|
Clsd tx radius fracture w/manip 24655
|
$114.39 |
$114.39 |
$114.39 |
$1,806.10
|
|
Clsd tx shoulder dislc/fx 23665
|
$793.76 |
$793.76 |
$793.76 |
$1,856.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$793.76 |
$793.76 |
$793.76 |
$1,771.43
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,798.67 |
$1,798.67 |
$1,798.67 |
$2,321.95
|
|
Clsd tx temporomandibular dislocat 21480
|
$107.42 |
$107.42 |
$107.42 |
$445.15
|
|
Clsd tx toe dislocation without anes28660
|
$94.71 |
$94.71 |
$94.71 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$128.74 |
$128.74 |
$128.74 |
$501.20
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$596.96 |
$596.96 |
$596.96 |
$1,592.00
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$124.23 |
$124.23 |
$124.23 |
$496.61
|
|
Cls tx of heel fracture w/manip 28405
|
$171.38 |
$171.38 |
$171.38 |
$759.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,835.16 |
$1,835.16 |
$1,835.16 |
$2,064.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$757.27 |
$757.27 |
$757.27 |
$2,211.05
|
|
Cltx humrl cndylr fx w/mnpj
|
$793.76 |
$793.76 |
$793.76 |
$1,858.00
|
|
Cltx lunate dislc w/mnpj
|
$1,908.55 |
$1,908.55 |
$1,908.55 |
$2,464.50
|
|
Cltx post ankle fx w/mnpj
|
$793.76 |
$793.76 |
$793.76 |
$2,172.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$793.76 |
$793.76 |
$793.76 |
$2,035.80
|
|
Cmv pcr-sendout
|
$292.74 |
$292.74 |
$292.74 |
$172.25
|
|
Collection blood specimen from completely implantable venous access device
|
$92.66 |
$92.66 |
$92.66 |
$157.80
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$92.66 |
$92.66 |
$92.66 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$11.07 |
$11.07 |
$11.07 |
$20.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$3,761.34 |
$3,761.34 |
$3,761.34 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$62.32 |
$62.32 |
$62.32 |
$165.00
|
|
Compatibility test each unit electronic
|
$139.40 |
$139.40 |
$139.40 |
$176.70
|
|
Compatibility test each unit immediate spin technique
|
$139.40 |
$139.40 |
$139.40 |
$169.52
|
|
Compatibility test incubate
|
$26.24 |
$26.24 |
$26.24 |
$143.65
|
|
Complement antigen each component c3
|
$88.56 |
$88.56 |
$88.56 |
$108.80
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$379.66 |
$379.66 |
$379.66 |
$1,098.35
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$207.46 |
$207.46 |
$207.46 |
$1,218.40
|
|
Complx repair fccmnaxghf 13131
|
$301.35 |
$301.35 |
$301.35 |
$820.00
|
|
Complx repair fccmnaxghf 13132
|
$258.71 |
$258.71 |
$258.71 |
$1,177.60
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$208.69 |
$208.69 |
$208.69 |
$1,016.25
|
|
Concentration infection agents any type
|
$25.83 |
$25.83 |
$25.83 |
$49.95
|
|
Condylomata destruction 56420
|
$126.69 |
$126.69 |
$126.69 |
$473.75
|
|
Consultation/report referred slides prepared elsewhere
|
$107.01 |
$107.01 |
$107.01 |
$171.65
|
|
Contrast baths charges
|
$29.93 |
$29.93 |
$29.93 |
$72.15
|
|
Control nosebleed pack+caut 30905
|
$103.32 |
$103.32 |
$103.32 |
$426.40
|
|
Control of nosebleed ant comp 30903
|
$88.56 |
$88.56 |
$88.56 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$73.39 |
$73.39 |
$73.39 |
$364.96
|
|
Control oropharyngeal hemorr/simp 42960
|
$148.01 |
$148.01 |
$148.01 |
$638.25
|
|
Coombs direct
|
$52.89 |
$52.89 |
$52.89 |
$72.78
|
|
Coronary thrombolysis/iv infusion 92977
|
$258.30 |
$258.30 |
$258.30 |
$484.37
|
|
Cortisol total am
|
$148.42 |
$148.42 |
$148.42 |
$117.81
|
|
Co-treatment - group 15 mins, st
|
$144.73 |
$144.73 |
$144.73 |
$110.40
|
|
Counseling smoke cess interm >10mins
|
$48.38 |
$48.38 |
$48.38 |
$56.89
|
|
Covid-19 administration immunization im inj 1st/only component
|
$53.30 |
$53.30 |
$53.30 |
$49.13
|
|
Covid-19 convalescent plasma
|
$1,037.71 |
$1,037.71 |
$1,037.71 |
$582.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$647.39 |
$647.39 |
$647.39 |
$553.80
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$647.39 |
$647.39 |
$647.39 |
$551.64
|
|
Covid-19 lab test non-cdc
|
$76.26 |
$76.26 |
$76.26 |
$68.50
|
|
#covid19rsv-rsv
|
$93.48 |
$93.48 |
$93.48 |
$146.00
|
|
#coxa-coxsackie a serotype a16
|
$107.01 |
$107.01 |
$107.01 |
$60.00
|
|
C-peptide
|
$125.46 |
$125.46 |
$125.46 |
$90.27
|
|
C-reactive protein
|
$35.26 |
$35.26 |
$35.26 |
$62.40
|
|
C-reactive protein high sensitivity
|
$14.35 |
$14.35 |
$14.35 |
$78.91
|
|
Creatine kinase
|
$36.90 |
$36.90 |
$36.90 |
$63.00
|
|
Creatine kinase isoenzymes
|
$59.45 |
$59.45 |
$59.45 |
$48.48
|
|
Creatine kinase mb
|
$45.92 |
$45.92 |
$45.92 |
$114.00
|
|
Creatinine
|
$24.60 |
$24.60 |
$24.60 |
$44.35
|
|
Creatinine 24 hour urine
|
$76.67 |
$76.67 |
$76.67 |
$55.25
|
|
Creatinine clearance urine
|
$53.30 |
$53.30 |
$53.30 |
$87.50
|
|
Critical care 30-74 minutes
|
$504.71 |
$504.71 |
$504.71 |
$2,540.23
|
|
Cryptococcus abs qn - sendout
|
$24.60 |
$24.60 |
$24.60 |
$80.85
|
|
Cryptosporidium antigen
|
$53.71 |
$53.71 |
$53.71 |
$52.08
|
|
Crystal identification light microscopy
|
$76.67 |
$76.67 |
$76.67 |
$58.50
|
|
Cta abdomen without & /or w/contrast
|
$1,186.95 |
$1,186.95 |
$1,186.95 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,403.02 |
$1,403.02 |
$1,403.02 |
$1,934.40
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,403.02 |
$1,403.02 |
$1,403.02 |
$2,075.53
|
|
Cta neck without &/or w/contrast
|
$886.42 |
$886.42 |
$886.42 |
$1,940.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,241.48 |
$1,241.48 |
$1,241.48 |
$2,848.80
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,132.42 |
$1,132.42 |
$1,132.42 |
$1,940.00
|
|
CT Angiogram of the Head
|
$886.42 |
$886.42 |
$886.42 |
$2,005.44
|
|
CT angio hrt w/3d image
|
$1,079.12 |
$1,079.12 |
$1,079.12 |
$1,514.10
|
|
Cta upper extremity w &/or without contrast left
|
$1,655.17 |
$1,655.17 |
$1,655.17 |
$1,697.80
|
|
CT bone density axial
|
$331.69 |
$331.69 |
$331.69 |
$360.85
|
|
CT heart w/evaluation of calcium without contrast
|
$110.29 |
$110.29 |
$110.29 |
$192.00
|
|
CT limited or localized follow-up study
|
$147.60 |
$147.60 |
$147.60 |
$633.60
|
|
CT lower extremity w/contrast (both sides)
|
$863.46 |
$863.46 |
$863.46 |
$1,585.20
|
|
CT lower extremity without contrast (both sides)
|
$755.63 |
$755.63 |
$755.63 |
$1,398.82
|
|
CT lwr extremity w/o&w/dye
|
$1,598.59 |
$1,598.59 |
$1,598.59 |
$1,851.60
|
|
CT neck soft tissue w/contrast
|
$755.63 |
$755.63 |
$755.63 |
$1,645.15
|
|
CT neck soft tissue without contrast
|
$701.10 |
$701.10 |
$701.10 |
$1,318.20
|
|
CT neck soft tissue without & w/contrast
|
$808.93 |
$808.93 |
$808.93 |
$1,946.21
|
|
CT orbit/sella/fossa w/wo contrast
|
$688.80 |
$688.80 |
$688.80 |
$1,686.75
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,270.18 |
$1,270.18 |
$1,270.18 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$584.25 |
$584.25 |
$584.25 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$89.38 |
$89.38 |
$89.38 |
$450.77
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$1,268.13 |
$1,268.13 |
$1,268.13 |
$3,472.50
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$1,186.95 |
$1,186.95 |
$1,186.95 |
$2,883.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$922.50 |
$922.50 |
$922.50 |
$2,368.80
|
|
CT thoracic spine w/contrast
|
$971.29 |
$971.29 |
$971.29 |
$1,700.40
|
|
CT thoracic spine without contrast
|
$755.63 |
$755.63 |
$755.63 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$52.48 |
$52.48 |
$52.48 |
$346.80
|
|
CT t-spine w /wo contrast
|
$1,186.95 |
$1,186.95 |
$1,186.95 |
$2,033.46
|
|
CT upper extremity w/contrast (both sides)
|
$863.46 |
$863.46 |
$863.46 |
$1,687.88
|
|
CT upper extremity without contrast (both sides)
|
$755.63 |
$755.63 |
$755.63 |
$1,440.00
|
|
CT uppr extremity w/o&w/dye
|
$868.38 |
$868.38 |
$868.38 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$38.13 |
$38.13 |
$38.13 |
$67.05
|
|
Culture afb any source
|
$42.64 |
$42.64 |
$42.64 |
$107.50
|
|
Culture anaerobic additional method definitive id each
|
$86.92 |
$86.92 |
$86.92 |
$76.35
|
|
Culture anaerobic except blood
|
$163.59 |
$163.59 |
$163.59 |
$117.00
|