|
Clsd tx/metacarpal fx/sg without manip 26600
|
$256.95 |
$256.95 |
$256.95 |
$519.12
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$135.90 |
$135.90 |
$135.90 |
$688.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$135.90 |
$135.90 |
$135.90 |
$572.36
|
|
Clsd tx of ankle fracture w/manip 28435
|
$831.15 |
$831.15 |
$831.15 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$103.95 |
$103.95 |
$103.95 |
$593.60
|
|
Clsd tx/patellar fx without manip 27520
|
$367.20 |
$367.20 |
$367.20 |
$495.80
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$871.20 |
$871.20 |
$871.20 |
$2,322.60
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$109.80 |
$109.80 |
$109.80 |
$416.65
|
|
Clsd tx radius fracture w/manip 24655
|
$125.55 |
$125.55 |
$125.55 |
$1,806.10
|
|
Clsd tx shoulder dislc/fx 23665
|
$871.20 |
$871.20 |
$871.20 |
$1,893.86
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$871.20 |
$871.20 |
$871.20 |
$1,790.00
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,974.15 |
$1,974.15 |
$1,974.15 |
$2,421.00
|
|
Clsd tx temporomandibular dislocat 21480
|
$117.90 |
$117.90 |
$117.90 |
$445.15
|
|
Clsd tx toe dislocation without anes28660
|
$103.95 |
$103.95 |
$103.95 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$141.30 |
$141.30 |
$141.30 |
$510.67
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$655.20 |
$655.20 |
$655.20 |
$1,602.79
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$136.35 |
$136.35 |
$136.35 |
$513.75
|
|
Cls tx of heel fracture w/manip 28405
|
$188.10 |
$188.10 |
$188.10 |
$761.40
|
|
Cltx carpl scphd fx w/mnpj
|
$2,014.20 |
$2,014.20 |
$2,014.20 |
$2,090.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$831.15 |
$831.15 |
$831.15 |
$2,274.40
|
|
Cltx humrl cndylr fx w/mnpj
|
$871.20 |
$871.20 |
$871.20 |
$1,877.71
|
|
Cltx lunate dislc w/mnpj
|
$2,094.75 |
$2,094.75 |
$2,094.75 |
$2,626.00
|
|
Cltx post ankle fx w/mnpj
|
$871.20 |
$871.20 |
$871.20 |
$2,211.05
|
|
Cltx scap fx w/mnpj +-tractj
|
$871.20 |
$871.20 |
$871.20 |
$2,030.33
|
|
Cmv pcr-sendout
|
$321.30 |
$321.30 |
$321.30 |
$172.25
|
|
Collection blood specimen from completely implantable venous access device
|
$101.70 |
$101.70 |
$101.70 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$101.70 |
$101.70 |
$101.70 |
$157.80
|
|
Collection of venous blood by venipuncture
|
$12.15 |
$12.15 |
$12.15 |
$20.91
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$4,128.30 |
$4,128.30 |
$4,128.30 |
$3,907.93
|
|
Compatibility test each unit antiglobulin technique
|
$68.40 |
$68.40 |
$68.40 |
$165.00
|
|
Compatibility test each unit electronic
|
$153.00 |
$153.00 |
$153.00 |
$175.45
|
|
Compatibility test each unit immediate spin technique
|
$153.00 |
$153.00 |
$153.00 |
$169.52
|
|
Compatibility test incubate
|
$28.80 |
$28.80 |
$28.80 |
$143.64
|
|
Complement antigen each component c3
|
$97.20 |
$97.20 |
$97.20 |
$110.40
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$416.70 |
$416.70 |
$416.70 |
$1,179.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$227.70 |
$227.70 |
$227.70 |
$1,244.80
|
|
Complx repair fccmnaxghf 13131
|
$330.75 |
$330.75 |
$330.75 |
$832.02
|
|
Complx repair fccmnaxghf 13132
|
$283.95 |
$283.95 |
$283.95 |
$1,193.40
|
|
Complx repair sal addl 5 cm/> 13122
|
$141.30 |
$141.30 |
$141.30 |
$546.29
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$229.05 |
$229.05 |
$229.05 |
$1,116.00
|
|
Concentration infection agents any type
|
$28.35 |
$28.35 |
$28.35 |
$51.32
|
|
Condylomata destruction 56420
|
$139.05 |
$139.05 |
$139.05 |
$490.88
|
|
Consultation/report referred slides prepared elsewhere
|
$117.45 |
$117.45 |
$117.45 |
$173.46
|
|
Contrast baths charges
|
$32.85 |
$32.85 |
$32.85 |
$74.25
|
|
Control nosebleed pack+caut 30905
|
$113.40 |
$113.40 |
$113.40 |
$426.40
|
|
Control of nosebleed ant comp 30903
|
$97.20 |
$97.20 |
$97.20 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$80.55 |
$80.55 |
$80.55 |
$373.75
|
|
Control oropharyngeal hemorr/simp 42960
|
$162.45 |
$162.45 |
$162.45 |
$638.25
|
|
Coombs direct
|
$58.05 |
$58.05 |
$58.05 |
$72.80
|
|
Coronary thrombolysis/iv infusion 92977
|
$283.50 |
$283.50 |
$283.50 |
$482.56
|
|
Cortisol total am
|
$162.90 |
$162.90 |
$162.90 |
$121.55
|
|
Co-treatment - group 15 mins, st
|
$158.85 |
$158.85 |
$158.85 |
$114.00
|
|
Counseling smoke cess interm >10mins
|
$53.10 |
$53.10 |
$53.10 |
$57.60
|
|
Covid-19 administration immunization im inj 1st/only component
|
$58.50 |
$58.50 |
$58.50 |
$49.60
|
|
Covid-19 convalescent plasma
|
$1,138.95 |
$1,138.95 |
$1,138.95 |
$582.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$710.55 |
$710.55 |
$710.55 |
$562.44
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$710.55 |
$710.55 |
$710.55 |
$553.80
|
|
Covid-19 lab test non-cdc
|
$83.70 |
$83.70 |
$83.70 |
$65.30
|
|
#covid19rsv-rsv
|
$102.60 |
$102.60 |
$102.60 |
$146.00
|
|
#coxa-coxsackie a serotype a16
|
$117.45 |
$117.45 |
$117.45 |
$60.00
|
|
C-peptide
|
$137.70 |
$137.70 |
$137.70 |
$93.60
|
|
C-reactive protein
|
$38.70 |
$38.70 |
$38.70 |
$61.20
|
|
C-reactive protein high sensitivity
|
$15.75 |
$15.75 |
$15.75 |
$79.77
|
|
Creatine kinase
|
$40.50 |
$40.50 |
$40.50 |
$64.35
|
|
Creatine kinase isoenzymes
|
$65.25 |
$65.25 |
$65.25 |
$49.40
|
|
Creatine kinase mb
|
$50.40 |
$50.40 |
$50.40 |
$114.66
|
|
Creatinine
|
$27.00 |
$27.00 |
$27.00 |
$44.25
|
|
Creatinine 24 hour urine
|
$84.15 |
$84.15 |
$84.15 |
$56.45
|
|
Creatinine clearance urine
|
$58.50 |
$58.50 |
$58.50 |
$87.50
|
|
Critical care 30-74 minutes
|
$553.95 |
$553.95 |
$553.95 |
$2,549.60
|
|
Cryptococcus abs qn - sendout
|
$27.00 |
$27.00 |
$27.00 |
$80.85
|
|
Cryptosporidium antigen
|
$58.95 |
$58.95 |
$58.95 |
$52.08
|
|
Crystal identification light microscopy
|
$84.15 |
$84.15 |
$84.15 |
$59.15
|
|
Cta abdomen without & /or w/contrast
|
$1,302.75 |
$1,302.75 |
$1,302.75 |
$2,050.28
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,539.90 |
$1,539.90 |
$1,539.90 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,539.90 |
$1,539.90 |
$1,539.90 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$972.90 |
$972.90 |
$972.90 |
$1,940.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,362.60 |
$1,362.60 |
$1,362.60 |
$2,910.00
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,242.90 |
$1,242.90 |
$1,242.90 |
$1,940.00
|
|
CT Angiogram of the Head
|
$972.90 |
$972.90 |
$972.90 |
$2,027.35
|
|
CT angio hrt w/3d image
|
$1,184.40 |
$1,184.40 |
$1,184.40 |
$1,555.00
|
|
Cta upper extremity w &/or without contrast left
|
$1,816.65 |
$1,816.65 |
$1,816.65 |
$1,698.32
|
|
CT bone density axial
|
$364.05 |
$364.05 |
$364.05 |
$368.76
|
|
CT heart w/evaluation of calcium without contrast
|
$121.05 |
$121.05 |
$121.05 |
$196.67
|
|
CT limited or localized follow-up study
|
$162.00 |
$162.00 |
$162.00 |
$649.38
|
|
CT lower extremity w/contrast (both sides)
|
$947.70 |
$947.70 |
$947.70 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$829.35 |
$829.35 |
$829.35 |
$1,409.58
|
|
CT lwr extremity w/o&w/dye
|
$1,754.55 |
$1,754.55 |
$1,754.55 |
$1,857.80
|
|
CT neck soft tissue w/contrast
|
$829.35 |
$829.35 |
$829.35 |
$1,667.00
|
|
CT neck soft tissue without contrast
|
$769.50 |
$769.50 |
$769.50 |
$1,363.35
|
|
CT neck soft tissue without & w/contrast
|
$887.85 |
$887.85 |
$887.85 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$756.00 |
$756.00 |
$756.00 |
$1,740.00
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,394.10 |
$1,394.10 |
$1,394.10 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$641.25 |
$641.25 |
$641.25 |
$1,373.25
|
|
Ctrl nosebld postir subsq 30906
|
$98.10 |
$98.10 |
$98.10 |
$450.77
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,391.85 |
$1,391.85 |
$1,391.85 |
$3,580.00
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,302.75 |
$1,302.75 |
$1,302.75 |
$2,985.60
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,012.50 |
$1,012.50 |
$1,012.50 |
$2,418.75
|
|
CT thoracic spine w/contrast
|
$1,066.05 |
$1,066.05 |
$1,066.05 |
$1,732.50
|
|
CT thoracic spine without contrast
|
$829.35 |
$829.35 |
$829.35 |
$1,468.80
|
