|
Chemo extend IV infus w/pump
|
$1,462.00 |
$1,462.00 |
$1,462.00 |
$754.00
|
|
Chest apical lordotic proj
|
$491.00 |
$491.00 |
$491.00 |
$303.21
|
|
Chest CT scan (with and without contrast)
|
$5,430.00 |
$5,430.00 |
$5,430.00 |
$2,014.50
|
|
Chest CT scan (with contrast)
|
$4,327.00 |
$4,327.00 |
$4,327.00 |
$1,701.60
|
|
Chest CT scan (without contrast)
|
$2,855.00 |
$2,855.00 |
$2,855.00 |
$1,350.03
|
|
Chest X-ray
|
$462.00 |
$462.00 |
$462.00 |
$302.90
|
|
Chest X-ray (single view)
|
$232.00 |
$232.00 |
$232.00 |
$246.94
|
|
Chg pr pul rehab for copd patients
|
$276.00 |
$276.00 |
$276.00 |
$150.00
|
|
Chlamydia culture
|
$185.00 |
$185.00 |
$185.00 |
$94.90
|
|
Chlamydia type
|
$107.00 |
$107.00 |
$107.00 |
$34.80
|
|
Chloride
|
$36.00 |
$36.00 |
$36.00 |
$39.05
|
|
Chloride 24 hour urine
|
$36.00 |
$36.00 |
$36.00 |
$46.13
|
|
Chloroprocaine hcl injection
|
$36.86 |
$36.86 |
$36.86 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$60.61 |
$60.61 |
$60.61 |
$355.99
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$106.44 |
$106.44 |
$106.44 |
$91.92
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$956.00 |
$956.00 |
$956.00 |
$625.60
|
|
Cholesterol
|
$34.00 |
$34.00 |
$34.00 |
$46.15
|
|
Cholesterol (Lipid) Test
|
$132.00 |
$132.00 |
$132.00 |
$115.70
|
|
Cholinesterase
|
$101.00 |
$101.00 |
$101.00 |
$38.68
|
|
Chromatography
|
$155.00 |
$155.00 |
$155.00 |
$77.00
|
|
Chromosome analysis 15-20 cell count
|
$1,726.00 |
$1,726.00 |
$1,726.00 |
$433.01
|
|
Chromosome karyotype study
|
$149.00 |
$149.00 |
$149.00 |
$102.00
|
|
Chylomicron screen, bf - sendout
|
$166.92 |
$166.92 |
$166.92 |
$123.20
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$58.35 |
$58.35 |
$58.35 |
$45.27
|
|
Circum 28 days or older
|
$15,954.00 |
$15,954.00 |
$15,954.00 |
$4,074.80
|
|
Circumcision (newborn)
|
$12,454.00 |
$12,454.00 |
$12,454.00 |
$1,549.50
|
|
Cisplatin 1 mg/ml desensitization
|
$536.14 |
$536.14 |
$536.14 |
$175.08
|
|
C-kit mutation liquid tumor - sendout
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$606.06
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$4,213.80 |
$4,213.80 |
$4,213.80 |
$496.70
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$75.63 |
$75.63 |
$75.63 |
$62.03
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$25.42 |
$25.42 |
$25.42 |
$81.25
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$4,006.00 |
$4,006.00 |
$4,006.00 |
$432.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$3,495.00 |
$3,495.00 |
$3,495.00 |
$1,181.99
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$2,738.00 |
$2,738.00 |
$2,738.00 |
$716.95
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$611.10
|
|
Clsd tx dist fib fx w/manip 27788
|
$3,171.00 |
$3,171.00 |
$3,171.00 |
$731.04
|
|
Clsd tx elbow dislocation child 24640
|
$2,202.00 |
$2,202.00 |
$2,202.00 |
$525.28
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$1,582.00 |
$1,582.00 |
$1,582.00 |
$508.80
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$3,171.00 |
$3,171.00 |
$3,171.00 |
$641.16
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$10,371.00 |
$10,371.00 |
$10,371.00 |
$1,893.86
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$10,469.00 |
$10,469.00 |
$10,469.00 |
$1,827.71
|
|
Clsd tx hip disloc without anes 27265
|
$2,738.00 |
$2,738.00 |
$2,738.00 |
$716.95
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,720.00 |
$1,720.00 |
$1,720.00 |
$716.95
|
|
Clsd tx patella disloc without anes 27560
|
$2,202.00 |
$2,202.00 |
$2,202.00 |
$705.60
|
|
Clsd tx radius fracture w/manip 24655
|
$10,371.00 |
$10,371.00 |
$10,371.00 |
$1,884.74
|
|
Clsd tx shoulder dislc/fx 23665
|
$10,371.00 |
$10,371.00 |
$10,371.00 |
$2,055.00
|
|
Clsd tx temporomandibular dislocat 21480
|
$4,240.00 |
$4,240.00 |
$4,240.00 |
$511.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$10,469.00 |
$10,469.00 |
$10,469.00 |
$1,707.42
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$692.03
|
|
Cltx carpl scphd fx w/mnpj
|
$10,469.00 |
$10,469.00 |
$10,469.00 |
$2,316.80
|
|
#cmvcul-virus inoculation shell
|
$249.00 |
$249.00 |
$249.00 |
$102.57
|
|
Cmv pcr-sendout
|
$337.00 |
$337.00 |
$337.00 |
$173.25
|
|
Cocaine 4 % nasal solution
|
$1,089.04 |
$1,089.04 |
$1,089.04 |
$624.58
|
|
Cold agglutinin screen (arc)
|
$45.00 |
$45.00 |
$45.00 |
$47.19
|
|
Collection blood specimen from completely implantable venous access device
|
$212.00 |
$212.00 |
$212.00 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$172.00 |
$172.00 |
$172.00 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$31.00 |
$31.00 |
$31.00 |
$22.00
|
|
Colonoscopy (with biopsy)
|
$8,636.00 |
$8,636.00 |
$8,636.00 |
$2,512.42
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$4,876.00 |
$4,876.00 |
$4,876.00 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$1,217.00 |
$1,217.00 |
$1,217.00 |
$326.30
|
|
Colposcopy vulva w/biopsy 56821
|
$3,744.00 |
$3,744.00 |
$3,744.00 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$1,614.00 |
$1,614.00 |
$1,614.00 |
$544.70
|
|
Compatibility test each unit antiglobulin technique
|
$240.00 |
$240.00 |
$240.00 |
$173.25
|
|
Compatibility test each unit electronic
|
$352.00 |
$352.00 |
$352.00 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$179.00 |
$179.00 |
$179.00 |
$169.52
|
|
Comp cystometrogram/void presssure 51728
|
$1,651.00 |
$1,651.00 |
$1,651.00 |
$958.81
|
|
Comp cystometrogram/void/uret pres 51729
|
$4,655.00 |
$4,655.00 |
$4,655.00 |
$1,099.00
|
|
Complement antigen each component c3
|
$175.00 |
$175.00 |
$175.00 |
$111.15
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$3,477.00 |
$3,477.00 |
$3,477.00 |
$940.00
|
|
Complex uroflowmetry (electronic) 51741
|
$161.00 |
$161.00 |
$161.00 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$4,229.00 |
$4,229.00 |
$4,229.00 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$4,229.00 |
$4,229.00 |
$4,229.00 |
$1,388.40
|
|
Complx repair fccmnaxghf 13131
|
$1,999.00 |
$1,999.00 |
$1,999.00 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$2,562.00 |
$2,562.00 |
$2,562.00 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,530.00 |
$2,530.00 |
$2,530.00 |
$576.66
|
|
Comprehensive hearing test
|
$295.00 |
$295.00 |
$295.00 |
$224.40
|
|
Concentration infection agents any type
|
$109.00 |
$109.00 |
$109.00 |
$51.32
|
|
Condylomata destruction 56420
|
$1,594.00 |
$1,594.00 |
$1,594.00 |
$509.81
|
|
Conization/cerv/loop electrode exc 57522
|
$21,949.00 |
$21,949.00 |
$21,949.00 |
$3,986.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$238.00 |
$238.00 |
$238.00 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$480.00 |
$480.00 |
$480.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$563.00 |
$563.00 |
$563.00 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$1,013.00 |
$1,013.00 |
$1,013.00 |
$239.85
|
|
Contrast x-ray gallbladder
|
$1,646.00 |
$1,646.00 |
$1,646.00 |
$312.00
|
|
Contrast x-ray of elbow
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$637.14
|
|
Contrast x-ray of hip
|
$1,117.00 |
$1,117.00 |
$1,117.00 |
$768.00
|
|
Contrast x-ray of knee joint
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$683.20
|
|
Contrast x-ray of wrist
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$623.50
|
|
Control nosebleed pack+caut 30905
|
$1,079.00 |
$1,079.00 |
$1,079.00 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$385.45
|
|
Coombs direct
|
$81.00 |
$81.00 |
$81.00 |
$73.26
|
|
Coombs indirect qualitative each reagent red cell reference
|
$42.00 |
$42.00 |
$42.00 |
$94.90
|
|
Coombs indirect titer reference
|
$193.00 |
$193.00 |
$193.00 |
$146.00
|
|
Core ndl bx lng/med perq
|
$6,271.00 |
$6,271.00 |
$6,271.00 |
$2,963.00
|
|
Cortisol total am
|
$257.00 |
$257.00 |
$257.00 |
$122.20
|
|
Co-treatment - group 15 mins, st
|
$132.00 |
$132.00 |
$132.00 |
$108.81
|
