|
Change stent via transureth
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Change ureter stent percut
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Chct for mal hyperthermia
|
$187.28 |
$189.67 |
$201.80 |
|
|
Chemical exfoliation acne 17360
|
$217.16 |
$3,986.00 |
$6,839.00 |
|
|
Chemical peel face epiderm 15788
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Chemical peel nonfacial 15793
|
$436.64 |
$3,986.00 |
$6,839.00 |
|
|
Chemical peel nonfacial; epidermal
|
$668.98 |
$3,986.00 |
$6,839.00 |
|
|
Chemo adm cns w/lmbr punct
|
$170.66 |
$367.45 |
$710.72 |
|
|
Chemodener muscle larynx emg
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv 1 extrem 1-4 ea 64643
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
|
|
Chemodenerv 1 extrem 5/> mus 64644
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv 1 extremity 1-4 64642
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenervation anal musc
|
$1,288.59 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenervation/face muscl/unilat 64612
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenervation nerve of eye muscle 67345
|
$326.69 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv eccrine glands
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv eccrine glands 64650
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv musc migraine 64615
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv musc neck dyston 64616
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv saliv glands bilat 64611
|
$322.61 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv trunk musc 1-5 64646
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Chemodenerv trunk musc 6/] 64647
|
$756.84 |
$3,986.00 |
$6,839.00 |
|
|
Chemo extend IV infus w/pump
|
$362.50 |
$367.13 |
$390.62 |
|
|
Chemo ia infuse each addl hr
|
$50.43 |
$51.11 |
$97.41 |
|
|
Chemo ia infusion up to 1 hr
|
$115.45 |
$367.13 |
$390.62 |
|
|
Chemo ia push tecnique
|
$114.75 |
$362.50 |
$390.62 |
|
|
Chemo intralesional over 7
|
$64.50 |
$233.20 |
$248.12 |
|
|
Chemo intralesional up to 7 96405
|
$55.21 |
$78.78 |
$140.77 |
|
|
Chemotaxis assay
|
$15.99 |
$17.59 |
$17.59 |
|
|
Chemotherapy injection 96542
|
$76.70 |
$362.50 |
$390.62 |
|
|
Chemotx admn pertl cav impl
|
$81.79 |
$362.50 |
$390.62 |
|
|
Chest 2 vws w oblique
|
$86.68 |
$117.81 |
$139.05 |
|
|
Chest apical lordotic proj
|
$81.14 |
$103.69 |
$128.59 |
|
|
Chest CT scan (with and without contrast)
|
$194.55 |
$685.48 |
$1,165.50 |
|
|
Chest CT scan (with contrast)
|
$194.55 |
$559.90 |
$977.00 |
|
|
Chest CT scan (without contrast)
|
$116.22 |
$433.18 |
$744.50 |
|
|
Chest Physiotherapy (first session)
|
$25.67 |
$70.01 |
$151.80 |
|
|
Chest Physiotherapy (follow-up session)
|
$26.57 |
$64.36 |
$151.80 |
|
|
Chest Ultrasound
|
$52.89 |
$117.81 |
$209.67 |
|
|
Chest X-ray
|
$63.59 |
$97.54 |
$198.80 |
|
|
Chest X-ray (single view)
|
$54.95 |
$97.54 |
$171.60 |
|
|
Chg pr pul rehab for copd patients
|
$51.21 |
$65.80 |
$120.57 |
|
|
Chg radiologic exam esophagus double contrast
|
$141.25 |
$201.88 |
$288.33 |
|
|
Chimerism anal no cell selec
|
$207.46 |
$228.21 |
$228.21 |
|
|
Chimerism anal w/cell select
|
$260.79 |
$286.87 |
$286.87 |
|
|
Chiropractic manj 5 regions
|
$27.65 |
$28.00 |
$29.79 |
|
|
Chiropract manj 1-2 regions
|
$27.65 |
$28.00 |
$29.79 |
|
|
Chiropract manj 3-4 regions
|
$27.65 |
$28.00 |
$29.79 |
|
|
Chlamydia culture
|
$19.60 |
$21.56 |
$128.00 |
|
|
Chlamydia trachomatis ag if
|
$11.98 |
$13.18 |
$13.18 |
|
|
Chlamydia type
|
$5.57 |
$6.13 |
$6.13 |
|
|
Chlmyd pneum dna dir probe
|
$20.05 |
$22.06 |
$22.06 |
|
|
Chlmyd pneum dna quant
|
$42.84 |
$47.12 |
$47.12 |
|
|
Chlnggrphy intraop addl s&i
|
$69.82 |
$69.82 |
$69.82 |
|
|
Chloride
|
$4.60 |
$5.06 |
$5.06 |
|
|
Chloride 24 hour urine
|
$5.75 |
$6.33 |
$6.33 |
|
|
Chloroprocaine opht gel, 1mg
|
$0.60 |
$0.60 |
$0.63 |
|
|
Chmotx admn plrl cav thrcnts
|
$132.51 |
$367.13 |
$390.62 |
|
|
Cholangiogram percutaneous compl
|
$3,786.00 |
$4,156.03 |
$6,839.00 |
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$95.71 |
$147.58 |
$176.84 |
|
|
Cholecystostomy complete w/supervision & interpretation
|
$3,786.00 |
$4,156.03 |
$6,839.00 |
|
|
Cholesterol
|
$4.35 |
$4.79 |
$20.50 |
|
|
Cholesterol body fluid
|
$20.27 |
$25.67 |
$226.68 |
|
|
Cholesterol (Lipid) Test
|
$13.39 |
$14.73 |
$102.00 |
|
|
Choline c-11
|
$2,062.94 |
$2,062.94 |
$2,062.94 |
|
|
Cholinesterase
|
$7.87 |
$8.66 |
$8.66 |
|
|
Cholinesterase challenge
|
$340.32 |
$344.68 |
$366.72 |
|
|
Chorion biopsy
|
$951.61 |
$3,986.00 |
$6,839.00 |
|
|
Chrom analysis
|
$34.81 |
$38.29 |
$38.29 |
|
|
Chromatogram assay sugars
|
$39.00 |
$42.90 |
$42.90 |
|
|
Chromatography
|
$18.06 |
$19.87 |
$19.87 |
|
|
Chromogenic substrate assay
|
$11.89 |
$13.08 |
$15.00 |
|
|
Chromo high res and frag x - sendout
|
$57.04 |
$62.74 |
$312.00 |
|
|
Chromosome analys amniotic
|
$173.66 |
$191.03 |
$191.03 |
|
|
Chromosome analysis 100
|
$173.17 |
$190.49 |
$190.49 |
|
|
Chromosome analysis 15-20 cell count
|
$125.49 |
$138.04 |
$138.04 |
|
|
Chromosome analysis 20-25
|
$173.17 |
$190.49 |
$190.49 |
|
|
Chromosome analysis 45
|
$150.29 |
$165.32 |
$165.32 |
|
|
Chromosome analysis 5
|
$264.34 |
$290.77 |
$290.77 |
|
|
Chromosome analysis 50-100
|
$173.17 |
$190.49 |
$523.50 |
|
|
Chromosome analys placenta
|
$188.57 |
$207.43 |
$207.43 |
|
|
Chromosome banding study
|
$68.60 |
$75.46 |
$75.46 |
|
|
Chromosome count additional
|
$26.91 |
$29.60 |
$29.60 |
|
|
Chromosome karyotype study
|
$33.47 |
$36.82 |
$798.00 |
|
|
Chromosome study additional
|
$34.43 |
$37.87 |
$37.87 |
|
|
Chronic urticaria - sendout
|
$12.46 |
$13.71 |
$13.71 |
|
|
Chylomicron screen, bf - sendout
|
$61.50 |
$67.65 |
$67.65 |
|
|
Cidofovir injection
|
$528.00 |
$529.38 |
$529.38 |
|
|
Ciliary transsleral therapy
|
$2,549.65 |
$3,986.00 |
$6,839.00 |
|
|
Ciltacabtagene car-pos t
|
$527,123.43 |
$553,378.83 |
$553,378.83 |
|
|
Cine/video x-rays
|
$116.22 |
$125.23 |
$215.07 |
|
|
Cine/video x-rays add-on
|
$38.29 |
$40.61 |
$42.76 |
|
|
Circum 28 days or older
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
Circumcise/surg/28 days or < 54160
|
$729.46 |
$3,986.00 |
$6,839.00 |
|
|
Circumcision (newborn)
|
$2,238.78 |
$3,986.00 |
$6,839.00 |
|
|
C-kit mutation liquid tumor - sendout
|
$329.51 |
$362.46 |
$362.46 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$9.73 |
$9.73 |
$14.25 |
|
|
Claviculectomy partial
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Claviculectomy total
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Clean out mastoid cavity
|
$556.55 |
$3,986.00 |
$6,839.00 |
|
