|
Cesarean section delivery only 59514
|
$1,754.40 |
$7,688.40 |
$9,873.00 |
|
|
Cetuximab 100 mg/50 ml intravenous solution
|
$9.00 |
$280.20 |
$12,415.20 |
|
|
#cf-97variants
|
$21.60 |
$3,216.00 |
$5,034.60 |
|
|
Cftr gene dup/delet variants
|
$2,890.80 |
$3,002.40 |
$4,592.40 |
|
|
Cftr gene intron poly t
|
$226.80 |
$283.80 |
$288.00 |
|
|
Cftr gene known fam variants
|
$321.00 |
$340.20 |
$355.80 |
|
|
Change cystostomy tube; complex 51710
|
$171.60 |
$2,270.40 |
$3,964.20 |
|
|
Change cystostomy tube simple
|
$257.40 |
$477.60 |
$1,728.00 |
|
|
Change g-tube to g-j perc
|
$2,179.80 |
$4,036.20 |
$7,895.40 |
|
|
Change nephroureteral cath
|
$2,062.00 |
$4,905.00 |
$7,311.00 |
|
|
Change of ureter tube/stent
|
$1,236.80 |
$3,457.20 |
$4,240.80 |
|
|
Change of windpipe airway 31502
|
$220.20 |
$463.80 |
$1,248.00 |
|
|
Change stent via transureth
|
$6,593.40 |
$6,593.40 |
$6,593.40 |
|
|
Change ureter stent percut
|
$4,696.80 |
$4,696.80 |
$14,870.40 |
|
|
Chemo adm cns w/lmbr punct
|
$534.50 |
$1,119.00 |
$2,903.40 |
|
|
Chemodener muscle larynx emg
|
$143.40 |
$221.40 |
$811.50 |
|
|
Chemodenerv 1 extrem 1-4 ea 64643
|
$93.00 |
$320.40 |
$369.60 |
|
|
Chemodenerv 1 extrem 5/> ea 64645
|
$104.40 |
$346.80 |
$450.00 |
|
|
Chemodenerv 1 extrem 5/> mus 64644
|
$147.00 |
$595.20 |
$872.40 |
|
|
Chemodenerv 1 extremity 1-4 64642
|
$134.40 |
$483.60 |
$647.40 |
|
|
Chemodenervation/face muscl/unilat 64612
|
$171.60 |
$1,466.40 |
$2,561.40 |
|
|
Chemodenerv eccrine glands
|
$353.00 |
$353.00 |
$353.00 |
|
|
Chemodenerv eccrine glands 64650
|
$353.00 |
$510.00 |
$1,238.40 |
|
|
Chemodenerv musc migraine 64615
|
$155.40 |
$594.60 |
$913.20 |
|
|
Chemodenerv musc neck dyston 64616
|
$220.80 |
$1,603.20 |
$2,513.40 |
|
|
Chemodenerv saliv glands bilat 64611
|
$353.00 |
$353.00 |
$870.00 |
|
|
Chemodenerv trunk musc 1-5 64646
|
$145.80 |
$472.20 |
$932.40 |
|
|
Chemodenerv trunk musc 6/] 64647
|
$168.00 |
$546.60 |
$2,727.00 |
|
|
Chemo extend IV infus w/pump
|
$534.50 |
$799.80 |
$1,050.60 |
|
|
Chemo ia infuse each addl hr
|
$70.50 |
$184.80 |
$228.60 |
|
|
Chemo ia infusion up to 1 hr
|
$201.60 |
$359.40 |
$727.20 |
|
|
Chemo ia push tecnique
|
$670.80 |
$2,376.60 |
$2,376.60 |
|
|
Chemo intralesional over 7
|
$350.00 |
$360.60 |
$996.60 |
|
|
Chemo intralesional up to 7 96405
|
$134.40 |
$240.00 |
$657.60 |
|
|
Chemotherapy injection 96542
|
$288.00 |
$288.00 |
$978.00 |
|
|
Chemotx admn pertl cav impl
|
$637.60 |
$1,071.00 |
$2,377.80 |
|
|
Chest 2 vws w oblique
|
$83.40 |
$405.00 |
$686.40 |
|
|
Chest apical lordotic proj
|
$125.40 |
$405.00 |
$686.40 |
|
|
Chest CT scan (with and without contrast)
|
$562.00 |
$1,448.40 |
$5,112.00 |
|
|
Chest CT scan (with contrast)
|
$470.00 |
$1,424.40 |
$4,599.60 |
|
|
Chest CT scan (without contrast)
|
$285.00 |
$876.00 |
$3,283.80 |
|
|
Chest Physiotherapy (first session)
|
$84.60 |
$248.40 |
$557.40 |
|
|
Chest Physiotherapy (follow-up session)
|
$48.60 |
$228.80 |
$555.00 |
|
|
Chest Ultrasound
|
$235.80 |
$461.40 |
$1,263.00 |
|
|
Chest X-ray
|
$115.80 |
$322.40 |
$701.60 |
|
|
Chest X-ray (single view)
|
$83.40 |
$215.40 |
$686.40 |
|
|
Chg pr pul rehab for copd patients
|
$87.50 |
$181.80 |
$330.60 |
|
|
Chg radiologic exam esophagus double contrast
|
$186.00 |
$427.80 |
$1,312.80 |
|
|
Chimerism anal no cell selec
|
$242.00 |
$1,237.20 |
$1,857.60 |
|
|
Chimerism anal w/cell select
|
$182.50 |
$2,258.40 |
$3,384.60 |
|
|
Chlamydia culture
|
$29.00 |
$144.60 |
$883.20 |
|
|
Chlamydia trachomatis ag if
|
$58.20 |
$66.60 |
$186.00 |
|
|
Chlamydia type
|
$31.20 |
$32.40 |
$112.80 |
|
|
Chlmyd pneum dna dir probe
|
$154.20 |
$154.20 |
$154.20 |
|
|
Chlnggrphy intraop addl s&i
|
$27.60 |
$134.40 |
$390.00 |
|
|
Chloride
|
$11.50 |
$33.00 |
$147.00 |
|
|
Chloride 24 hour urine
|
$12.50 |
$34.80 |
$382.20 |
|
|
Chloroprocaine hcl injection
|
$0.60 |
$1.20 |
$223.80 |
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$76.60 |
$357.60 |
$2,846.40 |
|
|
Chlorpromazine 0.125 mg/ml IV syringe - cnr
|
$16.80 |
$72.60 |
$255.60 |
|
|
Chlorpromazine 100 mg tablet
|
$0.80 |
$2.40 |
$15.00 |
|
|
Chmotx admn plrl cav thrcnts
|
$850.00 |
$850.00 |
$850.00 |
|
|
Cholangiogram percutaneous compl
|
$2,247.00 |
$3,542.40 |
$8,599.80 |
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$168.50 |
$728.40 |
$1,195.80 |
|
|
Cholecystostomy complete w/supervision & interpretation
|
$2,867.40 |
$3,951.60 |
$8,569.60 |
|
|
Cholesterol
|
$9.50 |
$32.40 |
$301.20 |
|
|
Cholesterol body fluid
|
$49.60 |
$514.80 |
$9,563.40 |
|
|
Cholesterol (Lipid) Test
|
$40.00 |
$87.60 |
$720.00 |
|
|
Cholinesterase
|
$8.00 |
$78.60 |
$223.20 |
|
|
Cholinesterase challenge
|
$372.00 |
$372.00 |
$372.00 |
|
|
Chorion biopsy
|
$1,058.50 |
$1,511.40 |
$2,431.80 |
|
|
Chorionic gonadotropin/1000u
|
$66.00 |
$66.00 |
$66.00 |
|
|
Chrnc care mgmt phys 1st 30
|
$50.00 |
$50.00 |
$50.00 |
|
|
Chrom analysis
|
$123.00 |
$228.60 |
$652.20 |
|
|
Chromatogram assay sugars
|
$186.60 |
$186.60 |
$186.60 |
|
|
Chromatography
|
$18.60 |
$159.50 |
$495.00 |
|
|
Chromogenic substrate assay
|
$117.00 |
$158.40 |
$478.80 |
|
|
Chromo high res and frag x - sendout
|
$232.80 |
$770.40 |
$3,739.80 |
|
|
Chromosome analys amniotic
|
$522.00 |
$627.00 |
$627.00 |
|
|
Chromosome analysis 100
|
$802.80 |
$1,663.80 |
$3,003.60 |
|
|
Chromosome analysis 15-20 cell count
|
$346.20 |
$867.00 |
$2,698.20 |
|
|
Chromosome analysis 45
|
$917.40 |
$961.80 |
$2,686.20 |
|
|
Chromosome analysis 5
|
$848.40 |
$2,099.40 |
$3,701.40 |
|
|
Chromosome analysis 50-100
|
$625.80 |
$625.80 |
$1,174.80 |
|
|
Chromosome analys placenta
|
$871.20 |
$1,302.60 |
$1,974.00 |
|
|
Chromosome banding study
|
$74.00 |
$74.00 |
$499.20 |
|
|
Chromosome count additional
|
$62.50 |
$97.80 |
$293.40 |
|
|
Chromosome karyotype study
|
$96.00 |
$122.40 |
$274.80 |
|
|
Chromosome study additional
|
$313.80 |
$472.80 |
$1,276.00 |
|
|
Chronic urticaria - sendout
|
$24.60 |
$123.00 |
$264.60 |
|
|
Chylomicron screen, bf - sendout
|
$104.50 |
$334.80 |
$774.00 |
|
|
Cidofovir injection
|
$118.20 |
$118.20 |
$27,738.00 |
|
|
Cilastatin sodium injection
|
$19.80 |
$145.60 |
$1,249.80 |
|
|
Ciliary transsleral therapy
|
$3,349.80 |
$4,193.40 |
$6,005.40 |
|
|
Ciltacabtagene car-pos t
|
$4,224,000.00 |
$4,224,000.00 |
$4,224,000.00 |
|
|
Cine/video x-rays
|
$345.60 |
$523.20 |
$4,165.80 |
|
|
Cine/video x-rays add-on
|
$288.60 |
$288.60 |
$424.80 |
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$5.40 |
$86.00 |
$1,024.80 |
|
|
Ciprofloxacin otic susp 6 mg
|
$128.80 |
$876.00 |
$963.20 |
|
|
Circum 28 days or older
|
$383.40 |
$383.40 |
$2,519.50 |
|
