|
Chemo intralesional up to 7 96405
|
$99.00 |
$203.00 |
$203.00 |
|
|
Chemotaxis assay
|
$22.07 |
$22.07 |
$190.40 |
|
|
Chemotherapy injection 96542
|
$434.00 |
$454.19 |
$879.00 |
|
|
Chemotx admn pertl cav impl
|
$454.19 |
$454.19 |
$454.19 |
|
|
Chest 2 vws w oblique
|
$75.04 |
$455.00 |
$516.00 |
|
|
Chest apical lordotic proj
|
$53.76 |
$407.00 |
$448.00 |
|
|
Chest CT scan (with and without contrast)
|
$241.18 |
$2,131.00 |
$2,976.00 |
|
|
Chest CT scan (with contrast)
|
$241.18 |
$1,786.00 |
$2,934.00 |
|
|
Chest CT scan (without contrast)
|
$143.75 |
$1,151.00 |
$2,304.00 |
|
|
Chest Physiotherapy (first session)
|
$73.36 |
$136.64 |
$295.00 |
|
|
Chest Physiotherapy (follow-up session)
|
$73.36 |
$127.00 |
$450.00 |
|
|
Chest Ultrasound
|
$80.64 |
$796.00 |
$992.00 |
|
|
Chest X-ray
|
$53.76 |
$362.00 |
$390.00 |
|
|
Chest X-ray (single view)
|
$47.60 |
$306.00 |
$342.00 |
|
|
Chg pr pul rehab for copd patients
|
$77.28 |
$81.12 |
$281.60 |
|
|
Chg radiologic exam esophagus double contrast
|
$97.44 |
$659.00 |
$1,524.80 |
|
|
Chimerism anal no cell selec
|
$286.29 |
$1,130.00 |
$1,130.00 |
|
|
Chimerism anal w/cell select
|
$359.89 |
$1,130.00 |
$1,130.00 |
|
|
Chiropractic manj 5 regions
|
$52.55 |
$52.55 |
$52.55 |
|
|
Chiropract manj 1-2 regions
|
$29.68 |
$29.68 |
$29.68 |
|
|
Chiropract manj 3-4 regions
|
$38.81 |
$38.81 |
$38.81 |
|
|
Chlamydia culture
|
$12.55 |
$32.90 |
$309.60 |
|
|
Chlamydia trachomatis ag if
|
$16.53 |
$16.53 |
$29.09 |
|
|
Chlamydia type
|
$7.69 |
$13.77 |
$106.40 |
|
|
Chlmyd pneum dna dir probe
|
$27.67 |
$27.67 |
$27.67 |
|
|
Chlmyd pneum dna quant
|
$59.12 |
$59.12 |
$59.12 |
|
|
Chlnggrphy intraop addl s&i
|
$85.68 |
$85.68 |
$636.80 |
|
|
Chloramphenicol sodium injec
|
$36.82 |
$69.36 |
$69.36 |
|
|
Chloride
|
$6.35 |
$17.00 |
$67.20 |
|
|
Chloride 24 hour urine
|
$7.94 |
$20.00 |
$108.00 |
|
|
Chloroprocaine hcl injection
|
$0.05 |
$0.05 |
$0.05 |
|
|
Chloroprocaine opht gel, 1mg
|
$0.80 |
$0.80 |
$0.80 |
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$80.21 |
$80.21 |
$220.20 |
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$31.53 |
$32.80 |
$49.27 |
|
|
Chlorpromazine 100 mg tablet
|
$6.68 |
$6.68 |
$6.68 |
|
|
Chmotx admn plrl cav thrcnts
|
$454.19 |
$454.19 |
$454.19 |
|
|
Cholangiogram percutaneous compl
|
$3,123.20 |
$7,651.00 |
$10,472.00 |
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$18.77 |
$191.76 |
$905.60 |
|
|
Cholecystectomy expl duct 47612
|
$1,803.74 |
$1,803.74 |
$1,803.74 |
|
|
Cholecystectomy w/cholangiography 47605
|
$1,597.52 |
$1,597.52 |
$1,597.52 |
|
|
Cholecystoenterostomy direct 47720
|
$1,647.53 |
$1,647.53 |
$1,647.53 |
|
|
Cholecystostomy complete w/supervision & interpretation
|
$4,923.19 |
$5,027.00 |
$10,996.00 |
|
|
Cholesterol
|
$4.23 |
$18.00 |
$94.40 |
|
|
Cholesterol body fluid
|
$23.15 |
$101.00 |
$364.00 |
|
|
Cholesterol (Lipid) Test
|
$18.48 |
$48.00 |
$208.00 |
|
|
Choline c-11
|
$3,472.67 |
$3,472.67 |
$3,472.67 |
|
|
Cholinesterase
|
$10.86 |
$14.39 |
$333.60 |
|
|
Cholinesterase challenge
|
$108.64 |
$296.91 |
$296.91 |
|
|
Chorion biopsy
|
$613.76 |
$1,266.48 |
$2,549.00 |
|
|
Chorionic gonadotropin/1000u
|
$21.25 |
$21.25 |
$21.25 |
|
|
Chrnc care mgmt phys 1st 30
|
$92.60 |
$92.60 |
$92.60 |
|
|
Chrom analysis
|
$48.04 |
$426.00 |
$592.80 |
|
|
Chromatogram assay sugars
|
$18.33 |
$53.82 |
$53.82 |
|
|
Chromatography
|
$18.80 |
$69.00 |
$1,009.60 |
|
|
Chromogenic substrate assay
|
$6.21 |
$16.41 |
$1,227.20 |
|
|
Chromo high res and frag x - sendout
|
$61.57 |
$176.40 |
$1,710.40 |
|
|
Chromosome analys amniotic
|
$239.65 |
$466.00 |
$1,166.40 |
|
|
Chromosome analysis 100
|
$90.24 |
$238.97 |
$238.97 |
|
|
Chromosome analysis 15-20 cell count
|
$173.18 |
$908.00 |
$1,297.60 |
|
|
Chromosome analysis 20-25
|
$90.24 |
$238.97 |
$411.04 |
|
|
Chromosome analysis 45
|
$207.40 |
$207.40 |
$887.20 |
|
|
Chromosome analysis 5
|
$112.00 |
$364.79 |
$884.00 |
|
|
Chromosome analysis 50-100
|
$90.24 |
$238.97 |
$238.97 |
|
|
Chromosome analys placenta
|
$131.13 |
$660.00 |
$731.00 |
|
|
Chromosome banding study
|
$75.60 |
$94.67 |
$94.67 |
|
|
Chromosome count additional
|
$16.69 |
$166.00 |
$504.00 |
|
|
Chromosome karyotype study
|
$22.03 |
$166.00 |
$359.20 |
|
|
Chromosome study additional
|
$47.51 |
$47.51 |
$433.60 |
|
|
Chronic urticaria - sendout
|
$17.19 |
$17.19 |
$641.60 |
|
|
Chylomicron screen, bf - sendout
|
$29.14 |
$66.64 |
$265.60 |
|
|
Cid ext controller repl
|
$2,159.88 |
$2,159.88 |
$2,159.88 |
|
|
Cid ext speech process repl
|
$12,123.18 |
$12,123.18 |
$12,123.18 |
|
|
Cidofovir injection
|
$507.92 |
$723.79 |
$723.79 |
|
|
Cid transmit coil and cable
|
$304.26 |
$304.26 |
$304.26 |
|
|
Cilastatin sodium injection
|
$9.80 |
$9.80 |
$9.80 |
|
|
Ciliary transsleral therapy
|
$3,269.14 |
$3,269.14 |
$3,269.14 |
|
|
Ciltacabtagene car-pos t
|
$810,956.41 |
$810,956.41 |
$810,956.41 |
|
|
Cine/video x-rays
|
$143.75 |
$143.75 |
$143.75 |
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$2.76 |
$2.76 |
$11.36 |
|
|
Circum 28 days or older
|
$2,874.36 |
$2,874.36 |
$2,874.36 |
|
|
Circumcise/surg/28 days or < 54160
|
$958.81 |
$958.81 |
$958.81 |
|
|
Circumcision (newborn)
|
$82.32 |
$1,865.00 |
$4,535.20 |
|
|
Cisplatin 1 mg/ml desensitization
|
$2.91 |
$4.17 |
$8.48 |
|
|
C-kit mutation liquid tumor - sendout
|
$155.10 |
$1,063.00 |
$1,063.00 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$10.24 |
$10.24 |
$34.89 |
|
|
C-laminoplasty w/graft/plate
|
$2,388.27 |
$2,388.27 |
$2,388.27 |
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$62.16 |
$4,939.20 |
$12,032.00 |
|
|
Clamp neck artery
|
$2,085.35 |
$2,085.35 |
$2,085.35 |
|
|
Claviculectomy partial
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Claviculectomy total
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
|
|
Clean out mastoid cavity
|
$741.60 |
$741.60 |
$741.60 |
|
|
Clearance of airways
|
$56.00 |
$315.00 |
$443.00 |
|
|
Clearance of airways
|
$101.20 |
$101.20 |
$821.52 |
|
|
Clearance of tear duct
|
$436.44 |
$436.44 |
$436.44 |
|
|
C-lens fitg corneosclrl lens
|
$182.95 |
$182.95 |
$182.95 |
|
|
C-lens fitg tech aphakia 1
|
$182.95 |
$182.95 |
$182.95 |
|
|
C-lens fitg tech aphakia ou
|
$182.95 |
$182.95 |
$182.95 |
|
|
C-lens fitg tech corneosclrl
|
$51.36 |
$51.36 |
$51.36 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$2.64 |
$2.64 |
$2.64 |
|
|
Clip ligating vesolock lg
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
|
