|
Closed tx humerus fx without manip 23600
|
$2,226.95 |
$2,226.95 |
$2,226.95 |
$498.40
|
|
Closed tx humerus fx w/manip 24505
|
$1,274.10 |
$1,274.10 |
$1,274.10 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$1,040.60 |
$1,040.60 |
$1,040.60 |
$386.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$2,569.28
|
|
Closed tx septal&nose fx
|
$5,352.85 |
$5,352.85 |
$5,352.85 |
$3,651.90
|
|
Closed tx sesamoid fx 28530
|
$303.75 |
$303.75 |
$303.75 |
$445.50
|
|
Closed tx/talus fracture without manip 28430
|
$1,939.55 |
$1,939.55 |
$1,939.55 |
$442.80
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$967.75 |
$967.75 |
$967.75 |
$472.50
|
|
Clos txnose fx without stablz 21315
|
$570.95 |
$570.95 |
$570.95 |
$2,392.80
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$982.55 |
$982.55 |
$982.55 |
$1,259.62
|
|
Clot factor xii hageman
|
$217.55 |
$217.55 |
$217.55 |
$138.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$797.70 |
$797.70 |
$797.70 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$708.60 |
$708.60 |
$708.60 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$738.30 |
$738.30 |
$738.30 |
$489.60
|
|
Clsd tx clav dislc without manip 23520
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$1,980.00
|
|
Clsd tx clavicle dislocation without manip 23540
|
$1,374.00 |
$1,374.00 |
$1,374.00 |
$419.40
|
|
Clsd tx clavicle fracture w/manip 23505
|
$2,457.75 |
$2,457.75 |
$2,457.75 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$604.60 |
$604.60 |
$604.60 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$1,380.80 |
$1,380.80 |
$1,380.80 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$728.85 |
$728.85 |
$728.85 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$1,140.55 |
$1,140.55 |
$1,140.55 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$848.90 |
$848.90 |
$848.90 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$604.60 |
$604.60 |
$604.60 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$2,364.70 |
$2,364.70 |
$2,364.70 |
$2,211.05
|
|
Clsd tx fracture of radius 25500
|
$445.40 |
$445.40 |
$445.40 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$413.05 |
$413.05 |
$413.05 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$655.95 |
$655.95 |
$655.95 |
$464.20
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,114.85 |
$1,114.85 |
$1,114.85 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$1,166.15 |
$1,166.15 |
$1,166.15 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$924.50 |
$924.50 |
$924.50 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$676.20 |
$676.20 |
$676.20 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,422.60 |
$1,422.60 |
$1,422.60 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$812.50 |
$812.50 |
$812.50 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$2,129.80 |
$2,129.80 |
$2,129.80 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$813.90 |
$813.90 |
$813.90 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,391.50 |
$1,391.50 |
$1,391.50 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$587.15 |
$587.15 |
$587.15 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$604.60 |
$604.60 |
$604.60 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$758.60 |
$758.60 |
$758.60 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$472.15 |
$472.15 |
$472.15 |
$522.78
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,771.10 |
$2,771.10 |
$2,771.10 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$850.30 |
$850.30 |
$850.30 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$695.15 |
$695.15 |
$695.15 |
$498.85
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$2,222.00
|
|
Clsd tx radius fracture w/manip 24655
|
$2,770.90 |
$2,770.90 |
$2,770.90 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$1,637.20 |
$1,637.20 |
$1,637.20 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,129.70 |
$1,129.70 |
$1,129.70 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,341.55 |
$1,341.55 |
$1,341.55 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$252.40 |
$252.40 |
$252.40 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$728.85 |
$728.85 |
$728.85 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$796.35 |
$796.35 |
$796.35 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,490.00 |
$1,490.00 |
$1,490.00 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,820.75 |
$1,820.75 |
$1,820.75 |
$473.00
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,357.90 |
$1,357.90 |
$1,357.90 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,952.95 |
$1,952.95 |
$1,952.95 |
$535.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,649.40 |
$1,649.40 |
$1,649.40 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$772.55 |
$772.55 |
$772.55 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$808.45 |
$808.45 |
$808.45 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$1,851.78
|
|
Cltx lunate dislc w/mnpj
|
$2,884.30 |
$2,884.30 |
$2,884.30 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$9,271.05 |
$9,271.05 |
$9,271.05 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$2,432.15 |
$2,432.15 |
$2,432.15 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$4,827.35 |
$4,827.35 |
$4,827.35 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$4,698.35 |
$4,698.35 |
$4,698.35 |
$4,377.24
|
|
Cltx post ankle fx w/mnpj
|
$2,771.10 |
$2,771.10 |
$2,771.10 |
$1,939.00
|
|
#cmvcul-virus inoculation shell
|
$58.10 |
$58.10 |
$58.10 |
$89.76
|
|
Cmv pcr-sendout
|
$97.45 |
$97.45 |
$97.45 |
$175.70
|
|
Collagen imp urinary 2.5 ml
|
$349.95 |
$349.95 |
$349.95 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$437.25 |
$437.25 |
$437.25 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$219.95 |
$219.95 |
$219.95 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$248.10 |
$248.10 |
$248.10 |
$155.40
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$4,856.25 |
$4,856.25 |
$4,856.25 |
$3,907.93
|
|
Colpotomy drng of abscess 57010
|
$4,856.25 |
$4,856.25 |
$4,856.25 |
$3,762.53
|
|
Combination bilateral ho
|
$858.20 |
$858.20 |
$858.20 |
$4,015.50
|
|
Compatibility test each unit antiglobulin technique
|
$245.65 |
$245.65 |
$245.65 |
$173.50
|
|
Compatibility test each unit electronic
|
$458.20 |
$458.20 |
$458.20 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$473.75 |
$473.75 |
$473.75 |
$169.52
|
|
Complement antigen each component c3
|
$25.10 |
$25.10 |
$25.10 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,043.30 |
$1,043.30 |
$1,043.30 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$2,181.10 |
$2,181.10 |
$2,181.10 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$2,519.80 |
$2,519.80 |
$2,519.80 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$4,236.70 |
$4,236.70 |
$4,236.70 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$1,055.45 |
$1,055.45 |
$1,055.45 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$2,096.10 |
$2,096.10 |
$2,096.10 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$3,274.35 |
$3,274.35 |
$3,274.35 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$1,530.55 |
$1,530.55 |
$1,530.55 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$287.50 |
$287.50 |
$287.50 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,599.35 |
$1,599.35 |
$1,599.35 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$2,355.20 |
$2,355.20 |
$2,355.20 |
$537.00
|
|
Comprehensive hearing test
|
$360.30 |
$360.30 |
$360.30 |
$261.46
|
|
Concentration infection agents any type
|
$19.80 |
$19.80 |
$19.80 |
$51.32
|
|
Conditioning play audiometry 92582
|
$176.85 |
$176.85 |
$176.85 |
$189.15
|
|
Condylomata destruction 56420
|
$897.50 |
$897.50 |
$897.50 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,594.54 |
$1,594.54 |
$1,594.54 |
$860.00
|
|
Connect omega .5mm
|
$451.00 |
$451.00 |
$451.00 |
$1,260.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$223.15 |
$223.15 |
$223.15 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$350.20 |
$350.20 |
$350.20 |
$226.50
|
|
Consultation/report referred slides prepared elsewhere
|
$21.25 |
$21.25 |
$21.25 |
$176.28
|
|
Cont gluc mntr analysis i&r 95251
|
$65.70 |
$65.70 |
$65.70 |
$80.00
|