|
Closed tx metatarsophalangeal jnt disl without anes
|
$79.44 |
$79.44 |
$79.44 |
$388.00
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$128.16 |
$128.16 |
$128.16 |
$487.69
|
|
Clos txnose fx without stablz 21315
|
$623.52 |
$623.52 |
$623.52 |
$2,403.33
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$227.28 |
$227.28 |
$227.28 |
$1,208.93
|
|
Clot factor fletcher fact
|
$14.64 |
$14.64 |
$14.64 |
$116.82
|
|
Clot factor wght kininogen
|
$14.64 |
$14.64 |
$14.64 |
$157.50
|
|
Clot factor xii hageman
|
$69.60 |
$69.60 |
$69.60 |
$126.00
|
|
Clot factor xiii fibrin scrn
|
$66.00 |
$66.00 |
$66.00 |
$51.91
|
|
Clotting assay whole blood
|
$47.52 |
$47.52 |
$47.52 |
$101.52
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$75.36 |
$75.36 |
$75.36 |
$686.40
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$251.28 |
$251.28 |
$251.28 |
$503.40
|
|
Clsd tx/clavicular fx without manip 23500
|
$99.36 |
$99.36 |
$99.36 |
$452.40
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$251.28 |
$251.28 |
$251.28 |
$413.40
|
|
Clsd tx dist fib fx w/manip 27788
|
$75.36 |
$75.36 |
$75.36 |
$691.60
|
|
Clsd tx elbow dislocation child 24640
|
$75.36 |
$75.36 |
$75.36 |
$494.90
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$461.04 |
$461.04 |
$461.04 |
$2,319.00
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$75.36 |
$75.36 |
$75.36 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$75.36 |
$75.36 |
$75.36 |
$546.00
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$439.68 |
$439.68 |
$439.68 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$750.24 |
$750.24 |
$750.24 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$75.36 |
$75.36 |
$75.36 |
$665.60
|
|
Clsd tx humerus fract without manip 24500
|
$251.28 |
$251.28 |
$251.28 |
$492.99
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$75.36 |
$75.36 |
$75.36 |
$519.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$75.36 |
$75.36 |
$75.36 |
$670.40
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$75.36 |
$75.36 |
$75.36 |
$533.60
|
|
Clsd tx of ankle fracture w/manip 28435
|
$461.04 |
$461.04 |
$461.04 |
$1,843.91
|
|
Clsd tx patella disloc without anes 27560
|
$60.00 |
$60.00 |
$60.00 |
$577.20
|
|
Clsd tx/patellar fx without manip 27520
|
$75.36 |
$75.36 |
$75.36 |
$478.40
|
|
Clsd tx pelvic ring fx
|
$77.28 |
$77.28 |
$77.28 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$77.28 |
$77.28 |
$77.28 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$439.68 |
$439.68 |
$439.68 |
$2,275.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$251.28 |
$251.28 |
$251.28 |
$408.85
|
|
Clsd tx radius fracture w/manip 24655
|
$750.24 |
$750.24 |
$750.24 |
$1,806.10
|
|
Clsd tx shoulder dislc/fx 23665
|
$439.68 |
$439.68 |
$439.68 |
$1,851.78
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$439.68 |
$439.68 |
$439.68 |
$1,771.43
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,025.04 |
$1,025.04 |
$1,025.04 |
$2,287.20
|
|
Clsd tx temporomandibular dislocat 21480
|
$147.12 |
$147.12 |
$147.12 |
$445.15
|
|
Clsd tx toe dislocation without anes28660
|
$204.96 |
$204.96 |
$204.96 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$75.36 |
$75.36 |
$75.36 |
$501.20
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$439.68 |
$439.68 |
$439.68 |
$1,592.00
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$68.88 |
$68.88 |
$68.88 |
$496.61
|
|
Cls tx of heel fracture w/manip 28405
|
$95.52 |
$95.52 |
$95.52 |
$759.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,074.24 |
$1,074.24 |
$1,074.24 |
$2,064.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$461.04 |
$461.04 |
$461.04 |
$2,211.05
|
|
Cltx humrl cndylr fx w/mnpj
|
$439.68 |
$439.68 |
$439.68 |
$1,858.00
|
|
Cltx lunate dislc w/mnpj
|
$1,117.20 |
$1,117.20 |
$1,117.20 |
$2,464.50
|
|
Cltx post ankle fx w/mnpj
|
$439.68 |
$439.68 |
$439.68 |
$2,172.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$439.68 |
$439.68 |
$439.68 |
$2,035.80
|
|
#cmvcul-virus inoculation shell
|
$32.40 |
$32.40 |
$32.40 |
$100.80
|
|
Cmv pcr-sendout
|
$27.36 |
$27.36 |
$27.36 |
$172.25
|
|
Cocaine 4 % nasal solution
|
$1,386.75 |
$1,386.75 |
$1,386.75 |
$624.55
|
|
Cold agglutinin titer
|
$89.04 |
$89.04 |
$89.04 |
$50.00
|
|
Colistimethate sodium inj
|
$46.63 |
$46.63 |
$46.63 |
$68.47
|
|
Collection blood specimen from completely implantable venous access device
|
$104.40 |
$104.40 |
$104.40 |
$156.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$109.68 |
$109.68 |
$109.68 |
$154.80
|
|
Collection of venous blood by venipuncture
|
$9.12 |
$9.12 |
$9.12 |
$20.40
|
|
Colonoscopy w/control bleed
|
$310.08 |
$310.08 |
$310.08 |
$2,071.85
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$2,201.76 |
$2,201.76 |
$2,201.76 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$72.48 |
$72.48 |
$72.48 |
$165.00
|
|
Compatibility test each unit electronic
|
$58.80 |
$58.80 |
$58.80 |
$177.75
|
|
Compatibility test each unit immediate spin technique
|
$84.96 |
$84.96 |
$84.96 |
$169.52
|
|
Complement antigen each component c3
|
$175.92 |
$175.92 |
$175.92 |
$108.80
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$739.92 |
$739.92 |
$739.92 |
$1,098.35
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$739.92 |
$739.92 |
$739.92 |
$1,218.40
|
|
Complx repair enel addl 5cm/< 13153
|
$100.32 |
$100.32 |
$100.32 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$473.04 |
$473.04 |
$473.04 |
$820.00
|
|
Complx repair fccmnaxghf 13132
|
$739.92 |
$739.92 |
$739.92 |
$1,177.60
|
|
Complx repair fccmnaxghf 13133
|
$473.04 |
$473.04 |
$473.04 |
$589.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$161.28 |
$161.28 |
$161.28 |
$538.64
|
|
Concentration infection agents any type
|
$62.88 |
$62.88 |
$62.88 |
$49.95
|
|
Condylomata destruction 56420
|
$68.88 |
$68.88 |
$68.88 |
$473.75
|
|
Consultation pathology during surgery cytological exam initial site
|
$252.48 |
$252.48 |
$252.48 |
$447.33
|
|
Consultation pathology during surgery frozen section each additional block
|
$9.12 |
$9.12 |
$9.12 |
$110.51
|
|
Consultation pathology during surgery frozen section first tissue block
|
$68.88 |
$68.88 |
$68.88 |
$223.86
|
|
Consultation/report referred slides prepared elsewhere
|
$62.64 |
$62.64 |
$62.64 |
$171.65
|
|
Contrast baths charges
|
$47.76 |
$47.76 |
$47.76 |
$73.85
|
|
Contrast x-ray gallbladder
|
$137.28 |
$137.28 |
$137.28 |
$350.22
|
|
Contrast x-ray of ankle
|
$356.40 |
$356.40 |
$356.40 |
$612.30
|
|
Contrast x-ray of elbow
|
$356.40 |
$356.40 |
$356.40 |
$649.80
|
|
Contrast x-ray of hip
|
$302.88 |
$302.88 |
$302.88 |
$768.00
|
|
Contrast x-ray of knee joint
|
$372.24 |
$372.24 |
$372.24 |
$719.40
|
|
Contrast x-ray of wrist
|
$286.32 |
$286.32 |
$286.32 |
$623.50
|
|
Control nosebleed pack+caut 30905
|
$45.36 |
$45.36 |
$45.36 |
$426.40
|
|
Control of nosebleed ant comp 30903
|
$51.84 |
$51.84 |
$51.84 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$46.32 |
$46.32 |
$46.32 |
$364.96
|
|
Control oropharyngeal hemorr/simp 42960
|
$171.36 |
$171.36 |
$171.36 |
$638.25
|
|
Coombs direct
|
$72.48 |
$72.48 |
$72.48 |
$72.78
|
|
Coombs indirect qualitative each reagent red cell reference
|
$68.88 |
$68.88 |
$68.88 |
$102.90
|
|
Coombs indirect titer reference
|
$37.92 |
$37.92 |
$37.92 |
$146.00
|
|
Core ndl bx lng/med perq
|
$1,258.08 |
$1,258.08 |
$1,258.08 |
$2,684.50
|
|
Coronary thrombolysis/iv infusion 92977
|
$82.32 |
$82.32 |
$82.32 |
$484.37
|
|
Cortisol total am
|
$79.20 |
$79.20 |
$79.20 |
$118.40
|
|
Cosyntropin 0.25 mg solution for injection
|
$112.69 |
$112.69 |
$112.69 |
$219.49
|
|
Counseling smoke cess interm >10mins
|
$28.32 |
$28.32 |
$28.32 |
$56.89
|
|
Covid-19 administration immunization im inj 1st/only component
|
$31.20 |
$31.20 |
$31.20 |
$49.13
|
|
Covid-19 convalescent plasma
|
$607.44 |
$607.44 |
$607.44 |
$582.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 1st dose
|
$378.96 |
$378.96 |
$378.96 |
$569.31
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$378.96 |
$378.96 |
$378.96 |
$553.80
|
|
Covid-19 lab test non-cdc
|
$44.64 |
$44.64 |
$44.64 |
$68.50
|
|
#coxa-coxsackie a serotype a16
|
$9.60 |
$9.60 |
$9.60 |
$60.00
|
