|
Cold agglutinin titer
|
$87.00 |
$87.00 |
$87.00 |
$50.00
|
|
Colistimethate sodium inj
|
$132.72 |
$132.72 |
$132.72 |
$68.47
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$223.06 |
$223.06 |
$223.06 |
$56.00
|
|
Collar cerv adlt perfit ace extric
|
$149.58 |
$149.58 |
$149.58 |
$56.85
|
|
Collar cerv ascend 172 reg
|
$360.73 |
$360.73 |
$360.73 |
$187.48
|
|
Collar cerv patriot adlt
|
$247.23 |
$247.23 |
$247.23 |
$141.60
|
|
Collection of venous blood by venipuncture
|
$12.60 |
$12.60 |
$12.60 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$5,476.68 |
$5,476.68 |
$5,476.68 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$13,703.33 |
$13,703.33 |
$13,703.33 |
$2,288.00
|
|
Colonoscopy submucous njx
|
$8,022.65 |
$8,022.65 |
$8,022.65 |
$2,080.00
|
|
Colonoscopy w/control bleed
|
$10,645.45 |
$10,645.45 |
$10,645.45 |
$2,118.20
|
|
Colonoscopy (with biopsy)
|
$8,158.14 |
$8,158.14 |
$8,158.14 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$5,362.80 |
$5,362.80 |
$5,362.80 |
$1,645.43
|
|
Colonoscopy (with polyp removal)
|
$8,037.56 |
$8,037.56 |
$8,037.56 |
$2,288.00
|
|
Colonoscopy w/resection
|
$9,626.66 |
$9,626.66 |
$9,626.66 |
$3,229.60
|
|
Colpopexy extraperitoneal
|
$27,838.66 |
$27,838.66 |
$27,838.66 |
$5,855.00
|
|
Colposcopy/cervix/ conization 57461
|
$7,918.02 |
$7,918.02 |
$7,918.02 |
$3,762.53
|
|
Combination bilateral ho
|
$4,575.46 |
$4,575.46 |
$4,575.46 |
$3,279.58
|
|
Compatibility test each unit antiglobulin technique
|
$138.60 |
$138.60 |
$138.60 |
$165.00
|
|
Compatibility test each unit electronic
|
$274.80 |
$274.80 |
$274.80 |
$175.45
|
|
Compatibility test each unit immediate spin technique
|
$269.40 |
$269.40 |
$269.40 |
$169.52
|
|
Compatibility test incubate
|
$269.40 |
$269.40 |
$269.40 |
$143.64
|
|
Complement antigen each component c3
|
$372.60 |
$372.60 |
$372.60 |
$110.40
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$13,874.94 |
$13,874.94 |
$13,874.94 |
$1,214.25
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,003.80 |
$1,003.80 |
$1,003.80 |
$1,244.80
|
|
Complx repair fccmnaxghf 13131
|
$663.00 |
$663.00 |
$663.00 |
$820.00
|
|
Complx repair fccmnaxghf 13132
|
$778.80 |
$778.80 |
$778.80 |
$1,193.40
|
|
Complx repair fccmnaxghf 13133
|
$778.80 |
$778.80 |
$778.80 |
$606.48
|
|
Complx repair sal addl 5 cm/> 13122
|
$480.60 |
$480.60 |
$480.60 |
$541.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,003.80 |
$1,003.80 |
$1,003.80 |
$1,116.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$2,183.35 |
$2,183.35 |
$2,183.35 |
$1,198.33
|
|
Concentration infection agents any type
|
$40.80 |
$40.80 |
$40.80 |
$51.32
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$18,356.42 |
$18,356.42 |
$18,356.42 |
$3,322.20
|
|
Conization/cerv/loop electrode exc 57522
|
$10,837.02 |
$10,837.02 |
$10,837.02 |
$4,451.18
|
|
Conization of cervix
|
$9,893.70 |
$9,893.70 |
$9,893.70 |
$3,762.53
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,786.44 |
$1,786.44 |
$1,786.44 |
$871.08
|
|
Connect omega .5mm
|
$8,764.90 |
$8,764.90 |
$8,764.90 |
$1,349.47
|
|
Connector tis 2x10mm
|
$8,114.09 |
$8,114.09 |
$8,114.09 |
$3,967.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,348.20 |
$1,348.20 |
$1,348.20 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$162.00 |
$162.00 |
$162.00 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$287.40 |
$287.40 |
$287.40 |
$223.86
|
|
Consultation/report referred material w/preparation of slides
|
$433.20 |
$433.20 |
$433.20 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$165.60 |
$165.60 |
$165.60 |
$173.46
|
|
Consult comp w/report rfrd material
|
$944.40 |
$944.40 |
$944.40 |
$365.60
|
|
Contrast baths charges
|
$162.60 |
$162.60 |
$162.60 |
$74.25
|
|
Contrast exam abdominl aorta 75625-26
|
$6,624.00 |
$6,624.00 |
$6,624.00 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$6,624.00 |
$6,624.00 |
$6,624.00 |
$3,724.63
|
|
Contrast exam thoracic aorta 75605-26
|
$6,537.60 |
$6,537.60 |
$6,537.60 |
$3,663.60
|
|
Contrast x-ray gallbladder
|
$772.20 |
$772.20 |
$772.20 |
$350.22
|
|
Contrast x-ray of ankle
|
$1,003.80 |
$1,003.80 |
$1,003.80 |
$642.95
|
|
Contrast x-ray of brain
|
$822.60 |
$822.60 |
$822.60 |
$934.93
|
|
Contrast x-ray of elbow
|
$649.80 |
$649.80 |
$649.80 |
$647.20
|
|
Contrast x-ray of hip
|
$948.00 |
$948.00 |
$948.00 |
$770.88
|
|
Contrast x-ray of knee joint
|
$1,003.80 |
$1,003.80 |
$1,003.80 |
$747.65
|
|
Contrast x-ray of wrist
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$627.90
|
|
Controler lvad heartmate 3 includes ebb
|
$18,763.18 |
$18,763.18 |
$18,763.18 |
$11,518.85
|
|
Controller infinity pt dbs
|
$6,494.95 |
$6,494.95 |
$6,494.95 |
$4,699.80
|
|
Conversion ext bil drg cath
|
$6,095.40 |
$6,095.40 |
$6,095.40 |
$4,176.15
|
|
Convert nephrostomy catheter
|
$1,301.40 |
$1,301.40 |
$1,301.40 |
$2,874.36
|
|
Coombs direct
|
$100.20 |
$100.20 |
$100.20 |
$72.80
|
|
Coombs indirect qualitative each reagent red cell reference
|
$84.00 |
$84.00 |
$84.00 |
$102.70
|
|
Coombs indirect titer reference
|
$114.60 |
$114.60 |
$114.60 |
$146.00
|
|
Core ndl bx lng/med perq
|
$3,273.60 |
$3,273.60 |
$3,273.60 |
$2,871.04
|
|
Cor hlx vlgs double osteot
|
$29,028.98 |
$29,028.98 |
$29,028.98 |
$5,986.40
|
|
Cor hlx vlgs dstl mtar osteo
|
$37,478.40 |
$37,478.40 |
$37,478.40 |
$4,539.20
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$13,121.10 |
$13,121.10 |
$13,121.10 |
$8,104.23
|
|
Coroners autopsy (necropsy)
|
$789.60 |
$789.60 |
$789.60 |
$352.80
|
|
Cortisol acth stimulation test - sendout
|
$296.40 |
$296.40 |
$296.40 |
$146.25
|
|
Cortisol total am
|
$147.00 |
$147.00 |
$147.00 |
$121.55
|
|
Cosyntropin 0.25 mg solution for injection
|
$122.16 |
$122.16 |
$122.16 |
$221.94
|
|
Co-treatment - group 15 mins, st
|
$168.00 |
$168.00 |
$168.00 |
$114.00
|
|
Coveredge 32 lead kit 40cm 48
|
$8,358.14 |
$8,358.14 |
$8,358.14 |
$3,647.70
|
|
Covers for upright each
|
$89.98 |
$89.98 |
$89.98 |
$64.50
|
|
Cover wrist
|
$88.18 |
$88.18 |
$88.18 |
$308.82
|
|
Covid-19 lab test non-cdc
|
$122.40 |
$122.40 |
$122.40 |
$67.49
|
|
#covid19rsv-rsv
|
$122.40 |
$122.40 |
$122.40 |
$146.25
|
|
#coxa-coxsackie a serotype a16
|
$108.00 |
$108.00 |
$108.00 |
$60.00
|
|
C-peptide
|
$120.60 |
$120.60 |
$120.60 |
$92.04
|
|
Cranial cervical orthosis
|
$16,401.38 |
$16,401.38 |
$16,401.38 |
$2,616.15
|
|
Crbrospnl fld flw imag cistern
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$1,210.30
|
|
C-reactive protein
|
$190.80 |
$190.80 |
$190.80 |
$61.60
|
|
C-reactive protein high sensitivity
|
$222.00 |
$222.00 |
$222.00 |
$79.77
|
|
C-reactive protein, quantitative
|
$29.40 |
$29.40 |
$29.40 |
$62.50
|
|
Creatine kinase
|
$85.20 |
$85.20 |
$85.20 |
$64.35
|
|
Creatine kinase isoenzymes
|
$95.40 |
$95.40 |
$95.40 |
$49.40
|
|
Creatine kinase mb
|
$121.80 |
$121.80 |
$121.80 |
$114.66
|
|
Creatine - sendout
|
$78.60 |
$78.60 |
$78.60 |
$38.07
|
|
Creatinine
|
$37.20 |
$37.20 |
$37.20 |
$44.35
|
|
Creatinine 24 hour urine
|
$84.00 |
$84.00 |
$84.00 |
$56.45
|
|
Creatinine clearance urine
|
$102.60 |
$102.60 |
$102.60 |
$87.50
|
|
#creutz-prot.,western blot
|
$236.40 |
$236.40 |
$236.40 |
$163.50
|
|
Cryofibrinogen qualitative - sendout
|
$88.80 |
$88.80 |
$88.80 |
$52.50
|
|
Cryoprecipitate each unit
|
$235.20 |
$235.20 |
$235.20 |
$144.78
|
|
Cryptosporidium antigen
|
$135.00 |
$135.00 |
$135.00 |
$52.08
|
|
Crystal identification light microscopy
|
$128.40 |
$128.40 |
$128.40 |
$60.00
|
|
Cstb gene full gene sequence
|
$694.80 |
$694.80 |
$694.80 |
$288.21
|
|
CT 3d report other modality w/workstation
|
$212.40 |
$212.40 |
$212.40 |
$633.00
|
|
Cta abdomen without & /or w/contrast
|
$2,026.20 |
$2,026.20 |
$2,026.20 |
$2,050.28
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,026.20 |
$2,026.20 |
$2,026.20 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,926.60 |
$1,926.60 |
$1,926.60 |
$2,075.53
|
