|
Collagen imp urinary 2.5 ml
|
$1,800.00 |
$1,800.00 |
$1,800.00 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$147.00 |
$147.00 |
$147.00 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$39.60 |
$39.60 |
$39.60 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$39.60 |
$39.60 |
$39.60 |
$155.40
|
|
Colonoscopy (diagnostic)
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,288.00
|
|
Colonoscopy for bleeding 44391
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,147.00
|
|
Colonoscopy for foreign body
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,899.00
|
|
Colonoscopy w/balloon dilat
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,681.30
|
|
Colonoscopy w/control bleed
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,101.71
|
|
Colonoscopy w/decompression
|
$748.80 |
$748.80 |
$748.80 |
$1,572.20
|
|
Colonoscopy w/fb removal
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,645.43
|
|
Colonoscopy w/injection
|
$748.80 |
$748.80 |
$748.80 |
$2,449.20
|
|
Colonoscopy (with biopsy)
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,214.00
|
|
Colonoscopy with biopsy
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$1,555.20
|
|
Colonoscopy (with polyp removal)
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$2,288.00
|
|
Compatibility test each unit antiglobulin technique
|
$56.40 |
$56.40 |
$56.40 |
$173.50
|
|
Compatibility test each unit immediate spin technique
|
$56.40 |
$56.40 |
$56.40 |
$169.52
|
|
Complement antigen each component c3
|
$29.40 |
$29.40 |
$29.40 |
$110.00
|
|
Complement fixation each
|
$108.00 |
$108.00 |
$108.00 |
$29.12
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$281.40 |
$281.40 |
$281.40 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$281.40 |
$281.40 |
$281.40 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$281.40 |
$281.40 |
$281.40 |
$1,212.00
|
|
Complx repair fccmnaxghf 13131
|
$217.80 |
$217.80 |
$217.80 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$217.80 |
$217.80 |
$217.80 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$217.80 |
$217.80 |
$217.80 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$217.80 |
$217.80 |
$217.80 |
$508.44
|
|
Complx repair trunk addl 5cm/< 13102
|
$281.40 |
$281.40 |
$281.40 |
$537.00
|
|
Composite drsg >16<=48 sq in
|
$3.00 |
$3.00 |
$3.00 |
$42.60
|
|
Composite drsg <= 16 sq in
|
$3.60 |
$3.60 |
$3.60 |
$6.62
|
|
Comprehensive hearing test
|
$122.40 |
$122.40 |
$122.40 |
$261.46
|
|
Concentration infection agents any type
|
$25.80 |
$25.80 |
$25.80 |
$51.32
|
|
Conditioning play audiometry 92582
|
$122.40 |
$122.40 |
$122.40 |
$189.15
|
|
Condylomata destruction 56420
|
$90.60 |
$90.60 |
$90.60 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$811.20 |
$811.20 |
$811.20 |
$860.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$83.40 |
$83.40 |
$83.40 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$24.00 |
$24.00 |
$24.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$66.00 |
$66.00 |
$66.00 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$96.00 |
$96.00 |
$96.00 |
$224.83
|
|
Contrast exam abdominl aorta 75625-26
|
$3,860.40 |
$3,860.40 |
$3,860.40 |
$3,480.00
|
|
Contrast exam thoracic aorta 75605-26
|
$4,310.40 |
$4,310.40 |
$4,310.40 |
$3,745.00
|
|
Contrast x-ray of elbow
|
$660.00 |
$660.00 |
$660.00 |
$708.00
|
|
Contrast x-ray of hip
|
$660.00 |
$660.00 |
$660.00 |
$796.38
|
|
Contrast x-ray of knee joint
|
$660.00 |
$660.00 |
$660.00 |
$790.50
|
|
Contrast x-ray of wrist
|
$660.00 |
$660.00 |
$660.00 |
$667.50
|
|
Controller infinity pt dbs
|
$4,978.80 |
$4,978.80 |
$4,978.80 |
$4,836.44
|
|
Control nosebleed pack+caut 30905
|
$70.80 |
$70.80 |
$70.80 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$70.80 |
$70.80 |
$70.80 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$70.80 |
$70.80 |
$70.80 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$70.80 |
$70.80 |
$70.80 |
$620.00
|
|
Convert nephrostomy catheter
|
$3,120.60 |
$3,120.60 |
$3,120.60 |
$2,777.60
|
|
Coombs direct
|
$13.20 |
$13.20 |
$13.20 |
$76.80
|
|
Coombs indirect titer reference
|
$12.60 |
$12.60 |
$12.60 |
$156.71
|
|
Copper intrauterine device
|
$2,529.60 |
$2,529.60 |
$2,529.60 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$2,904.48
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$4,666.80 |
$4,666.80 |
$4,666.80 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$4,666.80 |
$4,666.80 |
$4,666.80 |
$10,353.29
|
|
Coronary angio/lv gram/rt< heart
|
$4,666.80 |
$4,666.80 |
$4,666.80 |
$11,228.50
|
|
Cortisol acth stimulation test - sendout
|
$80.40 |
$80.40 |
$80.40 |
$146.25
|
|
Cortisol total am
|
$40.20 |
$40.20 |
$40.20 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$338.40 |
$338.40 |
$338.40 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$48.00 |
$48.00 |
$48.00 |
$54.60
|
|
Covid-19 administration immunization im inj 1st/only component
|
$24.00 |
$24.00 |
$24.00 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$592.49
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$540.00
|
|
#coxa-coxsackie a serotype a16
|
$31.80 |
$31.80 |
$31.80 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$250.20 |
$250.20 |
$250.20 |
$584.50
|
|
C-peptide
|
$51.00 |
$51.00 |
$51.00 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$152.40 |
$152.40 |
$152.40 |
$777.71
|
|
Crbrospnl fld flw imag cistern
|
$1,176.60 |
$1,176.60 |
$1,176.60 |
$1,330.02
|
|
C-reactive protein
|
$12.60 |
$12.60 |
$12.60 |
$69.36
|
|
C-reactive protein high sensitivity
|
$56.40 |
$56.40 |
$56.40 |
$85.50
|
|
Creatine kinase
|
$15.60 |
$15.60 |
$15.60 |
$66.30
|
|
Creatine kinase isoenzymes
|
$62.40 |
$62.40 |
$62.40 |
$56.20
|
|
Creatine kinase mb
|
$27.60 |
$27.60 |
$27.60 |
$113.63
|
|
Creatine - sendout
|
$90.60 |
$90.60 |
$90.60 |
$41.25
|
|
Creatinine
|
$12.60 |
$12.60 |
$12.60 |
$46.20
|
|
Creatinine 24 hour urine
|
$12.60 |
$12.60 |
$12.60 |
$57.85
|
|
Creatinine clearance urine
|
$22.80 |
$22.80 |
$22.80 |
$90.26
|
|
#creutz-prot.,western blot
|
$156.60 |
$156.60 |
$156.60 |
$163.50
|
|
Critical care each additional 30 minutes
|
$757.20 |
$757.20 |
$757.20 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$1,895.40 |
$1,895.40 |
$1,895.40 |
$2,535.00
|
|
Cryocautery of cervix 57511
|
$510.00 |
$510.00 |
$510.00 |
$429.60
|
|
Cryofibrinogen qualitative - sendout
|
$56.40 |
$56.40 |
$56.40 |
$52.50
|
|
Cryoprecipitate each unit
|
$118.20 |
$118.20 |
$118.20 |
$144.78
|
|
Cryptococcus abs qn - sendout
|
$35.40 |
$35.40 |
$35.40 |
$89.70
|
|
Cryptosporidium antigen
|
$29.40 |
$29.40 |
$29.40 |
$52.08
|
|
Crystal identification light microscopy
|
$17.40 |
$17.40 |
$17.40 |
$66.43
|
|
CT 3d report other modality w/workstation
|
$181.80 |
$181.80 |
$181.80 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$540.60 |
$540.60 |
$540.60 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,114.80 |
$1,114.80 |
$1,114.80 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$799.20 |
$799.20 |
$799.20 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$540.60 |
$540.60 |
$540.60 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$799.20 |
$799.20 |
$799.20 |
$1,915.30
|
|
CT Angiogram of the Head
|
$796.80 |
$796.80 |
$796.80 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$796.80 |
$796.80 |
$796.80 |
$1,881.75
|
