|
Clsd tx/dis tib/wt bear no manip 27824
|
$435.61 |
$435.61 |
$435.61 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$152.39 |
$152.39 |
$152.39 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,017.24 |
$1,017.24 |
$1,017.24 |
$2,211.05
|
|
Clsd tx fracture of radius 25500
|
$391.02 |
$391.02 |
$391.02 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$249.41 |
$249.41 |
$249.41 |
$385.60
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$225.40 |
$225.40 |
$225.40 |
$459.84
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$465.01 |
$465.01 |
$465.01 |
$537.55
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$735.49 |
$735.49 |
$735.49 |
$1,684.00
|
|
Clsd tx fx radius/ulna without manip 25560
|
$398.37 |
$398.37 |
$398.37 |
$478.40
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$708.05 |
$708.05 |
$708.05 |
$1,560.75
|
|
Clsd tx hip disloc without anes 27265
|
$555.17 |
$555.17 |
$555.17 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$523.32 |
$523.32 |
$523.32 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$495.88 |
$495.88 |
$495.88 |
$492.99
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$413.56 |
$413.56 |
$413.56 |
$499.20
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$454.72 |
$454.72 |
$454.72 |
$613.14
|
|
Clsd tx/metatarsal fx without manip 28470
|
$300.37 |
$300.37 |
$300.37 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$1,301.93 |
$1,301.93 |
$1,301.93 |
$3,678.17
|
|
Clsd tx nose fx without manip 21310
|
$589.96 |
$589.96 |
$589.96 |
$323.95
|
|
Clsd tx patella disloc without anes 27560
|
$504.21 |
$504.21 |
$504.21 |
$577.20
|
|
Clsd tx/patellar fx without manip 27520
|
$446.39 |
$446.39 |
$446.39 |
$495.80
|
|
Clsd tx pelvic ring fx
|
$128.87 |
$128.87 |
$128.87 |
$424.50
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$594.86 |
$594.86 |
$594.86 |
$2,132.25
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$274.89 |
$274.89 |
$274.89 |
$419.73
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$362.60 |
$362.60 |
$362.60 |
$465.00
|
|
Clsd tx radius fracture w/manip 24655
|
$611.03 |
$611.03 |
$611.03 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$322.42 |
$322.42 |
$322.42 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$591.43 |
$591.43 |
$591.43 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$751.17 |
$751.17 |
$751.17 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$556.64 |
$556.64 |
$556.64 |
$2,287.20
|
|
Clsd tx temporomandibular dislocat 21480
|
$194.04 |
$194.04 |
$194.04 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$166.60 |
$166.60 |
$166.60 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$453.74 |
$453.74 |
$453.74 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$666.40 |
$666.40 |
$666.40 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$362.60 |
$362.60 |
$362.60 |
$466.14
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$422.38 |
$422.38 |
$422.38 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$453.74 |
$453.74 |
$453.74 |
$611.10
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$401.31 |
$401.31 |
$401.31 |
$483.12
|
|
Cltx carpl scphd fx w/mnpj
|
$670.81 |
$670.81 |
$670.81 |
$1,958.40
|
|
Cltx humrl cndylr fx w/mnpj
|
$757.54 |
$757.54 |
$757.54 |
$1,858.00
|
|
Cltx humrl cndylr fx wo mnpj
|
$482.65 |
$482.65 |
$482.65 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$667.38 |
$667.38 |
$667.38 |
$2,420.60
|
|
Cltx mndblr/max alv ridge fx
|
$962.36 |
$962.36 |
$962.36 |
$3,907.80
|
|
Cltx palatal/max fx wire fix
|
$1,452.85 |
$1,452.85 |
$1,452.85 |
$4,377.24
|
|
Cltx post ankle fx w/mnpj
|
$607.11 |
$607.11 |
$607.11 |
$1,940.40
|
|
#cmvcul-virus inoculation shell
|
$49.98 |
$49.98 |
$49.98 |
$89.00
|
|
Cmv pcr-sendout
|
$272.93 |
$272.93 |
$272.93 |
$175.70
|
|
Co2 monitor per day
|
$463.54 |
$463.54 |
$463.54 |
$450.60
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$26,920.60 |
$26,920.60 |
$26,920.60 |
$8,798.60
|
|
Cocaine 4 % nasal solution
|
$643.55 |
$643.55 |
$643.55 |
$629.41
|
|
Cold agglutinin titer
|
$121.03 |
$121.03 |
$121.03 |
$50.00
|
|
Colistimethate sodium inj
|
$65.30 |
$65.30 |
$65.30 |
$68.47
|
|
Collagenase, clost hist inj
|
$12,823.04 |
$12,823.04 |
$12,823.04 |
$12,906.28
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$289.21 |
$289.21 |
$289.21 |
$58.65
|
|
Collar cerv adlt perfit ace extric
|
$52.47 |
$52.47 |
$52.47 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$346.43 |
$346.43 |
$346.43 |
$225.20
|
|
Collection blood specimen from completely implantable venous access device
|
$104.37 |
$104.37 |
$104.37 |
$159.88
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$57.33 |
$57.33 |
$57.33 |
$154.80
|
|
Collection of venous blood by venipuncture
|
$55.37 |
$55.37 |
$55.37 |
$21.60
|
|
Colonoscopy (diagnostic)
|
$1,152.48 |
$1,152.48 |
$1,152.48 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$1,059.38 |
$1,059.38 |
$1,059.38 |
$1,846.40
|
|
Colonoscopy for bleeding 44391
|
$915.32 |
$915.32 |
$915.32 |
$2,076.00
|
|
Colonoscopy for foreign body
|
$571.83 |
$571.83 |
$571.83 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$540.47 |
$540.47 |
$540.47 |
$1,395.28
|
|
Colonoscopy stoma w/snare 44394
|
$618.87 |
$618.87 |
$618.87 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$629.65 |
$629.65 |
$629.65 |
$2,063.25
|
|
Colonoscopy thru stoma spx
|
$442.96 |
$442.96 |
$442.96 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$3,587.29 |
$3,587.29 |
$3,587.29 |
$2,571.00
|
|
Colonoscopy w/balloon dilat
|
$875.63 |
$875.63 |
$875.63 |
$1,501.08
|
|
Colonoscopy w/control bleed
|
$954.52 |
$954.52 |
$954.52 |
$2,019.60
|
|
Colonoscopy w/endoscope Ultrasound
|
$352.31 |
$352.31 |
$352.31 |
$1,395.28
|
|
Colonoscopy w/endoscopic fnb
|
$415.03 |
$415.03 |
$415.03 |
$1,430.00
|
|
Colonoscopy/w endoscopic stent 45389
|
$395.92 |
$395.92 |
$395.92 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$614.46 |
$614.46 |
$614.46 |
$1,395.28
|
|
Colonoscopy with ablation
|
$3,476.06 |
$3,476.06 |
$3,476.06 |
$3,290.95
|
|
Colonoscopy (with biopsy)
|
$1,549.87 |
$1,549.87 |
$1,549.87 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$584.08 |
$584.08 |
$584.08 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$1,117.69 |
$1,117.69 |
$1,117.69 |
$2,288.00
|
|
Colonoscopy w/stent plcmt
|
$357.70 |
$357.70 |
$357.70 |
$5,419.00
|
|
Colpocentesis 57020
|
$419.44 |
$419.44 |
$419.44 |
$4,232.80
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$1,059.87 |
$1,059.87 |
$1,059.87 |
$3,907.93
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$74.48 |
$74.48 |
$74.48 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$151.41 |
$151.41 |
$151.41 |
$314.00
|
|
Colposcopy vulva w/biopsy 56821
|
$112.70 |
$112.70 |
$112.70 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$151.41 |
$151.41 |
$151.41 |
$502.80
|
|
Compatibility test each unit antiglobulin technique
|
$154.84 |
$154.84 |
$154.84 |
$172.26
|
|
Compatibility test each unit electronic
|
$155.33 |
$155.33 |
$155.33 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$56.84 |
$56.84 |
$56.84 |
$169.52
|
|
Compatibility test incubate
|
$57.33 |
$57.33 |
$57.33 |
$149.60
|
|
Complement antigen each component c3
|
$86.73 |
$86.73 |
$86.73 |
$108.94
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$493.43 |
$493.43 |
$493.43 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$552.23 |
$552.23 |
$552.23 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$586.04 |
$586.04 |
$586.04 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$688.45 |
$688.45 |
$688.45 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$262.15 |
$262.15 |
$262.15 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$538.51 |
$538.51 |
$538.51 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$654.64 |
$654.64 |
$654.64 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$262.15 |
$262.15 |
$262.15 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$262.15 |
$262.15 |
$262.15 |
$506.40
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$473.34 |
$473.34 |
$473.34 |
$1,003.80
|
|
Complx repair trunk addl 5cm/< 13102
|
$262.15 |
$262.15 |
$262.15 |
$537.00
|