|
Circum 28 days or older
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$3,786.00
|
|
Circumcise/surg/28 days or < 54160
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$1,219.20
|
|
Circumcision (newborn)
|
$3,442.80 |
$3,442.80 |
$3,442.80 |
$1,358.70
|
|
C-kit mutation liquid tumor - sendout
|
$624.40 |
$624.40 |
$624.40 |
$659.20
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$18,200.00 |
$18,200.00 |
$18,200.00 |
$15,779.40
|
|
Clearance of airways
|
$128.00 |
$128.00 |
$128.00 |
$208.00
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$31.46 |
$31.46 |
$31.46 |
$55.20
|
|
Clip ligating vesolock lg
|
$4,900.00 |
$4,900.00 |
$4,900.00 |
$4,194.00
|
|
Clip phn wireless f/baha4 proc
|
$179.60 |
$179.60 |
$179.60 |
$474.43
|
|
Cllr miami j sm
|
$169.20 |
$169.20 |
$169.20 |
$552.23
|
|
Closure paravalvlr leak pq
|
$1,531.60 |
$1,531.60 |
$1,531.60 |
$8,455.19
|
|
Clot factor fletcher fact
|
$52.40 |
$52.40 |
$52.40 |
$116.82
|
|
Clot factor viii reltd antgn
|
$50.40 |
$50.40 |
$50.40 |
$159.06
|
|
Clot factor wght kininogen
|
$52.40 |
$52.40 |
$52.40 |
$157.50
|
|
Clot factor xii hageman
|
$48.40 |
$48.40 |
$48.40 |
$135.01
|
|
Clot factor xiii fibrin scrn
|
$22.40 |
$22.40 |
$22.40 |
$57.75
|
|
Clot factor xiii fibrin stab
|
$39.60 |
$39.60 |
$39.60 |
$106.26
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$1,046.00 |
$1,046.00 |
$1,046.00 |
$448.80
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$5,009.20 |
$5,009.20 |
$5,009.20 |
$3,678.17
|
|
#cms hgb-sulfhemoglobin
|
$22.40 |
$22.40 |
$22.40 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$48.40 |
$48.40 |
$48.40 |
$87.75
|
|
Cmv pcr-sendout
|
$88.40 |
$88.40 |
$88.40 |
$177.50
|
|
Cnbp gene detc abnor allele
|
$260.00 |
$260.00 |
$260.00 |
$313.60
|
|
Coagulation time activated teg
|
$11.20 |
$11.20 |
$11.20 |
$53.55
|
|
Coagulation time otr method
|
$10.00 |
$10.00 |
$10.00 |
$20.00
|
|
Cold agglutinin titer
|
$20.40 |
$20.40 |
$20.40 |
$51.60
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$27.20 |
$27.20 |
$27.20 |
$62.40
|
|
Collar cerv adlt perfit ace extric
|
$50.00 |
$50.00 |
$50.00 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$339.20 |
$339.20 |
$339.20 |
$213.89
|
|
Collar cerv patriot adlt
|
$66.40 |
$66.40 |
$66.40 |
$134.66
|
|
Collar extrication adult univ
|
$378.40 |
$378.40 |
$378.40 |
$800.32
|
|
Collection blood specimen from completely implantable venous access device
|
$136.40 |
$136.40 |
$136.40 |
$160.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$136.40 |
$136.40 |
$136.40 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$8.40 |
$8.40 |
$8.40 |
$21.00
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$338.00 |
$338.00 |
$338.00 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$2,230.80 |
$2,230.80 |
$2,230.80 |
$314.00
|
|
Colposcopy vulva 56820
|
$372.40 |
$372.40 |
$372.40 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$456.80 |
$456.80 |
$456.80 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$377.20 |
$377.20 |
$377.20 |
$485.50
|
|
Colpotomy w/exploration 57000
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$4,075.20
|
|
Combination bilateral ho
|
$1,182.40 |
$1,182.40 |
$1,182.40 |
$4,015.50
|
|
Combo ankle/foot prosthesis
|
$284.00 |
$284.00 |
$284.00 |
$512.40
|
|
Compatibility test each unit antiglobulin technique
|
$118.00 |
$118.00 |
$118.00 |
$172.00
|
|
Compatibility test each unit electronic
|
$118.00 |
$118.00 |
$118.00 |
$166.26
|
|
Compatibility test each unit immediate spin technique
|
$118.00 |
$118.00 |
$118.00 |
$167.17
|
|
Comp cystometrogram/void presssure 51728
|
$996.00 |
$996.00 |
$996.00 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,621.20 |
$1,621.20 |
$1,621.20 |
$1,111.03
|
|
Complement antigen each component c3
|
$31.20 |
$31.20 |
$31.20 |
$110.00
|
|
Complement fixation each
|
$17.60 |
$17.60 |
$17.60 |
$29.12
|
|
Complex cystometrogram 51726
|
$664.00 |
$664.00 |
$664.00 |
$727.35
|
|
Complex uroflowmetry (electronic) 51741
|
$315.60 |
$315.60 |
$315.60 |
$344.68
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$2,753.60 |
$2,753.60 |
$2,753.60 |
$1,003.80
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$433.20 |
$433.20 |
$433.20 |
$1,350.27
|
|
Comprehensive hearing test
|
$354.00 |
$354.00 |
$354.00 |
$260.40
|
|
Compression stocking bk18-30
|
$32.00 |
$32.00 |
$32.00 |
$62.88
|
|
Computed tomographic angiography head and neck with contrast
|
$3,020.40 |
$3,020.40 |
$3,020.40 |
$2,237.25
|
|
Concentration infection agents any type
|
$16.40 |
$16.40 |
$16.40 |
$51.32
|
|
Conditioning play audiometry 92582
|
$298.00 |
$298.00 |
$298.00 |
$189.15
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$4,638.40 |
$4,638.40 |
$4,638.40 |
$3,352.21
|
|
Connect omega .5mm
|
$1,413.20 |
$1,413.20 |
$1,413.20 |
$1,260.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$518.00 |
$518.00 |
$518.00 |
$407.20
|
|
Consultation pathology during surgery frozen section each additional block
|
$46.00 |
$46.00 |
$46.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$149.60 |
$149.60 |
$149.60 |
$224.87
|
|
Consultation/report referred material w/preparation of slides
|
$259.20 |
$259.20 |
$259.20 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$236.40 |
$236.40 |
$236.40 |
$176.15
|
|
Consult comp w/report rfrd material
|
$446.00 |
$446.00 |
$446.00 |
$375.00
|
|
Contrast baths charges
|
$28.40 |
$28.40 |
$28.40 |
$74.25
|
|
Contrast exam abdominl aorta 75625-26
|
$2,915.60 |
$2,915.60 |
$2,915.60 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$5,138.40 |
$5,138.40 |
$5,138.40 |
$3,570.00
|
|
Contrast exam thoracic aorta 75605-26
|
$3,877.60 |
$3,877.60 |
$3,877.60 |
$3,663.60
|
|
Contrast x-ray gallbladder
|
$311.60 |
$311.60 |
$311.60 |
$341.00
|
|
Contrast x-ray of ankle
|
$706.00 |
$706.00 |
$706.00 |
$676.80
|
|
Contrast x-ray of elbow
|
$859.60 |
$859.60 |
$859.60 |
$686.95
|
|
Contrast x-ray of hip
|
$993.60 |
$993.60 |
$993.60 |
$781.13
|
|
Contrast x-ray of knee joint
|
$921.60 |
$921.60 |
$921.60 |
$777.00
|
|
Contrast x-ray of wrist
|
$874.00 |
$874.00 |
$874.00 |
$655.00
|
|
Controler lvad heartmate 3 includes ebb
|
$10,508.80 |
$10,508.80 |
$10,508.80 |
$13,218.75
|
|
Controller infinity pt dbs
|
$4,444.00 |
$4,444.00 |
$4,444.00 |
$5,123.14
|
|
Control of nosebleedantersmpl 30901
|
$238.00 |
$238.00 |
$238.00 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$321.60 |
$321.60 |
$321.60 |
$618.80
|
|
Conversion ext bil drg cath
|
$1,809.20 |
$1,809.20 |
$1,809.20 |
$4,099.56
|
|
Convert nephrostomy catheter
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
$2,777.60
|
|
Coombs direct
|
$37.60 |
$37.60 |
$37.60 |
$76.44
|
|
Coombs indirect titer reference
|
$118.00 |
$118.00 |
$118.00 |
$155.40
|
|
Core ndl bx lng/med perq
|
$1,725.60 |
$1,725.60 |
$1,725.60 |
$2,862.11
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$9,531.20 |
$9,531.20 |
$9,531.20 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$9,060.40 |
$9,060.40 |
$9,060.40 |
$10,263.12
|
|
Coronary angio/lv gram/rt< heart
|
$9,346.80 |
$9,346.80 |
$9,346.80 |
$11,280.10
|
|
Coronary art/grft angio s&i
|
$8,298.00 |
$8,298.00 |
$8,298.00 |
$8,200.40
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$8,298.00 |
$8,298.00 |
$8,298.00 |
$7,950.49
|
|
Cortisol total am
|
$40.40 |
$40.40 |
$40.40 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$59.60 |
$59.60 |
$59.60 |
$189.02
|
|
Co-treatment - group 15 mins, st
|
$68.80 |
$68.80 |
$68.80 |
$114.00
|
|
Counseling smoke cess interm >10mins
|
$52.00 |
$52.00 |
$52.00 |
$54.12
|
|
Counseling visit to discuss need for ldct g0296
|
$219.20 |
$219.20 |
$219.20 |
$102.38
|
|
Coveredge 32 lead kit 40cm 48
|
$7,256.00 |
$7,256.00 |
$7,256.00 |
$4,395.30
|
|
Cover wrist
|
$206.00 |
$206.00 |
$206.00 |
$225.00
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$588.08
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$540.00
|
|
Covid-19 lab test non-cdc
|
$75.60 |
$75.60 |
$75.60 |
$81.00
|
