|
Clozapine, 25 mg
|
$4.87 |
$4.87 |
$9.28 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$601.90 |
$601.90 |
$633.10 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$501.15 |
$501.15 |
$501.15 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$702.00 |
$702.00 |
$702.00 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$386.10 |
$488.80 |
$488.80 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$370.50 |
$370.50 |
$415.35 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$949.00 |
$949.00 |
$1,095.25 |
|
|
Clsd tx elbow dislocation child 24640
|
$248.30 |
$248.30 |
$258.05 |
|
|
Clsd tx fracture of radius 25500
|
$440.05 |
$440.05 |
$462.80 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$243.10 |
$243.10 |
$285.35 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$354.25 |
$354.25 |
$386.75 |
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$639.60 |
$655.20 |
$655.20 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,132.95 |
$1,132.95 |
$1,188.85 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$551.20 |
$551.20 |
$551.20 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,011.40 |
$1,011.40 |
$1,048.45 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$591.50 |
$591.50 |
$591.50 |
|
|
Clsd tx hip disloc without anes 27265
|
$823.55 |
$842.40 |
$914.55 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$1,173.90 |
$1,173.90 |
$1,173.90 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$499.20 |
$537.55 |
$537.55 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$634.40 |
$683.80 |
$683.80 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$429.00 |
$429.00 |
$456.95 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$1,002.30 |
$1,002.30 |
$1,002.30 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$755.30 |
$755.30 |
$755.30 |
|
|
Clsd tx patella disloc without anes 27560
|
$614.25 |
$614.25 |
$646.10 |
|
|
Clsd tx/patellar fx without manip 27520
|
$656.50 |
$656.50 |
$656.50 |
|
|
Clsd tx pelvic ring fx
|
$358.15 |
$358.15 |
$358.15 |
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$365.95 |
$378.95 |
$429.65 |
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$435.50 |
$501.80 |
$501.80 |
|
|
Clsd tx radius fracture w/manip 24655
|
$1,701.70 |
$1,701.70 |
$1,701.70 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$720.20 |
$720.20 |
$943.15 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,121.90 |
$1,121.90 |
$1,121.90 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,025.05 |
$1,025.05 |
$1,025.05 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$322.40 |
$322.40 |
$324.35 |
|
|
Clsd tx toe dislocation without anes28660
|
$291.20 |
$291.20 |
$303.55 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,042.60 |
$1,042.60 |
$1,125.15 |
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$542.10 |
$542.10 |
$542.10 |
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$588.25 |
$588.25 |
$588.25 |
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$725.40 |
$725.40 |
$725.40 |
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$473.20 |
$473.20 |
$473.20 |
|
|
Cltx carpl scphd fx w/mnpj
|
$955.50 |
$955.50 |
$955.50 |
|
|
Cltx post ankle fx
|
$695.50 |
$695.50 |
$695.50 |
|
|
Cmbn ant pst colprhy
|
$12,152.82 |
$12,152.82 |
$12,152.82 |
|
|
#cmvcul-virus inoculation shell
|
$124.15 |
$137.80 |
$137.80 |
|
|
Cmv pcr-sendout
|
$61.75 |
$262.60 |
$262.60 |
|
|
Co2 monitor per day
|
$507.65 |
$507.65 |
$518.05 |
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$11,888.50 |
$11,888.50 |
$11,888.50 |
|
|
Coagulation time activated teg
|
$55.25 |
$55.25 |
$61.75 |
|
|
Cold agglutinin screen (arc)
|
$47.45 |
$57.85 |
$61.75 |
|
|
Cold agglutinin titer
|
$69.55 |
$72.15 |
$73.45 |
|
|
Colectomy partial w/anastomosis 44140
|
$2,553.85 |
$2,553.85 |
$2,553.85 |
|
|
Colistimethate sodium inj
|
$86.42 |
$86.42 |
$86.42 |
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$5.85 |
$5.85 |
$5.85 |
|
|
Collar cerv ascend 172 reg
|
$235.30 |
$235.30 |
$235.30 |
|
|
Collar cerv patriot adlt
|
$28.60 |
$28.60 |
$28.60 |
|
|
Collection blood specimen from completely implantable venous access device
|
$73.45 |
$73.45 |
$875.19 |
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$114.40 |
$114.40 |
$785.85 |
|
|
Collection of venous blood by venipuncture
|
$16.25 |
$16.25 |
$198.25 |
|
|
Colonoscopy (diagnostic)
|
$676.00 |
$2,142.53 |
$3,227.54 |
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$859.30 |
$859.30 |
$4,352.10 |
|
|
Colonoscopy & polypectomy 44392
|
$2,911.49 |
$2,911.49 |
$2,911.49 |
|
|
Colonoscopy stoma w/snare 44394
|
$3,037.12 |
$3,037.12 |
$3,037.12 |
|
|
Colonoscopy submucous njx
|
$956.15 |
$3,963.24 |
$5,965.40 |
|
|
Colonoscopy thru stoma spx
|
$2,681.90 |
$2,681.90 |
$2,681.90 |
|
|
Colonoscopy w/ablation
|
$991.25 |
$991.25 |
$2,975.70 |
|
|
Colonoscopy w/balloon dilat
|
$1,197.95 |
$1,197.95 |
$3,429.86 |
|
|
Colonoscopy w/band ligation
|
$928.85 |
$928.85 |
$5,320.34 |
|
|
Colonoscopy w/control bleed
|
$1,005.55 |
$1,005.55 |
$4,130.22 |
|
|
Colonoscopy w/fb removal
|
$762.45 |
$762.45 |
$762.45 |
|
|
Colonoscopy with ablation
|
$868.40 |
$868.40 |
$868.40 |
|
|
Colonoscopy (with biopsy)
|
$831.35 |
$3,246.33 |
$5,264.38 |
|
|
Colonoscopy with biopsy
|
$2,749.31 |
$2,749.31 |
$2,749.31 |
|
|
Colonoscopy (with polyp removal)
|
$992.55 |
$2,960.72 |
$5,547.42 |
|
|
Colpocleisis (le forte type) 57120
|
$5,416.56 |
$5,416.56 |
$5,416.56 |
|
|
Colpopexy extraperitoneal
|
$11,986.68 |
$11,986.68 |
$11,986.68 |
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$707.85 |
$707.85 |
$707.85 |
|
|
Colposcopy/cervix/ conization 57461
|
$5,648.57 |
$5,648.57 |
$5,648.57 |
|
|
Compatibility test each unit antiglobulin technique
|
$61.75 |
$94.90 |
$128.05 |
|
|
Compatibility test each unit electronic
|
$61.75 |
$95.55 |
$95.55 |
|
|
Compatibility test each unit immediate spin technique
|
$44.85 |
$94.90 |
$113.75 |
|
|
Compatibility test incubate
|
$44.85 |
$94.90 |
$96.85 |
|
|
Comp cystometrogram/void presssure 51728
|
$858.00 |
$858.00 |
$858.00 |
|
|
Complement antigen each component c3
|
$112.45 |
$112.45 |
$132.60 |
|
|
Complete removal of vulva
|
$4,032.44 |
$4,032.44 |
$4,032.44 |
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$488.15 |
$488.15 |
$4,636.89 |
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$6,190.52 |
$6,190.52 |
$6,190.52 |
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$852.80 |
$852.80 |
$852.80 |
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$5,102.90 |
$5,102.90 |
$5,102.90 |
|
|
Complx repair enel addl 5cm/< 13153
|
$3,973.09 |
$3,973.09 |
$3,973.09 |
|
|
Complx repair fccmnaxghf 13131
|
$666.25 |
$666.25 |
$666.25 |
|
|
Complx repair fccmnaxghf 13132
|
$937.30 |
$937.30 |
$3,549.77 |
|
|
Complx repair fccmnaxghf 13133
|
$306.15 |
$306.15 |
$306.15 |
|
|
Complx repair sal addl 5 cm/> 13122
|
$230.75 |
$230.75 |
$5,755.09 |
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$577.20 |
$577.20 |
$577.20 |
|
|
Complx repair trunk addl 5cm/< 13102
|
$6,833.79 |
$6,833.79 |
$6,833.79 |
|
|
Computed tomographic angiography head and neck with contrast
|
$1,856.40 |
$2,544.75 |
$2,678.65 |
|
|
Concentration infection agents any type
|
$36.40 |
$57.20 |
$57.20 |
|
|
Condylomata destruction 56420
|
$352.95 |
$352.95 |
$371.80 |
|
|
Conization/cerv/loop electrode exc 57522
|
$4,703.42 |
$4,703.42 |
$4,703.42 |
|
|
Conization of cervix
|
$3,852.15 |
$3,852.15 |
$3,852.15 |
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,169.89 |
$1,195.05 |
$1,195.05 |
|
