|
Cftr gene known fam variants
|
$340.20 |
$340.20 |
$340.20 |
$195.20
|
|
Change cystostomy tube; complex 51710
|
$2,706.00 |
$2,706.00 |
$2,706.00 |
$1,527.00
|
|
Change cystostomy tube simple
|
$388.20 |
$388.20 |
$388.20 |
$477.60
|
|
Chemodenerv 1 extrem 1-4 ea 64643
|
$320.40 |
$320.40 |
$320.40 |
$617.60
|
|
Chemodenerv 1 extrem 5/> ea 64645
|
$346.80 |
$346.80 |
$346.80 |
$631.80
|
|
Chemodenerv 1 extrem 5/> mus 64644
|
$552.00 |
$552.00 |
$552.00 |
$1,033.63
|
|
Chemodenerv 1 extremity 1-4 64642
|
$483.60 |
$483.60 |
$483.60 |
$988.50
|
|
Chemodenervation/face muscl/unilat 64612
|
$1,466.40 |
$1,466.40 |
$1,466.40 |
$600.00
|
|
Chemodenerv musc migraine 64615
|
$594.60 |
$594.60 |
$594.60 |
$540.80
|
|
Chemodenerv musc neck dyston 64616
|
$1,603.20 |
$1,603.20 |
$1,603.20 |
$719.20
|
|
Chemodenerv trunk musc 6/] 64647
|
$546.60 |
$546.60 |
$546.60 |
$1,278.40
|
|
Chemo extend IV infus w/pump
|
$799.80 |
$799.80 |
$799.80 |
$748.55
|
|
Chest 2 vws w oblique
|
$308.40 |
$308.40 |
$308.40 |
$375.60
|
|
Chest apical lordotic proj
|
$126.60 |
$126.60 |
$126.60 |
$310.80
|
|
Chest CT scan (with and without contrast)
|
$2,586.00 |
$2,586.00 |
$2,586.00 |
$1,947.00
|
|
Chest CT scan (with contrast)
|
$2,121.60 |
$2,121.60 |
$2,121.60 |
$1,658.80
|
|
Chest CT scan (without contrast)
|
$1,815.00 |
$1,815.00 |
$1,815.00 |
$1,303.15
|
|
Chest Physiotherapy (first session)
|
$145.80 |
$145.80 |
$145.80 |
$160.80
|
|
Chest Physiotherapy (follow-up session)
|
$108.60 |
$108.60 |
$108.60 |
$134.50
|
|
Chest Ultrasound
|
$325.20 |
$325.20 |
$325.20 |
$463.88
|
|
Chest X-ray
|
$426.00 |
$426.00 |
$426.00 |
$294.06
|
|
Chest X-ray (single view)
|
$306.00 |
$306.00 |
$306.00 |
$236.60
|
|
Chg pr pul rehab for copd patients
|
$245.40 |
$245.40 |
$245.40 |
$150.40
|
|
Chg radiologic exam esophagus double contrast
|
$400.80 |
$400.80 |
$400.80 |
$520.80
|
|
Chlamydia culture
|
$144.60 |
$144.60 |
$144.60 |
$91.00
|
|
Chlamydia trachomatis ag if
|
$58.20 |
$58.20 |
$58.20 |
$66.60
|
|
Chloride
|
$32.40 |
$32.40 |
$32.40 |
$42.63
|
|
Chloride 24 hour urine
|
$48.00 |
$48.00 |
$48.00 |
$50.88
|
|
Chloroprocaine hcl injection
|
$1.20 |
$1.20 |
$1.20 |
$69.08
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$357.60 |
$357.60 |
$357.60 |
$406.36
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$80.00 |
$80.00 |
$80.00 |
$79.74
|
|
Chlorpromazine 100 mg tablet
|
$0.80 |
$0.80 |
$0.80 |
$6.96
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$728.40 |
$728.40 |
$728.40 |
$602.40
|
|
Cholesterol
|
$27.00 |
$27.00 |
$27.00 |
$45.76
|
|
Cholesterol body fluid
|
$364.20 |
$364.20 |
$364.20 |
$89.28
|
|
Cholesterol (Lipid) Test
|
$86.40 |
$86.40 |
$86.40 |
$115.80
|
|
Chromatography
|
$149.40 |
$149.40 |
$149.40 |
$84.60
|
|
Chromogenic substrate assay
|
$117.00 |
$117.00 |
$117.00 |
$159.00
|
|
Chromo high res and frag x - sendout
|
$3,739.80 |
$3,739.80 |
$3,739.80 |
$250.00
|
|
Chromosome analysis 100
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$439.20
|
|
Chromosome analysis 15-20 cell count
|
$676.80 |
$676.80 |
$676.80 |
$517.11
|
|
Chromosome analysis 5
|
$1,782.00 |
$1,782.00 |
$1,782.00 |
$644.80
|
|
Chronic urticaria - sendout
|
$123.00 |
$123.00 |
$123.00 |
$75.71
|
|
Chylomicron screen, bf - sendout
|
$372.60 |
$372.60 |
$372.60 |
$136.09
|
|
Cilastatin sodium injection
|
$121.20 |
$121.20 |
$121.20 |
$77.40
|
|
Ciliary transsleral therapy
|
$3,349.80 |
$3,349.80 |
$3,349.80 |
$3,269.14
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$83.20 |
$83.20 |
$83.20 |
$35.65
|
|
Circumcise/surg/28 days or < 54160
|
$593.40 |
$593.40 |
$593.40 |
$1,219.20
|
|
Circumcision (newborn)
|
$593.40 |
$593.40 |
$593.40 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$592.80 |
$592.80 |
$592.80 |
$205.56
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$302.40 |
$302.40 |
$302.40 |
$576.60
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$88.00 |
$88.00 |
$88.00 |
$55.20
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$359.20 |
$359.20 |
$359.20 |
$85.37
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$2,614.20 |
$2,614.20 |
$2,614.20 |
$520.80
|
|
Closed tx humerus fx with manip 23605
|
$2,269.80 |
$2,269.80 |
$2,269.80 |
$2,291.20
|
|
Closed tx humerus fx w/manip 24505
|
$2,539.80 |
$2,539.80 |
$2,539.80 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$628.20 |
$628.20 |
$628.20 |
$386.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$3,521.40 |
$3,521.40 |
$3,521.40 |
$2,569.28
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$550.80 |
$550.80 |
$550.80 |
$472.50
|
|
Clot factor viii reltd antgn
|
$201.00 |
$201.00 |
$201.00 |
$140.42
|
|
Clot factor xii hageman
|
$142.20 |
$142.20 |
$142.20 |
$138.40
|
|
Clot factor xiii fibrin stab
|
$128.40 |
$128.40 |
$128.40 |
$106.40
|
|
Clozapine, 25 mg
|
$1.60 |
$1.60 |
$1.60 |
$5.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$1,696.20 |
$1,696.20 |
$1,696.20 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$346.80 |
$346.80 |
$346.80 |
$489.60
|
|
Clsd tx dist fib fx w/manip 27788
|
$2,301.00 |
$2,301.00 |
$2,301.00 |
$676.65
|
|
Clsd tx elbow dislocation child 24640
|
$400.80 |
$400.80 |
$400.80 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$3,625.20 |
$3,625.20 |
$3,625.20 |
$2,211.05
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$537.60 |
$537.60 |
$537.60 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$478.80 |
$478.80 |
$478.80 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,706.60 |
$2,706.60 |
$2,706.60 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$630.00
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$4,038.00 |
$4,038.00 |
$4,038.00 |
$883.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$2,358.00 |
$2,358.00 |
$2,358.00 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$3,178.80 |
$3,178.80 |
$3,178.80 |
$522.78
|
|
Clsd tx patella disloc without anes 27560
|
$2,419.20 |
$2,419.20 |
$2,419.20 |
$573.52
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,431.20 |
$2,431.20 |
$2,431.20 |
$2,222.00
|
|
Clsd tx radius fracture w/manip 24655
|
$2,629.80 |
$2,629.80 |
$2,629.80 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,621.00 |
$3,621.00 |
$3,621.00 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,386.00 |
$1,386.00 |
$1,386.00 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,619.00 |
$2,619.00 |
$2,619.00 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$2,629.80 |
$2,629.80 |
$2,629.80 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$626.40 |
$626.40 |
$626.40 |
$412.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,717.20 |
$1,717.20 |
$1,717.20 |
$1,592.00
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$3,209.40 |
$3,209.40 |
$3,209.40 |
$2,274.40
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,565.60 |
$2,565.60 |
$2,565.60 |
$2,021.04
|
|
#cms hgb-sulfhemoglobin
|
$27.00 |
$27.00 |
$27.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$156.60 |
$156.60 |
$156.60 |
$89.76
|
|
Cmv pcr-sendout
|
$699.60 |
$699.60 |
$699.60 |
$175.70
|
|
Cold agglutinin screen (arc)
|
$59.40 |
$59.40 |
$59.40 |
$48.10
|
|
Cold agglutinin titer
|
$91.20 |
$91.20 |
$91.20 |
$52.00
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$321.00 |
$321.00 |
$321.00 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$75.60 |
$75.60 |
$75.60 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$249.60 |
$249.60 |
$249.60 |
$224.11
|
|
Collar cerv patriot adlt
|
$226.20 |
$226.20 |
$226.20 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$213.00 |
$213.00 |
$213.00 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$213.00 |
$213.00 |
$213.00 |
$155.40
|
|
Collj & interpj data ea 30 d
|
$255.00 |
$255.00 |
$255.00 |
$172.35
|
