|
Chest X-ray
|
$172.80 |
$219.20 |
$364.80 |
|
|
Chest X-ray (single view)
|
$147.20 |
$183.20 |
$315.20 |
|
|
Chg pr pul rehab for copd patients
|
$156.80 |
$156.80 |
$254.40 |
|
|
Chg radiologic exam esophagus double contrast
|
$488.80 |
$488.80 |
$608.00 |
|
|
Chlnggrphy intraop addl s&i
|
$343.20 |
$343.20 |
$343.20 |
|
|
Chloride
|
$27.20 |
$27.20 |
$27.20 |
|
|
Chloride 24 hour urine
|
$27.20 |
$27.20 |
$27.20 |
|
|
Chloroprocaine hcl injection
|
$39.36 |
$39.36 |
$68.91 |
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$170.74 |
$170.74 |
$406.36 |
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$56.43 |
$56.43 |
$86.38 |
|
|
Chmotx admn plrl cav thrcnts
|
$514.40 |
$514.40 |
$604.80 |
|
|
Cholangiogram percutaneous compl
|
$2,464.80 |
$2,464.80 |
$4,645.60 |
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$625.60 |
$769.60 |
$779.20 |
|
|
Cholecystostomy complete w/supervision & interpretation
|
$4,912.80 |
$4,912.80 |
$5,772.00 |
|
|
Cholesterol
|
$30.40 |
$30.40 |
$30.40 |
|
|
Cholesterol (Lipid) Test
|
$112.80 |
$112.80 |
$112.80 |
|
|
Chorionic gonadotropin/1000u
|
$692.24 |
$692.24 |
$692.24 |
|
|
Chrom analysis
|
$288.80 |
$288.80 |
$288.80 |
|
|
Chromo high res and frag x - sendout
|
$405.60 |
$405.60 |
$405.60 |
|
|
Chromosome analys amniotic
|
$406.40 |
$406.40 |
$501.60 |
|
|
Chromosome analysis 15-20 cell count
|
$306.40 |
$306.40 |
$306.40 |
|
|
Chromosome analysis 45
|
$366.40 |
$366.40 |
$366.40 |
|
|
Chromosome analysis 5
|
$644.80 |
$644.80 |
$644.80 |
|
|
Chylomicron screen, bf - sendout
|
$172.80 |
$172.80 |
$172.80 |
|
|
Cidofovir injection
|
$857.52 |
$857.52 |
$1,613.65 |
|
|
Cilastatin sodium injection
|
$33.86 |
$64.44 |
$88.64 |
|
|
Ciltacabtagene car-pos t
|
$1,611,182.40 |
$1,611,182.40 |
$1,611,182.40 |
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$16.80 |
$69.28 |
$71.52 |
|
|
Ciprofloxacin otic susp 6 mg
|
$683.20 |
$683.20 |
$683.20 |
|
|
Circum 28 days or older
|
$2,846.40 |
$2,846.40 |
$2,846.40 |
|
|
Circumcision (newborn)
|
$2,174.40 |
$2,174.40 |
$2,174.40 |
|
|
Cisplatin 1 mg/ml desensitization
|
$101.24 |
$101.24 |
$187.68 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$726.04 |
$726.04 |
$773.27 |
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$12,196.80 |
$12,196.80 |
$16,224.00 |
|
|
Clearance of airways
|
$268.80 |
$268.80 |
$329.60 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$50.12 |
$69.04 |
$112.24 |
|
|
Clip ligating vesolock lg
|
$1,575.20 |
$1,575.20 |
$2,291.20 |
|
|
Cllr miami j sm
|
$175.44 |
$175.44 |
$349.36 |
|
|
Clofarabine 1 mg/ml intravenous solution
|
$3,150.39 |
$3,150.39 |
$4,168.91 |
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$65.43 |
$65.43 |
$71.44 |
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$388.00 |
$388.00 |
$655.20 |
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$1,608.80 |
$1,608.80 |
$1,608.80 |
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$750.40 |
$750.40 |
$750.40 |
|
|
Closed tx/acetabululm without manip 27220
|
$722.40 |
$722.40 |
$751.20 |
|
|
Closed tx humerus fx with manip 23605
|
$2,037.60 |
$2,037.60 |
$2,286.40 |
|
|
Closed tx humerus fx without manip 23600
|
$398.40 |
$398.40 |
$636.80 |
|
|
Closed tx humerus fx w/manip 24505
|
$1,610.40 |
$1,610.40 |
$2,040.80 |
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$388.00 |
$496.80 |
$596.80 |
|
|
Closed tx nose/jaw fx
|
$2,821.60 |
$2,821.60 |
$2,821.60 |
|
|
Closed tx orbit without manipulj
|
$1,879.20 |
$1,879.20 |
$1,879.20 |
|
|
Closed tx orbit w/manipulj
|
$996.80 |
$996.80 |
$996.80 |
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,712.00 |
$2,712.00 |
$3,718.40 |
|
|
Closed tx septal&nose fx
|
$2,754.40 |
$2,754.40 |
$4,320.80 |
|
|
Closed tx sesamoid fx 28530
|
$600.80 |
$600.80 |
$600.80 |
|
|
Closed tx/talus fracture without manip 28430
|
$380.00 |
$462.40 |
$622.40 |
|
|
Closed tx vert fx w/manj
|
$3,115.20 |
$3,115.20 |
$3,277.60 |
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$381.60 |
$511.20 |
$573.60 |
|
|
Clos txnose fx without stablz 21315
|
$2,186.40 |
$2,392.80 |
$2,728.80 |
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$897.60 |
$1,122.40 |
$1,259.20 |
|
|
Closure of windpipe lesion 31820
|
$5,277.60 |
$5,277.60 |
$5,277.60 |
|
|
Closure paravalvlr leak pq
|
$18,370.40 |
$18,370.40 |
$22,664.80 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$440.80 |
$440.80 |
$805.60 |
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$460.80 |
$460.80 |
$518.40 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$394.40 |
$568.00 |
$616.80 |
|
|
Clsd tx clav dislc without manip 23520
|
$1,444.00 |
$1,444.00 |
$1,444.00 |
|
|
Clsd tx clavicle dislocation without manip 23540
|
$388.00 |
$388.00 |
$607.20 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,916.00 |
$1,916.00 |
$1,916.00 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$399.20 |
$462.40 |
$560.80 |
|
|
Clsd tx coccygeal fracture 27200
|
$399.20 |
$399.20 |
$615.20 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$398.40 |
$456.00 |
$589.60 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$394.40 |
$765.60 |
$788.80 |
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$388.00 |
$536.80 |
$603.20 |
|
|
Clsd tx elbow dislocation child 24640
|
$391.20 |
$412.00 |
$689.60 |
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$2,184.00 |
$2,184.00 |
$2,680.80 |
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$2,404.80 |
$2,404.80 |
$2,404.80 |
|
|
Clsd tx fracture of radius 25500
|
$380.00 |
$419.20 |
$521.60 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$359.20 |
$359.20 |
$537.60 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$394.40 |
$618.40 |
$649.60 |
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$429.60 |
$551.20 |
$693.60 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,421.60 |
$1,421.60 |
$2,110.40 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$380.00 |
$537.60 |
$693.60 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,547.20 |
$1,547.20 |
$2,040.80 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$516.80 |
$516.80 |
$548.00 |
|
|
Clsd tx hip disloc without anes 27265
|
$432.80 |
$432.80 |
$1,038.40 |
|
|
Clsd tx humeral fract without manip 24530
|
$380.00 |
$380.00 |
$651.20 |
|
|
Clsd tx humerus fract without manip 24500
|
$398.40 |
$536.00 |
$704.00 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$374.40 |
$374.40 |
$428.80 |
|
|
Clsd tx mandibular fx without manip 21450
|
$788.00 |
$788.00 |
$788.00 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$451.20 |
$451.20 |
$557.60 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$399.20 |
$464.80 |
$589.60 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$413.60 |
$900.00 |
$934.40 |
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,164.00 |
$3,164.00 |
$4,188.00 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$388.00 |
$388.00 |
$924.80 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$399.20 |
$446.40 |
$596.00 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,385.60 |
$3,385.60 |
$4,241.60 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,740.00 |
$1,740.00 |
$2,105.60 |
|
|
Clsd tx patella disloc without anes 27560
|
$388.00 |
$560.00 |
$628.00 |
|
|
Clsd tx/patellar fx without manip 27520
|
$398.40 |
$507.20 |
$687.20 |
|
|
Clsd tx pelvic ring fx
|
$340.80 |
$340.80 |
$340.80 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,304.00 |
$2,304.00 |
$2,587.20 |
|
