|
Clsd tx wrist ulnar styloid fx 25650
|
$313.00 |
$692.03 |
$1,603.00 |
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$172.00 |
$487.15 |
$487.15 |
|
|
Cls tx of heel fracture w/manip 28405
|
$492.00 |
$1,719.90 |
$1,719.90 |
|
|
Cltx carpl scphd fx w/mnpj
|
$522.45 |
$522.45 |
$10,469.00 |
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,047.00 |
$1,568.28 |
$1,568.28 |
|
|
Cltx hum epcndylr fx wo mnpj
|
$224.00 |
$408.23 |
$408.23 |
|
|
Cltx humrl cndylr fx w/mnpj
|
$373.95 |
$373.95 |
$1,901.00 |
|
|
Cltx humrl cndylr fx wo mnpj
|
$348.50 |
$463.48 |
$463.48 |
|
|
Cltx lunate dislc w/mnpj
|
$187.70 |
$187.70 |
$1,754.50 |
|
|
Cltx mndblr fx ntrdntl fixj
|
$3,857.50 |
$5,835.75 |
$5,835.75 |
|
|
Cltx mndblr fx w/mnpj
|
$863.83 |
$863.83 |
$863.83 |
|
|
Cltx mndblr/max alv ridge fx
|
$1,793.50 |
$3,676.40 |
$3,676.40 |
|
|
Cltx post ankle fx
|
$521.30 |
$521.30 |
$1,636.11 |
|
|
Cltx post ankle fx w/mnpj
|
$1,939.00 |
$3,276.43 |
$3,276.43 |
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,034.50 |
$1,034.50 |
$1,034.50 |
|
|
Cltx strnclav dislc w/mnpj
|
$590.00 |
$995.40 |
$995.40 |
|
|
Cltx thigh fx
|
$4,013.50 |
$4,013.50 |
$4,013.50 |
|
|
Cltx thigh fx w/mnpj
|
$6,734.30 |
$6,734.30 |
$6,734.30 |
|
|
C motor evoked lwr limbs
|
$532.50 |
$532.50 |
$532.50 |
|
|
C motor evoked uppr limbs
|
$532.50 |
$532.50 |
$532.50 |
|
|
C motor evoked upr&lwr limbs
|
$886.00 |
$886.00 |
$886.00 |
|
|
#cmvcul-virus inoculation shell
|
$89.00 |
$179.15 |
$249.00 |
|
|
Cmv pcr-sendout
|
$79.50 |
$380.15 |
$380.15 |
|
|
Co2 monitor per day
|
$253.50 |
$253.50 |
$253.50 |
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$19,437.50 |
$19,437.50 |
$19,437.50 |
|
|
Coagulation time activated teg
|
$73.50 |
$92.45 |
$92.45 |
|
|
Cocaine 4 % nasal solution
|
$450.90 |
$450.90 |
$1,089.04 |
|
|
Cocaine hcl nasal (numbrino)
|
$512.30 |
$512.30 |
$512.30 |
|
|
Coil axium 3d 14mmx40cm qc
|
$294.98 |
$294.98 |
$294.98 |
|
|
Cold agglutinin screen (arc)
|
$37.50 |
$37.50 |
$45.00 |
|
|
Cold agglutinin titer
|
$69.50 |
$328.78 |
$328.78 |
|
|
Colistimethate sodium inj
|
$90.55 |
$90.55 |
$90.55 |
|
|
Collagenase, clost hist inj
|
$13,694.93 |
$13,694.93 |
$13,694.93 |
|
|
Collagen based wound filler
|
$227.50 |
$227.50 |
$227.50 |
|
|
Collagen dressing <=16 sq in
|
$40.50 |
$198.30 |
$198.30 |
|
|
Collagen drsg>16<=48 sq in
|
$23.29 |
$23.29 |
$23.29 |
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$222.20 |
$222.20 |
$358.58 |
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$13.50 |
$13.50 |
$30.54 |
|
|
Collar cerv ascend 172 reg
|
$17.50 |
$17.50 |
$109.71 |
|
|
Collection blood specimen from completely implantable venous access device
|
$87.45 |
$87.45 |
$212.00 |
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$100.13 |
$100.13 |
$188.48 |
|
|
Collj & interpj data ea 30 d
|
$86.50 |
$86.50 |
$86.50 |
|
|
Colonoscopy (diagnostic)
|
$931.50 |
$931.50 |
$931.50 |
|
|
Colonoscopy (with biopsy)
|
$8,636.00 |
$8,636.00 |
$8,636.00 |
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$1,549.50 |
$3,115.70 |
$3,115.70 |
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$618.90 |
$618.90 |
$4,876.00 |
|
|
Colposcopy/cervix/ conization 57461
|
$419.08 |
$419.08 |
$419.08 |
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$528.93 |
$528.93 |
$1,217.00 |
|
|
Colposcopy vulva 56820
|
$428.58 |
$428.58 |
$428.58 |
|
|
Colposcopy vulva w/biopsy 56821
|
$343.53 |
$343.53 |
$3,744.00 |
|
|
Colposcopy w/biopsy of cervix 57455
|
$494.50 |
$642.63 |
$1,614.00 |
|
|
Compatibility test each unit antiglobulin technique
|
$74.00 |
$131.80 |
$240.00 |
|
|
Compatibility test each unit electronic
|
$103.50 |
$103.50 |
$352.00 |
|
|
Compatibility test each unit immediate spin technique
|
$78.33 |
$170.95 |
$179.00 |
|
|
Compatibility test incubate
|
$55.28 |
$55.28 |
$80.00 |
|
|
Comp cystometrogram/void presssure 51728
|
$830.50 |
$830.50 |
$1,651.00 |
|
|
Comp cystometrogram/void/uret pres 51729
|
$815.10 |
$815.10 |
$4,655.00 |
|
|
Complement antigen each component c3
|
$104.50 |
$144.63 |
$175.00 |
|
|
Complex cystometrogram 51726
|
$398.70 |
$398.70 |
$398.70 |
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$248.05 |
$248.05 |
$3,477.00 |
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$904.00 |
$1,191.78 |
$1,191.78 |
|
|
Complex uroflowmetry (electronic) 51741
|
$77.45 |
$77.45 |
$161.00 |
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$386.03 |
$386.03 |
$4,229.00 |
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$855.93 |
$855.93 |
$4,229.00 |
|
|
Complx repair enel addl 5cm/< 13153
|
$316.18 |
$316.18 |
$965.00 |
|
|
Complx repair fccmnaxghf 13131
|
$454.65 |
$454.65 |
$1,999.00 |
|
|
Complx repair fccmnaxghf 13132
|
$454.65 |
$454.65 |
$2,562.00 |
|
|
Complx repair fccmnaxghf 13133
|
$258.90 |
$258.90 |
$2,172.00 |
|
|
Complx repair sal addl 5 cm/> 13122
|
$118.50 |
$274.48 |
$2,579.85 |
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$348.00 |
$688.45 |
$688.45 |
|
|
Complx repair trunk addl 5cm/< 13102
|
$406.00 |
$1,191.78 |
$1,191.78 |
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$733.30 |
$733.30 |
$733.30 |
|
|
Comprehensive hearing test
|
$220.23 |
$220.23 |
$295.00 |
|
|
Concentration infection agents any type
|
$19.00 |
$48.68 |
$109.00 |
|
|
Conditioning play audiometry 92582
|
$143.08 |
$143.08 |
$143.08 |
|
|
Condylomata destruction 56420
|
$394.48 |
$394.48 |
$1,594.00 |
|
|
Conform band n/s w>=3"<5"/yd
|
$9.32 |
$9.32 |
$9.32 |
|
|
Conivaptan hcl
|
$1,660.50 |
$1,660.50 |
$1,660.50 |
|
|
Conization/cerv/loop electrode exc 57522
|
$2,636.65 |
$2,636.65 |
$21,949.00 |
|
|
Conjugated estrogens 25 mg solution for injection
|
$871.08 |
$871.08 |
$871.08 |
|
|
Connect omega .5mm
|
$243.50 |
$243.50 |
$243.50 |
|
|
Consultation pathology during surgery
|
$93.00 |
$93.00 |
$93.00 |
|
|
Consultation pathology during surgery cytological exam initial site
|
$100.08 |
$100.08 |
$499.00 |
|
|
Consultation pathology during surgery frozen section each additional block
|
$115.50 |
$134.38 |
$480.00 |
|
|
Consultation pathology during surgery frozen section first tissue block
|
$139.50 |
$238.40 |
$563.00 |
|
|
Consultation/report referred material w/preparation of slides
|
$79.50 |
$181.55 |
$1,013.00 |
|
|
Consultation with family
|
$108.83 |
$108.83 |
$108.83 |
|
|
Consult comp w/report rfrd material
|
$570.33 |
$570.33 |
$570.33 |
|
|
Contact layer >16<= 48 sq in
|
$15.01 |
$15.01 |
$15.01 |
|
|
Contrast baths charges
|
$77.98 |
$77.98 |
$92.00 |
|
|
Contrast exam abdominl aorta 75625-26
|
$2,044.00 |
$2,786.28 |
$2,786.28 |
|
|
Contrast exam thoracic aorta
|
$2,746.50 |
$4,158.23 |
$4,158.23 |
|
|
Contrast exam thoracic aorta 75605-26
|
$2,414.08 |
$2,414.08 |
$2,851.50 |
|
|
Contrast x-ray gallbladder
|
$1,646.00 |
$1,646.00 |
$1,646.00 |
|
|
Contrast x-ray of ankle
|
$798.00 |
$798.00 |
$798.00 |
|
|
Contrast x-ray of brain
|
$897.88 |
$897.88 |
$1,062.50 |
|
|
Contrast x-ray of elbow
|
$588.75 |
$588.75 |
$1,117.83 |
|
|
Contrast x-ray of hip
|
$588.75 |
$588.75 |
$1,117.00 |
|
|
Contrast x-ray of knee joint
|
$577.58 |
$577.58 |
$1,110.27 |
|
|
Contrast x-ray of wrist
|
$388.00 |
$744.15 |
$1,079.00 |
|
