|
Circumcision (newborn)
|
$1,248.60 |
$1,248.60 |
$1,248.60 |
$1,364.88
|
|
Cisplatin 1 mg/ml desensitization
|
$446.40 |
$446.40 |
$446.40 |
$205.56
|
|
C-kit mutation liquid tumor - sendout
|
$3,723.60 |
$3,723.60 |
$3,723.60 |
$666.60
|
|
Cladribine 10 mg/10 ml intravenous solution
|
$613.20 |
$613.20 |
$613.20 |
$576.60
|
|
Clamp isol transpolr 5mmx6.5cm transpolar
|
$15,970.80 |
$15,970.80 |
$15,970.80 |
$15,560.16
|
|
Clindamycin 600 mg/50 ml in 5 % dextrose intravenous piggyback
|
$45.80 |
$45.80 |
$45.80 |
$55.20
|
|
Clip ligating vesolock lg
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$4,320.00
|
|
Closed carpo/metacarpal disl thumb w/manip
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$520.80
|
|
Closed carpo/metacarpal fx disl thumb w/manip
|
$3,515.40 |
$3,515.40 |
$3,515.40 |
$1,806.01
|
|
Closed treatment of femoral fracture proximal end neck; wi
|
$8,112.00 |
$8,112.00 |
$8,112.00 |
$1,642.82
|
|
Closed tx humerus fx with manip 23605
|
$4,707.00 |
$4,707.00 |
$4,707.00 |
$2,291.20
|
|
Closed tx humerus fx w/manip 24505
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$1,549.52
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$530.40 |
$530.40 |
$530.40 |
$386.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$4,522.80 |
$4,522.80 |
$4,522.80 |
$2,569.28
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$530.40 |
$530.40 |
$530.40 |
$472.50
|
|
Clos txnose fx without stablz 21315
|
$4,494.00 |
$4,494.00 |
$4,494.00 |
$2,392.80
|
|
Closure paravalvlr leak pq
|
$11,757.60 |
$11,757.60 |
$11,757.60 |
$9,434.46
|
|
Clot factor viii reltd antgn
|
$286.80 |
$286.80 |
$286.80 |
$140.42
|
|
Clot factor xii hageman
|
$163.20 |
$163.20 |
$163.20 |
$138.40
|
|
Clot factor xiii fibrin stab
|
$106.20 |
$106.20 |
$106.20 |
$106.40
|
|
Clozapine, 25 mg
|
$1.00 |
$1.00 |
$1.00 |
$5.40
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$648.96
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$379.20 |
$379.20 |
$379.20 |
$489.60
|
|
Clsd tx dist fib fx w/manip 27788
|
$2,275.20 |
$2,275.20 |
$2,275.20 |
$676.65
|
|
Clsd tx elbow dislocation child 24640
|
$408.60 |
$408.60 |
$408.60 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$3,184.80 |
$3,184.80 |
$3,184.80 |
$2,211.05
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$408.60 |
$408.60 |
$408.60 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$574.80 |
$574.80 |
$574.80 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$3,637.80 |
$3,637.80 |
$3,637.80 |
$1,726.01
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$3,184.80 |
$3,184.80 |
$3,184.80 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$630.00
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$5,187.60 |
$5,187.60 |
$5,187.60 |
$883.00
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$3,184.80 |
$3,184.80 |
$3,184.80 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$4,493.40 |
$4,493.40 |
$4,493.40 |
$522.78
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$4,599.00 |
$4,599.00 |
$4,599.00 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$3,184.80 |
$3,184.80 |
$3,184.80 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$2,275.20 |
$2,275.20 |
$2,275.20 |
$573.52
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,275.20 |
$2,275.20 |
$2,275.20 |
$2,222.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$585.00 |
$585.00 |
$585.00 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,184.80 |
$3,184.80 |
$3,184.80 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$4,790.40 |
$4,790.40 |
$4,790.40 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,842.00 |
$1,842.00 |
$1,842.00 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$530.40 |
$530.40 |
$530.40 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$3,505.20 |
$3,505.20 |
$3,505.20 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,275.20 |
$2,275.20 |
$2,275.20 |
$1,592.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$836.40 |
$836.40 |
$836.40 |
$612.80
|
|
Cltx lunate dislc w/mnpj
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$2,384.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$2,021.04
|
|
Cltx thigh fx w/mnpj
|
$5,389.80 |
$5,389.80 |
$5,389.80 |
$3,276.70
|
|
C motor evoked lwr limbs
|
$363.00 |
$363.00 |
$363.00 |
$627.89
|
|
C motor evoked upr&lwr limbs
|
$2,816.40 |
$2,816.40 |
$2,816.40 |
$1,333.36
|
|
#cms hgb-sulfhemoglobin
|
$36.00 |
$36.00 |
$36.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$40.20 |
$40.20 |
$40.20 |
$89.76
|
|
Cmv pcr-sendout
|
$860.40 |
$860.40 |
$860.40 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$6.40 |
$6.40 |
$6.40 |
$11,888.50
|
|
Coagulation time activated teg
|
$25.20 |
$25.20 |
$25.20 |
$52.47
|
|
Coagulation time otr method
|
$50.40 |
$50.40 |
$50.40 |
$20.00
|
|
Cold agglutinin titer
|
$113.40 |
$113.40 |
$113.40 |
$52.00
|
|
Collagen imp urinary 2.5 ml
|
$2,188.20 |
$2,188.20 |
$2,188.20 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$267.60 |
$267.60 |
$267.60 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$62.40 |
$62.40 |
$62.40 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$156.00 |
$156.00 |
$156.00 |
$224.11
|
|
Collar cerv patriot adlt
|
$117.00 |
$117.00 |
$117.00 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$50.40 |
$50.40 |
$50.40 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$93.60 |
$93.60 |
$93.60 |
$155.40
|
|
Colonoscopy (diagnostic)
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$2,288.00
|
|
Colonoscopy for bleeding 44391
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$2,147.00
|
|
Colonoscopy for foreign body
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$2,288.00
|
|
Colonoscopy & polypectomy 44392
|
$3,558.00 |
$3,558.00 |
$3,558.00 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$1,395.28
|
|
Colonoscopy submucous njx
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$3,378.00 |
$3,378.00 |
$3,378.00 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$3,029.00
|
|
Colonoscopy w/balloon dilat
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$1,681.30
|
|
Colonoscopy w/control bleed
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$2,101.71
|
|
Colonoscopy w/decompression
|
$2,940.60 |
$2,940.60 |
$2,940.60 |
$1,572.20
|
|
Colonoscopy w/fb removal
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$1,645.43
|
|
Colonoscopy w/injection
|
$2,940.60 |
$2,940.60 |
$2,940.60 |
$2,449.20
|
|
Colonoscopy with ablation
|
$2,044.20 |
$2,044.20 |
$2,044.20 |
$3,290.95
|
|
Colonoscopy (with biopsy)
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$2,214.00
|
|
Colonoscopy with biopsy
|
$2,032.80 |
$2,032.80 |
$2,032.80 |
$1,555.20
|
|
Colonoscopy (with polyp removal)
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$2,288.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$3,792.60 |
$3,792.60 |
$3,792.60 |
$3,907.93
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$50.40 |
$50.40 |
$50.40 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$192.00 |
$192.00 |
$192.00 |
$314.00
|
|
Colposcopy w/biopsy of cervix 57455
|
$57.00 |
$57.00 |
$57.00 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$135.60 |
$135.60 |
$135.60 |
$173.50
|
|
Compatibility test each unit electronic
|
$82.80 |
$82.80 |
$82.80 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$136.80 |
$136.80 |
$136.80 |
$169.52
|
|
Comp cystometrogram/void/uret pres 51729
|
$2,209.80 |
$2,209.80 |
$2,209.80 |
$1,111.03
|
|
Complement antigen each component c3
|
$143.40 |
$143.40 |
$143.40 |
$110.00
|
|
Complement fixation each
|
$100.20 |
$100.20 |
$100.20 |
$29.12
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,321.80 |
$1,321.80 |
$1,321.80 |
$893.41
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$3,637.80 |
$3,637.80 |
$3,637.80 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$3,637.80 |
$3,637.80 |
$3,637.80 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$1,975.20 |
$1,975.20 |
$1,975.20 |
$490.50
|
