|
Clsd tx/radial head/neck fx/no manip 24650
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$488.40
|
|
Clsd tx radius fracture w/manip 24655
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$1,884.74
|
|
Clsd tx/scapular fx without manip 23570
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,030.33 |
$2,030.33 |
$2,030.33 |
$2,466.40
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,842.58
|
|
Clsd tx temporomandibular dislocat 21480
|
$2,797.19 |
$2,797.19 |
$2,797.19 |
$511.70
|
|
Clsd tx toe dislocation without anes28660
|
$749.52 |
$749.52 |
$749.52 |
$436.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,617.33 |
$1,617.33 |
$1,617.33 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$487.80
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$705.60
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$579.88
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$857.50
|
|
Cltx carpl scphd fx w/mnpj
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$15,563.00 |
$15,563.00 |
$15,563.00 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$4,045.88 |
$4,045.88 |
$4,045.88 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$8,292.12 |
$8,292.12 |
$8,292.12 |
$4,199.49
|
|
Cltx post ankle fx
|
$1,241.93 |
$1,241.93 |
$1,241.93 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$4,181.05 |
$4,181.05 |
$4,181.05 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,030.33 |
$2,030.33 |
$2,030.33 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$1,520.36 |
$1,520.36 |
$1,520.36 |
$722.16
|
|
Cltx thigh fx
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
$3,881.76
|
|
Cltx tmprmand dislc comp
|
$2,797.19 |
$2,797.19 |
$2,797.19 |
$3,986.00
|
|
C motor evoked lwr limbs
|
$2,909.75 |
$2,909.75 |
$2,909.75 |
$627.89
|
|
C motor evoked uppr limbs
|
$2,904.28 |
$2,904.28 |
$2,904.28 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$2,140.53 |
$2,140.53 |
$2,140.53 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$313.16 |
$313.16 |
$313.16 |
$102.57
|
|
Cmv pcr-sendout
|
$461.03 |
$461.03 |
$461.03 |
$173.25
|
|
Co2 monitor per day
|
$660.33 |
$660.33 |
$660.33 |
$388.85
|
|
Coagulation time activated teg
|
$320.57 |
$320.57 |
$320.57 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$2,108.10 |
$2,108.10 |
$2,108.10 |
$807.71
|
|
Cochlear implt f/up exam <7
|
$423.87 |
$423.87 |
$423.87 |
$369.60
|
|
Cochlear implt f/up exam 7/>
|
$423.87 |
$423.87 |
$423.87 |
$345.60
|
|
Cold agglutinin screen (arc)
|
$206.48 |
$206.48 |
$206.48 |
$47.19
|
|
Cold agglutinin titer
|
$130.72 |
$130.72 |
$130.72 |
$48.57
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$103.03 |
$103.03 |
$103.03 |
$66.69
|
|
Collar cerv adlt perfit ace extric
|
$190.87 |
$190.87 |
$190.87 |
$29.25
|
|
Collar cerv ascend 172 reg
|
$241.88 |
$241.88 |
$241.88 |
$241.88
|
|
Collar cerv patriot adlt
|
$312.97 |
$312.97 |
$312.97 |
$153.57
|
|
Collar extrication adult univ
|
$889.25 |
$889.25 |
$889.25 |
$567.53
|
|
Collection blood specimen from completely implantable venous access device
|
$551.21 |
$551.21 |
$551.21 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$589.23 |
$589.23 |
$589.23 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$59.58 |
$59.58 |
$59.58 |
$22.00
|
|
Colposcopy vulva 56820
|
$519.18 |
$519.18 |
$519.18 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$850.95 |
$850.95 |
$850.95 |
$393.60
|
|
Compatibility test each unit antiglobulin technique
|
$1,178.98 |
$1,178.98 |
$1,178.98 |
$173.25
|
|
Compatibility test each unit electronic
|
$1,178.98 |
$1,178.98 |
$1,178.98 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$1,178.98 |
$1,178.98 |
$1,178.98 |
$169.52
|
|
Comp cystometrogram/void/uret pres 51729
|
$6,349.23 |
$6,349.23 |
$6,349.23 |
$1,099.00
|
|
Complement antigen each component c3
|
$543.97 |
$543.97 |
$543.97 |
$111.15
|
|
Complement fixation each
|
$159.38 |
$159.38 |
$159.38 |
$24.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$2,345.59 |
$2,345.59 |
$2,345.59 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$2,654.00 |
$2,654.00 |
$2,654.00 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$916.67 |
$916.67 |
$916.67 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$2,345.59 |
$2,345.59 |
$2,345.59 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$2,863.40 |
$2,863.40 |
$2,863.40 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$2,243.31 |
$2,243.31 |
$2,243.31 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$2,045.57 |
$2,045.57 |
$2,045.57 |
$683.25
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$1,901.69 |
$1,901.69 |
$1,901.69 |
$1,051.20
|
|
Comprehensive hearing test
|
$522.45 |
$522.45 |
$522.45 |
$224.40
|
|
Concentration infection agents any type
|
$151.63 |
$151.63 |
$151.63 |
$51.32
|
|
Conditioning play audiometry 92582
|
$423.87 |
$423.87 |
$423.87 |
$185.15
|
|
Condylomata destruction 56420
|
$1,635.16 |
$1,635.16 |
$1,635.16 |
$509.81
|
|
Consultation pathology during surgery
|
$320.78 |
$320.78 |
$320.78 |
$123.75
|
|
Consultation pathology during surgery cytological exam initial site
|
$4,803.71 |
$4,803.71 |
$4,803.71 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$188.01 |
$188.01 |
$188.01 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$2,028.92 |
$2,028.92 |
$2,028.92 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$2,028.92 |
$2,028.92 |
$2,028.92 |
$239.85
|
|
Consultation/report referred slides prepared elsewhere
|
$332.69 |
$332.69 |
$332.69 |
$176.15
|
|
Consult comp w/report rfrd material
|
$772.26 |
$772.26 |
$772.26 |
$359.87
|
|
Contrast baths charges
|
$48.83 |
$48.83 |
$48.83 |
$75.35
|
|
Contrast exam abdominl aorta 75625-26
|
$7,884.68 |
$7,884.68 |
$7,884.68 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$7,824.58 |
$7,824.58 |
$7,824.58 |
$4,178.00
|
|
Contrast x-ray gallbladder
|
$940.54 |
$940.54 |
$940.54 |
$312.00
|
|
Contrast x-ray of ankle
|
$3,895.09 |
$3,895.09 |
$3,895.09 |
$602.40
|
|
Contrast x-ray of elbow
|
$1,891.78 |
$1,891.78 |
$1,891.78 |
$637.14
|
|
Contrast x-ray of hip
|
$1,350.64 |
$1,350.64 |
$1,350.64 |
$768.00
|
|
Contrast x-ray of knee joint
|
$1,720.79 |
$1,720.79 |
$1,720.79 |
$683.20
|
|
Contrast x-ray of wrist
|
$1,989.03 |
$1,989.03 |
$1,989.03 |
$623.50
|
|
Control nosebleed pack+caut 30905
|
$1,750.35 |
$1,750.35 |
$1,750.35 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$1,425.00 |
$1,425.00 |
$1,425.00 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$857.46 |
$857.46 |
$857.46 |
$385.45
|
|
Conversion ext bil drg cath
|
$6,900.75 |
$6,900.75 |
$6,900.75 |
$4,661.80
|
