|
Complex repair trunk 2.6-7.5cm 13101
|
$898.92 |
$898.92 |
$898.92 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$207.50 |
$207.50 |
$207.50 |
$346.71
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,285.02 |
$1,285.02 |
$1,285.02 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$681.12 |
$681.12 |
$681.12 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$1,186.68 |
$1,186.68 |
$1,186.68 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$1,285.02 |
$1,285.02 |
$1,285.02 |
$1,108.88
|
|
Complx repair fccmnaxghf 13133
|
$494.34 |
$494.34 |
$494.34 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$494.34 |
$494.34 |
$494.34 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$898.92 |
$898.92 |
$898.92 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$494.34 |
$494.34 |
$494.34 |
$537.00
|
|
Composite graft/pri close/don area 15760
|
$3,930.30 |
$3,930.30 |
$3,930.30 |
$2,765.76
|
|
Concentration infection agents any type
|
$40.92 |
$40.92 |
$52.50 |
$49.95
|
|
Condylomata destruction 56420
|
$463.98 |
$463.98 |
$463.98 |
$469.00
|
|
Consultation pathology during surgery
|
$353.10 |
$353.10 |
$353.10 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$67.50 |
$820.38 |
$820.38 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$160.00 |
$168.30 |
$168.30 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$230.00 |
$262.68 |
$262.68 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$366.96 |
$366.96 |
$372.50 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$456.72 |
$456.72 |
$456.72 |
$171.65
|
|
Consult comp w/report rfrd material
|
$993.96 |
$993.96 |
$993.96 |
$365.60
|
|
Contact layer >16<= 48 sq in
|
$45.00 |
$45.00 |
$45.00 |
$36.17
|
|
Contrast exam abdominl aorta 75625-26
|
$2,590.00 |
$3,833.94 |
$3,833.94 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$2,235.00 |
$6,243.60 |
$6,243.60 |
$3,728.24
|
|
Contrast x-ray of ankle
|
$1,242.78 |
$1,242.78 |
$1,242.78 |
$612.30
|
|
Contrast x-ray of brain
|
$915.00 |
$915.00 |
$915.00 |
$981.75
|
|
Contrast x-ray of elbow
|
$900.90 |
$900.90 |
$900.90 |
$649.80
|
|
Contrast x-ray of hip
|
$965.00 |
$1,657.92 |
$1,657.92 |
$781.13
|
|
Contrast x-ray of knee joint
|
$955.68 |
$955.68 |
$965.00 |
$769.88
|
|
Contrast x-ray of wrist
|
$655.00 |
$830.94 |
$830.94 |
$639.00
|
|
Controller infinity pt dbs
|
$2,801.86 |
$2,801.86 |
$2,801.86 |
$4,611.60
|
|
Control nosebleed pack+caut 30905
|
$411.84 |
$411.84 |
$411.84 |
$396.00
|
|
Control of nosebleed ant comp 30903
|
$434.28 |
$434.28 |
$434.28 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$357.72 |
$357.72 |
$357.72 |
$355.50
|
|
Conversion ext bil drg cath
|
$1,955.00 |
$4,076.16 |
$4,076.16 |
$4,176.15
|
|
Convert nephrostomy catheter
|
$3,635.00 |
$6,106.32 |
$6,106.32 |
$2,777.60
|
|
Coombs direct
|
$59.40 |
$59.40 |
$67.50 |
$74.75
|
|
Coombs indirect qualitative each reagent red cell reference
|
$172.26 |
$172.26 |
$172.26 |
$102.90
|
|
Coombs indirect titer reference
|
$130.00 |
$172.26 |
$172.26 |
$146.40
|
|
Copper cu 64 dotatate diag
|
$1,250.00 |
$1,250.00 |
$1,250.00 |
$2,417.86
|
|
Core ndl bx lng/med perq
|
$1,270.00 |
$4,041.18 |
$4,041.18 |
$2,678.00
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$5,320.00 |
$5,320.00 |
$5,320.00 |
$8,272.50
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$7,242.84 |
$7,242.84 |
$7,242.84 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$8,833.44 |
$8,833.44 |
$8,833.44 |
$10,263.12
|
|
Coronary angio/lv gram/rt< heart
|
$7,684.38 |
$7,684.38 |
$7,684.38 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$8,833.44 |
$8,833.44 |
$8,833.44 |
$8,194.20
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$9,716.52 |
$9,716.52 |
$9,716.52 |
$7,914.00
|
|
Coronary thrombolysis/iv infusion 92977
|
$603.24 |
$603.24 |
$603.24 |
$476.00
|
|
Cortisol acth stimulation test - sendout
|
$200.00 |
$200.00 |
$200.00 |
$146.25
|
|
Cortisol total am
|
$99.00 |
$99.00 |
$117.50 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$350.33 |
$350.33 |
$350.33 |
$189.22
|
|
Counseling smoke cess interm >10mins
|
$52.80 |
$52.80 |
$52.80 |
$55.90
|
|
Counseling visit to discuss need for ldct g0296
|
$106.92 |
$106.92 |
$106.92 |
$98.14
|
|
Coveredge 32 lead kit 40cm 48
|
$2,570.00 |
$2,570.00 |
$2,570.00 |
$3,902.40
|
|
Cover wrist
|
$225.00 |
$225.00 |
$225.00 |
$225.00
|
|
Covid-19 administration immunization im inj 1st/only component
|
$42.50 |
$42.50 |
$42.50 |
$49.13
|
|
#coxa-coxsackie a serotype a16
|
$60.00 |
$129.36 |
$129.36 |
$60.00
|
|
C-peptide
|
$81.18 |
$81.18 |
$87.50 |
$97.30
|
|
Cptr-asst dir ms px
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$7,972.25
|
|
Crbrospnl fld flw imag cistern
|
$1,155.00 |
$1,828.86 |
$1,828.86 |
$1,240.80
|
|
C-reactive protein
|
$39.60 |
$39.60 |
$60.00 |
$68.38
|
|
C-reactive protein high sensitivity
|
$77.50 |
$147.84 |
$147.84 |
$85.00
|
|
C-reactive protein, quantitative
|
$57.50 |
$71.28 |
$71.28 |
$71.06
|
|
Creatine kinase
|
$42.24 |
$42.24 |
$62.50 |
$66.30
|
|
Creatine kinase isoenzymes
|
$57.50 |
$73.92 |
$73.92 |
$57.50
|
|
Creatine kinase mb
|
$54.12 |
$54.12 |
$130.00 |
$114.00
|
|
Creatine - sendout
|
$33.66 |
$33.66 |
$33.66 |
$38.35
|
|
Creatinine
|
$31.68 |
$31.68 |
$37.50 |
$44.72
|
|
Creatinine 24 hour urine
|
$50.00 |
$66.66 |
$66.66 |
$58.85
|
|
Creatinine clearance urine
|
$72.60 |
$72.60 |
$80.00 |
$89.50
|
|
#creutz-prot.,western blot
|
$361.68 |
$361.68 |
$400.00 |
$166.20
|
|
Crisis psychotherapy 90839
|
$217.80 |
$217.80 |
$217.80 |
$313.30
|
|
Crisis psychotherapy additional 30 mins 90840
|
$108.90 |
$108.90 |
$108.90 |
$149.52
|
|
Critical care 30-74 minutes
|
$945.00 |
$2,028.84 |
$2,445.96 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$312.50 |
$312.50 |
$312.50 |
$731.40
|
|
Crizanlizumab-tmca 10 mg/ml intravenous solution
|
$271.28 |
$271.28 |
$271.28 |
$4,288.58
|
|
Cryo fib comp path redu each
|
$370.00 |
$370.00 |
$370.00 |
$470.50
|
|
Cryofibrinogen qualitative - sendout
|
$42.24 |
$42.24 |
$52.50 |
$52.50
|
|
Cryoprecipitate each unit
|
$75.00 |
$155.10 |
$155.10 |
$144.78
|
|
Cryopreserve testicular tiss
|
$60.00 |
$60.00 |
$60.00 |
$72.08
|
|
Cryptosporidium antigen
|
$89.10 |
$89.10 |
$89.10 |
$52.08
|
|
Crystal identification light microscopy
|
$49.50 |
$49.50 |
$55.00 |
$62.40
|
|
Csf leakage imaging
|
$1,828.86 |
$1,828.86 |
$1,828.86 |
$1,544.85
|
|
Cstb gene full gene sequence
|
$317.46 |
$317.46 |
$317.46 |
$302.31
|
|
CT 3d report other modality w/workstation
|
$312.50 |
$724.68 |
$724.68 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$1,940.00 |
$1,994.52 |
$1,994.52 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$1,907.40 |
$1,907.40 |
$1,940.00 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$1,940.00 |
$2,002.44 |
$2,002.44 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$1,126.62 |
$1,126.62 |
$1,940.00 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$2,910.00 |
$3,358.08 |
$3,358.08 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,859.88 |
$1,859.88 |
$1,940.00 |
$1,940.00
|
|
CT Angiogram of the Head
|
$1,940.00 |
$2,091.54 |
$2,091.54 |
$1,996.80
|
|
CT angio hrt w/3d image
|
$1,259.28 |
$1,259.28 |
$1,675.00 |
$1,501.56
|
|
CT angio pelvis
|
$1,818.96 |
$1,818.96 |
$1,940.00 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$1,818.96 |
$1,818.96 |
$3,880.00 |
$1,697.80
|
|
CT colonography dx
|
$1,119.36 |
$1,119.36 |
$1,470.00 |
$791.00
|
|
CT colonography dx w/dye
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,037.00
|
|
CT colonography screening
|
$500.00 |
$500.00 |
$500.00 |
$1,084.20
|
|
CT guidance for needle placement
|
$1,263.24 |
$1,263.24 |
$1,300.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,215.06 |
$1,215.06 |
$1,250.00 |
$1,168.20
|
