|
Chest CT scan (with and without contrast)
|
$785.00 |
$785.00 |
$785.00 |
$1,975.00
|
|
Chest CT scan (with contrast)
|
$629.00 |
$629.00 |
$629.00 |
$1,689.00
|
|
Chest CT scan (without contrast)
|
$525.50 |
$525.50 |
$525.50 |
$1,350.03
|
|
Chest X-ray
|
$164.00 |
$164.00 |
$164.00 |
$294.06
|
|
Chest X-ray (single view)
|
$164.00 |
$164.00 |
$164.00 |
$239.04
|
|
Chg pr pul rehab for copd patients
|
$87.50 |
$87.50 |
$87.50 |
$147.95
|
|
Chg radiologic exam esophagus double contrast
|
$460.00 |
$460.00 |
$460.00 |
$511.59
|
|
Chimerism anal no cell selec
|
$242.00 |
$242.00 |
$242.00 |
$347.20
|
|
Chimerism anal w/cell select
|
$182.50 |
$182.50 |
$182.50 |
$585.60
|
|
Chlamydia culture
|
$29.00 |
$29.00 |
$29.00 |
$93.90
|
|
Chlamydia type
|
$35.00 |
$35.00 |
$35.00 |
$34.20
|
|
Chloride
|
$11.50 |
$11.50 |
$11.50 |
$40.95
|
|
Chloride 24 hour urine
|
$12.50 |
$12.50 |
$12.50 |
$49.50
|
|
Chlorpromazine 100 mg tablet
|
$4.38 |
$4.38 |
$4.38 |
$3.95
|
|
Chmotx admn plrl cav thrcnts
|
$850.00 |
$850.00 |
$850.00 |
$489.30
|
|
Cholangiogram percutaneous compl
|
$3,100.00 |
$3,100.00 |
$3,100.00 |
$3,495.00
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$168.50 |
$168.50 |
$168.50 |
$602.40
|
|
Cholecystostomy complete w/supervision & interpretation
|
$4,019.50 |
$4,019.50 |
$4,019.50 |
$3,690.60
|
|
Cholesterol
|
$9.50 |
$9.50 |
$9.50 |
$45.76
|
|
Cholesterol body fluid
|
$1,637.50 |
$1,637.50 |
$1,637.50 |
$77.55
|
|
Cholesterol (Lipid) Test
|
$62.50 |
$62.50 |
$62.50 |
$115.80
|
|
Cholinesterase
|
$8.00 |
$8.00 |
$8.00 |
$38.69
|
|
Cholinesterase challenge
|
$372.00 |
$372.00 |
$372.00 |
$366.72
|
|
Chorion biopsy
|
$1,058.50 |
$1,058.50 |
$1,058.50 |
$1,086.00
|
|
Chrnc care mgmt phys 1st 30
|
$50.00 |
$50.00 |
$50.00 |
$156.00
|
|
Chromatography
|
$159.50 |
$159.50 |
$159.50 |
$81.25
|
|
Chromogenic substrate assay
|
$355.50 |
$355.50 |
$355.50 |
$148.68
|
|
Chromo high res and frag x - sendout
|
$510.50 |
$510.50 |
$510.50 |
$247.59
|
|
Chromosome analys amniotic
|
$522.00 |
$522.00 |
$522.00 |
$450.00
|
|
Chromosome analysis 15-20 cell count
|
$474.50 |
$474.50 |
$474.50 |
$512.20
|
|
Chromosome banding study
|
$74.00 |
$74.00 |
$74.00 |
$184.24
|
|
Chromosome count additional
|
$62.50 |
$62.50 |
$62.50 |
$92.45
|
|
Chromosome karyotype study
|
$96.00 |
$96.00 |
$96.00 |
$119.87
|
|
Chronic urticaria - sendout
|
$91.00 |
$91.00 |
$91.00 |
$75.00
|
|
Chylomicron screen, bf - sendout
|
$104.50 |
$104.50 |
$104.50 |
$124.15
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$13.50 |
$13.50 |
$13.50 |
$34.88
|
|
Circum 28 days or older
|
$2,519.50 |
$2,519.50 |
$2,519.50 |
$3,860.64
|
|
Circumcise/surg/28 days or < 54160
|
$801.50 |
$801.50 |
$801.50 |
$1,219.20
|
|
Circumcision (newborn)
|
$2,788.50 |
$2,788.50 |
$2,788.50 |
$1,395.20
|
|
Cisplatin 1 mg/ml desensitization
|
$33.32 |
$33.32 |
$33.32 |
$192.66
|
|
Claviculectomy partial
|
$4,201.75 |
$4,201.75 |
$4,201.75 |
$3,594.44
|
|
Clean out mastoid cavity
|
$620.00 |
$620.00 |
$620.00 |
$1,033.60
|
|
Clearance of airways
|
$311.50 |
$311.50 |
$311.50 |
$208.86
|
|
Clearance of tear duct
|
$365.00 |
$365.00 |
$365.00 |
$656.38
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$19.92 |
$19.92 |
$19.92 |
$55.20
|
|
Clip ligating vesolock lg
|
$2,698.00 |
$2,698.00 |
$2,698.00 |
$4,320.00
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$3.50 |
$3.50 |
$3.50 |
$81.90
|
|
Closed tx/acetabululm without manip 27220
|
$298.50 |
$298.50 |
$298.50 |
$478.53
|
|
Closed tx humerus fx with manip 23605
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$378.00 |
$378.00 |
$378.00 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$2,208.00 |
$2,208.00 |
$2,208.00 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$283.50 |
$283.50 |
$283.50 |
$376.96
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$2,520.60
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$288.50 |
$288.50 |
$288.50 |
$481.80
|
|
Close tear duct opening
|
$365.00 |
$365.00 |
$365.00 |
$436.44
|
|
Closure enterostomy lg/sm intestine 44620
|
$8,212.50 |
$8,212.50 |
$8,212.50 |
$1,641.60
|
|
Closure of eyelid by suture
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$1,613.00
|
|
Closure of windpipe lesion 31820
|
$3,810.50 |
$3,810.50 |
$3,810.50 |
$3,837.72
|
|
Clot factor xii hageman
|
$338.00 |
$338.00 |
$338.00 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$88.54 |
$88.54 |
$88.54 |
$55.44
|
|
Clot factor xiii fibrin stab
|
$75.00 |
$75.00 |
$75.00 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$375.00 |
$375.00 |
$375.00 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$283.50 |
$283.50 |
$283.50 |
$526.35
|
|
Clsd tx clavicle dislocation without manip 23540
|
$283.50 |
$283.50 |
$283.50 |
$419.29
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$337.50 |
$337.50 |
$337.50 |
$448.80
|
|
Clsd tx coccygeal fracture 27200
|
$283.50 |
$283.50 |
$283.50 |
$388.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$337.50 |
$337.50 |
$337.50 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$320.50 |
$320.50 |
$320.50 |
$653.60
|
|
Clsd tx elbow dislocation child 24640
|
$308.00 |
$308.00 |
$308.00 |
$462.80
|
|
Clsd tx fracture of radius 25500
|
$283.50 |
$283.50 |
$283.50 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$283.50 |
$283.50 |
$283.50 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$334.50 |
$334.50 |
$334.50 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$378.00 |
$378.00 |
$378.00 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,772.50 |
$2,772.50 |
$2,772.50 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$283.50 |
$283.50 |
$283.50 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$325.00 |
$325.00 |
$325.00 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$388.50 |
$388.50 |
$388.50 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$389.00 |
$389.00 |
$389.00 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$389.00 |
$389.00 |
$389.00 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$332.00 |
$332.00 |
$332.00 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$620.00 |
$620.00 |
$620.00 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$289.50 |
$289.50 |
$289.50 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$389.00 |
$389.00 |
$389.00 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$389.00 |
$389.00 |
$389.00 |
$606.00
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,760.50 |
$3,760.50 |
$3,760.50 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$283.50 |
$283.50 |
$283.50 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$337.50 |
$337.50 |
$337.50 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$4,226.50 |
$4,226.50 |
$4,226.50 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$308.00 |
$308.00 |
$308.00 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$389.00 |
$389.00 |
$389.00 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$409.50 |
$409.50 |
$409.50 |
$416.35
|
|
Clsd tx pelvic ring fx
|
$283.50 |
$283.50 |
$283.50 |
$660.40
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$389.00 |
$389.00 |
$389.00 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$337.50 |
$337.50 |
$337.50 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$283.50 |
$283.50 |
$283.50 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,839.54
|
