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chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

chrg# cdsc cdept csrv cupr crev# 3095 med/surg, semi ... - CT.gov

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6390132 US-MIDLINE CATHETER 278 0 130 4251<br />

6390157 PICC KIT 270 0 148 4251<br />

6401210 PET/<strong>CT</strong> SKULL TO THIGH INITIAL 404 0 6699.84 4220<br />

6401228 PET/<strong>CT</strong> SKULL TO THIGH SUBSEQUENT 404 0 6699.84 4220<br />

6401251 PET/<strong>CT</strong> WHOLE BODY MELANOMA INITIAL 404 0 7724.53 4220<br />

6401269 PET/<strong>CT</strong> WHOLE BODY MELANOMA SUB 404 0 7724.53 4220<br />

6401509 PET/<strong>CT</strong>-LIMITED AREA 404 0 1775.06 4220<br />

6401608 PET-BRAIN-METAB EVAL 404 0 3732.34 4220<br />

6401616 PET-BRAIN-PERFU EVAL 404 0 3732.34 4220<br />

6401707 PET-MYOCAR META EVAL 404 0 3407.43 4220<br />

6401715 PET-CARD-REST-OR-STR 404 0 3407.43 4220<br />

6401723 PET-CARD FULL MULTI 404 0 3407.43 4220<br />

6401731 PET/<strong>CT</strong> SKULL TO THIGH INI NOPR 404 0 6699.84 4220<br />

6401749 PET/<strong>CT</strong> SKULL TO THIGH SUB NOPR 404 0 6699.84 4220<br />

6401756 PET/<strong>CT</strong> WHOLE BODY MELANOMA IN NOPR 404 0 7724.53 4220<br />

6401764 PET/<strong>CT</strong> WHOLE BODY MEL SUB NOPR 404 0 7724.53 4220<br />

6490106 PET-FDG-ISOTOPE 343 0 992.77 4220<br />

6500102 MRI-ABDOMEN W/O CONT 610 0 1430 4270<br />

6500110 MRI-ABDOMEN W/CONTRA 610 0 2299.83 4270<br />

6500128 MRI-ABDOMEN W/WO CON 610 0 4516.22 4270<br />

6500219 MRI-C SPINE W/O CONT 612 0 1373.37 4270<br />

6500227 MRI-C SPINE W CONTRA 612 0 1646.07 4270<br />

6500235 MRI-C SPINE W/WO CON 612 0 3051.54 4270<br />

6500300 MRI-CHEST W/O CONTR 610 0 1373.37 4270<br />

6500318 MRI-CHEST W/CONTRAST 610 0 1373.37 4270<br />

6500326 MRI-CHEST W/WO CONTR 610 0 1373.37 4270<br />

6500409 MRI-FACE W/O CONTRAS 611 0 1352.39 4270<br />

6500417 MRI-FACE W/CONTRAST 611 0 1622.64 4270<br />

6500425 MRI-FACE W/WO CONTR 611 0 3003.41 4270<br />

6500508 MRI-HEAD W/O CONTRAS 611 0 1373.37 4270<br />

6500516 MRI-HEAD W CONTRAST 611 0 1646.07 4270<br />

6500524 MRI-HEAD W/WO CONTRA 611 0 3051.54 4270<br />

6500607 MRI-IAC'S W/WO CONTRAST 611 0 3051.54 4270<br />

6500615 MRI-IACS-WO 611 0 1373.37 4270<br />

6500623 MRI-UPEXT JOINT W/CONTRAST LT 610 0 2299.83 4270<br />

6500631 MRI-UPEXT JOINT W/CONTRAST RT 610 0 2299.83 4270<br />

6500649 MRI-UPEXT JOINT W/O CON LT 610 0 1839.86 4270<br />

6500656 MRI-PIT/SELLA W/WO CO 611 0 3051.54 4270<br />

6500664 MRI-UPEXT JOINT W/O CONTRAST RT 610 0 1839.86 4270<br />

6500672 MRI-UPEXT W W/O CONT LT 610 0 3003.41 4270<br />

6500680 MRI-UPEXT W W/O CONT RT 610 0 3003.41 4270<br />

6500706 MRI-HIP WO CONTR-LT 610 0 1839.86 4270<br />

6500714 MRI-HIP WO CONTR-RT 610 0 1839.86 4270<br />

6500722 MRI-HIP W&WO CON-LT 610 0 3003.41 4270<br />

6500730 MRI-HIP W&WO CON-RT 610 0 3003.41 4270<br />

6500748 MRI-HIP-W/CONT-RT 610 0 2299.83 4270<br />

6500755 MRI-HIP-W/CONT-LT 610 0 2299.83 4270

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