|
Clsd tx clavicle fracture w/manip 23505
|
$4,687.20 |
$4,687.20 |
$4,687.20 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$935.20 |
$935.20 |
$935.20 |
$390.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$424.45
|
|
Clsd tx dist fib fx w/manip 27788
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$676.20
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$935.20 |
$935.20 |
$935.20 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$6,384.00 |
$6,384.00 |
$6,384.00 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$5,247.20 |
$5,247.20 |
$5,247.20 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$385.60
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$459.84
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$537.55
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,010.40 |
$2,010.40 |
$2,010.40 |
$1,684.00
|
|
Clsd tx fx radius/ulna without manip 25560
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$478.40
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,560.75
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$448.80
|
|
Clsd tx hip disloc without anes 27265
|
$1,220.80 |
$1,220.80 |
$1,220.80 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$935.20 |
$935.20 |
$935.20 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$828.80 |
$828.80 |
$828.80 |
$889.96
|
|
Clsd tx mandibular fx without manip 21450
|
$1,836.80 |
$1,836.80 |
$1,836.80 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$1,086.40 |
$1,086.40 |
$1,086.40 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$499.20
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$613.14
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$6,305.60 |
$6,305.60 |
$6,305.60 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$1,148.00 |
$1,148.00 |
$1,148.00 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$1,282.40 |
$1,282.40 |
$1,282.40 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$7,890.40 |
$7,890.40 |
$7,890.40 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$4,748.80 |
$4,748.80 |
$4,748.80 |
$1,884.74
|
|
Clsd tx patella disloc without anes 27560
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$577.20
|
|
Clsd tx/patellar fx without manip 27520
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$495.80
|
|
Clsd tx pelvic ring fx
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$1,209.60 |
$1,209.60 |
$1,209.60 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$5,359.20 |
$5,359.20 |
$5,359.20 |
$2,132.25
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$419.73
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$465.00
|
|
Clsd tx radius fracture w/manip 24655
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,808.00 |
$3,808.00 |
$3,808.00 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,198.40 |
$1,198.40 |
$1,198.40 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$6,512.80 |
$6,512.80 |
$6,512.80 |
$2,287.20
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$5,252.80 |
$5,252.80 |
$5,252.80 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,047.20 |
$1,047.20 |
$1,047.20 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$3,808.00 |
$3,808.00 |
$3,808.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$466.14
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$929.60 |
$929.60 |
$929.60 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$935.20 |
$935.20 |
$935.20 |
$478.40
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$496.61
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$611.10
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$483.12
|
|
Cls tx of heel fracture w/manip 28405
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$716.95
|
|
Cltx carpl scphd fx w/mnpj
|
$3,332.00 |
$3,332.00 |
$3,332.00 |
$1,958.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$5,700.80 |
$5,700.80 |
$5,700.80 |
$2,317.60
|
|
Cltx hum epcndylr fx wo mnpj
|
$935.20 |
$935.20 |
$935.20 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$1,858.00
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$5,846.40 |
$5,846.40 |
$5,846.40 |
$2,420.60
|
|
Cltx mndblr fx ntrdntl fixj
|
$14,397.60 |
$14,397.60 |
$14,397.60 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$5,986.40 |
$5,986.40 |
$5,986.40 |
$2,411.20
|
|
Cltx mndblr/max alv ridge fx
|
$8,192.80 |
$8,192.80 |
$8,192.80 |
$3,907.80
|
|
Cltx palatal/max fx wire fix
|
$11,776.80 |
$11,776.80 |
$11,776.80 |
$4,377.24
|
|
Cltx post ankle fx
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$1,114.40 |
$1,114.40 |
$1,114.40 |
$1,940.40
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$1,985.60
|
|
Cltx strnclav dislc w/mnpj
|
$1,120.00 |
$1,120.00 |
$1,120.00 |
$619.30
|
|
Cltx thigh fx
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$4,008.00
|
|
Cltx tmprmand dislc comp
|
$4,065.60 |
$4,065.60 |
$4,065.60 |
$3,740.85
|
|
Cmbn ant pst colprhy
|
$4,928.00 |
$4,928.00 |
$4,928.00 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$1,562.40 |
$1,562.40 |
$1,562.40 |
$627.89
|
|
C motor evoked uppr limbs
|
$2,760.80 |
$2,760.80 |
$2,760.80 |
$837.76
|
|
C motor evoked upr&lwr limbs
|
$2,508.80 |
$2,508.80 |
$2,508.80 |
$1,308.00
|
|
Cmptr ophth dx img ant segmt
|
$146.16 |
$146.16 |
$146.16 |
$117.00
|
|
Cmptr ophth img optic nerve
|
$192.64 |
$192.64 |
$192.64 |
$119.00
|
|
#cms hgb-carboxyhemoglobin
|
$61.60 |
$61.60 |
$61.60 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$84.00 |
$84.00 |
$84.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$55.44 |
$55.44 |
$55.44 |
$89.00
|
|
Cmv ig IV
|
$778.40 |
$778.40 |
$778.40 |
$778.40
|
|
Cmv pcr-sendout
|
$134.40 |
$134.40 |
$134.40 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$313.60 |
$313.60 |
$313.60 |
$313.60
|
|
Co2 monitor per day
|
$459.20 |
$459.20 |
$459.20 |
$450.60
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$9.22 |
$9.22 |
$9.22 |
$8,798.60
|
|
Coagulation time activated teg
|
$145.04 |
$145.04 |
$145.04 |
$52.47
|
|
Coagulation time lee & white
|
$43.68 |
$43.68 |
$43.68 |
$11.20
|
|
Coagulation time otr method
|
$57.12 |
$57.12 |
$57.12 |
$20.00
|
|
Cocaine 4 % nasal solution
|
$630.04 |
$630.04 |
$630.04 |
$629.41
|
|
Cocaine hcl nasal (numbrino)
|
$44.80 |
$44.80 |
$44.80 |
$512.30
|
|
Coch imp ext proc/contr rplc
|
$9,520.00 |
$9,520.00 |
$9,520.00 |
$19,680.00
|
|
Coch implant headset replace
|
$1,064.00 |
$1,064.00 |
$1,064.00 |
$1,064.00
|
|
Coch implant tran cable repl
|
$30.80 |
$30.80 |
$30.80 |
$193.52
|
|
Coch implant trans coil repl
|
$103.60 |
$103.60 |
$103.60 |
$677.57
|
|
Cochlear implt f/up exam <7
|
$487.20 |
$487.20 |
$487.20 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$604.80 |
$604.80 |
$604.80 |
$423.87
|
|
Coil axium 3d 14mmx40cm qc
|
$308.00 |
$308.00 |
$308.00 |
$308.00
|
|
Cold agglutinin screen (arc)
|
$43.12 |
$43.12 |
$43.12 |
$45.31
|
|
Cold agglutinin titer
|
$20.16 |
$20.16 |
$20.16 |
$50.00
|
|
Colistimethate sodium inj
|
$66.77 |
$66.77 |
$66.77 |
$68.47
|
