|
Clsd tx/ulnar shaft fx without manip 25530
|
$285.80 |
$285.80 |
$285.80 |
$473.00
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$900.50 |
$900.50 |
$900.50 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$993.45 |
$993.45 |
$993.45 |
$1,893.86
|
|
Cltx lunate dislc w/mnpj
|
$4,794.90 |
$4,794.90 |
$4,794.90 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$16,932.90 |
$16,932.90 |
$16,932.90 |
$6,776.64
|
|
Cltx mndblr/max alv ridge fx
|
$9,108.10 |
$9,108.10 |
$9,108.10 |
$3,986.00
|
|
Cltx post ankle fx w/mnpj
|
$4,709.60 |
$4,709.60 |
$4,709.60 |
$1,939.00
|
|
#cmvcul-virus inoculation shell
|
$175.75 |
$175.75 |
$175.75 |
$89.76
|
|
Cmv pcr-sendout
|
$233.85 |
$233.85 |
$233.85 |
$175.70
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$229.15 |
$229.15 |
$229.15 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$515.00 |
$515.00 |
$515.00 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$176.65 |
$176.65 |
$176.65 |
$155.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$8,837.45 |
$8,837.45 |
$8,837.45 |
$3,907.93
|
|
Compatibility test each unit antiglobulin technique
|
$101.15 |
$101.15 |
$101.15 |
$173.50
|
|
Compatibility test each unit electronic
|
$93.05 |
$93.05 |
$93.05 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$55.30 |
$55.30 |
$55.30 |
$169.52
|
|
Complement antigen each component c3
|
$125.05 |
$125.05 |
$125.05 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,004.35 |
$1,004.35 |
$1,004.35 |
$893.41
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,581.25 |
$1,581.25 |
$1,581.25 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,686.40 |
$1,686.40 |
$1,686.40 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$1,552.35 |
$1,552.35 |
$1,552.35 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$1,101.35 |
$1,101.35 |
$1,101.35 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,693.00 |
$1,693.00 |
$1,693.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$524.35 |
$524.35 |
$524.35 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$416.55 |
$416.55 |
$416.55 |
$508.44
|
|
Concentration infection agents any type
|
$59.95 |
$59.95 |
$59.95 |
$51.32
|
|
Condylomata destruction 56420
|
$467.80 |
$467.80 |
$467.80 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,719.37 |
$1,719.37 |
$1,719.37 |
$860.00
|
|
Consultation pathology during surgery
|
$74.00 |
$74.00 |
$74.00 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$136.00 |
$136.00 |
$136.00 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$93.70 |
$93.70 |
$93.70 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$190.00 |
$190.00 |
$190.00 |
$226.50
|
|
Contrast baths charges
|
$106.55 |
$106.55 |
$106.55 |
$75.60
|
|
Contrast x-ray of ankle
|
$221.00 |
$221.00 |
$221.00 |
$684.00
|
|
Contrast x-ray of elbow
|
$831.70 |
$831.70 |
$831.70 |
$708.00
|
|
Contrast x-ray of hip
|
$822.35 |
$822.35 |
$822.35 |
$796.38
|
|
Contrast x-ray of knee joint
|
$1,083.85 |
$1,083.85 |
$1,083.85 |
$790.50
|
|
Contrast x-ray of wrist
|
$893.80 |
$893.80 |
$893.80 |
$667.50
|
|
Control of nosebleed ant comp 30903
|
$630.85 |
$630.85 |
$630.85 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$373.35 |
$373.35 |
$373.35 |
$352.80
|
|
Coombs direct
|
$62.00 |
$62.00 |
$62.00 |
$76.80
|
|
Coombs indirect titer reference
|
$59.40 |
$59.40 |
$59.40 |
$156.71
|
|
Copper intrauterine device
|
$3,464.16 |
$3,464.16 |
$3,464.16 |
$1,953.00
|
|
Coronary thrombolysis/iv infusion 92977
|
$508.20 |
$508.20 |
$508.20 |
$484.37
|
|
Cortisol acth stimulation test - sendout
|
$358.65 |
$358.65 |
$358.65 |
$146.25
|
|
Cortisol total am
|
$179.05 |
$179.05 |
$179.05 |
$121.20
|
|
Co-treatment - group 15 mins, st
|
$213.00 |
$213.00 |
$213.00 |
$112.00
|
|
Counseling smoke cess interm >10mins
|
$63.70 |
$63.70 |
$63.70 |
$54.60
|
|
Covid-19 administration immunization im inj 1st/only component
|
$50.00 |
$50.00 |
$50.00 |
$49.13
|
|
Covid-19 lab test non-cdc
|
$107.00 |
$107.00 |
$107.00 |
$82.40
|
|
#covid19rsv-rsv
|
$275.25 |
$275.25 |
$275.25 |
$145.60
|
|
CPAP or BiPAP Setup (first day)
|
$318.20 |
$318.20 |
$318.20 |
$584.50
|
|
C-peptide
|
$187.05 |
$187.05 |
$187.05 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,020.40 |
$1,020.40 |
$1,020.40 |
$777.71
|
|
Cranial cervical torticollis
|
$377.95 |
$377.95 |
$377.95 |
$377.95
|
|
C-reactive protein
|
$59.40 |
$59.40 |
$59.40 |
$69.36
|
|
C-reactive protein high sensitivity
|
$59.40 |
$59.40 |
$59.40 |
$85.50
|
|
Creatine kinase
|
$71.50 |
$71.50 |
$71.50 |
$66.30
|
|
Creatine kinase mb
|
$87.55 |
$87.55 |
$87.55 |
$113.63
|
|
Creatinine
|
$59.40 |
$59.40 |
$59.40 |
$46.20
|
|
Creatinine 24 hour urine
|
$56.45 |
$56.45 |
$56.45 |
$57.85
|
|
Creatinine clearance urine
|
$103.80 |
$103.80 |
$103.80 |
$90.26
|
|
#creutz-prot.,western blot
|
$173.45 |
$173.45 |
$173.45 |
$163.50
|
|
Crisis psychotherapy 90839
|
$478.75 |
$478.75 |
$478.75 |
$313.30
|
|
Crisis psychotherapy additional 30 mins 90840
|
$209.10 |
$209.10 |
$209.10 |
$149.52
|
|
Critical care each additional 30 minutes
|
$518.90 |
$518.90 |
$518.90 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$1,547.55 |
$1,547.55 |
$1,547.55 |
$2,535.00
|
|
Cryofibrinogen qualitative - sendout
|
$100.85 |
$100.85 |
$100.85 |
$52.50
|
|
Cryoprecipitate each unit
|
$554.00 |
$554.00 |
$554.00 |
$144.78
|
|
Crystal identification light microscopy
|
$80.85 |
$80.85 |
$80.85 |
$66.43
|
|
Csf leakage imaging
|
$5,068.55 |
$5,068.55 |
$5,068.55 |
$1,564.11
|
|
CT 3d report other modality w/workstation
|
$533.90 |
$533.90 |
$533.90 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,584.15 |
$2,584.15 |
$2,584.15 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,363.30 |
$3,363.30 |
$3,363.30 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,881.75
|
|
CT angio pelvis
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,585.50 |
$2,585.50 |
$2,585.50 |
$1,691.30
|
|
CT guidance for needle placement
|
$1,035.30 |
$1,035.30 |
$1,035.30 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$614.70 |
$614.70 |
$614.70 |
$1,215.06
|
|
CT guid cryo ablat intramuscular
|
$1,693.00 |
$1,693.00 |
$1,693.00 |
$2,039.76
|
|
CT limited or localized follow-up study
|
$775.10 |
$775.10 |
$775.10 |
$636.55
|
|
CT lwr extremity w/o&w/dye
|
$2,504.65 |
$2,504.65 |
$2,504.65 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,589.55 |
$2,589.55 |
$2,589.55 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,961.30 |
$1,961.30 |
$1,961.30 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,028.50 |
$1,028.50 |
$1,028.50 |
$2,272.00
|
|
CT t-spine w /wo contrast
|
$2,504.65 |
$2,504.65 |
$2,504.65 |
$1,975.00
|
|
CT uppr extremity w/o&w/dye
|
$2,504.65 |
$2,504.65 |
$2,504.65 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$59.45 |
$59.45 |
$59.45 |
$72.00
|
|
Culture afb any source
|
$121.35 |
$121.35 |
$121.35 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$50.45 |
$50.45 |
$50.45 |
$84.76
|
|
Culture anaerobic except blood
|
$103.80 |
$103.80 |
$103.80 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$103.80 |
$103.80 |
$103.80 |
$52.50
|
|
Culture body fluid
|
$79.80 |
$79.80 |
$79.80 |
$126.75
|
|
Culture fungi definitive id mold
|
$64.40 |
$64.40 |
$64.40 |
$80.00
|
|
Culture fungi definitive id yeast
|
$114.55 |
$114.55 |
$114.55 |
$80.00
|
|
Culture fungi other (except blood)
|
$94.40 |
$94.40 |
$94.40 |
$111.10
|
