|
Clsd tx/nasal bone fx/stabilize 21320
|
$10,326.00 |
$10,326.00 |
$10,326.00 |
$3,600.75
|
|
Clsd tx of ankle fracture w/manip 28435
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,843.91
|
|
Clsd tx patella disloc without anes 27560
|
$777.00 |
$777.00 |
$777.00 |
$665.50
|
|
Clsd tx/patellar fx without manip 27520
|
$777.00 |
$777.00 |
$777.00 |
$544.80
|
|
Clsd tx pelvic ring fx
|
$777.00 |
$777.00 |
$777.00 |
$416.35
|
|
Clsd tx pelvic ring fx
|
$777.00 |
$777.00 |
$777.00 |
$789.94
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$7,121.00 |
$7,121.00 |
$7,121.00 |
$2,378.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$777.00 |
$777.00 |
$777.00 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$777.00 |
$777.00 |
$777.00 |
$501.80
|
|
Clsd tx radius fracture w/manip 24655
|
$3,415.00 |
$3,415.00 |
$3,415.00 |
$1,868.38
|
|
Clsd tx/scapular fx without manip 23570
|
$777.00 |
$777.00 |
$777.00 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$2,078.00 |
$2,078.00 |
$2,078.00 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,797.83
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,423.85
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$10,690.00 |
$10,690.00 |
$10,690.00 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,206.00 |
$1,206.00 |
$1,206.00 |
$512.40
|
|
Clsd tx toe dislocation without anes28660
|
$1,161.00 |
$1,161.00 |
$1,161.00 |
$415.20
|
|
Clsd tx trimall ankle fx without manip 27816
|
$777.00 |
$777.00 |
$777.00 |
$597.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$777.00 |
$777.00 |
$777.00 |
$510.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$777.00 |
$777.00 |
$777.00 |
$730.08
|
|
Clsd tx wrist carpal fx without manip 25630
|
$777.00 |
$777.00 |
$777.00 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$777.00 |
$777.00 |
$777.00 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$777.00 |
$777.00 |
$777.00 |
$682.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$777.00 |
$777.00 |
$777.00 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$777.00 |
$777.00 |
$777.00 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$777.00 |
$777.00 |
$777.00 |
$1,232.40
|
|
Cltx carpl scphd fx w/mnpj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,368.00
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$777.00 |
$777.00 |
$777.00 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$1,877.71
|
|
Cltx humrl cndylr fx wo mnpj
|
$777.00 |
$777.00 |
$777.00 |
$581.99
|
|
Cltx lunate dislc w/mnpj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$19,198.00 |
$19,198.00 |
$19,198.00 |
$5,835.75
|
|
Cltx mndblr fx w/mnpj
|
$20,804.00 |
$20,804.00 |
$20,804.00 |
$2,133.48
|
|
Cltx mndblr/max alv ridge fx
|
$10,326.00 |
$10,326.00 |
$10,326.00 |
$3,837.72
|
|
Cltx palatal/max fx wire fix
|
$10,326.00 |
$10,326.00 |
$10,326.00 |
$3,837.72
|
|
Cltx post ankle fx
|
$777.00 |
$777.00 |
$777.00 |
$521.30
|
|
Cltx post ankle fx w/mnpj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,211.05
|
|
Cltx scap fx w/mnpj +-tractj
|
$5,258.00 |
$5,258.00 |
$5,258.00 |
$2,050.29
|
|
Cltx strnclav dislc w/mnpj
|
$777.00 |
$777.00 |
$777.00 |
$777.00
|
|
Cltx thigh fx
|
$10,690.00 |
$10,690.00 |
$10,690.00 |
$3,821.05
|
|
Cltx tmprmand dislc comp
|
$5,107.00 |
$5,107.00 |
$5,107.00 |
$3,786.00
|
|
C motor evoked lwr limbs
|
$1,223.00 |
$1,223.00 |
$3,542.00 |
$621.00
|
|
C motor evoked uppr limbs
|
$1,188.30 |
$1,188.30 |
$6,679.00 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$2,407.00 |
$2,407.00 |
$2,748.85 |
$1,273.61
|
|
#cmvcul-virus inoculation shell
|
$26.25 |
$26.25 |
$288.00 |
$102.57
|
|
Cmv pcr-sendout
|
$82.25 |
$82.25 |
$734.00 |
$172.25
|
|
Coagulation time activated teg
|
$554.00 |
$554.00 |
$1,136.90 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$1,955.83 |
$1,955.83 |
$1,955.83 |
$781.82
|
|
Cochlear implt f/up exam <7
|
$975.00 |
$975.00 |
$975.00 |
$369.60
|
|
Cochlear implt f/up exam 7/>
|
$975.00 |
$975.00 |
$975.00 |
$345.60
|
|
Cold agglutinin screen (arc)
|
$195.43 |
$195.43 |
$241.00 |
$47.19
|
|
Cold agglutinin titer
|
$4.84 |
$4.85 |
$84.00 |
$49.40
|
|
Colistimethate sodium inj
|
$158.00 |
$158.00 |
$170.75 |
$84.60
|
|
Collar cerv adlt perfit ace extric
|
$1,475.00 |
$1,475.00 |
$1,475.00 |
$29.25
|
|
Collar cerv ascend 172 reg
|
$238.00 |
$238.00 |
$238.00 |
$174.01
|
|
Collection blood specimen from completely implantable venous access device
|
$364.00 |
$364.00 |
$364.00 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$364.00 |
$364.00 |
$364.00 |
$164.05
|
|
Collection of venous blood by venipuncture
|
$28.00 |
$28.00 |
$28.00 |
$22.00
|
|
Colonoscopy (diagnostic)
|
$2,996.00 |
$2,996.00 |
$2,996.00 |
$1,620.84
|
|
Colonoscopy submucous njx
|
$3,914.00 |
$3,914.00 |
$3,914.00 |
$2,353.00
|
|
Colonoscopy w/ablation
|
$3,803.00 |
$3,803.00 |
$3,803.00 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$4,729.00 |
$4,729.00 |
$4,729.00 |
$1,631.37
|
|
Colonoscopy w/control bleed
|
$3,914.00 |
$3,914.00 |
$3,914.00 |
$2,262.00
|
|
Colonoscopy (with biopsy)
|
$3,914.00 |
$3,914.00 |
$3,914.00 |
$2,538.00
|
|
Colonoscopy (with polyp removal)
|
$3,914.00 |
$3,914.00 |
$3,914.00 |
$2,472.75
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$2,392.00 |
$2,392.00 |
$2,392.00 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$9,904.00 |
$9,904.00 |
$9,904.00 |
$3,519.29
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$2,732.00 |
$2,732.00 |
$2,732.00 |
$314.00
|
|
Colposcopy vulva 56820
|
$818.00 |
$818.00 |
$818.00 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$1,065.00 |
$1,065.00 |
$1,065.00 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$4,546.00 |
$4,546.00 |
$4,546.00 |
$534.30
|
|
Compatibility test each unit antiglobulin technique
|
$749.00 |
$749.00 |
$749.00 |
$165.00
|
|
Compatibility test each unit electronic
|
$59.40 |
$158.35 |
$282.00 |
$171.25
|
|
Compatibility test each unit immediate spin technique
|
$154.89 |
$158.35 |
$459.00 |
$159.95
|
|
Compatibility test incubate
|
$186.65 |
$186.65 |
$186.65 |
$143.64
|
|
Comp cystometrogram/void presssure 51728
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$958.81
|
|
Comp cystometrogram/void/uret pres 51729
|
$2,171.00 |
$2,171.00 |
$2,171.00 |
$1,099.00
|
|
Complement antigen each component c3
|
$590.00 |
$590.00 |
$590.00 |
$113.13
|
|
Complement fixation each
|
$54.00 |
$54.00 |
$119.20 |
$25.70
|
|
Complex cystometrogram 51726
|
$1,005.00 |
$1,005.00 |
$1,005.00 |
$710.40
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$913.68
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$4,055.00 |
$4,055.00 |
$4,055.00 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$526.00 |
$526.00 |
$526.00 |
$353.50
|
|
Compl oph exam general anes
|
$2,236.60 |
$2,236.60 |
$2,236.60 |
$2,584.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,193.40
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,252.90
|
|
Complx repair enel addl 5cm/< 13153
|
$2,837.00 |
$2,837.00 |
$2,837.00 |
$523.78
|
|
Complx repair fccmnaxghf 13131
|
$1,305.00 |
$1,305.00 |
$1,305.00 |
$927.55
|
|
Complx repair fccmnaxghf 13132
|
$1,977.00 |
$1,977.00 |
$1,977.00 |
$1,212.00
|
|
Complx repair fccmnaxghf 13133
|
$3,020.00 |
$3,020.00 |
$3,020.00 |
$781.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$426.00 |
$426.00 |
$426.00 |
$590.20
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$4,055.00 |
$4,055.00 |
$4,055.00 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$4,175.00 |
$4,175.00 |
$4,175.00 |
$741.60
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$981.00 |
$981.00 |
$981.00 |
$1,000.10
|
|
Comprehensive hearing test
|
$465.00 |
$465.00 |
$465.00 |
$220.23
|
|
Concentration infection agents any type
|
$196.00 |
$196.00 |
$196.00 |
$50.70
|
|
Conditioning play audiometry 92582
|
$238.00 |
$238.00 |
$238.00 |
$185.15
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$403.00 |
$403.00 |
$403.00 |
$2,242.57
|
