|
Cilastatin sodium injection
|
$43.44 |
$43.44 |
$119.65 |
|
|
Cine/video x-rays
|
$187.41 |
$187.41 |
$187.41 |
|
|
Ciprofloxacin 400 mg/200 ml in 5 % dextrose intravenous piggyback
|
$34.12 |
$39.00 |
$60.00 |
|
|
Circum 28 days or older
|
$5,888.19 |
$5,888.19 |
$6,703.07 |
|
|
Circumcise/surg/28 days or < 54160
|
$380.90 |
$414.05 |
$586.00 |
|
|
Circumcision (newborn)
|
$149.02 |
$176.49 |
$9,118.60 |
|
|
Cisplatin 1 mg/ml desensitization
|
$52.43 |
$52.43 |
$1,862.25 |
|
|
C-kit mutation liquid tumor - sendout
|
$347.75 |
$365.76 |
$868.00 |
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$347.10 |
$347.10 |
$1,278.87 |
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$2,613.00 |
$2,613.00 |
$3,064.75 |
|
|
Clearance of airways
|
$80.94 |
$136.50 |
$416.65 |
|
|
Clearance of tear duct
|
$535.39 |
$535.39 |
$656.38 |
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$63.43 |
$68.69 |
$88.88 |
|
|
Clip ligating vesolock lg
|
$304.85 |
$304.85 |
$1,617.20 |
|
|
Cllr miami j sm
|
$354.90 |
$612.95 |
$767.82 |
|
|
Clofarabine 1 mg/ml intravenous solution
|
$2,958.15 |
$3,993.47 |
$5,564.00 |
|
|
Clonidine (pf) 1,000 mcg/10 ml (100 mcg/ml) epidural solution
|
$109.36 |
$387.33 |
$387.33 |
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$230.88 |
$444.09 |
$589.55 |
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$2,628.48 |
$2,628.48 |
$2,628.48 |
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$1,505.99 |
$1,505.99 |
$1,505.99 |
|
|
Closed tx/acetabululm without manip 27220
|
$394.98 |
$394.98 |
$812.52 |
|
|
Closed tx humerus fx with manip 23605
|
$995.15 |
$3,388.46 |
$3,388.46 |
|
|
Closed tx humerus fx without manip 23600
|
$264.37 |
$393.96 |
$689.65 |
|
|
Closed tx humerus fx w/manip 24505
|
$887.25 |
$2,628.48 |
$2,628.48 |
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$258.82 |
$258.82 |
$376.35 |
|
|
Closed tx orbit without manipulj
|
$523.90 |
$920.38 |
$920.38 |
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$1,205.75 |
$2,569.28 |
$2,569.28 |
|
|
Closed tx septal&nose fx
|
$1,861.19 |
$1,861.19 |
$1,861.19 |
|
|
Closed tx/talus fracture without manip 28430
|
$376.11 |
$376.11 |
$376.11 |
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$315.52 |
$315.52 |
$441.35 |
|
|
Clos txnose fx without stablz 21315
|
$433.55 |
$916.49 |
$916.49 |
|
|
Closure enterostomy lg/sm intestine oth/thn 44625
|
$11,803.27 |
$11,803.27 |
$11,803.27 |
|
|
Closure laceration vestibule mouth > 2.5 cm cmplx
|
$589.55 |
$730.75 |
$730.75 |
|
|
Closure of windpipe lesion 31820
|
$755.23 |
$755.23 |
$755.23 |
|
|
Clot factor xii hageman
|
$95.55 |
$95.74 |
$197.00 |
|
|
Clot factor xiii fibrin scrn
|
$84.50 |
$120.25 |
$185.00 |
|
|
Clot factor xiii fibrin stab
|
$84.27 |
$84.27 |
$194.00 |
|
|
Clotting assay whole blood
|
$59.39 |
$59.39 |
$59.39 |
|
|
Clozapine, 25 mg
|
$4.87 |
$4.87 |
$4.87 |
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$283.05 |
$381.75 |
$865.00 |
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$394.79 |
$512.82 |
$674.70 |
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$450.48 |
$450.48 |
$585.65 |
|
|
Clsd tx clav dislc without manip 23520
|
$2,628.48 |
$2,628.48 |
$2,628.48 |
|
|
Clsd tx clavicle dislocation without manip 23540
|
$235.32 |
$235.32 |
$271.03 |
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,321.64 |
$1,321.64 |
$1,321.64 |
|
|
Clsd tx/clavicular fx without manip 23500
|
$258.82 |
$264.55 |
$479.05 |
|
|
Clsd tx coccygeal fracture 27200
|
$188.05 |
$188.05 |
$188.05 |
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$115.07 |
$148.37 |
$395.20 |
|
|
Clsd tx dist fib fx w/manip 27788
|
$278.06 |
$511.06 |
$776.10 |
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$266.40 |
$377.03 |
$507.65 |
|
|
Clsd tx elbow dislocation child 24640
|
$214.50 |
$292.49 |
$365.00 |
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,461.85 |
$2,587.60 |
$2,587.60 |
|
|
Clsd tx fracture of radius 25500
|
$394.79 |
$394.79 |
$415.88 |
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$271.05 |
$376.11 |
$376.11 |
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$122.38 |
$130.89 |
$300.95 |
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$313.21 |
$393.96 |
$701.35 |
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$975.88 |
$975.88 |
$1,351.35 |
|
|
Clsd tx fx radius/ulna without manip 25560
|
$283.05 |
$335.68 |
$478.40 |
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$882.64 |
$882.64 |
$1,025.70 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$482.85 |
$482.85 |
$482.85 |
|
|
Clsd tx hip disloc without anes 27265
|
$302.66 |
$302.66 |
$489.51 |
|
|
Clsd tx humeral fract without manip 24530
|
$264.18 |
$264.18 |
$456.86 |
|
|
Clsd tx humerus fract without manip 24500
|
$394.79 |
$546.86 |
$689.65 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$692.90 |
$1,233.58 |
$1,233.58 |
|
|
Clsd tx mandibular fx without manip 21450
|
$483.22 |
$483.22 |
$483.22 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$376.11 |
$376.11 |
$376.11 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$131.17 |
$353.72 |
$553.80 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$111.83 |
$257.98 |
$626.60 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$345.77 |
$393.68 |
$551.85 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$247.90 |
$267.51 |
$434.85 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$1,888.11 |
$1,888.11 |
$1,888.11 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$587.60 |
$2,628.48 |
$2,628.48 |
|
|
Clsd tx patella disloc without anes 27560
|
$278.06 |
$441.69 |
$649.35 |
|
|
Clsd tx/patellar fx without manip 27520
|
$394.79 |
$495.80 |
$566.80 |
|
|
Clsd tx pelvic ring fx
|
$203.59 |
$203.59 |
$203.59 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,557.07 |
$2,557.07 |
$2,557.07 |
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$104.16 |
$159.29 |
$410.80 |
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$247.53 |
$314.69 |
$488.15 |
|
|
Clsd tx radius fracture w/manip 24655
|
$789.10 |
$2,628.48 |
$2,628.48 |
|
|
Clsd tx/scapular fx without manip 23570
|
$247.16 |
$279.17 |
$510.90 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$877.50 |
$2,628.48 |
$2,628.48 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$919.75 |
$2,628.48 |
$2,628.48 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$780.00 |
$2,132.50 |
$2,132.50 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$213.20 |
$224.59 |
$262.60 |
|
|
Clsd tx toe dislocation without anes28660
|
$50.00 |
$225.24 |
$330.20 |
|
|
Clsd tx trimall ankle fx without manip 27816
|
$264.74 |
$264.74 |
$384.62 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$832.32 |
$832.32 |
$1,027.00 |
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$394.79 |
$394.79 |
$399.60 |
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$622.05 |
$622.05 |
$622.05 |
|
|
Clsd tx wrist carpal fx without manip 25630
|
$394.79 |
$466.20 |
$570.05 |
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$212.75 |
$366.58 |
$665.60 |
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$227.74 |
$227.74 |
$579.88 |
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$239.02 |
$386.37 |
$631.15 |
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$376.11 |
$430.30 |
$455.00 |
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,558.00 |
$2,558.00 |
$2,558.00 |
|
|
Cltx hum epcndylr fx wo mnpj
|
$244.02 |
$388.13 |
$650.65 |
|
|
Cltx humrl cndylr fx wo mnpj
|
$376.11 |
$376.11 |
$520.22 |
|
|
Cltx lunate dislc w/mnpj
|
$2,691.75 |
$2,691.75 |
$2,691.75 |
|
|
Cltx mndblr fx w/mnpj
|
$728.07 |
$728.07 |
$728.07 |
|
|
Cltx mndblr/max alv ridge fx
|
$1,288.53 |
$1,288.53 |
$1,288.53 |
|