|
Change cystostomy tube simple
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$477.60
|
|
Change g-tube to g-j perc
|
$6,196.80 |
$6,196.80 |
$6,196.80 |
$2,198.81
|
|
Change nephroureteral cath
|
$4,905.00 |
$4,905.00 |
$4,905.00 |
$3,083.97
|
|
Change of ureter tube/stent
|
$3,457.20 |
$3,457.20 |
$3,457.20 |
$2,424.12
|
|
Change of windpipe airway 31502
|
$463.80 |
$463.80 |
$463.80 |
$401.50
|
|
Change stent via transureth
|
$6,593.40 |
$6,593.40 |
$6,593.40 |
$3,927.00
|
|
Change ureter stent percut
|
$4,696.80 |
$4,696.80 |
$4,696.80 |
$3,886.89
|
|
Chemo adm cns w/lmbr punct
|
$2,903.40 |
$2,903.40 |
$2,903.40 |
$720.20
|
|
Chemo ia push tecnique
|
$2,376.60 |
$2,376.60 |
$2,376.60 |
$499.50
|
|
Chemotherapy injection 96542
|
$288.00 |
$288.00 |
$288.00 |
$442.20
|
|
Chemotx admn pertl cav impl
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$590.00
|
|
Chest 2 vws w oblique
|
$262.80 |
$262.80 |
$262.80 |
$375.60
|
|
Chest apical lordotic proj
|
$188.40 |
$188.40 |
$188.40 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$876.00 |
$876.00 |
$876.00 |
$1,303.15
|
|
Chest Physiotherapy (first session)
|
$248.40 |
$248.40 |
$248.40 |
$160.80
|
|
Chest Physiotherapy (follow-up session)
|
$248.40 |
$248.40 |
$248.40 |
$134.50
|
|
Chest Ultrasound
|
$394.20 |
$394.20 |
$394.20 |
$463.88
|
|
Chest X-ray
|
$188.40 |
$188.40 |
$188.40 |
$294.06
|
|
Chest X-ray (single view)
|
$188.40 |
$188.40 |
$188.40 |
$236.60
|
|
Chg radiologic exam esophagus double contrast
|
$427.80 |
$427.80 |
$427.80 |
$520.80
|
|
Chlamydia culture
|
$109.80 |
$109.80 |
$109.80 |
$91.00
|
|
Chlamydia type
|
$31.20 |
$31.20 |
$31.20 |
$34.98
|
|
Chlnggrphy intraop addl s&i
|
$134.40 |
$134.40 |
$134.40 |
$281.18
|
|
Chloride
|
$23.40 |
$23.40 |
$23.40 |
$42.63
|
|
Chloride 24 hour urine
|
$29.40 |
$29.40 |
$29.40 |
$50.88
|
|
Chloroprocaine hcl injection
|
$0.60 |
$0.60 |
$0.60 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$178.20 |
$178.20 |
$178.20 |
$406.36
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$16.80 |
$16.80 |
$16.80 |
$79.74
|
|
Chlorpromazine 100 mg tablet
|
$8.40 |
$8.40 |
$8.40 |
$6.96
|
|
Cholangiogram percutaneous compl
|
$7,069.80 |
$7,069.80 |
$7,069.80 |
$3,427.55
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$1,026.60 |
$1,026.60 |
$1,026.60 |
$602.40
|
|
Cholecystostomy complete w/supervision & interpretation
|
$4,714.20 |
$4,714.20 |
$4,714.20 |
$3,856.84
|
|
Cholesterol
|
$22.20 |
$22.20 |
$22.20 |
$45.76
|
|
Cholesterol body fluid
|
$49.80 |
$49.80 |
$49.80 |
$89.28
|
|
Cholesterol (Lipid) Test
|
$87.60 |
$87.60 |
$87.60 |
$115.80
|
|
Cholinesterase
|
$40.80 |
$40.80 |
$40.80 |
$39.48
|
|
Chorion biopsy
|
$1,511.40 |
$1,511.40 |
$1,511.40 |
$1,392.05
|
|
Chrom analysis
|
$126.00 |
$126.00 |
$126.00 |
$156.00
|
|
Chromo high res and frag x - sendout
|
$329.40 |
$329.40 |
$329.40 |
$250.00
|
|
Chromosome analys amniotic
|
$627.00 |
$627.00 |
$627.00 |
$450.00
|
|
Chromosome analysis 15-20 cell count
|
$897.60 |
$897.60 |
$897.60 |
$517.11
|
|
Chromosome karyotype study
|
$120.60 |
$120.60 |
$120.60 |
$120.00
|
|
Chronic urticaria - sendout
|
$24.60 |
$24.60 |
$24.60 |
$75.71
|
|
Chylomicron screen, bf - sendout
|
$222.60 |
$222.60 |
$222.60 |
$136.09
|
|
Cidofovir injection
|
$118.20 |
$118.20 |
$118.20 |
$1,352.09
|
|
Cilastatin sodium injection
|
$19.80 |
$19.80 |
$19.80 |
$77.40
|
|
Circumcise/surg/28 days or < 54160
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$1,219.20
|
|
Circumcision (newborn)
|
$1,219.20 |
$1,219.20 |
$1,219.20 |
$1,364.88
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$25.80 |
$25.80 |
$25.80 |
$576.60
|
|
Clip ligating vesolock lg
|
$160.80 |
$160.80 |
$160.80 |
$4,320.00
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$1,420.80 |
$1,420.80 |
$1,420.80 |
$520.80
|
|
Closed tx/acetabululm without manip 27220
|
$759.00 |
$759.00 |
$759.00 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$2,291.20
|
|
Closed tx humerus fx without manip 23600
|
$447.60 |
$447.60 |
$447.60 |
$498.40
|
|
Closed tx humerus fx w/manip 24505
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$520.80 |
$520.80 |
$520.80 |
$386.40
|
|
Closed tx orbit without manipulj
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$998.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$2,569.28
|
|
Closed tx septal&nose fx
|
$3,971.40 |
$3,971.40 |
$3,971.40 |
$3,651.90
|
|
Closed tx sesamoid fx 28530
|
$759.00 |
$759.00 |
$759.00 |
$445.50
|
|
Closed tx/talus fracture without manip 28430
|
$327.60 |
$327.60 |
$327.60 |
$442.80
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$777.60 |
$777.60 |
$777.60 |
$472.50
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$1,259.62
|
|
Closure paravalvlr leak pq
|
$5,734.80 |
$5,734.80 |
$5,734.80 |
$9,434.46
|
|
Clot factor xii hageman
|
$97.80 |
$97.80 |
$97.80 |
$138.40
|
|
Clot factor xiii fibrin stab
|
$82.20 |
$82.20 |
$82.20 |
$106.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$856.20 |
$856.20 |
$856.20 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$327.60 |
$327.60 |
$327.60 |
$489.60
|
|
Clsd tx clav dislc without manip 23520
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,980.00
|
|
Clsd tx clavicle dislocation without manip 23540
|
$819.60 |
$819.60 |
$819.60 |
$419.40
|
|
Clsd tx/clavicular fx without manip 23500
|
$819.60 |
$819.60 |
$819.60 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$327.60 |
$327.60 |
$327.60 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$370.80 |
$370.80 |
$370.80 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$1,225.20 |
$1,225.20 |
$1,225.20 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$844.20 |
$844.20 |
$844.20 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$370.80 |
$370.80 |
$370.80 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$2,319.00 |
$2,319.00 |
$2,319.00 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$3,354.00 |
$3,354.00 |
$3,354.00 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$366.60 |
$366.60 |
$366.60 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$370.80 |
$370.80 |
$370.80 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$370.80 |
$370.80 |
$370.80 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$520.80 |
$520.80 |
$520.80 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$930.00 |
$930.00 |
$930.00 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$993.00 |
$993.00 |
$993.00 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,272.60 |
$1,272.60 |
$1,272.60 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$759.00 |
$759.00 |
$759.00 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$759.00 |
$759.00 |
$759.00 |
$492.99
|
|
Clsd tx mandibular fx without manip 21450
|
$669.60 |
$669.60 |
$669.60 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$370.80 |
$370.80 |
$370.80 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$470.40 |
$470.40 |
$470.40 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$808.20 |
$808.20 |
$808.20 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$759.00 |
$759.00 |
$759.00 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$520.80 |
$520.80 |
$520.80 |
$429.00
|
|
Clsd tx nose fx without manip 21310
|
$819.60 |
$819.60 |
$819.60 |
$323.95
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,440.80 |
$2,440.80 |
$2,440.80 |
$1,893.86
|
