|
Clsd tx/shoulder dislo/manip/anest 23655
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$763.42 |
$763.42 |
$819.58 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$763.42 |
$763.42 |
$819.58 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$727.07 |
$727.07 |
$766.90 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$763.42 |
$763.42 |
$819.58 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$495.44 |
$495.44 |
$609.78 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$763.42 |
$763.42 |
$819.58 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$763.42 |
$763.42 |
$819.58 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$819.58 |
$819.58 |
$819.58 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$763.42 |
$763.42 |
$819.58 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$763.42 |
$763.42 |
$939.60 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$654.26 |
$654.26 |
$819.58 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$4,572.13 |
$4,572.13 |
$4,908.52 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$608.60 |
$608.60 |
$623.11 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$4,572.13 |
$4,572.13 |
$4,572.13 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$654.23 |
$654.23 |
$805.21 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$4,572.13 |
$4,572.13 |
$4,572.13 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$14,043.05 |
$14,043.05 |
$14,043.05 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$3,762.02 |
$3,762.02 |
$3,762.02 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$7,267.74 |
$7,267.74 |
$7,267.74 |
$3,986.00
|
|
Cltx post ankle fx w/mnpj
|
$3,638.80 |
$3,638.80 |
$4,478.53 |
$1,939.00
|
|
Cltx tmprmand dislc comp
|
$3,762.02 |
$3,762.02 |
$3,762.02 |
$3,740.85
|
|
Cmptr ophth dx img ant segmt
|
$192.19 |
$192.19 |
$192.19 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$192.19 |
$192.19 |
$192.19 |
$98.00
|
|
#cms hgb-sulfhemoglobin
|
$73.16 |
$73.16 |
$90.05 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$70.78 |
$70.78 |
$87.12 |
$89.76
|
|
Cmv pcr-sendout
|
$127.02 |
$127.02 |
$156.33 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$303.73 |
$303.73 |
$373.82 |
$313.60
|
|
Coagulation time activated teg
|
$15.42 |
$15.42 |
$18.98 |
$52.47
|
|
Cold agglutinin screen (arc)
|
$24.24 |
$24.24 |
$29.83 |
$48.10
|
|
Cold agglutinin titer
|
$29.17 |
$29.17 |
$35.90 |
$52.00
|
|
Collagenase, clost hist inj
|
$173.35 |
$173.35 |
$213.35 |
$12,906.28
|
|
Collagen imp urinary 2.5 ml
|
$834.57 |
$834.57 |
$1,027.17 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$201.75 |
$201.75 |
$248.30 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$47.60 |
$47.60 |
$58.58 |
$61.20
|
|
Collar cerv adlt perfit ace extric
|
$114.85 |
$114.85 |
$141.35 |
$67.73
|
|
Collar cerv ascend 172 reg
|
$262.55 |
$262.55 |
$323.14 |
$224.11
|
|
Collar cerv patriot adlt
|
$221.85 |
$221.85 |
$273.05 |
$134.66
|
|
Collar extrication adult univ
|
$938.39 |
$938.39 |
$1,154.94 |
$766.23
|
|
Collection blood specimen from completely implantable venous access device
|
$335.52 |
$335.52 |
$360.21 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$335.52 |
$335.52 |
$360.21 |
$155.40
|
|
Colonoscopy (diagnostic)
|
$2,393.41 |
$2,393.41 |
$2,393.41 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$3,186.98 |
$3,186.98 |
$3,186.98 |
$3,029.00
|
|
Colonoscopy w/balloon dilat
|
$3,186.98 |
$3,186.98 |
$3,186.98 |
$1,681.30
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$7,627.40 |
$7,627.40 |
$7,806.34 |
$3,907.93
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$2,023.38 |
$2,023.38 |
$2,172.28 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$8,188.62 |
$8,188.62 |
$8,188.62 |
$3,762.53
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$558.63 |
$558.63 |
$599.71 |
$314.00
|
|
Colposcopy vulva 56820
|
$558.63 |
$558.63 |
$599.71 |
$333.20
|
|
Colposcopy vulva w/biopsy 56821
|
$757.63 |
$757.63 |
$979.98 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$958.48 |
$958.48 |
$1,028.98 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$318.32 |
$318.32 |
$391.78 |
$173.50
|
|
Compatibility test each unit electronic
|
$318.32 |
$318.32 |
$391.78 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$318.32 |
$318.32 |
$391.78 |
$169.52
|
|
Comp cystometrogram/void presssure 51728
|
$1,966.48 |
$1,966.48 |
$1,966.48 |
$985.00
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,966.48 |
$1,966.48 |
$2,111.18 |
$1,111.03
|
|
Complement antigen each component c3
|
$43.41 |
$43.41 |
$53.43 |
$110.00
|
|
Complex cystometrogram 51726
|
$1,966.48 |
$1,966.48 |
$2,111.18 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,651.23 |
$1,651.23 |
$1,772.72 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$482.35 |
$482.35 |
$517.84 |
$344.68
|
|
Compl oph exam general anes
|
$5,865.26 |
$5,865.26 |
$5,865.26 |
$2,161.60
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,651.23 |
$1,651.23 |
$1,772.72 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,651.23 |
$1,651.23 |
$1,772.72 |
$1,212.00
|
|
Complx repair fccmnaxghf 13131
|
$1,107.30 |
$1,107.30 |
$1,188.79 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,651.23 |
$1,651.23 |
$1,772.72 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$473.65 |
$473.65 |
$675.53 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$285.80 |
$285.80 |
$819.18 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,651.23 |
$1,651.23 |
$1,651.23 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$991.40 |
$991.40 |
$991.40 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$1,693.03 |
$1,693.03 |
$2,083.73 |
$1,350.27
|
|
Comprehensive hearing test
|
$356.57 |
$356.57 |
$356.57 |
$261.46
|
|
Compre oph exam est pt 1/>
|
$391.06 |
$391.06 |
$391.06 |
$207.20
|
|
Compre oph exam new pt 1/>
|
$391.06 |
$391.06 |
$391.06 |
$188.51
|
|
Computed tomographic angiography head and neck with contrast
|
$554.00 |
$554.00 |
$681.84 |
$2,247.00
|
|
Concentration infection agents any type
|
$24.15 |
$24.15 |
$29.73 |
$51.32
|
|
Condylomata destruction 56420
|
$558.63 |
$558.63 |
$599.71 |
$467.35
|
|
Conization/cerv/loop electrode exc 57522
|
$7,627.40 |
$7,627.40 |
$8,188.62 |
$4,840.07
|
|
Conization of cervix
|
$8,188.62 |
$8,188.62 |
$8,188.62 |
$3,820.00
|
|
Connect omega .5mm
|
$640.58 |
$640.58 |
$788.41 |
$1,260.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$177.40 |
$177.40 |
$218.34 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$152.93 |
$152.93 |
$188.22 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$318.32 |
$318.32 |
$391.78 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$130.14 |
$130.14 |
$160.18 |
$224.83
|
|
Contour of face bone lesion
|
$7,267.74 |
$7,267.74 |
$7,267.74 |
$3,837.72
|
|
Contrast baths charges
|
$46.14 |
$46.14 |
$111.37 |
$75.60
|
|
Contrast exam abdominl aorta 75625-26
|
$5,491.15 |
$5,491.15 |
$6,758.34 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$5,491.15 |
$5,491.15 |
$5,491.15 |
$3,616.90
|
|
Contrast exam thoracic aorta 75605-26
|
$9,536.59 |
$9,536.59 |
$11,025.51 |
$3,745.00
|
|
Contrast x-ray gallbladder
|
$336.54 |
$336.54 |
$336.54 |
$341.00
|
|
Contrast x-ray of ankle
|
$732.28 |
$732.28 |
$732.28 |
$684.00
|
|
Contrast x-ray of brain
|
$1,878.18 |
$1,878.18 |
$2,086.62 |
$1,077.92
|
|
Contrast x-ray of elbow
|
$732.28 |
$732.28 |
$732.28 |
$708.00
|
|
Contrast x-ray of hip
|
$732.28 |
$732.28 |
$901.26 |
$796.38
|
|
Contrast x-ray of knee joint
|
$732.28 |
$732.28 |
$732.28 |
$790.50
|
|
Contrast x-ray of wrist
|
$732.28 |
$732.28 |
$732.28 |
$667.50
|
|
Controler lvad heartmate 3 includes ebb
|
$10,725.00 |
$10,725.00 |
$10,725.00 |
$12,355.20
|
|
Control nosebleed pack+caut 30905
|
$335.52 |
$335.52 |
$360.21 |
$383.52
|
