|
Chest CT scan (without contrast)
|
$480.26 |
$480.26 |
$480.26 |
$1,350.03
|
|
Chest X-ray
|
$111.58 |
$111.58 |
$111.58 |
$295.22
|
|
Chest X-ray (single view)
|
$108.08 |
$108.08 |
$108.08 |
$232.17
|
|
Chg pr pul rehab for copd patients
|
$101.30 |
$101.30 |
$101.30 |
$150.40
|
|
Chg radiologic exam esophagus double contrast
|
$265.40 |
$265.40 |
$265.40 |
$541.82
|
|
Chimerism anal no cell selec
|
$228.21 |
$228.21 |
$228.21 |
$447.94
|
|
Chimerism anal w/cell select
|
$286.87 |
$286.87 |
$286.87 |
$585.60
|
|
Chlamydia culture
|
$21.56 |
$21.56 |
$21.56 |
$94.90
|
|
Chlamydia trachomatis ag if
|
$13.18 |
$13.18 |
$13.18 |
$30.40
|
|
Chlamydia type
|
$6.13 |
$6.13 |
$6.13 |
$34.92
|
|
Chloride
|
$5.06 |
$5.06 |
$5.06 |
$39.60
|
|
Chloride 24 hour urine
|
$6.33 |
$6.33 |
$6.33 |
$46.13
|
|
Cholangiogram percutaneous compl
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,747.56
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$162.78 |
$162.78 |
$162.78 |
$625.60
|
|
Cholecystostomy complete w/supervision & interpretation
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,712.80
|
|
Cholesterol
|
$4.79 |
$4.79 |
$4.79 |
$46.15
|
|
Cholesterol body fluid
|
$23.63 |
$23.63 |
$23.63 |
$92.80
|
|
Cholesterol (Lipid) Test
|
$14.73 |
$14.73 |
$14.73 |
$118.36
|
|
Cholinesterase
|
$8.66 |
$8.66 |
$8.66 |
$39.60
|
|
Chorion biopsy
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$975.00
|
|
Chrom analysis
|
$38.29 |
$38.29 |
$38.29 |
$128.25
|
|
Chromatogram assay sugars
|
$42.90 |
$42.90 |
$42.90 |
$64.13
|
|
Chromatography
|
$19.87 |
$19.87 |
$19.87 |
$81.25
|
|
Chromogenic substrate assay
|
$13.08 |
$13.08 |
$13.08 |
$184.60
|
|
Chromo high res and frag x - sendout
|
$62.74 |
$62.74 |
$62.74 |
$265.11
|
|
Chromosome analys amniotic
|
$191.03 |
$191.03 |
$191.03 |
$450.00
|
|
Chromosome analysis 100
|
$190.49 |
$190.49 |
$190.49 |
$422.50
|
|
Chromosome analysis 15-20 cell count
|
$138.04 |
$138.04 |
$138.04 |
$479.38
|
|
Chromosome analysis 20-25
|
$190.49 |
$190.49 |
$190.49 |
$277.09
|
|
Chromosome analysis 45
|
$165.32 |
$165.32 |
$165.32 |
$377.60
|
|
Chromosome analysis 5
|
$290.77 |
$290.77 |
$290.77 |
$663.30
|
|
Chromosome analysis 50-100
|
$190.49 |
$190.49 |
$190.49 |
$434.40
|
|
Chromosome analys placenta
|
$207.43 |
$207.43 |
$207.43 |
$660.00
|
|
Chromosome banding study
|
$75.46 |
$75.46 |
$75.46 |
$172.80
|
|
Chromosome count additional
|
$29.60 |
$29.60 |
$29.60 |
$116.61
|
|
Chromosome karyotype study
|
$36.82 |
$36.82 |
$36.82 |
$108.94
|
|
Chromosome study additional
|
$37.87 |
$37.87 |
$37.87 |
$147.03
|
|
Chronic urticaria - sendout
|
$13.71 |
$13.71 |
$13.71 |
$91.00
|
|
Chylomicron screen, bf - sendout
|
$67.65 |
$67.65 |
$67.65 |
$123.50
|
|
Ciliary transsleral therapy
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,269.14
|
|
Circum 28 days or older
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$4,968.60
|
|
Circumcise/surg/28 days or < 54160
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,995.50
|
|
Circumcision (newborn)
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,549.50
|
|
C-kit mutation liquid tumor - sendout
|
$362.46 |
$362.46 |
$362.46 |
$640.41
|
|
Claviculectomy partial
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,594.44
|
|
Claviculectomy total
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,786.00
|
|
Clean out mastoid cavity
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,033.60
|
|
Clearance of airways
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$206.80
|
|
Clearance of tear duct
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$811.45
|
|
Clitoroplasty intersex state
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,615.39
|
|
Cllr miami j sm
|
$21.96 |
$21.96 |
$21.96 |
$219.42
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$646.92
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,815.75
|
|
Closed tx/acetabululm without manip 27220
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$584.90
|
|
Closed tx humerus fx with manip 23605
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,460.00
|
|
Closed tx humerus fx without manip 23600
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$541.45
|
|
Closed tx humerus fx w/manip 24505
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,592.00
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$423.20
|
|
Closed tx nose/jaw fx
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,821.60
|
|
Closed tx orbit without manipulj
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,331.45
|
|
Closed tx orbit w/manipulj
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,825.35
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,864.00
|
|
Closed tx septal&nose fx
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,540.97
|
|
Closed tx sesamoid fx 28530
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$404.04
|
|
Closed tx/talus fracture without manip 28430
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$450.40
|
|
Closed tx vert fx w/manj
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,591.33
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$487.69
|
|
Close mastoid fistula
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,299.20
|
|
Close tear duct opening
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$462.80
|
|
Close tear duct opening
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$656.35
|
|
Close tear system fistula
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,116.80
|
|
Clostridium toxin a w/optic
|
$17.60 |
$17.60 |
$17.60 |
$17.60
|
|
Clos txnose fx without stablz 21315
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,728.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,183.65
|
|
Closure of eyelid by suture
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,170.80
|
|
Closure of salivary fistula
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,589.62
|
|
Closure of windpipe lesion 31820
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$3,589.62
|
|
Closure paravalvlr leak pq
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$10,497.50
|
|
Clot factor fletcher fact
|
$20.82 |
$20.82 |
$20.82 |
$108.61
|
|
Clot factor viii reltd antgn
|
$22.46 |
$22.46 |
$22.46 |
$95.76
|
|
Clot factor wght kininogen
|
$20.82 |
$20.82 |
$20.82 |
$157.50
|
|
Clot factor xii hageman
|
$21.29 |
$21.29 |
$21.29 |
$125.00
|
|
Clot factor xiii fibrin scrn
|
$10.02 |
$10.02 |
$10.02 |
$51.50
|
|
Clot factor xiii fibrin stab
|
$17.97 |
$17.97 |
$17.97 |
$91.80
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$626.40
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$543.00
|
|
Clsd tx clav dislc without manip 23520
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$1,839.79
|
|
Clsd tx clavicle dislocation without manip 23540
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$537.00
|
|
Clsd tx clavicle fracture w/manip 23505
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,034.18
|
|
Clsd tx/clavicular fx without manip 23500
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$497.00
|
|
Clsd tx coccygeal fracture 27200
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$336.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$731.04
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$507.65
|
|
Clsd tx elbow dislocation child 24640
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$525.28
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,587.60
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$2,109.16
|
|
Clsd tx fracture of radius 25500
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$470.21
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$5,419.00 |
$5,419.00 |
$5,419.00 |
$392.50
|