|
Clsd tx shoulder dislc/fx 23665
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$660.45 |
$660.45 |
$660.45 |
$362.50
|
|
Clsd tx toe dislocation without anes28660
|
$660.45 |
$660.45 |
$660.45 |
$392.50
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,565.74
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$861.90 |
$861.90 |
$861.90 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$757.35 |
$757.35 |
$757.35 |
$466.14
|
|
Cls tx of heel fracture w/manip 28405
|
$1,119.45 |
$1,119.45 |
$1,119.45 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,851.78
|
|
Cltx lunate dislc w/mnpj
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$14,363.30 |
$14,363.30 |
$14,363.30 |
$6,553.49
|
|
Cltx post ankle fx w/mnpj
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$3,941.45 |
$3,941.45 |
$3,941.45 |
$2,030.33
|
|
Cltx thigh fx w/mnpj
|
$7,037.15 |
$7,037.15 |
$7,037.15 |
$3,503.71
|
|
Cltx tmprmand dislc comp
|
$3,740.85 |
$3,740.85 |
$3,740.85 |
$3,740.85
|
|
#cmvcul-virus inoculation shell
|
$79.05 |
$79.05 |
$79.05 |
$97.50
|
|
Cmv pcr-sendout
|
$141.95 |
$141.95 |
$141.95 |
$172.25
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$14.00 |
$14.00 |
$14.00 |
$8,040.00
|
|
Coagulation time activated teg
|
$17.85 |
$17.85 |
$17.85 |
$53.72
|
|
Cocaine 4 % nasal solution
|
$956.32 |
$956.32 |
$956.32 |
$624.55
|
|
Coch imp ext proc/contr rplc
|
$12,888.72 |
$12,888.72 |
$12,888.72 |
$20,146.35
|
|
Coch implant headset replace
|
$888.25 |
$888.25 |
$888.25 |
$1,064.00
|
|
Cold agglutinin titer
|
$32.30 |
$32.30 |
$32.30 |
$50.00
|
|
Colistimethate sodium inj
|
$101.36 |
$101.36 |
$101.36 |
$68.47
|
|
Collagenase, clost hist inj
|
$19,589.89 |
$19,589.89 |
$19,589.89 |
$12,906.28
|
|
Collagen imp urinary 2.5 ml
|
$1,385.84 |
$1,385.84 |
$1,385.84 |
$1,876.55
|
|
Collection blood specimen from completely implantable venous access device
|
$277.95 |
$277.95 |
$277.95 |
$156.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$277.95 |
$277.95 |
$277.95 |
$152.54
|
|
Colonoscopy (diagnostic)
|
$2,485.40 |
$2,485.40 |
$2,485.40 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$1,645.43
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$1,846.40
|
|
Colonoscopy submucous njx
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$2,063.25
|
|
Colonoscopy w/control bleed
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$2,019.60
|
|
Colonoscopy (with biopsy)
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$3,208.75 |
$3,208.75 |
$3,208.75 |
$2,288.00
|
|
Colpocleisis (le forte type) 57120
|
$12,199.20 |
$12,199.20 |
$12,199.20 |
$5,394.95
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$7,667.85 |
$7,667.85 |
$7,667.85 |
$3,762.53
|
|
Colpotomy w/exploration 57000
|
$7,667.85 |
$7,667.85 |
$7,667.85 |
$3,905.53
|
|
Compatibility test each unit electronic
|
$87.55 |
$87.55 |
$87.55 |
$171.25
|
|
Compatibility test each unit immediate spin technique
|
$109.65 |
$109.65 |
$109.65 |
$169.52
|
|
Compatibility test incubate
|
$98.60 |
$98.60 |
$98.60 |
$155.40
|
|
Complement antigen each component c3
|
$48.45 |
$48.45 |
$48.45 |
$110.40
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$1,193.40
|
|
Complx repair enel addl 5cm/< 13153
|
$446.25 |
$446.25 |
$446.25 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$1,116.90 |
$1,116.90 |
$1,116.90 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,758.65 |
$1,758.65 |
$1,758.65 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$461.55 |
$461.55 |
$461.55 |
$531.30
|
|
Complx repair sal addl 5 cm/> 13122
|
$336.60 |
$336.60 |
$336.60 |
$498.60
|
|
Complx repair trunk addl 5cm/< 13102
|
$273.70 |
$273.70 |
$273.70 |
$537.00
|
|
Composite byp grft pros&vein
|
$1,016.60 |
$1,016.60 |
$1,016.60 |
$205.60
|
|
Computed tomographic angiography head and neck with contrast
|
$1,948.20 |
$1,948.20 |
$1,948.20 |
$2,237.25
|
|
Concentration infection agents any type
|
$28.05 |
$28.05 |
$28.05 |
$49.40
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$2,305.20 |
$2,305.20 |
$2,305.20 |
$3,322.20
|
|
Condylomata destruction 56420
|
$557.60 |
$557.60 |
$557.60 |
$469.00
|
|
Conivaptan hcl
|
$962.37 |
$962.37 |
$962.37 |
$1,625.08
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,003.74 |
$1,003.74 |
$1,003.74 |
$871.08
|
|
Connect omega .5mm
|
$11,590.82 |
$11,590.82 |
$11,590.82 |
$1,260.00
|
|
Connector tis 2x10mm
|
$3,113.54 |
$3,113.54 |
$3,113.54 |
$3,967.08
|
|
Consultation pathology during surgery
|
$174.25 |
$174.25 |
$174.25 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$170.00 |
$170.00 |
$170.00 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$145.35 |
$145.35 |
$145.35 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$219.30 |
$219.30 |
$219.30 |
$223.86
|
|
Consultation/report referred material w/preparation of slides
|
$161.50 |
$161.50 |
$161.50 |
$206.01
|
|
Consultation/report referred slides prepared elsewhere
|
$414.80 |
$414.80 |
$414.80 |
$171.65
|
|
Consult comp w/report rfrd material
|
$668.95 |
$668.95 |
$668.95 |
$345.71
|
|
Contrast exam abdominl aorta 75625-26
|
$15,025.45 |
$15,025.45 |
$15,025.45 |
$3,391.03
|
|
Contrast exam thoracic aorta
|
$15,025.45 |
$15,025.45 |
$15,025.45 |
$3,570.00
|
|
Contrast exam thoracic aorta 75605-26
|
$24,668.70 |
$24,668.70 |
$24,668.70 |
$3,663.60
|
|
Contrast x-ray of ankle
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$577.92
|
|
Contrast x-ray of elbow
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$628.80
|
|
Contrast x-ray of hip
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$750.00
|
|
Contrast x-ray of knee joint
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$719.40
|
|
Contrast x-ray of wrist
|
$1,727.20 |
$1,727.20 |
$1,727.20 |
$616.70
|
|
Controler lvad heartmate 3 includes ebb
|
$7,480.00 |
$7,480.00 |
$7,480.00 |
$12,355.20
|
|
Controller infinity pt dbs
|
$14,120.63 |
$14,120.63 |
$14,120.63 |
$4,494.00
|
|
Control nosebleed pack+caut 30905
|
$357.85 |
$357.85 |
$357.85 |
$385.45
|
|
Control nose/throat bleeding comp req hospital 42971
|
$3,315.85 |
$3,315.85 |
$3,315.85 |
$1,120.80
|
|
Control nose/throat bleeding w/pst nsl packs 42970
|
$1,107.55 |
$1,107.55 |
$1,107.55 |
$753.00
|
|
Control of nosebleed ant comp 30903
|
$357.85 |
$357.85 |
$357.85 |
$391.20
|
|
Control of nosebleedantersmpl 30901
|
$313.65 |
$313.65 |
$313.65 |
$342.24
|
|
Control oropharyngeal hemorr/simp 42960
|
$1,541.05 |
$1,541.05 |
$1,541.05 |
$624.78
|
|
Conversion ext bil drg cath
|
$8,485.55 |
$8,485.55 |
$8,485.55 |
$4,143.00
|
|
Convert nephrostomy catheter
|
$4,995.45 |
$4,995.45 |
$4,995.45 |
$2,777.60
|
|
Coombs direct
|
$21.25 |
$21.25 |
$21.25 |
$73.50
|
|
Coombs indirect qualitative each reagent red cell reference
|
$28.90 |
$28.90 |
$28.90 |
$101.15
|
|
Coombs indirect titer reference
|
$21.25 |
$21.25 |
$21.25 |
$146.00
|
|
Copper cu 64 dotatate diag
|
$3,935.50 |
$3,935.50 |
$3,935.50 |
$2,228.40
|
|
Copper intrauterine device
|
$3,023.11 |
$3,023.11 |
$3,023.11 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$3,976.30 |
$3,976.30 |
$3,976.30 |
$2,600.00
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$4,794.00 |
$4,794.00 |
$4,794.00 |
$8,280.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$9,314.30 |
$9,314.30 |
$9,314.30 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$9,314.30 |
$9,314.30 |
$9,314.30 |
$9,964.80
|
|
Coronary angio/lv gram/rt< heart
|
$9,314.30 |
$9,314.30 |
$9,314.30 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$9,314.30 |
$9,314.30 |
$9,314.30 |
$7,942.00
|
