|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,656.90
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,571.25
|
|
Clsd tx hip disloc without anes 27265
|
$259.20 |
$259.20 |
$259.20 |
$630.00
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$494.64 |
$494.64 |
$494.64 |
$883.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$273.60 |
$273.60 |
$273.60 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$467.28 |
$467.28 |
$467.28 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$446.40 |
$446.40 |
$446.40 |
$418.20
|
|
Clsd tx of ankle fracture w/manip 28435
|
$3,247.20 |
$3,247.20 |
$3,247.20 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$259.20 |
$259.20 |
$259.20 |
$566.72
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$2,146.20
|
|
Clsd tx radius fracture w/manip 24655
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$3,093.12 |
$3,093.12 |
$3,093.12 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$509.76 |
$509.76 |
$509.76 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$259.20 |
$259.20 |
$259.20 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$470.16 |
$470.16 |
$470.16 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,565.74
|
|
Cls tx of heel fracture w/manip 28405
|
$259.20 |
$259.20 |
$259.20 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$3,177.36 |
$3,177.36 |
$3,177.36 |
$2,317.60
|
|
Cltx humrl cndylr fx w/mnpj
|
$3,177.36 |
$3,177.36 |
$3,177.36 |
$1,815.75
|
|
Cltx lunate dislc w/mnpj
|
$3,177.36 |
$3,177.36 |
$3,177.36 |
$2,437.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,728.72 |
$1,728.72 |
$1,728.72 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$259.20 |
$259.20 |
$259.20 |
$619.30
|
|
#cmvcul-virus inoculation shell
|
$80.64 |
$80.64 |
$80.64 |
$100.80
|
|
Cmv pcr-sendout
|
$125.28 |
$125.28 |
$125.28 |
$177.50
|
|
Cold agglutinin titer
|
$115.92 |
$115.92 |
$115.92 |
$50.00
|
|
Collagen based wound filler
|
$46.08 |
$46.08 |
$46.08 |
$1,823.25
|
|
Collagen drsg>16<=48 sq in
|
$20.88 |
$20.88 |
$20.88 |
$24.71
|
|
Collection blood specimen from completely implantable venous access device
|
$123.84 |
$123.84 |
$123.84 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$138.96 |
$138.96 |
$138.96 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$25.92 |
$25.92 |
$25.92 |
$21.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$7,055.28 |
$7,055.28 |
$7,055.28 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$192.24 |
$192.24 |
$192.24 |
$170.05
|
|
Compatibility test each unit immediate spin technique
|
$192.24 |
$192.24 |
$192.24 |
$169.52
|
|
Compatibility test incubate
|
$228.24 |
$228.24 |
$228.24 |
$155.40
|
|
Complement antigen each component c3
|
$136.80 |
$136.80 |
$136.80 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$660.96 |
$660.96 |
$660.96 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$660.96 |
$660.96 |
$660.96 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$660.96 |
$660.96 |
$660.96 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$660.96 |
$660.96 |
$660.96 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$185.04 |
$185.04 |
$185.04 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$583.92 |
$583.92 |
$583.92 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$660.96 |
$660.96 |
$660.96 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$185.04 |
$185.04 |
$185.04 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$185.04 |
$185.04 |
$185.04 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$660.96 |
$660.96 |
$660.96 |
$1,000.00
|
|
Composite drsg <= 16 sq in
|
$7.92 |
$7.92 |
$7.92 |
$6.62
|
|
Concentration infection agents any type
|
$42.48 |
$42.48 |
$42.48 |
$49.95
|
|
Condylomata destruction 56420
|
$378.00 |
$378.00 |
$378.00 |
$469.00
|
|
Consultation pathology during surgery
|
$81.36 |
$81.36 |
$81.36 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,535.04 |
$1,535.04 |
$1,535.04 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$138.24 |
$138.24 |
$138.24 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$246.96 |
$246.96 |
$246.96 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$202.32 |
$202.32 |
$202.32 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$365.76 |
$365.76 |
$365.76 |
$171.65
|
|
Consult comp w/report rfrd material
|
$365.76 |
$365.76 |
$365.76 |
$365.60
|
|
Cont gluc mntr analysis i&r 95251
|
$80.64 |
$80.64 |
$80.64 |
$65.70
|
|
Contrast x-ray of elbow
|
$736.56 |
$736.56 |
$736.56 |
$649.80
|
|
Contrast x-ray of hip
|
$1,393.92 |
$1,393.92 |
$1,393.92 |
$771.12
|
|
Contrast x-ray of knee joint
|
$1,247.76 |
$1,247.76 |
$1,247.76 |
$769.88
|
|
Contrast x-ray of wrist
|
$1,247.76 |
$1,247.76 |
$1,247.76 |
$637.00
|
|
Control nosebleed pack+caut 30905
|
$162.72 |
$162.72 |
$162.72 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$255.60 |
$255.60 |
$255.60 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$162.72 |
$162.72 |
$162.72 |
$355.50
|
|
Coombs direct
|
$85.68 |
$85.68 |
$85.68 |
$75.00
|
|
Coombs indirect titer reference
|
$216.00 |
$216.00 |
$216.00 |
$146.40
|
|
Core ndl bx lng/med perq
|
$3,211.20 |
$3,211.20 |
$3,211.20 |
$2,678.00
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$2,460.96 |
$2,460.96 |
$2,460.96 |
$8,272.50
|
|
Cortisol total am
|
$202.32 |
$202.32 |
$202.32 |
$120.63
|
|
Cosyntropin 0.25 mg solution for injection
|
$368.35 |
$368.35 |
$368.35 |
$189.22
|
|
#coxa-coxsackie a serotype a16
|
$34.56 |
$34.56 |
$34.56 |
$60.00
|
|
C-peptide
|
$232.56 |
$232.56 |
$232.56 |
$97.30
|
|
C-reactive protein
|
$77.04 |
$77.04 |
$77.04 |
$68.38
|
|
C-reactive protein high sensitivity
|
$167.04 |
$167.04 |
$167.04 |
$85.00
|
|
C-reactive protein, quantitative
|
$78.48 |
$78.48 |
$78.48 |
$71.06
|
|
Creatine kinase
|
$108.00 |
$108.00 |
$108.00 |
$66.30
|
|
Creatine kinase isoenzymes
|
$115.92 |
$115.92 |
$115.92 |
$56.80
|
|
Creatine kinase mb
|
$128.16 |
$128.16 |
$128.16 |
$114.00
|
|
Creatinine
|
$79.20 |
$79.20 |
$79.20 |
$44.72
|
|
Creatinine 24 hour urine
|
$74.16 |
$74.16 |
$74.16 |
$58.85
|
|
Creatinine clearance urine
|
$167.76 |
$167.76 |
$167.76 |
$89.50
|
|
#creutz-prot.,western blot
|
$69.84 |
$69.84 |
$69.84 |
$166.20
|
|
Critical care 30-74 minutes
|
$1,881.36 |
$1,881.36 |
$1,881.36 |
$2,505.60
|
|
Critical care each additional 30 minutes
|
$714.24 |
$714.24 |
$714.24 |
$731.40
|
|
Cryptococcus abs qn - sendout
|
$118.08 |
$118.08 |
$118.08 |
$89.70
|
|
Cryptosporidium antigen
|
$86.40 |
$86.40 |
$86.40 |
$52.08
|
|
Crystal identification light microscopy
|
$58.32 |
$58.32 |
$58.32 |
$62.50
|
|
CT 3d report other modality w/workstation
|
$777.60 |
$777.60 |
$777.60 |
$613.47
|
|
Cta abdomen without & /or w/contrast
|
$2,435.04 |
$2,435.04 |
$2,435.04 |
$2,050.23
|
|
Cta abdominal aorta & (both sides) ileofemoral lower extremity w runoff without & w/contrast
|
$2,726.64 |
$2,726.64 |
$2,726.64 |
$1,940.00
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,589.84 |
$2,589.84 |
$2,589.84 |
$2,047.80
|
|
Cta neck without &/or w/contrast
|
$2,684.88 |
$2,684.88 |
$2,684.88 |
$1,931.40
|
|
CT Angiogram of Abdomen and Pelvis
|
$3,287.52 |
$3,287.52 |
$3,287.52 |
$2,849.55
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,903.76 |
$2,903.76 |
$2,903.76 |
$1,940.00
|
|
CT Angiogram of the Head
|
$2,396.88 |
$2,396.88 |
$2,396.88 |
$1,996.80
|
|
Cta upper extremity w &/or without contrast left
|
$534.24 |
$534.24 |
$534.24 |
$1,698.00
|
|
CT guidance for needle placement
|
$2,376.00 |
$2,376.00 |
$2,376.00 |
$1,494.00
|
|
CT guidance for percutaneous drain w/catheter placement supervision & interpretation
|
$1,409.04 |
$1,409.04 |
$1,409.04 |
$1,178.52
|
