|
Clsd tx humerus fract without manip 24500
|
$520.80 |
$520.80 |
$520.80 |
$492.99
|
|
Clsd tx mandibular fx without manip 21450
|
$1,125.60 |
$1,125.60 |
$1,125.60 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$520.80 |
$520.80 |
$520.80 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$520.80 |
$520.80 |
$520.80 |
$519.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$585.00 |
$585.00 |
$585.00 |
$670.40
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$520.80 |
$520.80 |
$520.80 |
$534.60
|
|
Clsd tx/metatarsal fx without manip 28470
|
$520.80 |
$520.80 |
$520.80 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$8,554.98 |
$8,554.98 |
$8,554.98 |
$3,606.50
|
|
Clsd tx of ankle fracture w/manip 28435
|
$3,520.20 |
$3,520.20 |
$3,520.20 |
$1,843.91
|
|
Clsd tx patella disloc without anes 27560
|
$578.40 |
$578.40 |
$578.40 |
$577.20
|
|
Clsd tx/patellar fx without manip 27520
|
$520.80 |
$520.80 |
$520.80 |
$478.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$3,520.20 |
$3,520.20 |
$3,520.20 |
$2,275.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$520.80 |
$520.80 |
$520.80 |
$410.80
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$520.80 |
$520.80 |
$520.80 |
$459.90
|
|
Clsd tx radius fracture w/manip 24655
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$1,806.10
|
|
Clsd tx/scapular fx without manip 23570
|
$520.80 |
$520.80 |
$520.80 |
$452.00
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,560.40 |
$3,560.40 |
$3,560.40 |
$1,856.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$3,520.20 |
$3,520.20 |
$3,520.20 |
$1,771.43
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,619.80 |
$3,619.80 |
$3,619.80 |
$2,321.95
|
|
Clsd tx temporomandibular dislocat 21480
|
$594.60 |
$594.60 |
$594.60 |
$445.15
|
|
Clsd tx toe dislocation without anes28660
|
$594.60 |
$594.60 |
$594.60 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$520.80 |
$520.80 |
$520.80 |
$501.20
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$3,566.40 |
$3,566.40 |
$3,566.40 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$520.80 |
$520.80 |
$520.80 |
$456.88
|
|
Clsd tx wrist carpal fx without manip 25630
|
$520.80 |
$520.80 |
$520.80 |
$471.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$520.80 |
$520.80 |
$520.80 |
$523.25
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$520.80 |
$520.80 |
$520.80 |
$496.61
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$520.80 |
$520.80 |
$520.80 |
$618.72
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$520.80 |
$520.80 |
$520.80 |
$478.40
|
|
Cls tx of heel fracture w/manip 28405
|
$520.80 |
$520.80 |
$520.80 |
$759.00
|
|
Cltx carpl scphd fx w/mnpj
|
$3,569.40 |
$3,569.40 |
$3,569.40 |
$2,064.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$2,211.05
|
|
Cltx hum epcndylr fx wo mnpj
|
$520.80 |
$520.80 |
$520.80 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$1,858.00
|
|
Cltx humrl cndylr fx wo mnpj
|
$520.80 |
$520.80 |
$520.80 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$2,464.50
|
|
Cltx mndblr fx w/mnpj
|
$2,956.20 |
$2,956.20 |
$2,956.20 |
$2,432.15
|
|
Cltx mndblr/max alv ridge fx
|
$4,296.60 |
$4,296.60 |
$4,296.60 |
$3,990.33
|
|
Cltx post ankle fx
|
$520.80 |
$520.80 |
$520.80 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$2,172.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$3,619.80 |
$3,619.80 |
$3,619.80 |
$2,035.80
|
|
Cltx strnclav dislc w/mnpj
|
$520.80 |
$520.80 |
$520.80 |
$705.60
|
|
Cltx thigh fx w/mnpj
|
$2,599.80 |
$2,599.80 |
$2,599.80 |
$3,503.71
|
|
Cmv pcr-sendout
|
$522.00 |
$522.00 |
$522.00 |
$172.25
|
|
Coagulation time activated teg
|
$58.20 |
$58.20 |
$58.20 |
$52.00
|
|
Cocaine 4 % nasal solution
|
$242.28 |
$242.28 |
$242.28 |
$610.00
|
|
Coch imp ext proc/contr rplc
|
$31,351.55 |
$31,351.55 |
$31,351.55 |
$14,283.08
|
|
Coch implant microphone repl
|
$774.14 |
$774.14 |
$774.14 |
$878.84
|
|
Cold agglutinin titer
|
$58.20 |
$58.20 |
$58.20 |
$50.00
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$223.06 |
$223.06 |
$223.06 |
$54.94
|
|
Collar cerv adlt perfit ace extric
|
$149.58 |
$149.58 |
$149.58 |
$60.00
|
|
Collar cerv ascend 172 reg
|
$360.73 |
$360.73 |
$360.73 |
$187.48
|
|
Collar cerv patriot adlt
|
$247.23 |
$247.23 |
$247.23 |
$154.00
|
|
Collection blood specimen from completely implantable venous access device
|
$145.80 |
$145.80 |
$145.80 |
$157.80
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$145.80 |
$145.80 |
$145.80 |
$155.40
|
|
Collection of venous blood by venipuncture
|
$18.00 |
$18.00 |
$18.00 |
$20.40
|
|
Colonoscopy (diagnostic)
|
$5,111.77 |
$5,111.77 |
$5,111.77 |
$1,899.00
|
|
Colonoscopy submucous njx
|
$11,340.42 |
$11,340.42 |
$11,340.42 |
$2,080.00
|
|
Colonoscopy w/balloon dilat
|
$10,049.08 |
$10,049.08 |
$10,049.08 |
$1,645.43
|
|
Colonoscopy w/control bleed
|
$11,934.91 |
$11,934.91 |
$11,934.91 |
$2,071.85
|
|
Colonoscopy (with biopsy)
|
$13,036.30 |
$13,036.30 |
$13,036.30 |
$2,080.00
|
|
Colonoscopy (with polyp removal)
|
$7,627.14 |
$7,627.14 |
$7,627.14 |
$2,288.00
|
|
Colonoscopy w/resection
|
$6,886.88 |
$6,886.88 |
$6,886.88 |
$3,035.44
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$4,546.80 |
$4,546.80 |
$4,546.80 |
$3,762.53
|
|
Combination bilateral ho
|
$4,575.46 |
$4,575.46 |
$4,575.46 |
$4,575.46
|
|
Compatibility test each unit antiglobulin technique
|
$104.40 |
$104.40 |
$104.40 |
$165.00
|
|
Compatibility test each unit electronic
|
$234.00 |
$234.00 |
$234.00 |
$176.70
|
|
Compatibility test each unit immediate spin technique
|
$93.60 |
$93.60 |
$93.60 |
$169.52
|
|
Compatibility test incubate
|
$87.60 |
$87.60 |
$87.60 |
$143.65
|
|
Complement antigen each component c3
|
$110.40 |
$110.40 |
$110.40 |
$108.80
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,294.20 |
$1,294.20 |
$1,294.20 |
$887.25
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,305.00 |
$1,305.00 |
$1,305.00 |
$1,098.35
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$1,218.40
|
|
Complx repair enel addl 5cm/< 13153
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$837.00 |
$837.00 |
$837.00 |
$820.00
|
|
Complx repair fccmnaxghf 13132
|
$8,735.40 |
$8,735.40 |
$8,735.40 |
$1,177.60
|
|
Complx repair fccmnaxghf 13133
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$589.60
|
|
Complx repair sal addl 5 cm/> 13122
|
$552.60 |
$552.60 |
$552.60 |
$538.64
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$1,016.25
|
|
Complx repair trunk addl 5cm/< 13102
|
$1,110.60 |
$1,110.60 |
$1,110.60 |
$555.33
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$2,183.35 |
$2,183.35 |
$2,183.35 |
$1,232.73
|
|
Concentration infection agents any type
|
$34.20 |
$34.20 |
$34.20 |
$49.95
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$18,356.42 |
$18,356.42 |
$18,356.42 |
$3,322.20
|
|
Condylomata destruction 56420
|
$438.00 |
$438.00 |
$438.00 |
$473.75
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,700.52 |
$1,700.52 |
$1,700.52 |
$864.99
|
|
Connect omega .5mm
|
$7,673.66 |
$7,673.66 |
$7,673.66 |
$1,348.80
|
|
Connector tis 2x10mm
|
$8,792.03 |
$8,792.03 |
$8,792.03 |
$3,967.08
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,356.60 |
$1,356.60 |
$1,356.60 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$100.20 |
$100.20 |
$100.20 |
$110.40
|
|
Consultation pathology during surgery frozen section first tissue block
|
$215.40 |
$215.40 |
$215.40 |
$222.97
|
|
Contrast baths charges
|
$61.20 |
$61.20 |
$61.20 |
$72.15
|
|
Contrast exam abdominl aorta 75625-26
|
$3,568.20 |
$3,568.20 |
$3,568.20 |
$3,480.00
|
|
Contrast exam thoracic aorta 75605-26
|
$3,489.00 |
$3,489.00 |
$3,489.00 |
$3,663.60
|
|
Contrast x-ray of ankle
|
$684.00 |
$684.00 |
$684.00 |
$612.30
|
|
Contrast x-ray of elbow
|
$708.00 |
$708.00 |
$708.00 |
$647.20
|
|
Contrast x-ray of hip
|
$714.00 |
$714.00 |
$714.00 |
$768.00
|
|
Contrast x-ray of knee joint
|
$799.80 |
$799.80 |
$799.80 |
$719.40
|
|
Contrast x-ray of wrist
|
$564.00 |
$564.00 |
$564.00 |
$623.50
|
|
Controler lvad heartmate 3 includes ebb
|
$18,763.18 |
$18,763.18 |
$18,763.18 |
$11,939.40
|
