|
Clsd tx/dis tib/wt bear no manip 27824
|
$507.97 |
$507.97 |
$507.97 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$390.23 |
$390.23 |
$390.23 |
$465.21
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$433.91 |
$433.91 |
$433.91 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$521.61 |
$521.61 |
$521.61 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,895.91 |
$1,895.91 |
$1,895.91 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,525.96 |
$1,525.96 |
$1,525.96 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$442.01 |
$442.01 |
$442.01 |
$630.00
|
|
Clsd tx humerus fract without manip 24500
|
$442.01 |
$442.01 |
$442.01 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$797.02 |
$797.02 |
$797.02 |
$883.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$530.65 |
$530.65 |
$530.65 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$463.22 |
$463.22 |
$463.22 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$442.01 |
$442.01 |
$442.01 |
$522.78
|
|
Clsd tx patella disloc without anes 27560
|
$594.51 |
$594.51 |
$594.51 |
$573.52
|
|
Clsd tx pelvic ring fx
|
$509.51 |
$509.51 |
$509.51 |
$424.50
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$465.60 |
$465.60 |
$465.60 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$715.15 |
$715.15 |
$715.15 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$2,986.09 |
$2,986.09 |
$2,986.09 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$656.57 |
$656.57 |
$656.57 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,663.67 |
$1,663.67 |
$1,663.67 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,383.66 |
$2,383.66 |
$2,383.66 |
$2,331.50
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,970.18 |
$1,970.18 |
$1,970.18 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$442.01 |
$442.01 |
$442.01 |
$473.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$619.10 |
$619.10 |
$619.10 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$586.79 |
$586.79 |
$586.79 |
$612.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,987.24 |
$2,987.24 |
$2,987.24 |
$2,274.40
|
|
Cltx mndblr fx w/mnpj
|
$2,833.45 |
$2,833.45 |
$2,833.45 |
$2,343.00
|
|
Cold agglutinin titer
|
$37.37 |
$37.37 |
$37.37 |
$52.00
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$157.19 |
$157.19 |
$157.19 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$352.82 |
$352.82 |
$352.82 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$352.82 |
$352.82 |
$352.82 |
$155.40
|
|
Colposcopy w/biopsy of cervix 57455
|
$832.58 |
$832.58 |
$832.58 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$265.65 |
$265.65 |
$265.65 |
$173.50
|
|
Compatibility test each unit immediate spin technique
|
$265.65 |
$265.65 |
$265.65 |
$169.52
|
|
Complement antigen each component c3
|
$63.75 |
$63.75 |
$63.75 |
$110.00
|
|
Complx repair fccmnaxghf 13132
|
$1,713.10 |
$1,713.10 |
$1,713.10 |
$1,107.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$285.80 |
$285.80 |
$285.80 |
$508.44
|
|
Computed tomographic angiography head and neck with contrast
|
$554.00 |
$554.00 |
$554.00 |
$2,247.00
|
|
Concentration infection agents any type
|
$65.93 |
$65.93 |
$65.93 |
$51.32
|
|
Condylomata destruction 56420
|
$328.95 |
$328.95 |
$328.95 |
$467.35
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,934.95 |
$1,934.95 |
$1,934.95 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$159.46 |
$159.46 |
$159.46 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$331.81 |
$331.81 |
$331.81 |
$226.50
|
|
Contrast baths charges
|
$43.16 |
$43.16 |
$43.16 |
$75.60
|
|
Contrast x-ray of hip
|
$753.38 |
$753.38 |
$753.38 |
$796.38
|
|
Contrast x-ray of wrist
|
$725.86 |
$725.86 |
$725.86 |
$667.50
|
|
Control nosebleed pack+caut 30905
|
$311.34 |
$311.34 |
$311.34 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$221.88 |
$221.88 |
$221.88 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$236.68 |
$236.68 |
$236.68 |
$352.80
|
|
Coombs direct
|
$47.61 |
$47.61 |
$47.61 |
$76.80
|
|
Coombs indirect titer reference
|
$331.81 |
$331.81 |
$331.81 |
$156.71
|
|
Copper intrauterine device
|
$430.07 |
$430.07 |
$430.07 |
$1,953.00
|
|
Cortisol total am
|
$135.17 |
$135.17 |
$135.17 |
$121.20
|
|
Counseling smoke cess interm >10mins
|
$72.82 |
$72.82 |
$72.82 |
$54.60
|
|
Counseling visit to discuss need for ldct g0296
|
$264.56 |
$264.56 |
$264.56 |
$102.38
|
|
Covid-19 administration immunization im inj 1st/only component
|
$106.68 |
$106.68 |
$106.68 |
$49.13
|
|
#covid19rsv-rsv
|
$203.45 |
$203.45 |
$203.45 |
$145.60
|
|
#coxa-coxsackie a serotype a16
|
$27.53 |
$27.53 |
$27.53 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$187.93 |
$187.93 |
$187.93 |
$584.50
|
|
C-peptide
|
$70.33 |
$70.33 |
$70.33 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$687.49 |
$687.49 |
$687.49 |
$777.71
|
|
C-reactive protein
|
$86.81 |
$86.81 |
$86.81 |
$69.36
|
|
C-reactive protein high sensitivity
|
$84.99 |
$84.99 |
$84.99 |
$85.50
|
|
Creatine kinase
|
$41.77 |
$41.77 |
$41.77 |
$66.30
|
|
Creatine kinase isoenzymes
|
$4,292.42 |
$4,292.42 |
$4,292.42 |
$56.20
|
|
Creatine kinase mb
|
$78.75 |
$78.75 |
$78.75 |
$113.63
|
|
Creatinine
|
$55.68 |
$55.68 |
$55.68 |
$46.20
|
|
Creatinine 24 hour urine
|
$25.64 |
$25.64 |
$25.64 |
$57.85
|
|
Creatinine clearance urine
|
$86.81 |
$86.81 |
$86.81 |
$90.26
|
|
#creutz-prot.,western blot
|
$108.80 |
$108.80 |
$108.80 |
$163.50
|
|
Crisis psychotherapy 90839
|
$299.99 |
$299.99 |
$299.99 |
$313.30
|
|
Crisis psychotherapy additional 30 mins 90840
|
$149.99 |
$149.99 |
$149.99 |
$149.52
|
|
Critical care each additional 30 minutes
|
$491.67 |
$491.67 |
$491.67 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$1,619.98 |
$1,619.98 |
$1,619.98 |
$2,535.00
|
|
Cryoprecipitate each unit
|
$200.34 |
$200.34 |
$200.34 |
$144.78
|
|
Cryptosporidium antigen
|
$25.32 |
$25.32 |
$25.32 |
$52.08
|
|
Crystal identification light microscopy
|
$82.80 |
$82.80 |
$82.80 |
$66.43
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,116.03 |
$2,116.03 |
$2,116.03 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,313.73 |
$4,313.73 |
$4,313.73 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$2,309.42 |
$2,309.42 |
$2,309.42 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$2,462.91 |
$2,462.91 |
$2,462.91 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,462.91 |
$2,462.91 |
$2,462.91 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,217.14 |
$2,217.14 |
$2,217.14 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,255.96 |
$2,255.96 |
$2,255.96 |
$1,881.75
|
|
CT angio pelvis
|
$879.20 |
$879.20 |
$879.20 |
$1,806.60
|
|
Cta upper extremity w &/or without contrast left
|
$2,042.14 |
$2,042.14 |
$2,042.14 |
$1,691.30
|
|
CT colonography screening
|
$446.52 |
$446.52 |
$446.52 |
$1,084.20
|
|
CT guidance for needle placement
|
$371.23 |
$371.23 |
$371.23 |
$1,494.00
|
|
CT lwr extremity w/o&w/dye
|
$1,009.89 |
$1,009.89 |
$1,009.89 |
$1,818.96
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,267.99 |
$3,267.99 |
$3,267.99 |
$3,426.52
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,772.77 |
$2,772.77 |
$2,772.77 |
$2,871.20
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,900.31 |
$1,900.31 |
$1,900.31 |
$2,272.00
|
|
CT uppr extremity w/o&w/dye
|
$286.86 |
$286.86 |
$286.86 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$39.94 |
$39.94 |
$39.94 |
$72.00
|
|
Culture afb any source
|
$172.54 |
$172.54 |
$172.54 |
$110.60
|
|
Culture anaerobic additional method definitive id each
|
$82.80 |
$82.80 |
$82.80 |
$84.76
|
|
Culture anaerobic except blood
|
$28.59 |
$28.59 |
$28.59 |
$121.22
|
|
Culture bact stool aero addl path ea
|
$134.43 |
$134.43 |
$134.43 |
$52.50
|
|
Culture body fluid
|
$27.44 |
$27.44 |
$27.44 |
$126.75
|
|
Culture fungi definitive id mold
|
$65.22 |
$65.22 |
$65.22 |
$80.00
|
|
Culture fungi definitive id yeast
|
$78.05 |
$78.05 |
$78.05 |
$80.00
|
