|
Clsd tx/metacarpal fx/sg without manip 26600
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$529.08
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$716.95
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$9,226.39 |
$9,226.39 |
$9,226.39 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$580.30
|
|
Clsd tx/metatarsal fx without manip 28470
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$446.40
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$30,746.36 |
$30,746.36 |
$30,746.36 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$705.60
|
|
Clsd tx/patellar fx without manip 27520
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$525.85
|
|
Clsd tx pelvic ring fx
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$448.80
|
|
Clsd tx pelvic ring fx
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$705.60
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,557.07
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$484.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$488.40
|
|
Clsd tx radius fracture w/manip 24655
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,884.74
|
|
Clsd tx/scapular fx without manip 23570
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,466.40
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,842.58
|
|
Clsd tx temporomandibular dislocat 21480
|
$5,105.33 |
$5,105.33 |
$5,105.33 |
$511.70
|
|
Clsd tx toe dislocation without anes28660
|
$1,486.13 |
$1,486.13 |
$1,486.13 |
$436.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$487.80
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$2,757.88 |
$2,757.88 |
$2,757.88 |
$705.60
|
|
Clsd tx wrist carpal fx without manip 25630
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$579.88
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$857.50
|
|
Cltx carpl scphd fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$56,158.69 |
$56,158.69 |
$56,158.69 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$15,514.83 |
$15,514.83 |
$15,514.83 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$33,427.05 |
$33,427.05 |
$33,427.05 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$33,427.05 |
$33,427.05 |
$33,427.05 |
$4,199.49
|
|
Cltx post ankle fx
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$2,536.71 |
$2,536.71 |
$2,536.71 |
$722.16
|
|
Cltx thigh fx
|
$33,752.58 |
$33,752.58 |
$33,752.58 |
$3,881.76
|
|
Cltx tmprmand dislc comp
|
$15,514.83 |
$15,514.83 |
$15,514.83 |
$3,986.00
|
|
C motor evoked lwr limbs
|
$467.97 |
$2,333.78 |
$5,546.51 |
$627.89
|
|
C motor evoked uppr limbs
|
$467.97 |
$11,386.02 |
$11,386.02 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$11,386.02 |
$11,386.02 |
$11,386.02 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$301.91 |
$301.91 |
$301.91 |
$102.57
|
|
Cmv pcr-sendout
|
$100.28 |
$541.61 |
$541.61 |
$173.25
|
|
Co2 monitor per day
|
$1,380.64 |
$1,380.64 |
$1,380.64 |
$388.85
|
|
Coagulation time activated teg
|
$113.47 |
$384.49 |
$776.24 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$1,859.51 |
$1,859.51 |
$2,221.24 |
$807.71
|
|
Cochlear implt f/up exam <7
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$369.60
|
|
Cochlear implt f/up exam 7/>
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$345.60
|
|
Codeine 15 mg/ml inj 2 ml
|
$171.00 |
$171.00 |
$171.00 |
$43.17
|
|
Cold agglutinin screen (arc)
|
$5.45 |
$44.94 |
$124.56 |
$47.19
|
|
Cold agglutinin titer
|
$124.40 |
$124.40 |
$185.44 |
$48.57
|
|
Colistimethate sodium inj
|
$699.56 |
$699.56 |
$779.00 |
$84.60
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$1,195.96 |
$1,195.96 |
$1,195.96 |
$66.69
|
|
Collar cerv ascend 172 reg
|
$243.97 |
$243.97 |
$715.97 |
$241.88
|
|
Collar extrication adult univ
|
$1,457.60 |
$1,457.60 |
$1,457.60 |
$567.53
|
|
Collection blood specimen from completely implantable venous access device
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$1,252.04 |
$1,252.04 |
$1,252.04 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$37.92 |
$37.92 |
$149.50 |
$22.00
|
|
Colonoscopy submucous njx
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,063.25
|
|
Colonoscopy w/ablation
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,571.00
|
|
Colonoscopy w/balloon dilat
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$1,645.43
|
|
Colonoscopy w/control bleed
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,101.71
|
|
Colonoscopy (with biopsy)
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,512.42
|
|
Colonoscopy (with polyp removal)
|
$12,166.92 |
$12,166.92 |
$12,166.92 |
$2,205.33
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$7,684.95 |
$7,684.95 |
$7,684.95 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$30,377.57 |
$30,377.57 |
$30,377.57 |
$3,519.29
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$2,089.82 |
$2,089.82 |
$2,089.82 |
$326.30
|
|
Colposcopy vulva 56820
|
$2,089.82 |
$2,089.82 |
$2,089.82 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$3,467.74 |
$3,467.74 |
$3,467.74 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$3,467.74 |
$3,467.74 |
$3,467.74 |
$544.70
|
|
Compatibility test each unit antiglobulin technique
|
$498.15 |
$531.02 |
$1,026.09 |
$173.25
|
|
Compatibility test each unit electronic
|
$161.01 |
$185.09 |
$531.02 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$498.15 |
$531.02 |
$625.31 |
$169.52
|
|
Compatibility test incubate
|
$1,271.71 |
$1,271.71 |
$1,388.61 |
$143.65
|
|
Comp cystometrogram/void presssure 51728
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$958.81
|
|
Comp cystometrogram/void/uret pres 51729
|
$6,913.16 |
$6,913.16 |
$6,913.16 |
$1,099.00
|
|
Complement antigen each component c3
|
$185.22 |
$185.22 |
$185.22 |
$111.15
|
|
Complement fixation each
|
$154.51 |
$154.51 |
$349.39 |
$24.00
|
|
Complex cystometrogram 51726
|
$1,824.22 |
$1,824.22 |
$1,824.22 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$1,707.79 |
$1,707.79 |
$1,707.79 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$1,653.72 |
$1,653.72 |
$1,653.72 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$1,703.05 |
$1,703.05 |
$1,703.05 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,024.14 |
$2,024.14 |
$2,024.14 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$6,289.69 |
$6,289.69 |
$6,289.69 |
$1,193.40
|