|
Clsd tx/shoulder dislo/manip/anest 23655
|
$10,650.84 |
$10,650.84 |
$10,650.84 |
$2,423.85
|
|
Clsd tx temporomandibular dislocat 21480
|
$3,493.81 |
$3,493.81 |
$3,493.81 |
$512.40
|
|
Clsd tx toe dislocation without anes28660
|
$1,924.32 |
$1,924.32 |
$1,924.32 |
$422.75
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,707.42
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,814.51 |
$1,814.51 |
$1,814.51 |
$682.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$494.40
|
|
Cltx carpl scphd fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,368.00
|
|
Cltx lunate dislc w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,884.30
|
|
Cltx post ankle fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,316.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,050.29
|
|
Cltx tmprmand dislc comp
|
$8,243.52 |
$8,243.52 |
$8,243.52 |
$3,786.00
|
|
#cmvcul-virus inoculation shell
|
$1,486.48 |
$1,486.48 |
$1,486.48 |
$102.57
|
|
Cmv pcr-sendout
|
$602.67 |
$602.67 |
$602.67 |
$172.25
|
|
Coagulation time activated teg
|
$179.22 |
$179.22 |
$179.22 |
$51.48
|
|
Cocaine 4 % nasal solution
|
$737.60 |
$737.60 |
$737.60 |
$836.06
|
|
Cold agglutinin screen (arc)
|
$243.03 |
$243.03 |
$243.03 |
$47.19
|
|
Collection blood specimen from completely implantable venous access device
|
$261.45 |
$261.45 |
$261.45 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$411.82 |
$411.82 |
$411.82 |
$168.80
|
|
Collection of venous blood by venipuncture
|
$64.18 |
$64.18 |
$64.18 |
$22.05
|
|
Colonoscopy (diagnostic)
|
$8,607.73 |
$8,607.73 |
$8,607.73 |
$1,615.20
|
|
Colonoscopy (with biopsy)
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,538.00
|
|
Colonoscopy (with polyp removal)
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,472.75
|
|
Colposcopy w/biopsy of cervix 57455
|
$3,572.10 |
$3,572.10 |
$3,572.10 |
$534.30
|
|
Compatibility test each unit antiglobulin technique
|
$329.67 |
$329.67 |
$329.67 |
$165.00
|
|
Compatibility test each unit electronic
|
$257.49 |
$257.49 |
$257.49 |
$175.45
|
|
Compatibility test each unit immediate spin technique
|
$245.22 |
$245.22 |
$245.22 |
$163.80
|
|
Complement antigen each component c3
|
$333.13 |
$333.13 |
$333.13 |
$113.30
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$3,562.63 |
$3,562.63 |
$3,562.63 |
$940.00
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$3,485.42 |
$3,485.42 |
$3,485.42 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$3,485.42 |
$3,485.42 |
$3,485.42 |
$1,252.90
|
|
Complx repair enel addl 5cm/< 13153
|
$1,779.00 |
$1,779.00 |
$1,779.00 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$2,719.07 |
$2,719.07 |
$2,719.07 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$2,397.32 |
$2,397.32 |
$2,397.32 |
$1,212.00
|
|
Complx repair fccmnaxghf 13133
|
$1,790.09 |
$1,790.09 |
$1,790.09 |
$797.64
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,085.05 |
$2,085.05 |
$2,085.05 |
$592.69
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$6,478.98 |
$6,478.98 |
$6,478.98 |
$1,193.40
|
|
Concentration infection agents any type
|
$233.15 |
$233.15 |
$233.15 |
$51.32
|
|
Condylomata destruction 56420
|
$2,257.44 |
$2,257.44 |
$2,257.44 |
$503.67
|
|
Consultation pathology during surgery
|
$304.56 |
$304.56 |
$304.56 |
$118.20
|
|
Consultation pathology during surgery cytological exam initial site
|
$178.03 |
$178.03 |
$178.03 |
$404.03
|
|
Consultation pathology during surgery frozen section each additional block
|
$389.66 |
$389.66 |
$389.66 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$610.05 |
$610.05 |
$610.05 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$1,582.45 |
$1,582.45 |
$1,582.45 |
$235.95
|
|
Consultation/report referred slides prepared elsewhere
|
$990.06 |
$990.06 |
$990.06 |
$176.15
|
|
Consult comp w/report rfrd material
|
$1,023.38 |
$1,023.38 |
$1,023.38 |
$337.44
|
|
Contrast exam abdominl aorta 75625-26
|
$3,372.60 |
$3,372.60 |
$3,372.60 |
$3,391.03
|
|
Contrast x-ray gallbladder
|
$1,695.86 |
$1,695.86 |
$1,695.86 |
$280.14
|
|
Contrast x-ray of hip
|
$674.82 |
$674.82 |
$674.82 |
$770.88
|
|
Contrast x-ray of knee joint
|
$741.66 |
$741.66 |
$741.66 |
$655.05
|
|
Control nosebleed pack+caut 30905
|
$889.19 |
$889.19 |
$889.19 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$890.27 |
$890.27 |
$890.27 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$922.72 |
$922.72 |
$922.72 |
$385.45
|
|
Convert nephrostomy catheter
|
$5,417.70 |
$5,417.70 |
$5,417.70 |
$3,927.00
|
|
Coombs direct
|
$205.47 |
$205.47 |
$205.47 |
$71.74
|
|
Coombs indirect qualitative each reagent red cell reference
|
$274.15 |
$274.15 |
$274.15 |
$100.29
|
|
Coombs indirect titer reference
|
$552.48 |
$552.48 |
$552.48 |
$144.00
|
|
Core ndl bx lng/med perq
|
$2,194.24 |
$2,194.24 |
$2,194.24 |
$2,963.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$25,189.33 |
$25,189.33 |
$25,189.33 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$21,090.75 |
$21,090.75 |
$21,090.75 |
$10,281.09
|
|
Coronary angio/lv gram/rt< heart
|
$22,667.64 |
$22,667.64 |
$22,667.64 |
$11,247.60
|
|
Coronary art/grft angio s&i
|
$18,425.17 |
$18,425.17 |
$18,425.17 |
$7,923.88
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$16,420.60 |
$16,420.60 |
$16,420.60 |
$7,697.25
|
|
Cortisol total am
|
$302.97 |
$302.97 |
$302.97 |
$122.20
|
|
Co-treatment - group 15 mins, st
|
$306.84 |
$306.84 |
$306.84 |
$110.00
|
|
#coxa-coxsackie a serotype a16
|
$219.76 |
$219.76 |
$219.76 |
$65.36
|
|
C-peptide
|
$206.91 |
$206.91 |
$206.91 |
$100.00
|
|
Crbrospnl fld flw imag cistern
|
$4,318.02 |
$4,318.02 |
$4,318.02 |
$1,410.04
|
|
C-reactive protein
|
$48.97 |
$48.97 |
$48.97 |
$61.20
|
|
C-reactive protein high sensitivity
|
$160.14 |
$160.14 |
$160.14 |
$91.65
|
|
C-reactive protein, quantitative
|
$54.62 |
$54.62 |
$54.62 |
$62.50
|
|
Create eardrum opening
|
$12,886.18 |
$12,886.18 |
$12,886.18 |
$3,006.50
|
|
Creatine kinase
|
$275.43 |
$275.43 |
$275.43 |
$58.30
|
|
Creatine kinase isoenzymes
|
$113.34 |
$113.34 |
$113.34 |
$49.02
|
|
Creatine kinase mb
|
$485.90 |
$485.90 |
$485.90 |
$109.20
|
|
Creatine - sendout
|
$473.56 |
$473.56 |
$473.56 |
$39.00
|
|
Creatinine
|
$188.58 |
$188.58 |
$188.58 |
$43.80
|
|
Creatinine 24 hour urine
|
$211.48 |
$211.48 |
$211.48 |
$61.95
|
|
Creatinine clearance urine
|
$352.39 |
$352.39 |
$352.39 |
$85.80
|
|
#creutz-prot.,western blot
|
$479.04 |
$479.04 |
$479.04 |
$179.28
|
|
Critical care 30-74 minutes
|
$6,886.73 |
$6,886.73 |
$6,886.73 |
$2,662.80
|
|
Critical care each additional 30 minutes
|
$1,567.14 |
$1,567.14 |
$1,567.14 |
$784.24
|
|
Cryofibrinogen qualitative - sendout
|
$142.39 |
$142.39 |
$142.39 |
$50.88
|
|
Cryoprecipitate each unit
|
$279.71 |
$279.71 |
$279.71 |
$195.02
|
|
Crystal identification light microscopy
|
$180.99 |
$180.99 |
$180.99 |
$64.40
|
|
Cta abdomen without & /or w/contrast
|
$6,341.16 |
$6,341.16 |
$6,341.16 |
$2,084.86
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$4,702.21 |
$4,702.21 |
$4,702.21 |
$2,092.73
|
|
Cta lower extremity without & w/contrast (both sides)
|
$3,523.94 |
$3,523.94 |
$3,523.94 |
$2,079.00
|
|
Cta neck without &/or w/contrast
|
$6,384.19 |
$6,384.19 |
$6,384.19 |
$1,987.50
|
|
CT Angiogram of Abdomen and Pelvis
|
$10,353.26 |
$10,353.26 |
$10,353.26 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$4,548.06 |
$4,548.06 |
$4,548.06 |
$2,057.90
|
|
CT Angiogram of the Head
|
$5,009.92 |
$5,009.92 |
$5,009.92 |
$2,080.00
|
|
CT angio hrt w/3d image
|
$10,787.26 |
$10,787.26 |
$10,787.26 |
$1,601.60
|
|
CT angio pelvis
|
$3,821.05 |
$3,821.05 |
$3,821.05 |
$1,802.35
|
|
Cta upper extremity w &/or without contrast left
|
$3,184.15 |
$3,184.15 |
$3,184.15 |
$1,691.30
|
|
CT guidance for needle placement
|
$4,378.19 |
$4,378.19 |
$4,378.19 |
$1,506.04
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$3,719.96 |
$3,719.96 |
$3,719.96 |
$1,058.40
|
|
CT guid parench tis ablat
|
$1,901.00 |
$1,901.00 |
$1,901.00 |
$1,282.50
|
|
CT heart w/evaluation of calcium without contrast
|
$634.07 |
$634.07 |
$634.07 |
$192.00
|
|
CT hrt w/3d image
|
$8,790.32 |
$8,790.32 |
$8,790.32 |
$1,481.04
|