|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$583.20 |
$583.20 |
$583.20 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$971.40 |
$971.40 |
$971.40 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$595.80 |
$595.80 |
$595.80 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$363.00 |
$363.00 |
$363.00 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$793.80 |
$793.80 |
$793.80 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$753.60 |
$753.60 |
$753.60 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$169.20 |
$169.20 |
$169.20 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,107.00 |
$1,107.00 |
$1,107.00 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$255.00 |
$255.00 |
$255.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$163.20 |
$163.20 |
$163.20 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$255.00 |
$255.00 |
$255.00 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$1,832.40 |
$1,832.40 |
$1,832.40 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$262.20 |
$262.20 |
$262.20 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$2,043.00 |
$2,043.00 |
$2,043.00 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,832.40 |
$1,832.40 |
$1,832.40 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$360.00 |
$360.00 |
$360.00 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$360.00 |
$360.00 |
$360.00 |
$475.68
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$163.20 |
$163.20 |
$163.20 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$558.00 |
$558.00 |
$558.00 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$553.20 |
$553.20 |
$553.20 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,945.20 |
$1,945.20 |
$1,945.20 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,974.60 |
$1,974.60 |
$1,974.60 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$151.20 |
$151.20 |
$151.20 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$198.00 |
$198.00 |
$198.00 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$360.00 |
$360.00 |
$360.00 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$550.80 |
$550.80 |
$550.80 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$622.80 |
$622.80 |
$622.80 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$646.20 |
$646.20 |
$646.20 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$643.80 |
$643.80 |
$643.80 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$694.80 |
$694.80 |
$694.80 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$608.40 |
$608.40 |
$608.40 |
$474.50
|
|
Cltx carpl scphd fx w/mnpj
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$667.80 |
$667.80 |
$667.80 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,757.40 |
$1,757.40 |
$1,757.40 |
$1,815.75
|
|
Cltx mndblr fx w/mnpj
|
$1,783.20 |
$1,783.20 |
$1,783.20 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$3,859.80 |
$3,859.80 |
$3,859.80 |
$3,990.33
|
|
Cltx post ankle fx w/mnpj
|
$1,965.60 |
$1,965.60 |
$1,965.60 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$2,021.04
|
|
C motor evoked lwr limbs
|
$340.80 |
$340.80 |
$340.80 |
$627.89
|
|
C motor evoked uppr limbs
|
$613.20 |
$613.20 |
$613.20 |
$824.67
|
|
C motor evoked upr&lwr limbs
|
$1,558.20 |
$1,558.20 |
$1,558.20 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$382.20 |
$382.20 |
$382.20 |
$100.80
|
|
Cmv pcr-sendout
|
$363.60 |
$363.60 |
$363.60 |
$177.50
|
|
Coagulation time activated teg
|
$104.40 |
$104.40 |
$104.40 |
$53.72
|
|
Coch imp ext proc/contr rplc
|
$33,111.00 |
$33,111.00 |
$33,111.00 |
$20,146.35
|
|
Cold agglutinin titer
|
$34.20 |
$34.20 |
$34.20 |
$50.00
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$307.80 |
$307.80 |
$307.80 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$85.20 |
$85.20 |
$85.20 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$85.20 |
$85.20 |
$85.20 |
$213.89
|
|
Collection of venous blood by venipuncture
|
$25.80 |
$25.80 |
$25.80 |
$21.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$3,226.80 |
$3,226.80 |
$3,226.80 |
$3,762.53
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$145.80 |
$145.80 |
$145.80 |
$312.90
|
|
Colposcopy w/biopsy of cervix 57455
|
$298.80 |
$298.80 |
$298.80 |
$502.80
|
|
Compatibility test each unit antiglobulin technique
|
$169.80 |
$169.80 |
$169.80 |
$170.05
|
|
Compatibility test each unit electronic
|
$315.60 |
$315.60 |
$315.60 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$108.00 |
$108.00 |
$108.00 |
$169.52
|
|
Compatibility test incubate
|
$108.00 |
$108.00 |
$108.00 |
$155.40
|
|
Complement antigen each component c3
|
$386.40 |
$386.40 |
$386.40 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$487.80 |
$487.80 |
$487.80 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$585.00 |
$585.00 |
$585.00 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$659.40 |
$659.40 |
$659.40 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$734.40 |
$734.40 |
$734.40 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$322.80 |
$322.80 |
$322.80 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$574.20 |
$574.20 |
$574.20 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$721.80 |
$721.80 |
$721.80 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$298.20 |
$298.20 |
$298.20 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$195.60 |
$195.60 |
$195.60 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$450.60 |
$450.60 |
$450.60 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$307.20 |
$307.20 |
$307.20 |
$537.00
|
|
Computed tomographic angiography head and neck with contrast
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
$2,237.25
|
|
Concentration infection agents any type
|
$69.00 |
$69.00 |
$69.00 |
$49.95
|
|
Condylomata destruction 56420
|
$212.40 |
$212.40 |
$212.40 |
$469.00
|
|
Conization/cerv/loop electrode exc 57522
|
$6,943.80 |
$6,943.80 |
$6,943.80 |
$4,840.07
|
|
Consultation pathology during surgery
|
$214.80 |
$214.80 |
$214.80 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$531.00 |
$531.00 |
$531.00 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$346.80 |
$346.80 |
$346.80 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$330.60 |
$330.60 |
$330.60 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$957.60 |
$957.60 |
$957.60 |
$224.80
|
|
Consult comp w/report rfrd material
|
$374.40 |
$374.40 |
$374.40 |
$365.60
|
|
Contrast exam abdominl aorta 75625-26
|
$5,272.80 |
$5,272.80 |
$5,272.80 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$5,028.60 |
$5,028.60 |
$5,028.60 |
$3,728.24
|
|
Contrast x-ray of ankle
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$612.30
|
|
Contrast x-ray of elbow
|
$690.60 |
$690.60 |
$690.60 |
$649.80
|
|
Contrast x-ray of hip
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$771.12
|
|
Contrast x-ray of knee joint
|
$1,356.00 |
$1,356.00 |
$1,356.00 |
$769.88
|
|
Contrast x-ray of wrist
|
$822.60 |
$822.60 |
$822.60 |
$637.00
|
|
Control nosebleed pack+caut 30905
|
$228.60 |
$228.60 |
$228.60 |
$392.60
|
|
Control nose/throat bleeding w/pst nsl packs 42970
|
$261.00 |
$261.00 |
$261.00 |
$753.50
|
|
Control of nosebleed ant comp 30903
|
$182.40 |
$182.40 |
$182.40 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$127.80 |
$127.80 |
$127.80 |
$355.50
|
|
Control oropharyngeal hemorr/simp 42960
|
$397.80 |
$397.80 |
$397.80 |
$634.80
|
|
Convert nephrostomy catheter
|
$2,946.60 |
$2,946.60 |
$2,946.60 |
$2,777.60
|
|
Coombs direct
|
$98.40 |
$98.40 |
$98.40 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$192.00 |
$192.00 |
$192.00 |
$102.90
|
|
Coombs indirect titer reference
|
$309.00 |
$309.00 |
$309.00 |
$146.40
|
