|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$6.90 |
$6.90 |
$6.90 |
$11,888.50
|
|
Coagulation time activated teg
|
$19.50 |
$19.50 |
$19.50 |
$52.47
|
|
Cocaine 4 % nasal solution
|
$125.97 |
$125.97 |
$125.97 |
$630.04
|
|
Coil axium 3d 14mmx40cm qc
|
$1,218.75 |
$1,218.75 |
$1,218.75 |
$308.00
|
|
Cold agglutinin titer
|
$36.40 |
$36.40 |
$36.40 |
$52.00
|
|
Colistimethate sodium inj
|
$65.52 |
$65.52 |
$65.52 |
$82.71
|
|
Collagenase, clost hist inj
|
$17,281.45 |
$17,281.45 |
$17,281.45 |
$12,906.28
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$395.20 |
$395.20 |
$395.20 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$30.55 |
$30.55 |
$30.55 |
$61.20
|
|
Collection blood specimen from completely implantable venous access device
|
$481.65 |
$481.65 |
$481.65 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$481.65 |
$481.65 |
$481.65 |
$155.40
|
|
Colonoscopy (diagnostic)
|
$2,726.10 |
$2,726.10 |
$2,726.10 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Colonoscopy submucous njx
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$2,726.10 |
$2,726.10 |
$2,726.10 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$3,029.00
|
|
Colonoscopy w/balloon dilat
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$1,681.30
|
|
Colonoscopy w/control bleed
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,101.71
|
|
Colonoscopy w/dilation
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,495.25
|
|
Colonoscopy (with biopsy)
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,214.00
|
|
Colonoscopy (with polyp removal)
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Colonoscopy w/resection
|
$8,199.75 |
$8,199.75 |
$8,199.75 |
$3,035.44
|
|
Colonoscopy w/ultrasound
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,636.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$9,506.90 |
$9,506.90 |
$9,506.90 |
$3,907.93
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$2,603.25 |
$2,603.25 |
$2,603.25 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$9,506.90 |
$9,506.90 |
$9,506.90 |
$3,762.53
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$601.25 |
$601.25 |
$601.25 |
$314.00
|
|
Colposcopy vulva 56820
|
$601.25 |
$601.25 |
$601.25 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$909.35 |
$909.35 |
$909.35 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$909.35 |
$909.35 |
$909.35 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$768.30 |
$768.30 |
$768.30 |
$173.50
|
|
Compatibility test each unit electronic
|
$768.30 |
$768.30 |
$768.30 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$768.30 |
$768.30 |
$768.30 |
$169.52
|
|
Compatibility test incubate
|
$768.30 |
$768.30 |
$768.30 |
$156.24
|
|
Comp cystometrogram/void presssure 51728
|
$1,995.50 |
$1,995.50 |
$1,995.50 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,995.50 |
$1,995.50 |
$1,995.50 |
$1,111.03
|
|
Complement antigen each component c3
|
$53.95 |
$53.95 |
$53.95 |
$110.00
|
|
Complex cystometrogram 51726
|
$727.35 |
$727.35 |
$727.35 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$893.41
|
|
Complex uroflowmetry (electronic) 51741
|
$930.80 |
$930.80 |
$930.80 |
$344.68
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$391.95 |
$391.95 |
$391.95 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$779.35 |
$779.35 |
$779.35 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$753.35 |
$753.35 |
$753.35 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$471.90 |
$471.90 |
$471.90 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,193.40 |
$1,193.40 |
$1,193.40 |
$1,012.00
|
|
Comprehensive hearing test
|
$406.90 |
$406.90 |
$406.90 |
$261.46
|
|
Compre oph exam est pt 1/>
|
$385.45 |
$385.45 |
$385.45 |
$207.20
|
|
Compre oph exam new pt 1/>
|
$385.45 |
$385.45 |
$385.45 |
$188.51
|
|
Computed tomographic angiography head and neck with contrast
|
$1,598.35 |
$1,598.35 |
$1,598.35 |
$2,247.00
|
|
Concentration infection agents any type
|
$29.90 |
$29.90 |
$29.90 |
$51.32
|
|
Conditioning play audiometry 92582
|
$406.90 |
$406.90 |
$406.90 |
$189.15
|
|
Condylomata destruction 56420
|
$601.25 |
$601.25 |
$601.25 |
$467.35
|
|
Conivaptan hcl
|
$21.72 |
$21.72 |
$21.72 |
$1,625.08
|
|
Conization/cerv/loop electrode exc 57522
|
$9,506.90 |
$9,506.90 |
$9,506.90 |
$4,840.07
|
|
Conjugated estrogens 25 mg solution for injection
|
$905.72 |
$905.72 |
$905.72 |
$860.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$3,664.05 |
$3,664.05 |
$3,664.05 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$118.95 |
$118.95 |
$118.95 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$768.30 |
$768.30 |
$768.30 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$239.85 |
$239.85 |
$239.85 |
$224.83
|
|
Consultation/report referred slides prepared elsewhere
|
$176.15 |
$176.15 |
$176.15 |
$176.28
|
|
Contrast baths charges
|
$81.90 |
$81.90 |
$81.90 |
$75.60
|
|
Contrast exam abdominl aorta 75625-26
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$14,116.70 |
$14,116.70 |
$14,116.70 |
$3,616.90
|
|
Contrast exam thoracic aorta 75605-26
|
$24,244.35 |
$24,244.35 |
$24,244.35 |
$3,745.00
|
|
Contrast x-ray of ankle
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$684.00
|
|
Contrast x-ray of elbow
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$708.00
|
|
Contrast x-ray of hip
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$796.38
|
|
Contrast x-ray of knee joint
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$790.50
|
|
Contrast x-ray of wrist
|
$1,601.60 |
$1,601.60 |
$1,601.60 |
$667.50
|
|
Control nosebleed pack+caut 30905
|
$385.45 |
$385.45 |
$385.45 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$385.45 |
$385.45 |
$385.45 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$385.45 |
$385.45 |
$385.45 |
$352.80
|
|
Conversion ext bil drg cath
|
$10,552.10 |
$10,552.10 |
$10,552.10 |
$4,122.00
|
|
Convert nephrostomy catheter
|
$6,124.95 |
$6,124.95 |
$6,124.95 |
$2,777.60
|
|
Coombs direct
|
$24.05 |
$24.05 |
$24.05 |
$76.80
|
|
Coombs indirect qualitative each reagent red cell reference
|
$25.35 |
$25.35 |
$25.35 |
$107.25
|
|
Coombs indirect titer reference
|
$23.40 |
$23.40 |
$23.40 |
$156.71
|
|
Copper cu 64 dotatate diag
|
$5,005.00 |
$5,005.00 |
$5,005.00 |
$2,820.66
|
|
Copper intrauterine device
|
$1,775.80 |
$1,775.80 |
$1,775.80 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$4,844.45 |
$4,844.45 |
$4,844.45 |
$2,904.48
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$6,279.00 |
$6,279.00 |
$6,279.00 |
$7,849.80
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$12,021.10 |
$12,021.10 |
$12,021.10 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$12,021.10 |
$12,021.10 |
$12,021.10 |
$10,353.29
|
|
Coronary angio/lv gram/rt< heart
|
$12,021.10 |
$12,021.10 |
$12,021.10 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$12,021.10 |
$12,021.10 |
$12,021.10 |
$8,191.00
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$12,021.10 |
$12,021.10 |
$12,021.10 |
$7,988.40
|
|
Cortisol acth stimulation test - sendout
|
$146.25 |
$146.25 |
$146.25 |
$146.25
|
|
Cortisol total am
|
$72.80 |
$72.80 |
$72.80 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$249.41 |
$249.41 |
$249.41 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$183.95 |
$183.95 |
$183.95 |
$112.00
|
|
Counseling smoke cess interm >10mins
|
$57.85 |
$57.85 |
$57.85 |
$54.60
|
|
Counseling visit to discuss need for ldct g0296
|
$240.50 |
$240.50 |
$240.50 |
$102.38
|
|
Coveredge 32 lead kit 40cm 48
|
$2,559.38 |
$2,559.38 |
$2,559.38 |
$4,180.79
|
|
Cover wrist
|
$55.25 |
$55.25 |
$55.25 |
$225.00
|
|
Covid-19 administration immunization im inj 1st/only component
|
$185.90 |
$185.90 |
$185.90 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$1,171.30 |
$1,171.30 |
$1,171.30 |
$592.49
|