|
Chromosome analys placenta
|
$311.80 |
$490.25 |
$1,176.65 |
|
|
Chromosome karyotype study
|
$42.20 |
$193.20 |
$877.45 |
|
|
Chronic urticaria - sendout
|
$182.20 |
$182.20 |
$182.20 |
|
|
Cine/video x-rays
|
$43.00 |
$43.00 |
$43.00 |
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$81.22 |
$81.22 |
$81.22 |
|
|
Ciprofloxacin otic susp 6 mg
|
$71.64 |
$71.64 |
$71.64 |
|
|
Circumcise/surg/28 days or < 54160
|
$283.40 |
$283.40 |
$283.40 |
|
|
Circumcision (newborn)
|
$91.60 |
$294.75 |
$709.90 |
|
|
Cisplatin 1 mg/ml desensitization
|
$124.29 |
$207.41 |
$393.63 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$1,596.74 |
$1,960.42 |
$2,525.88 |
|
|
Clearance of airways
|
$102.75 |
$319.90 |
$650.85 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$65.74 |
$92.42 |
$176.16 |
|
|
Clip ligating vesolock lg
|
$91.30 |
$91.30 |
$91.30 |
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$10.11 |
$15.19 |
$181.60 |
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$298.25 |
$623.65 |
$874.60 |
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$1,399.65 |
$1,399.65 |
$1,399.65 |
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$1,403.75 |
$1,403.75 |
$15,560.60 |
|
|
Closed tx/acetabululm without manip 27220
|
$1,077.10 |
$1,077.10 |
$1,077.10 |
|
|
Closed tx humerus fx with manip 23605
|
$564.60 |
$1,024.40 |
$3,878.20 |
|
|
Closed tx humerus fx without manip 23600
|
$175.25 |
$604.60 |
$2,226.95 |
|
|
Closed tx humerus fx w/manip 24505
|
$761.90 |
$1,087.85 |
$1,274.10 |
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$189.25 |
$461.00 |
$1,043.30 |
|
|
Closed tx nose/jaw fx
|
$1,726.30 |
$1,726.30 |
$1,726.30 |
|
|
Closed tx orbit without manipulj
|
$404.85 |
$404.85 |
$404.85 |
|
|
Closed tx orbit w/manipulj
|
$974.50 |
$974.50 |
$974.50 |
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$895.60 |
$2,353.95 |
$2,884.30 |
|
|
Closed tx septal&nose fx
|
$1,090.60 |
$5,352.85 |
$9,255.70 |
|
|
Closed tx sesamoid fx 28530
|
$219.95 |
$219.95 |
$303.75 |
|
|
Closed tx/talus fracture without manip 28430
|
$439.95 |
$439.95 |
$1,939.55 |
|
|
Closed tx vert fx w/manj
|
$1,797.80 |
$1,797.80 |
$1,797.80 |
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$305.30 |
$359.00 |
$967.75 |
|
|
Clos txnose fx without stablz 21315
|
$518.90 |
$730.20 |
$5,354.35 |
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$408.65 |
$719.35 |
$982.55 |
|
|
Clot factor xii hageman
|
$210.35 |
$217.55 |
$397.95 |
|
|
Clot factor xiii fibrin scrn
|
$56.85 |
$218.65 |
$342.00 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$379.65 |
$682.95 |
$1,043.45 |
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$619.60 |
$667.25 |
$1,033.90 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$420.45 |
$738.30 |
$886.95 |
|
|
Clsd tx clav dislc without manip 23520
|
$508.80 |
$508.80 |
$1,324.00 |
|
|
Clsd tx clavicle dislocation without manip 23540
|
$498.05 |
$498.05 |
$1,374.00 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$720.75 |
$2,353.95 |
$4,637.30 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$129.75 |
$404.85 |
$677.90 |
|
|
Clsd tx coccygeal fracture 27200
|
$271.20 |
$431.90 |
$1,380.80 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$728.85 |
$728.85 |
$728.85 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$580.20 |
$929.90 |
$1,376.30 |
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$583.10 |
$848.90 |
$977.30 |
|
|
Clsd tx elbow dislocation child 24640
|
$174.05 |
$328.00 |
$604.60 |
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,546.75 |
$2,364.70 |
$4,930.15 |
|
|
Clsd tx fracture of radius 25500
|
$445.40 |
$445.40 |
$506.10 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$311.15 |
$325.25 |
$413.05 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$176.60 |
$355.00 |
$655.95 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$639.50 |
$1,185.05 |
$2,911.75 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$514.30 |
$514.30 |
$1,166.15 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$639.50 |
$1,007.80 |
$2,911.75 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$499.35 |
$499.35 |
$676.20 |
|
|
Clsd tx hip disloc without anes 27265
|
$832.80 |
$972.55 |
$1,422.60 |
|
|
Clsd tx humeral fract without manip 24530
|
$705.90 |
$705.90 |
$812.50 |
|
|
Clsd tx humerus fract without manip 24500
|
$250.05 |
$1,198.55 |
$2,129.80 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$413.75 |
$813.90 |
$4,830.00 |
|
|
Clsd tx mandibular fx without manip 21450
|
$1,391.50 |
$1,391.50 |
$1,513.00 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$426.50 |
$426.50 |
$587.15 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$543.95 |
$587.15 |
$604.60 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$412.45 |
$697.80 |
$1,005.65 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$472.15 |
$536.50 |
$672.15 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$709.90 |
$709.90 |
$709.90 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$643.10 |
$739.65 |
$4,930.10 |
|
|
Clsd tx patella disloc without anes 27560
|
$425.05 |
$784.15 |
$1,139.10 |
|
|
Clsd tx/patellar fx without manip 27520
|
$171.15 |
$599.30 |
$695.15 |
|
|
Clsd tx pelvic ring fx
|
$1,122.95 |
$1,122.95 |
$1,122.95 |
|
|
Clsd tx pelvic ring fx
|
$1,679.05 |
$1,679.05 |
$1,679.05 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$534.55 |
$792.25 |
$4,930.15 |
|
|
Clsd tx radius fracture w/manip 24655
|
$528.60 |
$1,618.95 |
$2,770.90 |
|
|
Clsd tx/scapular fx without manip 23570
|
$136.35 |
$430.50 |
$1,637.20 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$635.70 |
$940.60 |
$1,129.70 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,020.35 |
$1,793.40 |
$4,709.90 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$897.50 |
$2,235.05 |
$2,884.30 |
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$676.20 |
$676.20 |
$676.20 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$88.30 |
$219.95 |
$475.90 |
|
|
Clsd tx toe dislocation without anes28660
|
$148.90 |
$283.10 |
$728.85 |
|
|
Clsd tx trimall ankle fx without manip 27816
|
$228.65 |
$596.55 |
$796.35 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$715.25 |
$1,300.85 |
$2,159.50 |
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$285.80 |
$484.55 |
$1,820.75 |
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$622.25 |
$622.25 |
$622.25 |
|
|
Clsd tx wrist carpal fx without manip 25630
|
$565.50 |
$565.50 |
$1,357.90 |
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$564.20 |
$564.20 |
$1,952.95 |
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$973.10 |
$973.10 |
$973.10 |
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$538.45 |
$900.50 |
$1,649.40 |
|
|
Cls tx of heel fracture w/manip 28405
|
$772.55 |
$772.55 |
$776.05 |
|
|
Cltx carpl scphd fx w/mnpj
|
$808.45 |
$884.00 |
$993.45 |
|
|
Cltx craniofacial separation
|
$1,527.85 |
$1,527.85 |
$1,527.85 |
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$778.70 |
$778.70 |
$778.70 |
|
|
Cltx hum epcndylr fx wo mnpj
|
$1,419.90 |
$1,419.90 |
$1,419.90 |
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,012.25 |
$1,381.75 |
$2,884.30 |
|
|
Cltx humrl cndylr fx wo mnpj
|
$701.80 |
$701.80 |
$701.80 |
|
|
Cltx lunate dislc w/mnpj
|
$1,058.15 |
$2,884.30 |
$4,794.90 |
|
|
Cltx mndblr fx ntrdntl fixj
|
$2,239.15 |
$8,595.35 |
$16,932.90 |
|
|
Cltx mndblr fx w/mnpj
|
$1,857.20 |
$1,857.20 |
$2,432.15 |
|
|
Cltx mndblr/max alv ridge fx
|
$1,350.10 |
$4,623.35 |
$9,108.10 |
|
|
Cltx palatal/max fx wire fix
|
$1,970.55 |
$1,970.55 |
$4,698.35 |
|
|
Cltx post ankle fx
|
$580.35 |
$580.35 |
$580.35 |
|