|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$716.95 |
$716.95 |
$716.95 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$716.95 |
$716.95 |
$716.95 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$722.80 |
$722.80 |
$722.80 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$716.95 |
$716.95 |
$716.95 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$716.95 |
$716.95 |
$716.95 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,362.40 |
$1,362.40 |
$1,362.40 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$959.40 |
$959.40 |
$959.40 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$975.00 |
$975.00 |
$975.00 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$1,014.00 |
$1,014.00 |
$1,014.00 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$1,522.95 |
$1,522.95 |
$1,522.95 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$716.95 |
$716.95 |
$716.95 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$743.60 |
$743.60 |
$743.60 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$866.45 |
$866.45 |
$866.45 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$1,424.80 |
$1,424.80 |
$1,424.80 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$782.60 |
$782.60 |
$782.60 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$716.95 |
$716.95 |
$716.95 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$455.00 |
$455.00 |
$455.00 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$1,037.40 |
$1,037.40 |
$1,037.40 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$790.40 |
$790.40 |
$790.40 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$716.95 |
$716.95 |
$716.95 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$1,358.50 |
$1,358.50 |
$1,358.50 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$716.95 |
$716.95 |
$716.95 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$716.95 |
$716.95 |
$716.95 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$716.95 |
$716.95 |
$716.95 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$907.40 |
$907.40 |
$907.40 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$716.95 |
$716.95 |
$716.95 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$716.95 |
$716.95 |
$716.95 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$878.15 |
$878.15 |
$878.15 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$716.95 |
$716.95 |
$716.95 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$897.00 |
$897.00 |
$897.00 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$866.45 |
$866.45 |
$866.45 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$725.40 |
$725.40 |
$725.40 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$839.80 |
$839.80 |
$839.80 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$716.95 |
$716.95 |
$716.95 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$1,232.40 |
$1,232.40 |
$1,232.40 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$774.80 |
$774.80 |
$774.80 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$874.90 |
$874.90 |
$874.90 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$1,726.40 |
$1,726.40 |
$1,726.40 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,469.00 |
$1,469.00 |
$1,469.00 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$894.40 |
$894.40 |
$894.40 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$1,565.20 |
$1,565.20 |
$1,565.20 |
$4,377.24
|
|
Cltx post ankle fx
|
$716.95 |
$716.95 |
$716.95 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$4,785.30 |
$4,785.30 |
$4,785.30 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$985.40 |
$985.40 |
$985.40 |
$619.30
|
|
Cltx thigh fx
|
$9,701.25 |
$9,701.25 |
$9,701.25 |
$3,986.00
|
|
Cltx thigh fx w/mnpj
|
$1,851.20 |
$1,851.20 |
$1,851.20 |
$3,276.70
|
|
Cmbn ant pst colprhy
|
$3,789.50 |
$3,789.50 |
$3,789.50 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$2,379.65 |
$2,379.65 |
$2,379.65 |
$627.89
|
|
C motor evoked upr&lwr limbs
|
$4,563.00 |
$4,563.00 |
$4,563.00 |
$1,333.36
|
|
Cmptr ophth dx img ant segmt
|
$260.65 |
$260.65 |
$260.65 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$265.85 |
$265.85 |
$265.85 |
$98.00
|
|
#cmvcul-virus inoculation shell
|
$87.75 |
$87.75 |
$87.75 |
$89.76
|
|
Cmv pcr-sendout
|
$157.30 |
$157.30 |
$157.30 |
$175.70
|
|
Co2 monitor per day
|
$988.00 |
$988.00 |
$988.00 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$6.90 |
$6.90 |
$6.90 |
$11,888.50
|
|
Coagulation time activated teg
|
$19.50 |
$19.50 |
$19.50 |
$52.47
|
|
Cocaine 4 % nasal solution
|
$125.97 |
$125.97 |
$125.97 |
$630.04
|
|
Coil axium 3d 14mmx40cm qc
|
$1,218.75 |
$1,218.75 |
$1,218.75 |
$308.00
|
|
Cold agglutinin titer
|
$36.40 |
$36.40 |
$36.40 |
$52.00
|
|
Colectomy/end colost/close dis seg 44143
|
$7,225.40 |
$7,225.40 |
$7,225.40 |
$2,880.80
|
|
Colectomy/ ileostomy without prctect 44150
|
$7,846.80 |
$7,846.80 |
$7,846.80 |
$3,530.40
|
|
Colectomy/ ileostomy w/prctect 44155
|
$8,949.20 |
$8,949.20 |
$8,949.20 |
$4,562.58
|
|
Colectomy partial w/anastomosis 44140
|
$5,873.40 |
$5,873.40 |
$5,873.40 |
$2,510.73
|
|
Colectomy prtl abdominal + transanal appr 44147
|
$8,759.40 |
$8,759.40 |
$8,759.40 |
$3,652.20
|
|
Colectomy prtl w/coloproctostomy 44145
|
$7,430.80 |
$7,430.80 |
$7,430.80 |
$3,142.80
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$9,178.00 |
$9,178.00 |
$9,178.00 |
$3,233.40
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$5,431.40 |
$5,431.40 |
$5,431.40 |
$2,136.00
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$7,776.60 |
$7,776.60 |
$7,776.60 |
$3,270.00
|
|
Colectomy/w colostomy or ileostomy 44144
|
$7,776.60 |
$7,776.60 |
$7,776.60 |
$3,176.40
|
|
Colectomy w/neo-rectum pouch
|
$9,542.00 |
$9,542.00 |
$9,542.00 |
$5,500.80
|
|
Colistimethate sodium inj
|
$65.52 |
$65.52 |
$65.52 |
$82.71
|
|
Collagenase, clost hist inj
|
$17,281.45 |
$17,281.45 |
$17,281.45 |
$12,906.28
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$436.80 |
$436.80 |
$436.80 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$30.55 |
$30.55 |
$30.55 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$104.65 |
$104.65 |
$104.65 |
$224.11
|
|
Collection blood specimen from completely implantable venous access device
|
$481.65 |
$481.65 |
$481.65 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$481.65 |
$481.65 |
$481.65 |
$155.40
|
|
Collj & interpj data ea 30 d
|
$314.60 |
$314.60 |
$314.60 |
$172.35
|
|
Colonoscopy (diagnostic)
|
$2,726.10 |
$2,726.10 |
$2,726.10 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,288.00
|
|
Colonoscopy for bleeding 44391
|
$1,071.20 |
$1,071.20 |
$1,071.20 |
$2,147.00
|
|
Colonoscopy for foreign body
|
$972.40 |
$972.40 |
$972.40 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$917.80 |
$917.80 |
$917.80 |
$1,645.43
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$1,430.00 |
$1,430.00 |
$1,430.00 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$1,047.80 |
$1,047.80 |
$1,047.80 |
$1,395.28
|
