|
Chest CT scan (with contrast)
|
$470.25 |
$470.25 |
$470.25 |
$1,669.00
|
|
Chest CT scan (without contrast)
|
$385.11 |
$385.11 |
$385.11 |
$1,364.99
|
|
Chest X-ray
|
$361.68 |
$361.68 |
$361.68 |
$299.40
|
|
Chest X-ray (single view)
|
$323.73 |
$323.73 |
$323.73 |
$245.98
|
|
Chlamydia culture
|
$197.34 |
$197.34 |
$197.34 |
$90.75
|
|
Chlamydia type
|
$89.43 |
$89.43 |
$89.43 |
$33.00
|
|
Chlnggrphy intraop addl s&i
|
$269.61 |
$269.61 |
$269.61 |
$298.48
|
|
Chloride
|
$111.87 |
$111.87 |
$111.87 |
$39.65
|
|
Chloride 24 hour urine
|
$111.21 |
$111.21 |
$111.21 |
$46.13
|
|
Chlorothiazide sodium 500 mg intravenous solution
|
$1,309.75 |
$1,309.75 |
$1,309.75 |
$358.30
|
|
Cholangiogram percutaneous compl
|
$2,771.34 |
$2,771.34 |
$2,771.34 |
$3,856.84
|
|
Cholangiography and/or pancreatography intraoperative supervision & interpretation
|
$784.08 |
$784.08 |
$784.08 |
$618.15
|
|
Cholecystostomy complete w/supervision & interpretation
|
$950.40 |
$950.40 |
$950.40 |
$3,874.00
|
|
Cholesterol
|
$68.64 |
$68.64 |
$68.64 |
$45.90
|
|
Cholesterol body fluid
|
$21.78 |
$21.78 |
$21.78 |
$72.10
|
|
Cholesterol (Lipid) Test
|
$102.30 |
$102.30 |
$102.30 |
$114.80
|
|
Cholinesterase
|
$87.78 |
$87.78 |
$87.78 |
$40.80
|
|
Chromatography
|
$111.21 |
$111.21 |
$111.21 |
$77.00
|
|
Chromo high res and frag x - sendout
|
$128.04 |
$128.04 |
$128.04 |
$250.00
|
|
Chromosome analysis 15-20 cell count
|
$990.99 |
$990.99 |
$990.99 |
$455.00
|
|
Chromosome karyotype study
|
$75.24 |
$75.24 |
$75.24 |
$110.43
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$48.39 |
$48.39 |
$48.39 |
$37.00
|
|
Circum 28 days or older
|
$787.05 |
$787.05 |
$787.05 |
$4,074.80
|
|
Circumcision (newborn)
|
$945.45 |
$945.45 |
$945.45 |
$1,422.04
|
|
Clearance of airways
|
$176.55 |
$176.55 |
$176.55 |
$208.00
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$81.67 |
$81.67 |
$81.67 |
$55.20
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$642.84 |
$642.84 |
$642.84 |
$546.60
|
|
Closed tx/acetabululm without manip 27220
|
$330.99 |
$330.99 |
$330.99 |
$478.53
|
|
Closed tx humerus fx without manip 23600
|
$1,041.48 |
$1,041.48 |
$1,041.48 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$66.00 |
$66.00 |
$66.00 |
$413.00
|
|
Closed tx/talus fracture without manip 28430
|
$229.35 |
$229.35 |
$229.35 |
$452.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$106.92 |
$106.92 |
$106.92 |
$498.00
|
|
Clos txnose fx without stablz 21315
|
$1,185.69 |
$1,185.69 |
$1,185.69 |
$2,478.30
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$210.21 |
$210.21 |
$210.21 |
$1,259.20
|
|
Clot factor xii hageman
|
$129.03 |
$129.03 |
$129.03 |
$125.28
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$972.84 |
$972.84 |
$972.84 |
$700.00
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$540.87 |
$540.87 |
$540.87 |
$536.00
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$1,145.43 |
$1,145.43 |
$1,145.43 |
$509.60
|
|
Clsd tx clavicle dislocation without manip 23540
|
$518.76 |
$518.76 |
$518.76 |
$448.00
|
|
Clsd tx clavicle fracture w/manip 23505
|
$741.51 |
$741.51 |
$741.51 |
$2,034.18
|
|
Clsd tx/clavicular fx without manip 23500
|
$511.17 |
$511.17 |
$511.17 |
$457.10
|
|
Clsd tx coccygeal fracture 27200
|
$239.91 |
$239.91 |
$239.91 |
$394.20
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$555.06 |
$555.06 |
$555.06 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$634.26 |
$634.26 |
$634.26 |
$696.23
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$289.74 |
$289.74 |
$289.74 |
$478.40
|
|
Clsd tx elbow dislocation child 24640
|
$198.00 |
$198.00 |
$198.00 |
$507.20
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$2,366.43 |
$2,366.43 |
$2,366.43 |
$2,394.40
|
|
Clsd tx fracture of radius 25500
|
$229.68 |
$229.68 |
$229.68 |
$445.40
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$477.51 |
$477.51 |
$477.51 |
$392.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$386.43 |
$386.43 |
$386.43 |
$490.40
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$323.07 |
$323.07 |
$323.07 |
$567.08
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,491.93 |
$1,491.93 |
$1,491.93 |
$1,781.00
|
|
Clsd tx fx radius/ulna without manip 25560
|
$627.00 |
$627.00 |
$627.00 |
$513.80
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$866.58 |
$866.58 |
$866.58 |
$1,696.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$476.00
|
|
Clsd tx hip disloc without anes 27265
|
$569.91 |
$569.91 |
$569.91 |
$665.60
|
|
Clsd tx humeral fract without manip 24530
|
$407.22 |
$407.22 |
$407.22 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$524.37 |
$524.37 |
$524.37 |
$522.81
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$4,916.67 |
$4,916.67 |
$4,916.67 |
$944.80
|
|
Clsd tx mandibular fx without manip 21450
|
$228.03 |
$228.03 |
$228.03 |
$1,028.67
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$480.48 |
$480.48 |
$480.48 |
$519.12
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$920.37 |
$920.37 |
$920.37 |
$688.00
|
|
Clsd tx/metatarsal fx without manip 28470
|
$181.83 |
$181.83 |
$181.83 |
$429.65
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,007.06 |
$2,007.06 |
$2,007.06 |
$1,884.74
|
|
Clsd tx patella disloc without anes 27560
|
$206.91 |
$206.91 |
$206.91 |
$599.00
|
|
Clsd tx/patellar fx without manip 27520
|
$190.08 |
$190.08 |
$190.08 |
$496.80
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$809.82 |
$809.82 |
$809.82 |
$2,322.60
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$202.95 |
$202.95 |
$202.95 |
$429.65
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$407.22 |
$407.22 |
$407.22 |
$476.80
|
|
Clsd tx radius fracture w/manip 24655
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$1,804.80
|
|
Clsd tx/scapular fx without manip 23570
|
$586.08 |
$586.08 |
$586.08 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,286.67 |
$1,286.67 |
$1,286.67 |
$1,893.86
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,173.48 |
$1,173.48 |
$1,173.48 |
$1,774.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,187.01 |
$1,187.01 |
$1,187.01 |
$2,423.85
|
|
Clsd tx temporomandibular dislocat 21480
|
$99.00 |
$99.00 |
$99.00 |
$460.80
|
|
Clsd tx toe dislocation without anes28660
|
$99.00 |
$99.00 |
$99.00 |
$415.20
|
|
Clsd tx trimall ankle fx without manip 27816
|
$354.42 |
$354.42 |
$354.42 |
$520.80
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$708.51 |
$708.51 |
$708.51 |
$1,614.40
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$279.18 |
$279.18 |
$279.18 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$107.25 |
$107.25 |
$107.25 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$238.26 |
$238.26 |
$238.26 |
$478.40
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$215.82 |
$215.82 |
$215.82 |
$535.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$483.12 |
$483.12 |
$483.12 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$1,204.83 |
$1,204.83 |
$1,204.83 |
$2,103.36
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,087.35 |
$1,087.35 |
$1,087.35 |
$1,858.00
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,679.04 |
$1,679.04 |
$1,679.04 |
$546.75
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,112.10 |
$1,112.10 |
$1,112.10 |
$2,030.33
|
|
Cltx thigh fx w/mnpj
|
$3,190.44 |
$3,190.44 |
$3,190.44 |
$3,503.71
|
|
Cmv pcr-sendout
|
$624.03 |
$624.03 |
$624.03 |
$172.25
|
|
Co2 monitor per day
|
$421.41 |
$421.41 |
$421.41 |
$409.50
|
|
Coagulation time activated teg
|
$164.67 |
$164.67 |
$164.67 |
$52.00
|
|
Cold agglutinin screen (arc)
|
$19.14 |
$19.14 |
$19.14 |
$44.94
|
|
Cold agglutinin titer
|
$47.52 |
$47.52 |
$47.52 |
$50.00
|
|
Collection blood specimen from completely implantable venous access device
|
$176.22 |
$176.22 |
$176.22 |
$159.88
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$999.57 |
$999.57 |
$999.57 |
$161.60
|
|
Collection of venous blood by venipuncture
|
$22.11 |
$22.11 |
$22.11 |
$20.80
|
|
Colonoscopy (diagnostic)
|
$998.91 |
$998.91 |
$998.91 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$886.05 |
$886.05 |
$886.05 |
$2,288.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$1,330.56 |
$1,330.56 |
$1,330.56 |
$2,288.00
|