|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$85.50 |
$85.50 |
$85.50 |
$81.90
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$1,055.40 |
$1,055.40 |
$1,055.40 |
$508.45
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$2,640.60 |
$2,640.60 |
$2,640.60 |
$1,806.01
|
|
Closed tx humerus fx with manip 23605
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$360.00 |
$360.00 |
$360.00 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$376.96
|
|
Closed tx orbit without manipulj
|
$865.80 |
$865.80 |
$865.80 |
$998.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$2,520.60 |
$2,520.60 |
$2,520.60 |
$2,520.60
|
|
Closed tx septal&nose fx
|
$4,039.80 |
$4,039.80 |
$4,039.80 |
$3,624.40
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$574.20 |
$574.20 |
$574.20 |
$481.80
|
|
Clos txnose fx without stablz 21315
|
$1,866.60 |
$1,866.60 |
$1,866.60 |
$2,326.08
|
|
Closure paravalvlr leak pq
|
$11,464.80 |
$11,464.80 |
$11,464.80 |
$7,723.17
|
|
Clot factor fletcher fact
|
$103.80 |
$103.80 |
$103.80 |
$119.50
|
|
Clot factor viii reltd antgn
|
$174.60 |
$174.60 |
$174.60 |
$158.20
|
|
Clot factor wght kininogen
|
$141.60 |
$141.60 |
$141.60 |
$167.96
|
|
Clot factor xii hageman
|
$70.80 |
$70.80 |
$70.80 |
$134.39
|
|
Clot factor xiii fibrin stab
|
$139.20 |
$139.20 |
$139.20 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$1,098.60 |
$1,098.60 |
$1,098.60 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$433.80 |
$433.80 |
$433.80 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$476.80
|
|
Clsd tx clavicle dislocation without manip 23540
|
$394.20 |
$394.20 |
$394.20 |
$419.29
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$208.80 |
$208.80 |
$208.80 |
$448.80
|
|
Clsd tx coccygeal fracture 27200
|
$394.20 |
$394.20 |
$394.20 |
$388.80
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$11,746.26 |
$11,746.26 |
$11,746.26 |
$401.00
|
|
Clsd tx dist fib fx w/manip 27788
|
$723.00 |
$723.00 |
$723.00 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$383.40 |
$383.40 |
$383.40 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$2,184.08
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$14,449.26 |
$14,449.26 |
$14,449.26 |
$2,630.50
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$394.20 |
$394.20 |
$394.20 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$39,414.46 |
$39,414.46 |
$39,414.46 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$394.20 |
$394.20 |
$394.20 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$394.20 |
$394.20 |
$394.20 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$723.00 |
$723.00 |
$723.00 |
$630.00
|
|
Clsd tx humerus fract without manip 24500
|
$394.20 |
$394.20 |
$394.20 |
$492.99
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$14,547.00 |
$14,547.00 |
$14,547.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$496.80 |
$496.80 |
$496.80 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$498.60 |
$498.60 |
$498.60 |
$520.38
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$17,530.74 |
$17,530.74 |
$17,530.74 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,640.60 |
$2,640.60 |
$2,640.60 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$360.00 |
$360.00 |
$360.00 |
$475.68
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,503.80 |
$2,503.80 |
$2,503.80 |
$2,146.20
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$10,753.20 |
$10,753.20 |
$10,753.20 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$394.20 |
$394.20 |
$394.20 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$3,555.00 |
$3,555.00 |
$3,555.00 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,151.80 |
$3,151.80 |
$3,151.80 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,585.80 |
$1,585.80 |
$1,585.80 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$400.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$418.20 |
$418.20 |
$418.20 |
$452.40
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$394.20 |
$394.20 |
$394.20 |
$496.61
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$394.20 |
$394.20 |
$394.20 |
$600.60
|
|
Cls tx of heel fracture w/manip 28405
|
$583.80 |
$583.80 |
$583.80 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,490.60 |
$2,490.60 |
$2,490.60 |
$2,317.60
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,986.20 |
$2,986.20 |
$2,986.20 |
$1,815.75
|
|
Cltx lunate dislc w/mnpj
|
$1,288.80 |
$1,288.80 |
$1,288.80 |
$2,437.00
|
|
Cltx post ankle fx w/mnpj
|
$2,667.00 |
$2,667.00 |
$2,667.00 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$2,021.04
|
|
Cltx thigh fx w/mnpj
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$3,503.71
|
|
Cmbn ant pst colprhy
|
$37,323.92 |
$37,323.92 |
$37,323.92 |
$4,928.00
|
|
#cmvcul-virus inoculation shell
|
$57.60 |
$57.60 |
$57.60 |
$100.80
|
|
Cmv pcr-sendout
|
$205.80 |
$205.80 |
$205.80 |
$177.50
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$90,032.40 |
$90,032.40 |
$90,032.40 |
$8,980.00
|
|
Coagulation time activated teg
|
$86.40 |
$86.40 |
$86.40 |
$53.72
|
|
Cocaine 4 % nasal solution
|
$377.94 |
$377.94 |
$377.94 |
$629.41
|
|
Coch imp ext proc/contr rplc
|
$36,076.84 |
$36,076.84 |
$36,076.84 |
$20,146.35
|
|
Coch implant microphone repl
|
$890.83 |
$890.83 |
$890.83 |
$977.17
|
|
Cold agglutinin screen (arc)
|
$40.20 |
$40.20 |
$40.20 |
$45.00
|
|
Cold agglutinin titer
|
$97.20 |
$97.20 |
$97.20 |
$50.00
|
|
Colistimethate sodium inj
|
$508.86 |
$508.86 |
$508.86 |
$68.47
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$256.68 |
$256.68 |
$256.68 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$172.13 |
$172.13 |
$172.13 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$415.09 |
$415.09 |
$415.09 |
$213.89
|
|
Collar cerv patriot adlt
|
$284.49 |
$284.49 |
$284.49 |
$154.00
|
|
Collection of venous blood by venipuncture
|
$24.00 |
$24.00 |
$24.00 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$12,874.68 |
$12,874.68 |
$12,874.68 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$29,610.50 |
$29,610.50 |
$29,610.50 |
$2,288.00
|
|
Colonoscopy submucous njx
|
$18,279.75 |
$18,279.75 |
$18,279.75 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$7,753.26 |
$7,753.26 |
$7,753.26 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$16,930.25 |
$16,930.25 |
$16,930.25 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$10,484.28 |
$10,484.28 |
$10,484.28 |
$1,645.43
|
|
Colonoscopy w/band ligation
|
$27,897.00 |
$27,897.00 |
$27,897.00 |
$2,080.80
|
|
Colonoscopy w/control bleed
|
$15,750.80 |
$15,750.80 |
$15,750.80 |
$2,030.25
|
|
Colonoscopy w/endoscope Ultrasound
|
$12,481.24 |
$12,481.24 |
$12,481.24 |
$1,645.43
|
|
Colonoscopy (with biopsy)
|
$16,362.96 |
$16,362.96 |
$16,362.96 |
$2,080.00
|
|
Colonoscopy (with polyp removal)
|
$29,268.63 |
$29,268.63 |
$29,268.63 |
$2,288.00
|
|
Colonoscopy w/resection
|
$30,694.52 |
$30,694.52 |
$30,694.52 |
$3,029.60
|
|
Colpocleisis (le forte type) 57120
|
$25,718.85 |
$25,718.85 |
$25,718.85 |
$5,419.00
|
|
Colpopexy extraperitoneal
|
$37,323.92 |
$37,323.92 |
$37,323.92 |
$5,110.00
|
|
Colpopexy intraperitoneal
|
$60,267.79 |
$60,267.79 |
$60,267.79 |
$6,906.50
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$103,392.67 |
$103,392.67 |
$103,392.67 |
$3,762.53
|
