|
Clsd tx fracture of radius 25500
|
$602.00 |
$602.00 |
$602.00 |
$445.40
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$523.25 |
$523.25 |
$523.25 |
$392.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$602.00 |
$602.00 |
$602.00 |
$508.80
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$602.00 |
$602.00 |
$602.00 |
$641.16
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,893.86
|
|
Clsd tx fx radius/ulna without manip 25560
|
$602.00 |
$602.00 |
$602.00 |
$547.20
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,827.71
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$523.25 |
$523.25 |
$523.25 |
$473.20
|
|
Clsd tx hip disloc without anes 27265
|
$824.60 |
$824.60 |
$824.60 |
$716.95
|
|
Clsd tx humeral fract without manip 24530
|
$523.25 |
$523.25 |
$523.25 |
$623.93
|
|
Clsd tx humerus fract without manip 24500
|
$602.00 |
$602.00 |
$602.00 |
$558.40
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$896.35 |
$896.35 |
$896.35 |
$1,014.00
|
|
Clsd tx mandibular fx without manip 21450
|
$651.00 |
$651.00 |
$651.00 |
$995.40
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$523.25 |
$523.25 |
$523.25 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$602.00 |
$602.00 |
$602.00 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$602.00 |
$602.00 |
$602.00 |
$716.95
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,137.40 |
$3,137.40 |
$3,137.40 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$602.00 |
$602.00 |
$602.00 |
$580.30
|
|
Clsd tx/metatarsal fx without manip 28470
|
$602.00 |
$602.00 |
$602.00 |
$446.40
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,485.65 |
$3,485.65 |
$3,485.65 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$602.00 |
$602.00 |
$602.00 |
$705.60
|
|
Clsd tx/patellar fx without manip 27520
|
$602.00 |
$602.00 |
$602.00 |
$525.85
|
|
Clsd tx pelvic ring fx
|
$523.25 |
$523.25 |
$523.25 |
$448.80
|
|
Clsd tx pelvic ring fx
|
$523.25 |
$523.25 |
$523.25 |
$705.60
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,190.00 |
$1,190.00 |
$1,190.00 |
$2,557.07
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$602.00 |
$602.00 |
$602.00 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$523.25 |
$523.25 |
$523.25 |
$488.40
|
|
Clsd tx radius fracture w/manip 24655
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,884.74
|
|
Clsd tx/scapular fx without manip 23570
|
$602.00 |
$602.00 |
$602.00 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,466.40
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$3,137.40 |
$3,137.40 |
$3,137.40 |
$3,842.58
|
|
Clsd tx temporomandibular dislocat 21480
|
$602.00 |
$602.00 |
$602.00 |
$511.70
|
|
Clsd tx toe dislocation without anes28660
|
$602.00 |
$602.00 |
$602.00 |
$436.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$523.25 |
$523.25 |
$523.25 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$523.25 |
$523.25 |
$523.25 |
$487.80
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$422.10 |
$422.10 |
$422.10 |
$705.60
|
|
Clsd tx wrist carpal fx without manip 25630
|
$523.25 |
$523.25 |
$523.25 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$523.25 |
$523.25 |
$523.25 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$523.25 |
$523.25 |
$523.25 |
$579.88
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$602.00 |
$602.00 |
$602.00 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$523.25 |
$523.25 |
$523.25 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$602.00 |
$602.00 |
$602.00 |
$857.50
|
|
Cltx carpl scphd fx w/mnpj
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,543.15 |
$1,543.15 |
$1,543.15 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$523.25 |
$523.25 |
$523.25 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$523.25 |
$523.25 |
$523.25 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$3,377.50 |
$3,377.50 |
$3,377.50 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,499.05 |
$1,499.05 |
$1,499.05 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$2,812.25 |
$2,812.25 |
$2,812.25 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$1,600.55 |
$1,600.55 |
$1,600.55 |
$4,199.49
|
|
Cltx post ankle fx
|
$523.25 |
$523.25 |
$523.25 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,774.50 |
$1,774.50 |
$1,774.50 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$896.35 |
$896.35 |
$896.35 |
$722.16
|
|
Cltx thigh fx
|
$2,531.20 |
$2,531.20 |
$2,531.20 |
$3,881.76
|
|
C motor evoked lwr limbs
|
$1,130.50 |
$1,130.50 |
$1,130.50 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,130.50 |
$1,130.50 |
$1,130.50 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$2,260.65 |
$2,260.65 |
$2,260.65 |
$1,308.00
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$9,445.55 |
$9,445.55 |
$9,445.55 |
$2,950.68
|
|
Coagulation time activated teg
|
$32.90 |
$32.90 |
$32.90 |
$50.05
|
|
Cold agglutinin screen (arc)
|
$10.71 |
$10.71 |
$10.71 |
$47.19
|
|
Cold agglutinin titer
|
$177.80 |
$177.80 |
$177.80 |
$48.57
|
|
Colistimethate sodium inj
|
$87.22 |
$87.22 |
$87.22 |
$84.60
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$49.90 |
$49.90 |
$49.90 |
$66.69
|
|
Collar cerv adlt perfit ace extric
|
$16.15 |
$16.15 |
$16.15 |
$29.25
|
|
Collar cerv ascend 172 reg
|
$213.89 |
$213.89 |
$213.89 |
$241.88
|
|
Collar cerv patriot adlt
|
$87.00 |
$87.00 |
$87.00 |
$153.57
|
|
Collar extrication adult univ
|
$110.25 |
$110.25 |
$110.25 |
$567.53
|
|
Collection blood specimen from completely implantable venous access device
|
$350.35 |
$350.35 |
$350.35 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$350.35 |
$350.35 |
$350.35 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$20.65 |
$20.65 |
$20.65 |
$22.00
|
|
Colonoscopy (diagnostic)
|
$511.00 |
$511.00 |
$511.00 |
$1,612.62
|
|
Colonoscopy w/control bleed
|
$718.55 |
$718.55 |
$718.55 |
$2,101.71
|
|
Colpocentesis 57020
|
$2,931.60 |
$2,931.60 |
$2,931.60 |
$5,419.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$2,697.10 |
$2,697.10 |
$2,697.10 |
$3,907.93
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$363.30 |
$363.30 |
$363.30 |
$326.30
|
|
Colposcopy vulva 56820
|
$523.25 |
$523.25 |
$523.25 |
$295.20
|
|
Colpotomy drng of abscess 57010
|
$2,345.35 |
$2,345.35 |
$2,345.35 |
$3,744.41
|
|
Colpotomy w/exploration 57000
|
$2,345.35 |
$2,345.35 |
$2,345.35 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$292.60 |
$292.60 |
$292.60 |
$173.25
|
|
Compatibility test each unit electronic
|
$253.75 |
$253.75 |
$253.75 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$292.60 |
$292.60 |
$292.60 |
$169.52
|
|
Complement antigen each component c3
|
$92.75 |
$92.75 |
$92.75 |
$111.15
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$602.00 |
$602.00 |
$602.00 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$602.00 |
$602.00 |
$602.00 |
$1,357.20
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$602.00 |
$602.00 |
$602.00 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$602.00 |
$602.00 |
$602.00 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$602.00 |
$602.00 |
$602.00 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$572.95 |
$572.95 |
$572.95 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$602.00 |
$602.00 |
$602.00 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$365.05 |
$365.05 |
$365.05 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$602.00 |
$602.00 |
$602.00 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$523.25 |
$523.25 |
$523.25 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$300.30 |
$300.30 |
$300.30 |
$683.25
|