|
Clsd tx temporomandibular dislocat 21480
|
$607.20 |
$607.20 |
$607.20 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$590.40 |
$590.40 |
$590.40 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$567.20 |
$567.20 |
$567.20 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,052.00 |
$1,052.00 |
$1,052.00 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$531.20 |
$531.20 |
$531.20 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$768.00 |
$768.00 |
$768.00 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$578.40 |
$578.40 |
$578.40 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$500.00 |
$500.00 |
$500.00 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$766.40 |
$766.40 |
$766.40 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$556.80 |
$556.80 |
$556.80 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$2,316.80 |
$2,316.80 |
$2,316.80 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$457.60 |
$457.60 |
$457.60 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,188.80 |
$1,188.80 |
$1,188.80 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$579.20 |
$579.20 |
$579.20 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,717.60 |
$2,717.60 |
$2,717.60 |
$2,384.00
|
|
Cltx mndblr fx w/mnpj
|
$6,891.20 |
$6,891.20 |
$6,891.20 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$4,850.40 |
$4,850.40 |
$4,850.40 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$5,281.60 |
$5,281.60 |
$5,281.60 |
$4,377.24
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,552.80 |
$1,552.80 |
$1,552.80 |
$2,021.04
|
|
Cltx thigh fx
|
$4,008.00 |
$4,008.00 |
$4,008.00 |
$3,986.00
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$8,980.00 |
$8,980.00 |
$8,980.00 |
$11,888.50
|
|
Cocaine 4 % nasal solution
|
$341.00 |
$341.00 |
$341.00 |
$630.04
|
|
Collagen based wound filler
|
$1,128.00 |
$1,128.00 |
$1,128.00 |
$1,794.78
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$365.60 |
$365.60 |
$365.60 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$116.68 |
$116.68 |
$116.68 |
$61.20
|
|
Collar cerv adlt perfit ace extric
|
$56.85 |
$56.85 |
$56.85 |
$67.73
|
|
Collar cerv ascend 172 reg
|
$224.11 |
$224.11 |
$224.11 |
$224.11
|
|
Collar extrication adult univ
|
$1,049.05 |
$1,049.05 |
$1,049.05 |
$766.23
|
|
Collection blood specimen from completely implantable venous access device
|
$69.60 |
$69.60 |
$69.60 |
$162.00
|
|
Colonoscopy (diagnostic)
|
$2,701.60 |
$2,701.60 |
$2,701.60 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$2,545.60 |
$2,545.60 |
$2,545.60 |
$3,029.00
|
|
Colonoscopy w/control bleed
|
$2,769.60 |
$2,769.60 |
$2,769.60 |
$2,101.71
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$6,548.00 |
$6,548.00 |
$6,548.00 |
$3,907.93
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$523.20 |
$523.20 |
$523.20 |
$314.00
|
|
Colposcopy vulva 56820
|
$380.00 |
$380.00 |
$380.00 |
$333.20
|
|
Comp cystometrogram/void presssure 51728
|
$1,418.40 |
$1,418.40 |
$1,418.40 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,512.80 |
$1,512.80 |
$1,512.80 |
$1,111.03
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,433.60 |
$1,433.60 |
$1,433.60 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$2,720.80 |
$2,720.80 |
$2,720.80 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$260.00 |
$260.00 |
$260.00 |
$344.68
|
|
Compl oph exam general anes
|
$44.80 |
$44.80 |
$44.80 |
$2,161.60
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,629.60 |
$1,629.60 |
$1,629.60 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,837.60 |
$1,837.60 |
$1,837.60 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$1,254.40 |
$1,254.40 |
$1,254.40 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$969.60 |
$969.60 |
$969.60 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,262.40 |
$1,262.40 |
$1,262.40 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$1,153.60 |
$1,153.60 |
$1,153.60 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$568.00 |
$568.00 |
$568.00 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,151.20 |
$1,151.20 |
$1,151.20 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$1,910.40 |
$1,910.40 |
$1,910.40 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$331.20 |
$331.20 |
$331.20 |
$1,350.27
|
|
Computed tomographic angiography head and neck with contrast
|
$4,000.00 |
$4,000.00 |
$4,000.00 |
$2,247.00
|
|
Condylomata destruction 56420
|
$490.40 |
$490.40 |
$490.40 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$317.60 |
$317.60 |
$317.60 |
$860.00
|
|
Connect omega .5mm
|
$1,463.38 |
$1,463.38 |
$1,463.38 |
$1,260.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,336.00 |
$1,336.00 |
$1,336.00 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$164.00 |
$164.00 |
$164.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$265.60 |
$265.60 |
$265.60 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$164.00 |
$164.00 |
$164.00 |
$224.83
|
|
Cont gluc mntr analysis i&r 95251
|
$101.60 |
$101.60 |
$101.60 |
$80.00
|
|
Contrast exam abdominl aorta 75625-26
|
$5,635.20 |
$5,635.20 |
$5,635.20 |
$3,480.00
|
|
Contrast exam thoracic aorta 75605-26
|
$5,688.80 |
$5,688.80 |
$5,688.80 |
$3,745.00
|
|
Contrast x-ray of hip
|
$1,072.00 |
$1,072.00 |
$1,072.00 |
$796.38
|
|
Contrast x-ray of knee joint
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
$790.50
|
|
Contrast x-ray of wrist
|
$962.40 |
$962.40 |
$962.40 |
$667.50
|
|
Controller infinity pt dbs
|
$4,028.00 |
$4,028.00 |
$4,028.00 |
$4,836.44
|
|
Control nosebleed pack+caut 30905
|
$468.80 |
$468.80 |
$468.80 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$440.00 |
$440.00 |
$440.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$391.20 |
$391.20 |
$391.20 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$312.00 |
$312.00 |
$312.00 |
$620.00
|
|
Control throat bleeding
|
$3,155.20 |
$3,155.20 |
$3,155.20 |
$972.84
|
|
Convert nephrostomy catheter
|
$3,569.60 |
$3,569.60 |
$3,569.60 |
$2,777.60
|
|
Copper intrauterine device
|
$2,516.44 |
$2,516.44 |
$2,516.44 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$2,112.80 |
$2,112.80 |
$2,112.80 |
$2,904.48
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$19,779.20 |
$19,779.20 |
$19,779.20 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$15,952.00 |
$15,952.00 |
$15,952.00 |
$10,353.29
|
|
Coronary angio/lv gram/rt< heart
|
$19,350.40 |
$19,350.40 |
$19,350.40 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$13,275.20 |
$13,275.20 |
$13,275.20 |
$8,191.00
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$11,734.40 |
$11,734.40 |
$11,734.40 |
$7,988.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$62.56 |
$62.56 |
$62.56 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$140.00 |
$140.00 |
$140.00 |
$112.00
|
|
Counseling smoke cess interm >10mins
|
$60.00 |
$60.00 |
$60.00 |
$54.60
|
|
Coveredge 32 lead kit 40cm 48
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$4,180.79
|
|
Covid-19 administration immunization im inj 1st/only component
|
$71.20 |
$71.20 |
$71.20 |
$49.13
|
|
CPAP or BiPAP Setup (first day)
|
$663.20 |
$663.20 |
$663.20 |
$584.50
|
|
CPR (Cardiopulmonary Resuscitation)
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$777.71
|
|
Critical care each additional 30 minutes
|
$870.40 |
$870.40 |
$870.40 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,949.60 |
$2,949.60 |
$2,949.60 |
$2,535.00
|
|
Cryocautery of cervix 57511
|
$371.20 |
$371.20 |
$371.20 |
$429.60
|
|
Cryoprecipitate each unit
|
$388.80 |
$388.80 |
$388.80 |
$144.78
|
|
Csf shunt reprogram 62252
|
$516.80 |
$516.80 |
$516.80 |
$535.00
|
|
CT 3d report other modality w/workstation
|
$956.00 |
$956.00 |
$956.00 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,539.20 |
$2,539.20 |
$2,539.20 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,071.20 |
$4,071.20 |
$4,071.20 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$2,702.40 |
$2,702.40 |
$2,702.40 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$3,056.00 |
$3,056.00 |
$3,056.00 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,758.40 |
$2,758.40 |
$2,758.40 |
$1,915.30
|
|
CT Angiogram of the Head
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$2,615.20 |
$2,615.20 |
$2,615.20 |
$1,881.75
|