|
Closed tx humerus fx w/manip 24505
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$270.00 |
$270.00 |
$270.00 |
$386.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$275.00 |
$275.00 |
$275.00 |
$472.50
|
|
Clos txnose fx without stablz 21315
|
$1,735.00 |
$1,735.00 |
$1,735.00 |
$2,392.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$580.00 |
$580.00 |
$580.00 |
$1,259.62
|
|
Closure paravalvlr leak pq
|
$14,800.00 |
$14,800.00 |
$14,800.00 |
$9,434.46
|
|
Clot factor xii hageman
|
$125.00 |
$125.00 |
$125.00 |
$138.40
|
|
Clot factor xiii fibrin stab
|
$105.00 |
$105.00 |
$105.00 |
$106.40
|
|
Clotting assay whole blood
|
$237.50 |
$237.50 |
$237.50 |
$105.95
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$540.00 |
$540.00 |
$540.00 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$270.00 |
$270.00 |
$270.00 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$270.00 |
$270.00 |
$270.00 |
$489.60
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,785.00 |
$1,785.00 |
$1,785.00 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$265.00 |
$265.00 |
$265.00 |
$452.40
|
|
Clsd tx dist fib fx w/manip 27788
|
$270.00 |
$270.00 |
$270.00 |
$676.65
|
|
Clsd tx elbow dislocation child 24640
|
$270.00 |
$270.00 |
$270.00 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,211.05
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$270.00 |
$270.00 |
$270.00 |
$464.20
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$3,580.00 |
$3,580.00 |
$3,580.00 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$270.00 |
$270.00 |
$270.00 |
$630.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$270.00 |
$270.00 |
$270.00 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$270.00 |
$270.00 |
$270.00 |
$522.78
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$270.00 |
$270.00 |
$270.00 |
$573.52
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$270.00 |
$270.00 |
$270.00 |
$414.40
|
|
Clsd tx radius fracture w/manip 24655
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,687.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$530.00 |
$530.00 |
$530.00 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$270.00 |
$270.00 |
$270.00 |
$412.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,592.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,851.78
|
|
Cltx lunate dislc w/mnpj
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$2,895.00 |
$2,895.00 |
$2,895.00 |
$6,776.64
|
|
Cltx post ankle fx w/mnpj
|
$1,790.00 |
$1,790.00 |
$1,790.00 |
$1,939.00
|
|
C motor evoked lwr limbs
|
$3,755.00 |
$3,755.00 |
$3,755.00 |
$627.89
|
|
C motor evoked uppr limbs
|
$3,755.00 |
$3,755.00 |
$3,755.00 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,435.00 |
$1,435.00 |
$1,435.00 |
$1,333.36
|
|
Cmv pcr-sendout
|
$177.50 |
$177.50 |
$177.50 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$5.74 |
$5.74 |
$5.74 |
$11,888.50
|
|
Coagulation time activated teg
|
$40.00 |
$40.00 |
$40.00 |
$52.47
|
|
Cochlear implt f/up exam <7
|
$217.50 |
$217.50 |
$217.50 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$290.00 |
$290.00 |
$290.00 |
$386.64
|
|
Cold agglutinin titer
|
$55.00 |
$55.00 |
$55.00 |
$52.00
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$280.00 |
$280.00 |
$280.00 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$205.00 |
$205.00 |
$205.00 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$192.50 |
$192.50 |
$192.50 |
$155.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$3,105.00 |
$3,105.00 |
$3,105.00 |
$3,907.93
|
|
Compatibility test each unit antiglobulin technique
|
$222.50 |
$222.50 |
$222.50 |
$173.50
|
|
Compatibility test each unit electronic
|
$95.00 |
$95.00 |
$95.00 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$137.50 |
$137.50 |
$137.50 |
$169.52
|
|
Compatibility test incubate
|
$122.50 |
$122.50 |
$122.50 |
$156.24
|
|
Complement antigen each component c3
|
$155.00 |
$155.00 |
$155.00 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$820.00 |
$820.00 |
$820.00 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$820.00 |
$820.00 |
$820.00 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$820.00 |
$820.00 |
$820.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$945.00 |
$945.00 |
$945.00 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$465.00 |
$465.00 |
$465.00 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$820.00 |
$820.00 |
$820.00 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$945.00 |
$945.00 |
$945.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$410.00 |
$410.00 |
$410.00 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$410.00 |
$410.00 |
$410.00 |
$508.44
|
|
Complx repair trunk addl 5cm/< 13102
|
$410.00 |
$410.00 |
$410.00 |
$537.00
|
|
Composite graft/pri close/don area 15760
|
$2,195.00 |
$2,195.00 |
$2,195.00 |
$2,816.50
|
|
Comprehensive hearing test
|
$255.00 |
$255.00 |
$255.00 |
$261.46
|
|
Concentration infection agents any type
|
$37.50 |
$37.50 |
$37.50 |
$51.32
|
|
Conditioning play audiometry 92582
|
$222.50 |
$222.50 |
$222.50 |
$189.15
|
|
Condylomata destruction 56420
|
$472.50 |
$472.50 |
$472.50 |
$467.35
|
|
Connect omega .5mm
|
$472.92 |
$472.92 |
$472.92 |
$1,260.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$262.50 |
$262.50 |
$262.50 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$187.50 |
$187.50 |
$187.50 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$200.00 |
$200.00 |
$200.00 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$370.00 |
$370.00 |
$370.00 |
$224.83
|
|
Contrast exam abdominl aorta 75625-26
|
$3,490.00 |
$3,490.00 |
$3,490.00 |
$3,480.00
|
|
Contrast exam thoracic aorta 75605-26
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$3,745.00
|
|
Contrast x-ray gallbladder
|
$417.50 |
$417.50 |
$417.50 |
$341.00
|
|
Contrast x-ray of ankle
|
$885.00 |
$885.00 |
$885.00 |
$684.00
|
|
Contrast x-ray of brain
|
$900.00 |
$900.00 |
$900.00 |
$1,077.92
|
|
Contrast x-ray of elbow
|
$750.00 |
$750.00 |
$750.00 |
$708.00
|
|
Contrast x-ray of hip
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$796.38
|
|
Contrast x-ray of knee joint
|
$885.00 |
$885.00 |
$885.00 |
$790.50
|
|
Contrast x-ray of wrist
|
$885.00 |
$885.00 |
$885.00 |
$667.50
|
|
Controller infinity pt dbs
|
$4,216.39 |
$4,216.39 |
$4,216.39 |
$4,836.44
|
|
Control nosebleed pack+caut 30905
|
$300.00 |
$300.00 |
$300.00 |
$383.52
|
|
Control nose/throat bleeding w/pst nsl packs 42970
|
$392.50 |
$392.50 |
$392.50 |
$644.80
|
|
Control of nosebleed ant comp 30903
|
$300.00 |
$300.00 |
$300.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$300.00 |
$300.00 |
$300.00 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$322.50 |
$322.50 |
$322.50 |
$620.00
|
|
Conversion ext bil drg cath
|
$2,430.00 |
$2,430.00 |
$2,430.00 |
$4,122.00
|
|
Convert nephrostomy catheter
|
$1,080.00 |
$1,080.00 |
$1,080.00 |
$2,777.60
|
|
Coombs direct
|
$77.50 |
$77.50 |
$77.50 |
$76.80
|
|
Coombs indirect titer reference
|
$170.00 |
$170.00 |
$170.00 |
$156.71
|
|
Copper intrauterine device
|
$2,624.00 |
$2,624.00 |
$2,624.00 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$2,165.00 |
$2,165.00 |
$2,165.00 |
$2,904.48
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$9,552.00 |
$9,552.00 |
$9,552.00 |
$7,849.80
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$5,480.00 |
$5,480.00 |
$5,480.00 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$4,730.00 |
$4,730.00 |
$4,730.00 |
$10,353.29
|
