|
Cltx carpl scphd fx w/mnpj
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,346.45 |
$1,346.45 |
$1,346.45 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$164.50 |
$164.50 |
$164.50 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$164.50 |
$164.50 |
$164.50 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$2,947.70 |
$2,947.70 |
$2,947.70 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,307.95 |
$1,307.95 |
$1,307.95 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$1,789.55 |
$1,789.55 |
$1,789.55 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$1,653.05 |
$1,653.05 |
$1,653.05 |
$4,199.49
|
|
Cltx post ankle fx
|
$164.50 |
$164.50 |
$164.50 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,548.40 |
$1,548.40 |
$1,548.40 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$233.80 |
$233.80 |
$233.80 |
$722.16
|
|
Cltx thigh fx
|
$2,614.50 |
$2,614.50 |
$2,614.50 |
$3,881.76
|
|
C motor evoked lwr limbs
|
$1,052.45 |
$1,052.45 |
$1,052.45 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,052.45 |
$1,052.45 |
$1,052.45 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$2,104.90 |
$2,104.90 |
$2,104.90 |
$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
|
$15.75 |
$15.75 |
$15.75 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$133.85 |
$133.85 |
$133.85 |
$807.71
|
|
Cold agglutinin screen (arc)
|
$10.71 |
$10.71 |
$10.71 |
$47.19
|
|
Cold agglutinin titer
|
$78.05 |
$78.05 |
$78.05 |
$48.57
|
|
Colistimethate sodium inj
|
$39.43 |
$39.43 |
$39.43 |
$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
|
$164.50 |
$164.50 |
$164.50 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$164.50 |
$164.50 |
$164.50 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$21.00 |
$21.00 |
$21.00 |
$22.00
|
|
Colonoscopy (diagnostic)
|
$610.75 |
$610.75 |
$610.75 |
$1,612.62
|
|
Colonoscopy w/control bleed
|
$798.00 |
$798.00 |
$798.00 |
$2,101.71
|
|
Colpocentesis 57020
|
$2,558.50 |
$2,558.50 |
$2,558.50 |
$5,419.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$2,786.00 |
$2,786.00 |
$2,786.00 |
$3,907.93
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$130.90 |
$130.90 |
$130.90 |
$326.30
|
|
Colposcopy vulva 56820
|
$164.50 |
$164.50 |
$164.50 |
$295.20
|
|
Colpotomy drng of abscess 57010
|
$2,422.70 |
$2,422.70 |
$2,422.70 |
$3,744.41
|
|
Colpotomy w/exploration 57000
|
$2,422.70 |
$2,422.70 |
$2,422.70 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$304.50 |
$304.50 |
$304.50 |
$173.25
|
|
Compatibility test each unit electronic
|
$304.50 |
$304.50 |
$304.50 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$185.50 |
$185.50 |
$185.50 |
$169.52
|
|
Complement antigen each component c3
|
$64.75 |
$64.75 |
$64.75 |
$111.15
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$582.75 |
$582.75 |
$582.75 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$582.75 |
$582.75 |
$582.75 |
$1,357.20
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$582.75 |
$582.75 |
$582.75 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$582.75 |
$582.75 |
$582.75 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$189.00 |
$189.00 |
$189.00 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$384.65 |
$384.65 |
$384.65 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$582.75 |
$582.75 |
$582.75 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$101.50 |
$101.50 |
$101.50 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$189.00 |
$189.00 |
$189.00 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$582.75 |
$582.75 |
$582.75 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$94.50 |
$94.50 |
$94.50 |
$683.25
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$830.30 |
$830.30 |
$830.30 |
$1,051.20
|
|
Composite graft/pri close/don area 15760
|
$1,818.60 |
$1,818.60 |
$1,818.60 |
$2,692.80
|
|
Concentration infection agents any type
|
$70.35 |
$70.35 |
$70.35 |
$51.32
|
|
Condylomata destruction 56420
|
$189.00 |
$189.00 |
$189.00 |
$509.81
|
|
Conivaptan hcl
|
$2,174.13 |
$2,174.13 |
$2,174.13 |
$438.57
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,354.59 |
$1,354.59 |
$1,354.59 |
$986.92
|
|
Connect omega .5mm
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$1,069.43
|
|
Connector tis 2x10mm
|
$3,180.28 |
$3,180.28 |
$3,180.28 |
$3,934.53
|
|
Consultation pathology during surgery
|
$190.05 |
$190.05 |
$190.05 |
$123.75
|
|
Consultation pathology during surgery cytological exam initial site
|
$504.35 |
$504.35 |
$504.35 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$39.55 |
$39.55 |
$39.55 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$190.05 |
$190.05 |
$190.05 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$53.20 |
$53.20 |
$53.20 |
$239.85
|
|
Contrast exam abdominl aorta 75625-26
|
$2,121.35 |
$2,121.35 |
$2,121.35 |
$3,458.54
|
|
Contrast exam thoracic aorta
|
$2,121.35 |
$2,121.35 |
$2,121.35 |
$3,724.63
|
|
Contrast exam thoracic aorta 75605-26
|
$4,402.30 |
$4,402.30 |
$4,402.30 |
$4,178.00
|
|
Contrast x-ray of ankle
|
$842.10 |
$842.10 |
$842.10 |
$602.40
|
|
Contrast x-ray of elbow
|
$647.15 |
$647.15 |
$647.15 |
$637.14
|
|
Contrast x-ray of hip
|
$894.60 |
$894.60 |
$894.60 |
$768.00
|
|
Contrast x-ray of knee joint
|
$942.55 |
$942.55 |
$942.55 |
$683.20
|
|
Contrast x-ray of wrist
|
$682.15 |
$682.15 |
$682.15 |
$623.50
|
|
Controler lvad heartmate 3 includes ebb
|
$8,731.80 |
$8,731.80 |
$8,731.80 |
$11,518.85
|
|
Controller infinity pt dbs
|
$4,494.00 |
$4,494.00 |
$4,494.00 |
$4,320.00
|
|
Control nosebleed pack+caut 30905
|
$204.75 |
$204.75 |
$204.75 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$189.00 |
$189.00 |
$189.00 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$189.00 |
$189.00 |
$189.00 |
$385.45
|
|
Control oropharyngeal hemorr/simp 42960
|
$503.30 |
$503.30 |
$503.30 |
$618.80
|
|
Control throat bleeding
|
$1,900.85 |
$1,900.85 |
$1,900.85 |
$4,122.30
|
|
Conversion ext bil drg cath
|
$2,198.35 |
$2,198.35 |
$2,198.35 |
$4,661.80
|
|
Convert nephrostomy catheter
|
$2,034.20 |
$2,034.20 |
$2,034.20 |
$3,569.60
|
|
Coombs direct
|
$182.00 |
$182.00 |
$182.00 |
$73.26
|
|
Coombs indirect qualitative each reagent red cell reference
|
$101.15 |
$101.15 |
$101.15 |
$94.90
|
|
Coombs indirect titer reference
|
$220.85 |
$220.85 |
$220.85 |
$146.00
|
|
Copper intrauterine device
|
$1,609.55 |
$1,609.55 |
$1,609.55 |
$2,346.79
|
|
Core ndl bx lng/med perq
|
$1,488.20 |
$1,488.20 |
$1,488.20 |
$2,963.00
|
|
Cor hlx vlgs dstl mtar osteo
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$4,499.12
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$7,570.50 |
$7,570.50 |
$7,570.50 |
$9,900.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$7,626.85 |
$7,626.85 |
$7,626.85 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$5,987.10 |
$5,987.10 |
$5,987.10 |
$10,595.00
|
|
Coronary angio/lv gram/rt< heart
|
$8,046.85 |
$8,046.85 |
$8,046.85 |
$11,280.10
|
|
Coronary art/grft angio s&i
|
$5,890.85 |
$5,890.85 |
$5,890.85 |
$8,308.05
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$4,251.10 |
$4,251.10 |
$4,251.10 |
$7,769.30
|
|
Coronary thrombolysis/iv infusion 92977
|
$516.25 |
$516.25 |
$516.25 |
$489.00
|
|
Correct finger deformity
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$4,108.00
|
|
Correction hallux valgus sesamoidectomy;prox meta osteotomy
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$4,108.00
|