|
Complex repair trunk 1.1-2.5cm 13120
|
$450.00 |
$450.00 |
$450.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$450.00 |
$450.00 |
$450.00 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$450.00 |
$450.00 |
$450.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,098.00 |
$1,098.00 |
$1,098.00 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$823.80 |
$823.80 |
$823.80 |
$490.50
|
|
Complx repair fccmnaxghf 13132
|
$1,045.80 |
$1,045.80 |
$1,045.80 |
$1,107.60
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$450.00 |
$450.00 |
$450.00 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$450.00 |
$450.00 |
$450.00 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$3,292.97 |
$3,292.97 |
$3,292.97 |
$1,350.27
|
|
Concentration infection agents any type
|
$27.00 |
$27.00 |
$27.00 |
$49.95
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$27,685.51 |
$27,685.51 |
$27,685.51 |
$3,322.20
|
|
Condylomata destruction 56420
|
$128.40 |
$128.40 |
$128.40 |
$469.00
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,537.67 |
$1,537.67 |
$1,537.67 |
$871.08
|
|
Connect omega .5mm
|
$11,573.57 |
$11,573.57 |
$11,573.57 |
$1,260.00
|
|
Connector tis 2x10mm
|
$12,237.83 |
$12,237.83 |
$12,237.83 |
$4,091.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$81.00 |
$81.00 |
$81.00 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$84.00 |
$84.00 |
$84.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$176.40 |
$176.40 |
$176.40 |
$225.96
|
|
Controler lvad heartmate 3 includes ebb
|
$28,298.99 |
$28,298.99 |
$28,298.99 |
$13,218.75
|
|
Controller infinity pt dbs
|
$7,294.41 |
$7,294.41 |
$7,294.41 |
$4,611.60
|
|
Control nosebleed pack+caut 30905
|
$207.60 |
$207.60 |
$207.60 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$207.60 |
$207.60 |
$207.60 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$270.00 |
$270.00 |
$270.00 |
$355.50
|
|
Control oropharyngeal hemorr/simp 42960
|
$329.40 |
$329.40 |
$329.40 |
$634.80
|
|
Control throat bleeding
|
$2,049.00 |
$2,049.00 |
$2,049.00 |
$3,984.00
|
|
Coombs direct
|
$103.20 |
$103.20 |
$103.20 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$91.20 |
$91.20 |
$91.20 |
$102.90
|
|
Coombs indirect titer reference
|
$283.20 |
$283.20 |
$283.20 |
$146.40
|
|
Copper cu 64 dotatate diag
|
$36,960.00 |
$36,960.00 |
$36,960.00 |
$2,417.86
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$19,789.50 |
$19,789.50 |
$19,789.50 |
$8,272.50
|
|
Cortisol total am
|
$64.20 |
$64.20 |
$64.20 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$105.10 |
$105.10 |
$105.10 |
$189.22
|
|
Coveredge 32 lead kit 40cm 48
|
$12,605.91 |
$12,605.91 |
$12,605.91 |
$3,908.16
|
|
Covers for upright each
|
$135.71 |
$135.71 |
$135.71 |
$89.98
|
|
Cover wrist
|
$132.98 |
$132.98 |
$132.98 |
$225.00
|
|
#coxa-coxsackie a serotype a16
|
$48.60 |
$48.60 |
$48.60 |
$60.00
|
|
C-peptide
|
$81.60 |
$81.60 |
$81.60 |
$97.30
|
|
Cranial cervical orthosis
|
$24,736.88 |
$24,736.88 |
$24,736.88 |
$11,130.00
|
|
C-reactive protein
|
$43.20 |
$43.20 |
$43.20 |
$68.38
|
|
C-reactive protein high sensitivity
|
$45.60 |
$45.60 |
$45.60 |
$85.00
|
|
Creatine kinase
|
$33.00 |
$33.00 |
$33.00 |
$66.30
|
|
Creatine kinase isoenzymes
|
$49.80 |
$49.80 |
$49.80 |
$56.80
|
|
Creatine - sendout
|
$18.00 |
$18.00 |
$18.00 |
$39.00
|
|
Creatinine
|
$20.40 |
$20.40 |
$20.40 |
$44.72
|
|
Creatinine 24 hour urine
|
$21.00 |
$21.00 |
$21.00 |
$58.85
|
|
Creatinine clearance urine
|
$36.60 |
$36.60 |
$36.60 |
$89.50
|
|
#creutz-prot.,western blot
|
$228.60 |
$228.60 |
$228.60 |
$166.20
|
|
Crisis psychotherapy 90839
|
$289.20 |
$289.20 |
$289.20 |
$313.30
|
|
Critical care 30-74 minutes
|
$553.20 |
$553.20 |
$553.20 |
$2,505.60
|
|
Crotalidae poly immune fab
|
$5,180.76 |
$5,180.76 |
$5,180.76 |
$5,590.35
|
|
Crystal identification light microscopy
|
$16.20 |
$16.20 |
$16.20 |
$62.50
|
|
Cta abdomen without & /or w/contrast
|
$979.80 |
$979.80 |
$979.80 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,991.60 |
$2,991.60 |
$2,991.60 |
$1,940.00
|
|
Cta neck without &/or w/contrast
|
$708.60 |
$708.60 |
$708.60 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$1,464.00 |
$1,464.00 |
$1,464.00 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$858.60 |
$858.60 |
$858.60 |
$1,940.00
|
|
CT Angiogram of the Head
|
$849.00 |
$849.00 |
$849.00 |
$1,996.80
|
|
CT angio pelvis
|
$1,537.20 |
$1,537.20 |
$1,537.20 |
$1,837.80
|
|
CT heart w/evaluation of calcium without contrast
|
$129.00 |
$129.00 |
$129.00 |
$171.60
|
|
CT lower extremity w/contrast (both sides)
|
$721.20 |
$721.20 |
$721.20 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$604.20 |
$604.20 |
$604.20 |
$1,421.85
|
|
Ctlso a-p-l control molded
|
$7,104.19 |
$7,104.19 |
$7,104.19 |
$3,746.69
|
|
Ctlso a-p-l control with inter
|
$7,809.45 |
$7,809.45 |
$7,809.45 |
$4,186.78
|
|
Ctlso axilla sling
|
$298.58 |
$298.58 |
$298.58 |
$197.97
|
|
Ctlso milwauke initial model
|
$7,236.31 |
$7,236.31 |
$7,236.31 |
$4,797.91
|
|
CT lwr extremity w/o&w/dye
|
$1,698.00 |
$1,698.00 |
$1,698.00 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$690.00 |
$690.00 |
$690.00 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$576.00 |
$576.00 |
$576.00 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$862.20 |
$862.20 |
$862.20 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$3,117.00 |
$3,117.00 |
$3,117.00 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$576.00 |
$576.00 |
$576.00 |
$1,360.00
|
|
Ctrl nosebld postir subsq 30906
|
$150.00 |
$150.00 |
$150.00 |
$437.04
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$2,065.80 |
$2,065.80 |
$2,065.80 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$2,169.00 |
$2,169.00 |
$2,169.00 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$1,409.40 |
$1,409.40 |
$1,409.40 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$862.20 |
$862.20 |
$862.20 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$721.20 |
$721.20 |
$721.20 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$283.80 |
$283.80 |
$283.80 |
$331.50
|
|
CT upper extremity w/contrast (both sides)
|
$721.20 |
$721.20 |
$721.20 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$604.20 |
$604.20 |
$604.20 |
$1,430.20
|
|
Cuffs adj lock with active con
|
$3,489.64 |
$3,489.64 |
$3,489.64 |
$1,472.80
|
|
Culture aerobic additional method definitive id each
|
$32.40 |
$32.40 |
$32.40 |
$68.64
|
|
Culture afb any source
|
$178.80 |
$178.80 |
$178.80 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$32.40 |
$32.40 |
$32.40 |
$79.00
|
|
Culture anaerobic except blood
|
$36.60 |
$36.60 |
$36.60 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$20.40 |
$20.40 |
$20.40 |
$51.45
|
|
Culture body fluid
|
$34.20 |
$34.20 |
$34.20 |
$126.75
|
|
Culture fungi definitive id mold
|
$39.00 |
$39.00 |
$39.00 |
$77.28
|
|
Culture fungi definitive id yeast
|
$81.60 |
$81.60 |
$81.60 |
$79.10
|
|
Culture fungi other (except blood)
|
$31.80 |
$31.80 |
$31.80 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$121.80 |
$121.80 |
$121.80 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$49.20 |
$49.20 |
$49.20 |
$89.70
|
|
Culture mycoplasma any source
|
$57.60 |
$57.60 |
$57.60 |
$85.26
|
|
Culture screening strep group a
|
$24.60 |
$24.60 |
$24.60 |
$81.00
|
|
Culture typing immunologic
|
$54.60 |
$54.60 |
$54.60 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$654.00 |
$654.00 |
$654.00 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$105.60 |
$105.60 |
$105.60 |
$133.90
|
|
Culture urine each isolate
|
$85.80 |
$85.80 |
$85.80 |
$57.00
|
|
Cutter lead
|
$14,129.71 |
$14,129.71 |
$14,129.71 |
$6,092.06
|
|
Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution
|
$4.80 |
$4.80 |
$4.80 |
$25.20
|
