|
Clsd tx clavicle fracture w/manip 23505
|
$3,256.40 |
$3,256.40 |
$3,256.40 |
$1,893.86
|
|
Clsd tx dist fib fx w/manip 27788
|
$1,026.20 |
$1,026.20 |
$1,026.20 |
$676.20
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$808.50 |
$808.50 |
$808.50 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$583.10 |
$583.10 |
$583.10 |
$462.80
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$336.70 |
$336.70 |
$336.70 |
$373.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$448.80
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$541.80 |
$541.80 |
$541.80 |
$529.65
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,250.20 |
$1,250.20 |
$1,250.20 |
$1,680.00
|
|
Clsd tx fx radius/ulna without manip 25560
|
$930.30 |
$930.30 |
$930.30 |
$487.20
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,849.40 |
$1,849.40 |
$1,849.40 |
$1,548.40
|
|
Clsd tx hip disloc without anes 27265
|
$816.20 |
$816.20 |
$816.20 |
$631.00
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$1,141.70 |
$1,141.70 |
$1,141.70 |
$883.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$566.30 |
$566.30 |
$566.30 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,228.50 |
$1,228.50 |
$1,228.50 |
$613.14
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$829.50 |
$829.50 |
$829.50 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$829.50 |
$829.50 |
$829.50 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,790.50 |
$3,790.50 |
$3,790.50 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$3,503.50 |
$3,503.50 |
$3,503.50 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$704.90 |
$704.90 |
$704.90 |
$577.20
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$5,644.80 |
$5,644.80 |
$5,644.80 |
$2,211.05
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$609.00 |
$609.00 |
$609.00 |
$414.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,509.20 |
$1,509.20 |
$1,509.20 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,084.20 |
$3,084.20 |
$3,084.20 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$621.60 |
$621.60 |
$621.60 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$424.20 |
$424.20 |
$424.20 |
$412.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,609.60 |
$2,609.60 |
$2,609.60 |
$1,565.74
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$760.90 |
$760.90 |
$760.90 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$829.50 |
$829.50 |
$829.50 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,967.30 |
$2,967.30 |
$2,967.30 |
$1,851.78
|
|
Cltx lunate dislc w/mnpj
|
$3,542.00 |
$3,542.00 |
$3,542.00 |
$2,384.00
|
|
Cltx post ankle fx
|
$525.00 |
$525.00 |
$525.00 |
$483.60
|
|
Cltx thigh fx w/mnpj
|
$2,366.70 |
$2,366.70 |
$2,366.70 |
$3,276.70
|
|
Cmbn ant pst colprhy
|
$41,764.51 |
$41,764.51 |
$41,764.51 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$1,364.30 |
$1,364.30 |
$1,364.30 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,332.10 |
$1,332.10 |
$1,332.10 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$3,391.50 |
$3,391.50 |
$3,391.50 |
$1,308.00
|
|
#cms hgb-sulfhemoglobin
|
$18.20 |
$18.20 |
$18.20 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$179.90 |
$179.90 |
$179.90 |
$87.75
|
|
Cmv pcr-sendout
|
$461.30 |
$461.30 |
$461.30 |
$177.50
|
|
Cnbp gene detc abnor allele
|
$434.00 |
$434.00 |
$434.00 |
$313.60
|
|
Co2 monitor per day
|
$1,104.60 |
$1,104.60 |
$1,104.60 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$66,799.25 |
$66,799.25 |
$66,799.25 |
$12,560.76
|
|
Coagulation time activated teg
|
$119.70 |
$119.70 |
$119.70 |
$53.55
|
|
Cold agglutinin screen (arc)
|
$156.10 |
$156.10 |
$156.10 |
$45.00
|
|
Cold agglutinin titer
|
$59.50 |
$59.50 |
$59.50 |
$51.60
|
|
Colistimethate sodium inj
|
$153.30 |
$153.30 |
$153.30 |
$71.09
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$342.77 |
$342.77 |
$342.77 |
$62.40
|
|
Collar cerv ascend 172 reg
|
$642.60 |
$642.60 |
$642.60 |
$213.89
|
|
Collar cerv patriot adlt
|
$30.20 |
$30.20 |
$30.20 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$6,158.77 |
$6,158.77 |
$6,158.77 |
$160.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$14,271.07 |
$14,271.07 |
$14,271.07 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$702.80 |
$702.80 |
$702.80 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$4,336.60 |
$4,336.60 |
$4,336.60 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$2,503.20 |
$2,503.20 |
$2,503.20 |
$1,679.48
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$29,474.06 |
$29,474.06 |
$29,474.06 |
$2,004.81
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$3,497.20 |
$3,497.20 |
$3,497.20 |
$1,517.60
|
|
Colonoscopy stoma w/snare 44394
|
$9,269.79 |
$9,269.79 |
$9,269.79 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$16,725.74 |
$16,725.74 |
$16,725.74 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$12,206.73 |
$12,206.73 |
$12,206.73 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$14,334.35 |
$14,334.35 |
$14,334.35 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$14,512.80 |
$14,512.80 |
$14,512.80 |
$1,645.43
|
|
Colonoscopy w/band ligation
|
$6,726.18 |
$6,726.18 |
$6,726.18 |
$2,030.00
|
|
Colonoscopy w/control bleed
|
$18,640.19 |
$18,640.19 |
$18,640.19 |
$2,030.25
|
|
Colonoscopy w/decompression
|
$1,572.20 |
$1,572.20 |
$1,572.20 |
$1,572.20
|
|
Colonoscopy w/dilation
|
$1,415.40 |
$1,415.40 |
$1,415.40 |
$2,495.25
|
|
Colonoscopy w/endoscope Ultrasound
|
$12,241.49 |
$12,241.49 |
$12,241.49 |
$1,645.43
|
|
Colonoscopy w/endoscopic fnb
|
$25,543.29 |
$25,543.29 |
$25,543.29 |
$1,645.43
|
|
Colonoscopy/w endoscopic stent 45389
|
$5,058.20 |
$5,058.20 |
$5,058.20 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$11,116.76 |
$11,116.76 |
$11,116.76 |
$1,395.28
|
|
Colonoscopy w/injection
|
$25,955.73 |
$25,955.73 |
$25,955.73 |
$2,448.60
|
|
Colonoscopy with ablation
|
$4,067.00 |
$4,067.00 |
$4,067.00 |
$3,290.95
|
|
Colonoscopy (with biopsy)
|
$11,528.19 |
$11,528.19 |
$11,528.19 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$10,820.05 |
$10,820.05 |
$10,820.05 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$7,901.69 |
$7,901.69 |
$7,901.69 |
$2,288.00
|
|
Colonoscopy w/ndl aspir/bx
|
$5,565.70 |
$5,565.70 |
$5,565.70 |
$2,495.25
|
|
Colonoscopy w/resection
|
$18,227.95 |
$18,227.95 |
$18,227.95 |
$3,029.60
|
|
Colonoscopy w/ultrasound
|
$1,449.00 |
$1,449.00 |
$1,449.00 |
$2,636.40
|
|
Colpocleisis (le forte type) 57120
|
$44,621.29 |
$44,621.29 |
$44,621.29 |
$5,463.96
|
|
Colpopexy extraperitoneal
|
$41,123.94 |
$41,123.94 |
$41,123.94 |
$5,741.00
|
|
Colpopexy intraperitoneal
|
$95,087.40 |
$95,087.40 |
$95,087.40 |
$7,212.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$89,225.01 |
$89,225.01 |
$89,225.01 |
$3,762.53
|
|
Colposcopy/cervix/ conization 57461
|
$26,952.09 |
$26,952.09 |
$26,952.09 |
$3,744.41
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$327.60 |
$327.60 |
$327.60 |
$314.00
|
|
Colposcopy vulva 56820
|
$676.90 |
$676.90 |
$676.90 |
$333.20
|
|
Colposcopy w/biopsy of cervix 57455
|
$13,627.47 |
$13,627.47 |
$13,627.47 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$239.40 |
$239.40 |
$239.40 |
$172.00
|
|
Compatibility test each unit electronic
|
$125.30 |
$125.30 |
$125.30 |
$166.26
|
|
Compatibility test each unit immediate spin technique
|
$151.90 |
$151.90 |
$151.90 |
$167.17
|
|
Compatibility test incubate
|
$125.30 |
$125.30 |
$125.30 |
$149.60
|
|
Complement antigen each component c3
|
$423.50 |
$423.50 |
$423.50 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$36,239.97 |
$36,239.97 |
$36,239.97 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,575.70 |
$1,575.70 |
$1,575.70 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$18,339.66 |
$18,339.66 |
$18,339.66 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$22,768.44 |
$22,768.44 |
$22,768.44 |
$490.50
|
|
Complx repair fccmnaxghf 13132
|
$21,680.82 |
$21,680.82 |
$21,680.82 |
$1,066.92
|
|
Complx repair fccmnaxghf 13133
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$493.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$34,202.46 |
$34,202.46 |
$34,202.46 |
$494.34
|
|
Complx repair trunk addl 5cm/< 13102
|
$38,694.96 |
$38,694.96 |
$38,694.96 |
$502.00
|
