|
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
|
$744.48 |
$744.48 |
$744.48 |
$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 |
$1,107.60
|
|
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
|
|
Concentration infection agents any type
|
$40.92 |
$40.92 |
$40.92 |
$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
|
$820.38 |
$820.38 |
$820.38 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$168.30 |
$168.30 |
$168.30 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$262.68 |
$262.68 |
$262.68 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$366.96 |
$366.96 |
$366.96 |
$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
|
|
Contrast x-ray of ankle
|
$1,242.78 |
$1,242.78 |
$1,242.78 |
$612.30
|
|
Contrast x-ray of elbow
|
$900.90 |
$900.90 |
$900.90 |
$649.80
|
|
Contrast x-ray of hip
|
$1,657.92 |
$1,657.92 |
$1,657.92 |
$771.12
|
|
Contrast x-ray of knee joint
|
$955.68 |
$955.68 |
$955.68 |
$769.88
|
|
Contrast x-ray of wrist
|
$830.94 |
$830.94 |
$830.94 |
$637.00
|
|
Control nosebleed pack+caut 30905
|
$411.84 |
$411.84 |
$411.84 |
$392.60
|
|
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
|
|
Coombs direct
|
$59.40 |
$59.40 |
$59.40 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$172.26 |
$172.26 |
$172.26 |
$102.90
|
|
Coombs indirect titer reference
|
$172.26 |
$172.26 |
$172.26 |
$146.40
|
|
Core ndl bx lng/med perq
|
$4,041.18 |
$4,041.18 |
$4,041.18 |
$2,678.00
|
|
Coronary thrombolysis/iv infusion 92977
|
$603.24 |
$603.24 |
$603.24 |
$476.00
|
|
Cortisol total am
|
$99.00 |
$99.00 |
$99.00 |
$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
|
|
#coxa-coxsackie a serotype a16
|
$129.36 |
$129.36 |
$129.36 |
$60.00
|
|
C-peptide
|
$81.18 |
$81.18 |
$81.18 |
$97.30
|
|
C-reactive protein
|
$125.40 |
$125.40 |
$125.40 |
$68.38
|
|
C-reactive protein high sensitivity
|
$147.84 |
$147.84 |
$147.84 |
$85.00
|
|
C-reactive protein, quantitative
|
$71.28 |
$71.28 |
$71.28 |
$71.06
|
|
Creatine kinase
|
$42.24 |
$42.24 |
$42.24 |
$66.30
|
|
Creatine kinase isoenzymes
|
$73.92 |
$73.92 |
$73.92 |
$56.80
|
|
Creatine kinase mb
|
$54.12 |
$54.12 |
$54.12 |
$114.00
|
|
Creatine - sendout
|
$33.66 |
$33.66 |
$33.66 |
$39.00
|
|
Creatinine
|
$62.04 |
$62.04 |
$62.04 |
$44.72
|
|
Creatinine 24 hour urine
|
$62.70 |
$62.70 |
$62.70 |
$58.85
|
|
Creatinine clearance urine
|
$72.60 |
$72.60 |
$72.60 |
$89.50
|
|
Critical care 30-74 minutes
|
$1,448.04 |
$1,448.04 |
$1,448.04 |
$2,505.60
|
|
Cryofibrinogen qualitative - sendout
|
$42.24 |
$42.24 |
$42.24 |
$52.50
|
|
Cryoprecipitate each unit
|
$155.10 |
$155.10 |
$155.10 |
$144.78
|
|
Cryptosporidium antigen
|
$89.10 |
$89.10 |
$89.10 |
$52.08
|
|
Crystal identification light microscopy
|
$49.50 |
$49.50 |
$49.50 |
$62.50
|
|
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
|
|
Cta abdomen without & /or w/contrast
|
$1,994.52 |
$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 |
$1,907.40 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,002.44 |
$2,002.44 |
$2,002.44 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,358.08 |
$3,358.08 |
$3,358.08 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$1,859.88 |
$1,859.88 |
$1,859.88 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,091.54 |
$2,091.54 |
$2,091.54 |
$1,996.80
|
|
CT angio pelvis
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$1,837.80
|
|
Cta upper extremity w &/or without contrast left
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$1,698.00
|
|
CT guidance for needle placement
|
$1,263.24 |
$1,263.24 |
$1,263.24 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,215.06 |
$1,215.06 |
$1,215.06 |
$1,178.52
|
|
CT limited or localized follow-up study
|
$769.56 |
$769.56 |
$769.56 |
$642.75
|
|
CT lower extremity w/contrast (both sides)
|
$1,574.76 |
$1,574.76 |
$1,574.76 |
$1,652.00
|
|
CT lower extremity without contrast (both sides)
|
$1,430.88 |
$1,430.88 |
$1,430.88 |
$1,421.85
|
|
CT lwr extremity w/o&w/dye
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$1,854.05
|
|
CT neck soft tissue w/contrast
|
$1,595.22 |
$1,595.22 |
$1,595.22 |
$1,652.00
|
|
CT neck soft tissue without contrast
|
$1,259.28 |
$1,259.28 |
$1,259.28 |
$1,327.95
|
|
CT neck soft tissue without & w/contrast
|
$2,091.54 |
$2,091.54 |
$2,091.54 |
$1,959.75
|
|
CT orbit/sella/fossa w/wo contrast
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$1,728.18
|
|
CT orbit/sella/ or posterior outer inner or middle ear w/contrast
|
$1,770.12 |
$1,770.12 |
$1,770.12 |
$1,543.83
|
|
CT orbit/sella/ or posterior outer inner or middle ear without contrast
|
$1,351.02 |
$1,351.02 |
$1,351.02 |
$1,360.00
|
|
CT scan for localization
|
$2,583.90 |
$2,583.90 |
$2,583.90 |
$1,205.14
|
|
CT Scan of Abdomen and Pelvis (with and without contrast)
|
$3,550.14 |
$3,550.14 |
$3,550.14 |
$3,493.80
|
|
CT Scan of Abdomen and Pelvis (with contrast)
|
$3,016.86 |
$3,016.86 |
$3,016.86 |
$2,971.80
|
|
CT Scan of Abdomen and Pelvis (without contrast)
|
$2,544.96 |
$2,544.96 |
$2,544.96 |
$2,370.63
|
|
CT thoracic spine w/contrast
|
$1,539.12 |
$1,539.12 |
$1,539.12 |
$1,690.32
|
|
CT thoracic spine without contrast
|
$1,448.04 |
$1,448.04 |
$1,448.04 |
$1,464.00
|
|
CT thorax low dose for lung screening without contrast
|
$769.56 |
$769.56 |
$769.56 |
$331.50
|
|
CT t-spine w /wo contrast
|
$1,818.96 |
$1,818.96 |
$1,818.96 |
$2,027.52
|
|
CT upper extremity w/contrast (both sides)
|
$1,770.12 |
$1,770.12 |
$1,770.12 |
$1,694.16
|
|
CT upper extremity without contrast (both sides)
|
$1,335.18 |
$1,335.18 |
$1,335.18 |
$1,430.20
|
|
CT uppr extremity w/o&w/dye
|
$1,846.68 |
$1,846.68 |
$1,846.68 |
$1,845.36
|
|
Culture aerobic additional method definitive id each
|
$108.90 |
$108.90 |
$108.90 |
$68.64
|
|
Culture afb any source
|
$143.22 |
$143.22 |
$143.22 |
$109.20
|
|
Culture anaerobic additional method definitive id each
|
$59.40 |
$59.40 |
$59.40 |
$79.00
|
|
Culture anaerobic except blood
|
$89.10 |
$89.10 |
$89.10 |
$120.00
|
|
Culture bact stool aero addl path ea
|
$203.94 |
$203.94 |
$203.94 |
$51.45
|
|
Culture body fluid
|
$237.60 |
$237.60 |
$237.60 |
$126.75
|
|
Culture fungi definitive id mold
|
$68.64 |
$68.64 |
$68.64 |
$77.28
|
|
Culture fungi definitive id yeast
|
$85.14 |
$85.14 |
$85.14 |
$79.10
|
|
Culture fungi other (except blood)
|
$68.64 |
$68.64 |
$68.64 |
$108.00
|
|
Culture fungi skin/hair/nail
|
$118.14 |
$118.14 |
$118.14 |
$74.88
|
|
Culture mycobacteria definitive id each isolate
|
$138.60 |
$138.60 |
$138.60 |
$89.70
|
|
Culture mycoplasma any source
|
$79.86 |
$79.86 |
$79.86 |
$85.26
|
|
Culture screening strep group a
|
$55.44 |
$55.44 |
$55.44 |
$81.00
|
|
Culture typing immunologic
|
$117.48 |
$117.48 |
$117.48 |
$44.00
|
|
Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets
|
$483.78 |
$483.78 |
$483.78 |
$392.50
|
|
Culture typing nucleic acid probe amplified per culture/isolate each organism
|
$173.58 |
$173.58 |
$173.58 |
$133.90
|