|
Clsd tx radius fracture w/manip 24655
|
$9,087.65 |
$9,087.65 |
$9,087.65 |
$1,782.86
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$473.00
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,347.45 |
$1,347.45 |
$1,347.45 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$9,087.65 |
$9,087.65 |
$9,087.65 |
$1,893.86
|
|
C motor evoked lwr limbs
|
$1,557.40 |
$1,557.40 |
$1,557.40 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,557.40 |
$1,557.40 |
$1,557.40 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,927.25 |
$1,927.25 |
$1,927.25 |
$1,333.36
|
|
#cms hgb-carboxyhemoglobin
|
$103.35 |
$103.35 |
$103.35 |
$61.60
|
|
#cmvcul-virus inoculation shell
|
$59.00 |
$199.55 |
$199.55 |
$89.76
|
|
Cmv pcr-sendout
|
$172.25 |
$172.25 |
$172.25 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$12.35 |
$12.35 |
$12.35 |
$11,888.50
|
|
Coagulation time activated teg
|
$37.05 |
$37.05 |
$37.05 |
$52.47
|
|
Coch implant trans coil repl
|
$1,054.30 |
$1,054.30 |
$1,054.30 |
$677.57
|
|
Cogenex amnio memb per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Cold agglutinin screen (arc)
|
$1,199.00 |
$1,199.00 |
$1,199.00 |
$48.10
|
|
Cold agglutinin titer
|
$14.30 |
$14.30 |
$315.00 |
$52.00
|
|
Colistimethate sodium inj
|
$254.15 |
$254.15 |
$835.00 |
$82.71
|
|
Collagenase, clost hist inj
|
$195.00 |
$195.00 |
$195.00 |
$12,906.28
|
|
Collagen based wound filler
|
$10,094.50 |
$10,094.50 |
$10,094.50 |
$1,794.78
|
|
Collagen dressing <=16 sq in
|
$61.10 |
$61.10 |
$61.10 |
$42.50
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$562.25 |
$562.25 |
$562.25 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$347.10 |
$347.10 |
$347.10 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$347.75 |
$347.75 |
$347.75 |
$155.40
|
|
Coll-e-derm 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Colon motility 6 hr study
|
$1,057.55 |
$1,057.55 |
$1,057.55 |
$477.92
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$2,395.90 |
$2,395.90 |
$2,395.90 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$6,806.80 |
$6,806.80 |
$6,806.80 |
$3,762.53
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$547.95 |
$547.95 |
$547.95 |
$314.00
|
|
Colposcopy vulva 56820
|
$547.95 |
$547.95 |
$547.95 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$992.55 |
$992.55 |
$992.55 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$944.45 |
$944.45 |
$944.45 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$144.95 |
$144.95 |
$588.00 |
$173.50
|
|
Compatibility test each unit electronic
|
$103.35 |
$103.35 |
$146.00 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$163.80 |
$163.80 |
$706.00 |
$169.52
|
|
Compatibility test incubate
|
$74.10 |
$74.10 |
$418.00 |
$156.24
|
|
Comp cystometrogram/void presssure 51728
|
$2,055.95 |
$2,055.95 |
$2,055.95 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,846.00 |
$1,846.00 |
$1,846.00 |
$1,111.03
|
|
Complement antigen each component c3
|
$490.10 |
$490.10 |
$490.10 |
$110.00
|
|
Complement fixation each
|
$98.00 |
$98.00 |
$98.00 |
$29.12
|
|
Complex cystometrogram 51726
|
$1,846.00 |
$1,846.00 |
$1,846.00 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,839.50 |
$1,839.50 |
$1,839.50 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,576.25 |
$1,576.25 |
$1,576.25 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$507.65 |
$507.65 |
$507.65 |
$344.68
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,576.25 |
$1,576.25 |
$1,576.25 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,576.25 |
$1,576.25 |
$1,576.25 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$486.20 |
$486.20 |
$486.20 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$1,034.80 |
$1,034.80 |
$1,034.80 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,734.20 |
$1,734.20 |
$1,734.20 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$877.50 |
$877.50 |
$877.50 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$877.50 |
$877.50 |
$877.50 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,266.20 |
$1,266.20 |
$1,266.20 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$595.40 |
$595.40 |
$595.40 |
$537.00
|
|
Composite drsg >16<=48 sq in
|
$336.05 |
$336.05 |
$336.05 |
$42.60
|
|
Composite drsg <= 16 sq in
|
$241.15 |
$241.15 |
$241.15 |
$6.62
|
|
Composite graft/pri close/don area 15760
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,816.50
|
|
Computed tomographic angiography head and neck with contrast
|
$1,092.96 |
$1,092.96 |
$1,092.96 |
$2,247.00
|
|
Concentration infection agents any type
|
$67.60 |
$67.60 |
$67.60 |
$51.32
|
|
Condylomata destruction 56420
|
$496.60 |
$496.60 |
$496.60 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$2,689.05 |
$2,689.05 |
$2,797.00 |
$860.00
|
|
Connect omega .5mm
|
$5,908.50 |
$5,908.50 |
$5,908.50 |
$1,260.00
|
|
Connector tis 2x10mm
|
$15,466.10 |
$15,466.10 |
$15,466.10 |
$4,024.34
|
|
Consultation pathology during surgery
|
$277.00 |
$445.90 |
$445.90 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$349.70 |
$349.70 |
$754.00 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$255.45 |
$255.45 |
$734.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$512.85 |
$512.85 |
$1,849.00 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$844.35 |
$844.35 |
$2,419.00 |
$224.83
|
|
Consultation/report referred slides prepared elsewhere
|
$522.00 |
$991.25 |
$991.25 |
$176.28
|
|
Consult comp w/report rfrd material
|
$494.00 |
$590.85 |
$590.85 |
$374.40
|
|
Contrast baths charges
|
$98.15 |
$98.15 |
$98.15 |
$75.60
|
|
Contrast exam abdominl aorta 75625-26
|
$8,858.20 |
$8,858.20 |
$8,858.20 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$3,732.95 |
$3,732.95 |
$3,732.95 |
$3,616.90
|
|
Contrast exam thoracic aorta 75605-26
|
$4,479.15 |
$4,479.15 |
$4,479.15 |
$3,745.00
|
|
Contrast x-ray gallbladder
|
$581.10 |
$581.10 |
$581.10 |
$341.00
|
|
Contrast x-ray of ankle
|
$612.30 |
$612.30 |
$612.30 |
$684.00
|
|
Contrast x-ray of elbow
|
$800.15 |
$800.15 |
$800.15 |
$708.00
|
|
Contrast x-ray of hip
|
$1,058.85 |
$1,058.85 |
$1,058.85 |
$796.38
|
|
Contrast x-ray of knee joint
|
$1,218.10 |
$1,218.10 |
$1,218.10 |
$790.50
|
|
Contrast x-ray of wrist
|
$941.20 |
$941.20 |
$941.20 |
$667.50
|
|
Controller infinity pt dbs
|
$10,700.95 |
$10,700.95 |
$10,700.95 |
$4,836.44
|
|
Conversion ext bil drg cath
|
$4,661.80 |
$4,661.80 |
$4,661.80 |
$4,122.00
|
|
Convert nephrostomy catheter
|
$5,428.15 |
$5,428.15 |
$5,428.15 |
$2,777.60
|
|
Conv gtube to jtube
|
$3,206.45 |
$3,206.45 |
$3,206.45 |
$2,099.70
|
|
Coombs direct
|
$79.95 |
$79.95 |
$79.95 |
$76.80
|
|
Coombs indirect qualitative each reagent red cell reference
|
$961.00 |
$961.00 |
$961.00 |
$107.25
|
|
Coombs indirect titer reference
|
$437.00 |
$437.00 |
$437.00 |
$156.71
|
|
Copper cu 64 dotatate diag
|
$2,282.15 |
$2,282.15 |
$48,184.00 |
$2,820.66
|
|
Core ndl bx lng/med perq
|
$4,640.35 |
$4,640.35 |
$4,640.35 |
$2,904.48
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$103,868.05 |
$103,868.05 |
$103,868.05 |
$7,849.80
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$27,659.45 |
$27,659.45 |
$27,659.45 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$24,402.95 |
$24,402.95 |
$24,402.95 |
$10,353.29
|
|
Coronary angio/lv gram/rt< heart
|
$25,198.55 |
$25,198.55 |
$25,198.55 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$12,404.60 |
$12,404.60 |
$12,404.60 |
$8,191.00
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$11,240.45 |
$11,240.45 |
$11,240.45 |
$7,988.40
|
|
Coronary thrombolysis/iv infusion 92977
|
$724.75 |
$724.75 |
$724.75 |
$484.37
|
|
Correct skin color 6.0 cm/<
|
$1,403.35 |
$1,403.35 |
$1,403.35 |
$1,016.25
|
|
Corticorelin ovine triflutal
|
$89.05 |
$89.05 |
$89.05 |
$1,462.49
|
