|
Cold agglutinin titer
|
$115.60 |
$115.60 |
$115.60 |
$51.60
|
|
Collagen drsg>16<=48 sq in
|
$45.36 |
$45.36 |
$45.36 |
$25.75
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$16.38 |
$16.38 |
$16.38 |
$62.40
|
|
Collar cerv ascend 172 reg
|
$13.86 |
$13.86 |
$13.86 |
$213.89
|
|
Collar cerv patriot adlt
|
$7.98 |
$7.98 |
$7.98 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$386.80 |
$386.80 |
$386.80 |
$160.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$266.80 |
$266.80 |
$266.80 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$14.80 |
$14.80 |
$14.80 |
$21.00
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$1,159.20 |
$1,159.20 |
$1,159.20 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$203.20 |
$203.20 |
$203.20 |
$314.00
|
|
Colposcopy vulva 56820
|
$568.40 |
$568.40 |
$568.40 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$646.80 |
$646.80 |
$646.80 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$327.60 |
$327.60 |
$327.60 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$140.80 |
$140.80 |
$140.80 |
$172.00
|
|
Compatibility test each unit electronic
|
$127.60 |
$127.60 |
$127.60 |
$166.26
|
|
Compatibility test each unit immediate spin technique
|
$127.60 |
$127.60 |
$127.60 |
$167.17
|
|
Complement antigen each component c3
|
$107.60 |
$107.60 |
$107.60 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$3,176.00 |
$3,176.00 |
$3,176.00 |
$876.00
|
|
Compression stocking bk18-30
|
$29.40 |
$29.40 |
$29.40 |
$62.88
|
|
Concentration infection agents any type
|
$97.20 |
$97.20 |
$97.20 |
$51.32
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$94.50 |
$94.50 |
$94.50 |
$3,352.21
|
|
Condylomata destruction 56420
|
$192.80 |
$192.80 |
$192.80 |
$463.98
|
|
Conization/cerv/loop electrode exc 57522
|
$2,959.20 |
$2,959.20 |
$2,959.20 |
$4,752.00
|
|
Connect omega .5mm
|
$522.90 |
$522.90 |
$522.90 |
$1,260.00
|
|
Consultation pathology during surgery
|
$83.60 |
$83.60 |
$83.60 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$397.20 |
$397.20 |
$397.20 |
$407.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$144.80 |
$144.80 |
$144.80 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$158.80 |
$158.80 |
$158.80 |
$224.87
|
|
Consultation/report referred material w/preparation of slides
|
$278.40 |
$278.40 |
$278.40 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$562.00 |
$562.00 |
$562.00 |
$176.15
|
|
Contact lens fitting for tx
|
$26.00 |
$26.00 |
$26.00 |
$92.96
|
|
Contrast baths charges
|
$128.80 |
$128.80 |
$128.80 |
$74.25
|
|
Contrast exam abdominl aorta 75625-26
|
$1,866.40 |
$1,866.40 |
$1,866.40 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$3,570.00
|
|
Contrast exam thoracic aorta 75605-26
|
$2,003.60 |
$2,003.60 |
$2,003.60 |
$3,663.60
|
|
Contrast x-ray of ankle
|
$676.80 |
$676.80 |
$676.80 |
$676.80
|
|
Contrast x-ray of brain
|
$1,497.20 |
$1,497.20 |
$1,497.20 |
$1,077.92
|
|
Contrast x-ray of elbow
|
$676.80 |
$676.80 |
$676.80 |
$686.95
|
|
Contrast x-ray of hip
|
$676.80 |
$676.80 |
$676.80 |
$781.13
|
|
Contrast x-ray of knee joint
|
$676.80 |
$676.80 |
$676.80 |
$777.00
|
|
Contrast x-ray of wrist
|
$676.80 |
$676.80 |
$676.80 |
$655.00
|
|
Controller infinity pt dbs
|
$22,680.00 |
$22,680.00 |
$22,680.00 |
$5,123.14
|
|
Conversion ext bil drg cath
|
$2,121.20 |
$2,121.20 |
$2,121.20 |
$4,099.56
|
|
Convert nephrostomy catheter
|
$2,375.60 |
$2,375.60 |
$2,375.60 |
$2,777.60
|
|
Coombs direct
|
$59.20 |
$59.20 |
$59.20 |
$76.44
|
|
Coombs indirect titer reference
|
$96.40 |
$96.40 |
$96.40 |
$155.40
|
|
Copper cu 64 dotatate diag
|
$978.10 |
$978.10 |
$978.10 |
$2,293.68
|
|
Copper intrauterine device
|
$1,181.88 |
$1,181.88 |
$1,181.88 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$4,282.40 |
$4,282.40 |
$4,282.40 |
$2,862.11
|
|
Corneal smear
|
$313.60 |
$313.60 |
$313.60 |
$472.21
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$4,788.00 |
$4,788.00 |
$4,788.00 |
$8,244.87
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$14,159.60 |
$14,159.60 |
$14,159.60 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$14,159.60 |
$14,159.60 |
$14,159.60 |
$10,263.12
|
|
Coronary angio/lv gram/rt< heart
|
$22,118.80 |
$22,118.80 |
$22,118.80 |
$11,280.10
|
|
Coronary art/grft angio s&i
|
$4,310.40 |
$4,310.40 |
$4,310.40 |
$8,200.40
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$3,690.80 |
$3,690.80 |
$3,690.80 |
$7,950.49
|
|
Correction trichiasis epilation forcep 67820
|
$145.20 |
$145.20 |
$145.20 |
$176.00
|
|
Cortisol total am
|
$83.20 |
$83.20 |
$83.20 |
$121.20
|
|
Counseling smoke cess interm >10mins
|
$46.80 |
$46.80 |
$46.80 |
$54.12
|
|
Coveredge 32 lead kit 40cm 48
|
$22,680.00 |
$22,680.00 |
$22,680.00 |
$4,395.30
|
|
Cover wrist
|
$209.16 |
$209.16 |
$209.16 |
$225.00
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$831.20 |
$831.20 |
$831.20 |
$588.08
|
|
Covid-19 lab test non-cdc
|
$82.40 |
$82.40 |
$82.40 |
$81.00
|
|
#covid19rsv-rsv
|
$112.40 |
$112.40 |
$112.40 |
$145.60
|
|
#coxa-coxsackie a serotype a16
|
$109.60 |
$109.60 |
$109.60 |
$60.00
|
|
C-peptide
|
$92.00 |
$92.00 |
$92.00 |
$93.60
|
|
Cptrized corneal topography
|
$64.80 |
$64.80 |
$64.80 |
$148.20
|
|
Cptr ophth dx img post segmt
|
$42.80 |
$42.80 |
$42.80 |
$98.00
|
|
Cr-51 sodium chromate
|
$534.40 |
$534.40 |
$534.40 |
$688.80
|
|
Crbrospnl fld flw imag cistern
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$1,281.00
|
|
C-reactive protein
|
$126.40 |
$126.40 |
$126.40 |
$68.38
|
|
C-reactive protein high sensitivity
|
$126.40 |
$126.40 |
$126.40 |
$85.00
|
|
Creatine kinase
|
$50.80 |
$50.80 |
$50.80 |
$65.60
|
|
Creatine kinase isoenzymes
|
$76.00 |
$76.00 |
$76.00 |
$54.60
|
|
Creatinine
|
$22.40 |
$22.40 |
$22.40 |
$45.65
|
|
Creatinine 24 hour urine
|
$42.00 |
$42.00 |
$42.00 |
$57.60
|
|
Creatinine clearance urine
|
$78.80 |
$78.80 |
$78.80 |
$89.28
|
|
#creutz-prot.,western blot
|
$278.40 |
$278.40 |
$278.40 |
$163.50
|
|
Crisis psychotherapy 90839
|
$858.40 |
$858.40 |
$858.40 |
$313.30
|
|
Crisis psychotherapy additional 30 mins 90840
|
$430.00 |
$430.00 |
$430.00 |
$149.52
|
|
Critical care 30-74 minutes
|
$2,108.80 |
$2,108.80 |
$2,108.80 |
$2,519.00
|
|
Critical care each additional 30 minutes
|
$378.00 |
$378.00 |
$378.00 |
$686.86
|
|
Cryofibrinogen qualitative - sendout
|
$19.20 |
$19.20 |
$19.20 |
$52.50
|
|
Cryoprecipitate each unit
|
$106.00 |
$106.00 |
$106.00 |
$144.78
|
|
Crystal identification light microscopy
|
$82.40 |
$82.40 |
$82.40 |
$65.50
|
|
Csf leakage imaging
|
$976.40 |
$976.40 |
$976.40 |
$1,564.11
|
|
CT 3d report other modality w/workstation
|
$568.40 |
$568.40 |
$568.40 |
$637.41
|
|
Cta abdomen without & /or w/contrast
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$2,002.00
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$1,916.50
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$2,002.44
|
|
Cta neck without &/or w/contrast
|
$1,304.40 |
$1,304.40 |
$1,304.40 |
$1,899.75
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,280.40 |
$1,280.40 |
$1,280.40 |
$2,842.40
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$1,912.50
|
|
CT Angiogram of the Head
|
$1,596.40 |
$1,596.40 |
$1,596.40 |
$1,946.10
|
|
CT angio hrt w/3d image
|
$1,049.60 |
$1,049.60 |
$1,049.60 |
$1,424.40
|
|
CT angio pelvis
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$1,795.97
|
|
Cta upper extremity w &/or without contrast left
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
$1,681.50
|
|
CT colonography dx
|
$1,110.40 |
$1,110.40 |
$1,110.40 |
$797.40
|
|
CT colonography dx w/dye
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,052.16
|
|
CT colonography screening
|
$395.20 |
$395.20 |
$395.20 |
$1,079.57
|
