Chloride
|
$33.35 |
$33.35 |
$33.35 |
$39.60
|
|
Chloride 24 hour urine
|
$33.35 |
$33.35 |
$33.35 |
$46.13
|
|
Chloroprocaine hcl injection
|
$44.62 |
$44.62 |
$44.62 |
$78.26
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$53.36 |
$53.36 |
$53.36 |
$89.81
|
|
Chlorpromazine 100 mg tablet
|
$457.69 |
$457.69 |
$457.69 |
$1.44
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$199.74 |
$199.74 |
$199.74 |
$625.60
|
|
Cholecystostomy complete w/supervision & interpretation
|
$3,125.72 |
$3,125.72 |
$3,125.72 |
$3,712.80
|
|
Cholesterol
|
$33.35 |
$33.35 |
$33.35 |
$46.15
|
|
Cholesterol body fluid
|
$268.64 |
$268.64 |
$268.64 |
$92.80
|
|
Cholesterol (Lipid) Test
|
$48.38 |
$48.38 |
$48.38 |
$118.36
|
|
Cholinesterase
|
$44.72 |
$44.72 |
$44.72 |
$39.60
|
|
Chromatography
|
$75.13 |
$75.13 |
$75.13 |
$81.25
|
|
Chromogenic substrate assay
|
$101.52 |
$101.52 |
$101.52 |
$184.60
|
|
Chromo high res and frag x - sendout
|
$289.16 |
$289.16 |
$289.16 |
$265.11
|
|
Chromosome analysis 15-20 cell count
|
$1,070.86 |
$1,070.86 |
$1,070.86 |
$479.38
|
|
Chromosome study additional
|
$237.85 |
$237.85 |
$237.85 |
$147.03
|
|
Chronic urticaria - sendout
|
$100.79 |
$100.79 |
$100.79 |
$91.00
|
|
Cidofovir injection
|
$607.91 |
$607.91 |
$607.91 |
$1,200.39
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$22.19 |
$22.19 |
$22.19 |
$45.27
|
|
Circumcision (newborn)
|
$774.74 |
$774.74 |
$774.74 |
$1,549.50
|
|
Cisplatin 1 mg/ml desensitization
|
$202.66 |
$202.66 |
$202.66 |
$127.11
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$148.96 |
$148.96 |
$148.96 |
$581.01
|
|
Clearance of airways
|
$13.20 |
$13.20 |
$13.20 |
$206.80
|
|
Clip ligating vesolock lg
|
$67.80 |
$67.80 |
$67.80 |
$977.62
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$62.27 |
$62.27 |
$62.27 |
$81.02
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$220.26 |
$220.26 |
$220.26 |
$646.92
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$288.06 |
$288.06 |
$288.06 |
$1,815.75
|
|
Closed tx/acetabululm without manip 27220
|
$288.06 |
$288.06 |
$288.06 |
$584.90
|
|
Closed tx humerus fx with manip 23605
|
$289.16 |
$289.16 |
$289.16 |
$2,460.00
|
|
Closed tx humerus fx without manip 23600
|
$288.06 |
$288.06 |
$288.06 |
$541.45
|
|
Closed tx humerus fx w/manip 24505
|
$288.06 |
$288.06 |
$288.06 |
$1,592.00
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$183.25 |
$183.25 |
$183.25 |
$423.20
|
|
Closed tx orbit without manipulj
|
$515.64 |
$515.64 |
$515.64 |
$1,331.45
|
|
Closed tx sesamoid fx 28530
|
$215.86 |
$215.86 |
$215.86 |
$404.04
|
|
Closed tx/talus fracture without manip 28430
|
$288.06 |
$288.06 |
$288.06 |
$450.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$186.18 |
$186.18 |
$186.18 |
$487.69
|
|
Clos txnose fx without stablz 21315
|
$231.99 |
$231.99 |
$231.99 |
$2,728.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$1,196.20 |
$1,196.20 |
$1,196.20 |
$1,183.65
|
|
Clot factor viii reltd antgn
|
$159.06 |
$159.06 |
$159.06 |
$95.76
|
|
Clot factor xiii fibrin scrn
|
$10.27 |
$10.27 |
$10.27 |
$51.50
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$215.13 |
$215.13 |
$215.13 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$288.06 |
$288.06 |
$288.06 |
$626.40
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$288.06 |
$288.06 |
$288.06 |
$543.00
|
|
Clsd tx clav dislc without manip 23520
|
$218.06 |
$218.06 |
$218.06 |
$1,839.79
|
|
Clsd tx clavicle fracture w/manip 23505
|
$218.06 |
$218.06 |
$218.06 |
$2,034.18
|
|
Clsd tx/clavicular fx without manip 23500
|
$218.06 |
$218.06 |
$218.06 |
$497.00
|
|
Clsd tx coccygeal fracture 27200
|
$218.06 |
$218.06 |
$218.06 |
$336.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$211.83 |
$211.83 |
$211.83 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$288.06 |
$288.06 |
$288.06 |
$731.04
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$288.06 |
$288.06 |
$288.06 |
$507.65
|
|
Clsd tx elbow dislocation child 24640
|
$247.75 |
$247.75 |
$247.75 |
$525.28
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,227.71 |
$1,227.71 |
$1,227.71 |
$2,587.60
|
|
Clsd tx fracture of radius 25500
|
$288.06 |
$288.06 |
$288.06 |
$470.21
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$163.46 |
$163.46 |
$163.46 |
$392.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$178.11 |
$178.11 |
$178.11 |
$478.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$288.06 |
$288.06 |
$288.06 |
$639.60
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$288.06 |
$288.06 |
$288.06 |
$1,912.80
|
|
Clsd tx fx radius/ulna without manip 25560
|
$288.06 |
$288.06 |
$288.06 |
$632.78
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$288.06 |
$288.06 |
$288.06 |
$1,790.00
|
|
Clsd tx hip disloc without anes 27265
|
$243.35 |
$243.35 |
$243.35 |
$716.95
|
|
Clsd tx humeral fract without manip 24530
|
$288.06 |
$288.06 |
$288.06 |
$623.93
|
|
Clsd tx humerus fract without manip 24500
|
$121.68 |
$121.68 |
$121.68 |
$568.92
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$200.84 |
$200.84 |
$200.84 |
$529.50
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$161.99 |
$161.99 |
$161.99 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$288.06 |
$288.06 |
$288.06 |
$717.75
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$274.13 |
$274.13 |
$274.13 |
$3,345.60
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$288.06 |
$288.06 |
$288.06 |
$580.30
|
|
Clsd tx/metatarsal fx without manip 28470
|
$288.06 |
$288.06 |
$288.06 |
$429.65
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$575.38 |
$575.38 |
$575.38 |
$3,600.75
|
|
Clsd tx of ankle fracture w/manip 28435
|
$288.06 |
$288.06 |
$288.06 |
$1,815.75
|
|
Clsd tx patella disloc without anes 27560
|
$274.13 |
$274.13 |
$274.13 |
$707.30
|
|
Clsd tx/patellar fx without manip 27520
|
$127.54 |
$127.54 |
$127.54 |
$576.00
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$288.06 |
$288.06 |
$288.06 |
$2,548.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$204.50 |
$204.50 |
$204.50 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$288.06 |
$288.06 |
$288.06 |
$510.95
|
|
Clsd tx radius fracture w/manip 24655
|
$288.06 |
$288.06 |
$288.06 |
$1,835.20
|
|
Clsd tx/scapular fx without manip 23570
|
$218.06 |
$218.06 |
$218.06 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$861.97 |
$861.97 |
$861.97 |
$2,066.17
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$684.59 |
$684.59 |
$684.59 |
$2,423.85
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$684.59 |
$684.59 |
$684.59 |
$3,848.69
|
|
Clsd tx temporomandibular dislocat 21480
|
$156.86 |
$156.86 |
$156.86 |
$512.40
|
|
Clsd tx trimall ankle fx without manip 27816
|
$288.06 |
$288.06 |
$288.06 |
$666.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$288.06 |
$288.06 |
$288.06 |
$1,704.80
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$288.06 |
$288.06 |
$288.06 |
$510.40
|
|
Clsd tx wrist carpal fx without manip 25630
|
$288.06 |
$288.06 |
$288.06 |
$494.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$288.06 |
$288.06 |
$288.06 |
$553.00
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$288.06 |
$288.06 |
$288.06 |
$744.22
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$288.06 |
$288.06 |
$288.06 |
$705.55
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$288.06 |
$288.06 |
$288.06 |
$518.40
|
|
Cls tx of heel fracture w/manip 28405
|
$288.06 |
$288.06 |
$288.06 |
$1,241.93
|
|
Cltx carpl scphd fx w/mnpj
|
$288.06 |
$288.06 |
$288.06 |
$2,368.00
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,215.99 |
$1,215.99 |
$1,215.99 |
$2,610.40
|