|
Clot factor viii reltd antgn
|
$20.42 |
$20.42 |
$20.42 |
$140.42
|
|
Clot factor wght kininogen
|
$18.93 |
$18.93 |
$18.93 |
$157.50
|
|
Clot factor xii hageman
|
$19.35 |
$19.35 |
$19.35 |
$138.40
|
|
Clot factor xiii fibrin scrn
|
$9.11 |
$9.11 |
$9.11 |
$56.85
|
|
Clot factor xiii fibrin stab
|
$16.34 |
$16.34 |
$16.34 |
$106.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$283.86 |
$283.86 |
$283.86 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$283.86 |
$283.86 |
$283.86 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$283.86 |
$283.86 |
$283.86 |
$489.60
|
|
Clsd tx clav dislc without manip 23520
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,980.00
|
|
Clsd tx clavicle dislocation without manip 23540
|
$283.86 |
$283.86 |
$283.86 |
$419.40
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$283.86 |
$283.86 |
$283.86 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$283.86 |
$283.86 |
$283.86 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$283.86 |
$283.86 |
$283.86 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$283.86 |
$283.86 |
$283.86 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$283.86 |
$283.86 |
$283.86 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$283.86 |
$283.86 |
$283.86 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$283.86 |
$283.86 |
$283.86 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$283.86 |
$283.86 |
$283.86 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$283.86 |
$283.86 |
$283.86 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$283.86 |
$283.86 |
$283.86 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$283.86 |
$283.86 |
$283.86 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$283.86 |
$283.86 |
$283.86 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$283.86 |
$283.86 |
$283.86 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$283.86 |
$283.86 |
$283.86 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$283.86 |
$283.86 |
$283.86 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$314.28 |
$314.28 |
$314.28 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$602.63 |
$602.63 |
$602.63 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$283.86 |
$283.86 |
$283.86 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$283.86 |
$283.86 |
$283.86 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$283.86 |
$283.86 |
$283.86 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$283.86 |
$283.86 |
$283.86 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$283.86 |
$283.86 |
$283.86 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$283.86 |
$283.86 |
$283.86 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$283.86 |
$283.86 |
$283.86 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$283.86 |
$283.86 |
$283.86 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$283.86 |
$283.86 |
$283.86 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$283.86 |
$283.86 |
$283.86 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$283.86 |
$283.86 |
$283.86 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$283.86 |
$283.86 |
$283.86 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$283.86 |
$283.86 |
$283.86 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$283.86 |
$283.86 |
$283.86 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$283.86 |
$283.86 |
$283.86 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$283.86 |
$283.86 |
$283.86 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$283.86 |
$283.86 |
$283.86 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$283.86 |
$283.86 |
$283.86 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$283.86 |
$283.86 |
$283.86 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$283.86 |
$283.86 |
$283.86 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$283.86 |
$283.86 |
$283.86 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$283.86 |
$283.86 |
$283.86 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$283.86 |
$283.86 |
$283.86 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,893.86
|
|
Cltx craniofacial separation
|
$6,048.05 |
$6,048.05 |
$6,048.05 |
$8,139.99
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$283.86 |
$283.86 |
$283.86 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$283.86 |
$283.86 |
$283.86 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,377.24
|
|
Cltx post ankle fx
|
$283.86 |
$283.86 |
$283.86 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$283.86 |
$283.86 |
$283.86 |
$619.30
|
|
Cltx thigh fx
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,986.00
|
|
Cltx thigh fx w/mnpj
|
$1,642.82 |
$1,642.82 |
$1,642.82 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$3,740.85
|
|
Cmbn ant pst colprhy
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$627.89 |
$627.89 |
$627.89 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,203.94 |
$1,203.94 |
$1,203.94 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,203.94 |
$1,203.94 |
$1,203.94 |
$1,333.36
|
|
Cmptr ophth dx img ant segmt
|
$70.29 |
$70.29 |
$70.29 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$70.29 |
$70.29 |
$70.29 |
$98.00
|
|
#cms hgb-carboxyhemoglobin
|
$14.07 |
$14.07 |
$14.07 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$8.80 |
$8.80 |
$8.80 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$19.56 |
$19.56 |
$19.56 |
$89.76
|
|
Cmv pcr-sendout
|
$35.09 |
$35.09 |
$35.09 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$137.00 |
$137.00 |
$137.00 |
$313.60
|
|
Co2 monitor per day
|
$381.24 |
$381.24 |
$381.24 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$2.52 |
$2.52 |
$2.52 |
$11,888.50
|
|
Coagulation time activated teg
|
$4.28 |
$4.28 |
$4.28 |
$52.47
|
|
Coagulation time lee & white
|
$4.69 |
$4.69 |
$4.69 |
$11.20
|
|
Coagulation time otr method
|
$4.49 |
$4.49 |
$4.49 |
$20.00
|
|
Cochlear implt f/up exam <7
|
$185.15 |
$185.15 |
$185.15 |
$423.87
|