|
Clsd tx/scapular fx without manip 23570
|
$825.60 |
$825.60 |
$825.60 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$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
|
$3,135.00 |
$3,135.00 |
$3,135.00 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$825.60 |
$825.60 |
$825.60 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$613.80 |
$613.80 |
$613.80 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$825.60 |
$825.60 |
$825.60 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$718.20 |
$718.20 |
$718.20 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$825.60 |
$825.60 |
$825.60 |
$473.00
|
|
Clsd tx wrist carpal fx without manip 25630
|
$825.60 |
$825.60 |
$825.60 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$825.60 |
$825.60 |
$825.60 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$729.60 |
$729.60 |
$729.60 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$825.60 |
$825.60 |
$825.60 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$3,184.20 |
$3,184.20 |
$3,184.20 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$729.60 |
$729.60 |
$729.60 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$825.60 |
$825.60 |
$825.60 |
$525.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$825.60 |
$825.60 |
$825.60 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$825.60 |
$825.60 |
$825.60 |
$2,384.00
|
|
Cltx mndblr fx w/mnpj
|
$3,349.80 |
$3,349.80 |
$3,349.80 |
$2,343.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$2,021.04
|
|
#cmvcul-virus inoculation shell
|
$8.40 |
$8.40 |
$8.40 |
$89.76
|
|
Cmv pcr-sendout
|
$860.40 |
$860.40 |
$860.40 |
$175.70
|
|
Co2 monitor per day
|
$990.60 |
$990.60 |
$990.60 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$32,266.20 |
$32,266.20 |
$32,266.20 |
$11,888.50
|
|
Coagulation time activated teg
|
$25.20 |
$25.20 |
$25.20 |
$52.47
|
|
Cold agglutinin titer
|
$100.20 |
$100.20 |
$100.20 |
$52.00
|
|
Colistimethate sodium inj
|
$129.00 |
$129.00 |
$129.00 |
$82.71
|
|
Collagen gel/paste wound fil
|
$3,434.40 |
$3,434.40 |
$3,434.40 |
$9.65
|
|
Collagen imp urinary 2.5 ml
|
$2,188.20 |
$2,188.20 |
$2,188.20 |
$1,949.63
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$258.60 |
$258.60 |
$258.60 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$10.20 |
$10.20 |
$10.20 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$135.00 |
$135.00 |
$135.00 |
$224.11
|
|
Collar cerv patriot adlt
|
$117.00 |
$117.00 |
$117.00 |
$134.66
|
|
Collection blood specimen from completely implantable venous access device
|
$162.00 |
$162.00 |
$162.00 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$162.00 |
$162.00 |
$162.00 |
$155.40
|
|
Colonoscopy (diagnostic)
|
$1,653.60 |
$1,653.60 |
$1,653.60 |
$1,899.00
|
|
Colonoscopy thru stoma spx
|
$3,156.60 |
$3,156.60 |
$3,156.60 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$3,252.60 |
$3,252.60 |
$3,252.60 |
$3,029.00
|
|
Colonoscopy w/control bleed
|
$3,252.60 |
$3,252.60 |
$3,252.60 |
$2,101.71
|
|
Colonoscopy/w endoscopic stent 45389
|
$6,529.80 |
$6,529.80 |
$6,529.80 |
$3,571.80
|
|
Colonoscopy (with biopsy)
|
$3,252.60 |
$3,252.60 |
$3,252.60 |
$2,214.00
|
|
Colonoscopy with biopsy
|
$3,252.60 |
$3,252.60 |
$3,252.60 |
$1,555.20
|
|
Colonoscopy (with polyp removal)
|
$3,252.60 |
$3,252.60 |
$3,252.60 |
$2,288.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,907.93
|
|
Compatibility test each unit antiglobulin technique
|
$433.20 |
$433.20 |
$433.20 |
$173.50
|
|
Compatibility test each unit electronic
|
$82.80 |
$82.80 |
$82.80 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$220.80 |
$220.80 |
$220.80 |
$169.52
|
|
Complement antigen each component c3
|
$148.20 |
$148.20 |
$148.20 |
$110.00
|
|
Complement fixation each
|
$100.20 |
$100.20 |
$100.20 |
$29.12
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$825.60 |
$825.60 |
$825.60 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$660.00 |
$660.00 |
$660.00 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$2,172.00 |
$2,172.00 |
$2,172.00 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$825.60 |
$825.60 |
$825.60 |
$508.44
|
|
Complx repair trunk addl 5cm/< 13102
|
$1,095.60 |
$1,095.60 |
$1,095.60 |
$537.00
|
|
Concentration infection agents any type
|
$76.80 |
$76.80 |
$76.80 |
$51.32
|
|
Condylomata destruction 56420
|
$589.80 |
$589.80 |
$589.80 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$1,375.20 |
$1,375.20 |
$1,375.20 |
$860.00
|
|
Consultation pathology during surgery
|
$159.00 |
$159.00 |
$159.00 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$176.40 |
$176.40 |
$176.40 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$211.80 |
$211.80 |
$211.80 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$276.00 |
$276.00 |
$276.00 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$737.40 |
$737.40 |
$737.40 |
$224.83
|
|
Consultation/report referred slides prepared elsewhere
|
$184.20 |
$184.20 |
$184.20 |
$176.28
|
|
Contrast baths charges
|
$103.20 |
$103.20 |
$103.20 |
$75.60
|
|
Contrast x-ray gallbladder
|
$719.40 |
$719.40 |
$719.40 |
$341.00
|
|
Contrast x-ray of ankle
|
$718.20 |
$718.20 |
$718.20 |
$684.00
|
|
Contrast x-ray of elbow
|
$718.20 |
$718.20 |
$718.20 |
$708.00
|
|
Contrast x-ray of hip
|
$718.20 |
$718.20 |
$718.20 |
$796.38
|
|
Contrast x-ray of knee joint
|
$718.20 |
$718.20 |
$718.20 |
$790.50
|
|
Contrast x-ray of wrist
|
$718.20 |
$718.20 |
$718.20 |
$667.50
|
|
Controller infinity pt dbs
|
$4,678.20 |
$4,678.20 |
$4,678.20 |
$4,836.44
|
|
Control nosebleed pack+caut 30905
|
$471.00 |
$471.00 |
$471.00 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$471.00 |
$471.00 |
$471.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$471.00 |
$471.00 |
$471.00 |
$352.80
|
|
Coombs direct
|
$70.20 |
$70.20 |
$70.20 |
$76.80
|
|
Coombs indirect titer reference
|
$306.00 |
$306.00 |
$306.00 |
$156.71
|
|
Copper intrauterine device
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$1,953.00
|
|
Core ndl bx lng/med perq
|
$2,911.80 |
$2,911.80 |
$2,911.80 |
$2,904.48
|
|
Cornea pre-cut midwest eye cornea pre-cut midwest eye
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$7,849.80
|
|
Coronary thrombolysis/iv infusion 92977
|
$477.60 |
$477.60 |
$477.60 |
$484.37
|
|
Cortisol total am
|
$273.00 |
$273.00 |
$273.00 |
$121.20
|
|
Cosyntropin 0.25 mg solution for injection
|
$594.40 |
$594.40 |
$594.40 |
$189.22
|
|
Co-treatment - group 15 mins, st
|
$91.20 |
$91.20 |
$91.20 |
$112.00
|
|
Counseling smoke cess interm >10mins
|
$50.40 |
$50.40 |
$50.40 |
$54.60
|
|
Coveredge 32 lead kit 40cm 48
|
$3,029.40 |
$3,029.40 |
$3,029.40 |
$4,180.79
|
|
Cover eye w/membrane
|
$14,438.40 |
$14,438.40 |
$14,438.40 |
$2,827.97
|
|
Covid-19 administration immunization im inj 1st/only component
|
$25.20 |
$25.20 |
$25.20 |
$49.13
|
|
Covid-19 IV infusion and post admin monitoring tocilizumab 2nd dose
|
$1,071.00 |
$1,071.00 |
$1,071.00 |
$540.00
|
|
#coxa-coxsackie a serotype a16
|
$93.00 |
$93.00 |
$93.00 |
$60.00
|
|
CPAP or BiPAP Setup (first day)
|
$172.20 |
$172.20 |
$172.20 |
$584.50
|
|
C-peptide
|
$348.60 |
$348.60 |
$348.60 |
$93.60
|
|
CPR (Cardiopulmonary Resuscitation)
|
$603.60 |
$603.60 |
$603.60 |
$777.71
|
|
Cr-51 sodium chromate
|
$417.60 |
$417.60 |
$417.60 |
$688.80
|
|
Crbrospnl fld flw imag cistern
|
$3,014.40 |
$3,014.40 |
$3,014.40 |
$1,330.02
|
|
C-reactive protein
|
$238.20 |
$238.20 |
$238.20 |
$69.36
|
