|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$279.90 |
$279.90 |
$279.90 |
$603.00
|
|
Clsd tx patella disloc without anes 27560
|
$279.90 |
$279.90 |
$279.90 |
$553.15
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$2,211.05
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,163.85 |
$1,163.85 |
$1,163.85 |
$1,565.74
|
|
C motor evoked upr&lwr limbs
|
$758.10 |
$758.10 |
$758.10 |
$1,273.61
|
|
#cmvcul-virus inoculation shell
|
$160.95 |
$160.95 |
$160.95 |
$89.76
|
|
Cmv pcr-sendout
|
$226.05 |
$226.05 |
$226.05 |
$172.25
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$7,332.48 |
$7,332.48 |
$7,332.48 |
$6,482.92
|
|
Coagulation time activated teg
|
$97.05 |
$97.05 |
$97.05 |
$52.25
|
|
Cocaine 4 % nasal solution
|
$529.20 |
$529.20 |
$529.20 |
$624.55
|
|
Cold agglutinin screen (arc)
|
$156.90 |
$156.90 |
$156.90 |
$44.94
|
|
Cold agglutinin titer
|
$88.20 |
$88.20 |
$88.20 |
$50.00
|
|
Colistimethate sodium inj
|
$35.27 |
$35.27 |
$35.27 |
$68.47
|
|
Collagen based wound filler
|
$3,108.00 |
$3,108.00 |
$3,108.00 |
$1,788.15
|
|
Collagen dressing <=16 sq in
|
$56.02 |
$56.02 |
$56.02 |
$42.50
|
|
Collagen drsg>16<=48 sq in
|
$3,348.00 |
$3,348.00 |
$3,348.00 |
$24.71
|
|
Collagen gel/paste wound fil
|
$9.65 |
$9.65 |
$9.65 |
$9.65
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$86.48 |
$86.48 |
$86.48 |
$62.40
|
|
Collar cerv ascend 172 reg
|
$136.56 |
$136.56 |
$136.56 |
$224.11
|
|
Collar cerv patriot adlt
|
$16.50 |
$16.50 |
$16.50 |
$154.00
|
|
Collar extrication adult univ
|
$1,370.20 |
$1,370.20 |
$1,370.20 |
$764.15
|
|
Collection of venous blood by venipuncture
|
$23.85 |
$23.85 |
$23.85 |
$20.74
|
|
Coll-e-derm 1 sq cm
|
$342.21 |
$342.21 |
$342.21 |
$342.21
|
|
Colonoscopy (diagnostic)
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$760.95 |
$760.95 |
$760.95 |
$1,846.40
|
|
Colonoscopy submucous njx
|
$760.95 |
$760.95 |
$760.95 |
$2,063.25
|
|
Colonoscopy w/ablation
|
$760.95 |
$760.95 |
$760.95 |
$2,571.00
|
|
Colonoscopy w/control bleed
|
$760.95 |
$760.95 |
$760.95 |
$2,019.60
|
|
Colonoscopy w/fb removal
|
$760.95 |
$760.95 |
$760.95 |
$1,395.28
|
|
Colonoscopy (with biopsy)
|
$760.95 |
$760.95 |
$760.95 |
$2,080.00
|
|
Colonoscopy (with polyp removal)
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Compatibility test each unit antiglobulin technique
|
$156.90 |
$156.90 |
$156.90 |
$165.00
|
|
Compatibility test each unit electronic
|
$171.00 |
$171.00 |
$171.00 |
$171.25
|
|
Compatibility test each unit immediate spin technique
|
$177.90 |
$177.90 |
$177.90 |
$169.52
|
|
Complement antigen each component c3
|
$265.50 |
$265.50 |
$265.50 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$478.95 |
$478.95 |
$478.95 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$695.40 |
$695.40 |
$695.40 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$478.95 |
$478.95 |
$478.95 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$487.20 |
$487.20 |
$487.20 |
$1,193.40
|
|
Complx repair enel addl 5cm/< 13153
|
$490.50 |
$490.50 |
$490.50 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$449.25 |
$449.25 |
$449.25 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$478.95 |
$478.95 |
$478.95 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$490.50 |
$490.50 |
$490.50 |
$531.30
|
|
Complx repair sal addl 5 cm/> 13122
|
$478.95 |
$478.95 |
$478.95 |
$498.27
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$423.45 |
$423.45 |
$423.45 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$382.80 |
$382.80 |
$382.80 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$1,350.27 |
$1,350.27 |
$1,350.27 |
$1,350.27
|
|
Composite drsg >16<=48 sq in
|
$147.60 |
$147.60 |
$147.60 |
$43.20
|
|
Composite drsg <= 16 sq in
|
$31.98 |
$31.98 |
$31.98 |
$4.80
|
|
Compression stocking bk18-30
|
$186.96 |
$186.96 |
$186.96 |
$97.50
|
|
Concentration infection agents any type
|
$133.35 |
$133.35 |
$133.35 |
$48.91
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$5,061.60 |
$5,061.60 |
$5,061.60 |
$3,322.20
|
|
Condylomata destruction 56420
|
$306.90 |
$306.90 |
$306.90 |
$469.00
|
|
Conivaptan hcl
|
$1,838.43 |
$1,838.43 |
$1,838.43 |
$1,625.08
|
|
Conjugated estrogens 25 mg solution for injection
|
$794.99 |
$794.99 |
$794.99 |
$871.08
|
|
Connect omega .5mm
|
$1,393.59 |
$1,393.59 |
$1,393.59 |
$1,260.00
|
|
Connector tis 2x10mm
|
$6,223.20 |
$6,223.20 |
$6,223.20 |
$3,967.08
|
|
Consultation pathology during surgery
|
$74.70 |
$74.70 |
$74.70 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$490.20 |
$490.20 |
$490.20 |
$426.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$377.25 |
$377.25 |
$377.25 |
$109.90
|
|
Consultation pathology during surgery frozen section first tissue block
|
$832.50 |
$832.50 |
$832.50 |
$223.86
|
|
Consultation/report referred slides prepared elsewhere
|
$253.35 |
$253.35 |
$253.35 |
$171.65
|
|
Contact layer >16<= 48 sq in
|
$285.36 |
$285.36 |
$285.36 |
$36.12
|
|
Cont intraop neuro monitor
|
$709.35 |
$709.35 |
$709.35 |
$73.60
|
|
Contrast x-ray gallbladder
|
$505.95 |
$505.95 |
$505.95 |
$350.22
|
|
Contrast x-ray of ankle
|
$571.35 |
$571.35 |
$571.35 |
$575.82
|
|
Contrast x-ray of elbow
|
$594.30 |
$594.30 |
$594.30 |
$625.35
|
|
Contrast x-ray of hip
|
$468.00 |
$468.00 |
$468.00 |
$739.05
|
|
Contrast x-ray of knee joint
|
$564.45 |
$564.45 |
$564.45 |
$686.25
|
|
Contrast x-ray of wrist
|
$564.45 |
$564.45 |
$564.45 |
$602.68
|
|
Controller infinity pt dbs
|
$5,277.60 |
$5,277.60 |
$5,277.60 |
$4,494.00
|
|
Control nosebleed pack+caut 30905
|
$284.40 |
$284.40 |
$284.40 |
$385.45
|
|
Control of nosebleedantersmpl 30901
|
$284.40 |
$284.40 |
$284.40 |
$342.24
|
|
Coombs direct
|
$160.35 |
$160.35 |
$160.35 |
$73.15
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$11,443.20 |
$11,443.20 |
$11,443.20 |
$8,280.00
|
|
Cortisol total am
|
$396.00 |
$396.00 |
$396.00 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$230.22 |
$230.22 |
$230.22 |
$191.70
|
|
Coveredge 32 lead kit 40cm 48
|
$30,000.00 |
$30,000.00 |
$30,000.00 |
$3,961.00
|
|
#coxa-coxsackie a serotype a16
|
$47.55 |
$47.55 |
$47.55 |
$60.00
|
|
C-peptide
|
$67.95 |
$67.95 |
$67.95 |
$93.60
|
|
Cranial cervical torticollis
|
$573.85 |
$573.85 |
$573.85 |
$573.85
|
|
C-reactive protein
|
$123.90 |
$123.90 |
$123.90 |
$64.20
|
|
C-reactive protein high sensitivity
|
$47.55 |
$47.55 |
$47.55 |
$82.60
|
|
Creatine kinase
|
$236.40 |
$236.40 |
$236.40 |
$65.60
|
|
Creatine kinase mb
|
$317.85 |
$317.85 |
$317.85 |
$113.63
|
|
Creatine - sendout
|
$213.15 |
$213.15 |
$213.15 |
$39.00
|
|
Creatinine
|
$166.20 |
$166.20 |
$166.20 |
$44.72
|
|
Creatinine 24 hour urine
|
$113.40 |
$113.40 |
$113.40 |
$60.97
|
|
Creatinine clearance urine
|
$135.45 |
$135.45 |
$135.45 |
$87.50
|
|
#creutz-prot.,western blot
|
$326.40 |
$326.40 |
$326.40 |
$166.20
|
|
Critical care 30-74 minutes
|
$1,929.60 |
$1,929.60 |
$1,929.60 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$731.40 |
$731.40 |
$731.40 |
$731.40
|
|
Crotalidae poly immune fab
|
$12,664.08 |
$12,664.08 |
$12,664.08 |
$5,590.35
|
|
Cryofibrinogen qualitative - sendout
|
$55.65 |
$55.65 |
$55.65 |
$52.50
|
|
Crystal identification light microscopy
|
$84.00 |
$84.00 |
$84.00 |
$62.00
|
|
Cta abdomen without & /or w/contrast
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$2,022.72
|
|
Cta neck without &/or w/contrast
|
$2,830.05 |
$2,830.05 |
$2,830.05 |
$1,908.00
|
|
CT Angiogram of Abdomen and Pelvis
|
$5,878.20 |
$5,878.20 |
$5,878.20 |
$2,839.85
|
|
CT Angiogram of the Chest (for blood clot)
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$1,916.50
|
|
CT Angiogram of the Head
|
$2,830.05 |
$2,830.05 |
$2,830.05 |
$1,946.10
|
