|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$550.00 |
$550.00 |
$550.00 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$308.00 |
$308.00 |
$308.00 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$283.50 |
$283.50 |
$283.50 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,131.00 |
$2,131.00 |
$2,131.00 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$325.00 |
$325.00 |
$325.00 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$283.50 |
$283.50 |
$283.50 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$325.00 |
$325.00 |
$325.00 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$283.50 |
$283.50 |
$283.50 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$283.50 |
$283.50 |
$283.50 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$298.50 |
$298.50 |
$298.50 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$283.50 |
$283.50 |
$283.50 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,848.00 |
$1,848.00 |
$1,848.00 |
$1,893.86
|
|
Cltx hum epcndylr fx wo mnpj
|
$283.50 |
$283.50 |
$283.50 |
$520.80
|
|
Cltx mndblr fx w/mnpj
|
$2,095.50 |
$2,095.50 |
$2,095.50 |
$2,343.00
|
|
Cltx palatal/max fx wire fix
|
$4,226.50 |
$4,226.50 |
$4,226.50 |
$4,350.00
|
|
Cltx post ankle fx
|
$283.50 |
$283.50 |
$283.50 |
$483.60
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,208.00 |
$2,208.00 |
$2,208.00 |
$2,021.04
|
|
Cltx thigh fx w/mnpj
|
$4,490.00 |
$4,490.00 |
$4,490.00 |
$3,503.71
|
|
Cmbn ant pst colprhy
|
$2,159.92 |
$2,159.92 |
$2,159.92 |
$4,928.00
|
|
C motor evoked upr&lwr limbs
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$1,308.00
|
|
#cms hgb-sulfhemoglobin
|
$74.00 |
$74.00 |
$74.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$180.00 |
$180.00 |
$180.00 |
$100.80
|
|
Cmv pcr-sendout
|
$99.00 |
$99.00 |
$99.00 |
$177.50
|
|
Coagulation time activated teg
|
$14.00 |
$14.00 |
$14.00 |
$53.72
|
|
Cocaine hcl nasal (numbrino)
|
$309.45 |
$309.45 |
$309.45 |
$512.30
|
|
Cold agglutinin titer
|
$33.50 |
$33.50 |
$33.50 |
$50.00
|
|
Collagenase, clost hist inj
|
$10,707.85 |
$10,707.85 |
$10,707.85 |
$12,906.28
|
|
Collar cerv ascend 172 reg
|
$116.33 |
$116.33 |
$116.33 |
$213.89
|
|
Collection blood specimen from completely implantable venous access device
|
$164.50 |
$164.50 |
$164.50 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$184.00 |
$184.00 |
$184.00 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$18.00 |
$18.00 |
$18.00 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$1,234.00 |
$1,234.00 |
$1,234.00 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$691.50 |
$691.50 |
$691.50 |
$2,288.00
|
|
Colonoscopy submucous njx
|
$597.75 |
$597.75 |
$597.75 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$775.50 |
$775.50 |
$775.50 |
$2,708.80
|
|
Colonoscopy w/balloon dilat
|
$195.50 |
$195.50 |
$195.50 |
$1,645.43
|
|
Colonoscopy w/band ligation
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$2,080.80
|
|
Colonoscopy w/control bleed
|
$544.50 |
$544.50 |
$544.50 |
$2,030.25
|
|
Colonoscopy w/fb removal
|
$691.50 |
$691.50 |
$691.50 |
$1,395.28
|
|
Colonoscopy (with biopsy)
|
$1,027.50 |
$1,027.50 |
$1,027.50 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$1,375.50 |
$1,375.50 |
$1,375.50 |
$2,288.00
|
|
Colonoscopy w/resection
|
$727.00 |
$727.00 |
$727.00 |
$3,029.60
|
|
Colpocleisis (le forte type) 57120
|
$2,767.33 |
$2,767.33 |
$2,767.33 |
$5,419.00
|
|
Colpopexy extraperitoneal
|
$2,504.01 |
$2,504.01 |
$2,504.01 |
$5,110.00
|
|
Colpopexy intraperitoneal
|
$2,159.92 |
$2,159.92 |
$2,159.92 |
$6,906.50
|
|
Colposcopy/cervix/ conization 57461
|
$3,720.50 |
$3,720.50 |
$3,720.50 |
$3,744.41
|
|
Compatibility test each unit antiglobulin technique
|
$359.00 |
$359.00 |
$359.00 |
$170.05
|
|
Compatibility test each unit electronic
|
$87.00 |
$87.00 |
$87.00 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$359.00 |
$359.00 |
$359.00 |
$169.52
|
|
Compatibility test incubate
|
$185.00 |
$185.00 |
$185.00 |
$155.40
|
|
Comp cystometrogram/void presssure 51728
|
$832.50 |
$832.50 |
$832.50 |
$958.81
|
|
Comp cystometrogram/void/uret pres 51729
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,111.03
|
|
Complement antigen each component c3
|
$191.00 |
$191.00 |
$191.00 |
$108.55
|
|
Complex cystometrogram 51726
|
$420.00 |
$420.00 |
$420.00 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$467.00 |
$467.00 |
$467.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,984.00 |
$1,984.00 |
$1,984.00 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$248.00 |
$248.00 |
$248.00 |
$346.71
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$863.00 |
$863.00 |
$863.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$514.00 |
$514.00 |
$514.00 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$678.50 |
$678.50 |
$678.50 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$874.00 |
$874.00 |
$874.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$438.00 |
$438.00 |
$438.00 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$918.00 |
$918.00 |
$918.00 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$849.50 |
$849.50 |
$849.50 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$477.00 |
$477.00 |
$477.00 |
$537.00
|
|
Composite drsg <= 16 sq in
|
$8.00 |
$8.00 |
$8.00 |
$6.62
|
|
Composite graft/pri close/don area 15760
|
$2,371.50 |
$2,371.50 |
$2,371.50 |
$2,765.76
|
|
Concentration infection agents any type
|
$22.50 |
$22.50 |
$22.50 |
$49.95
|
|
Condylomata destruction 56420
|
$265.00 |
$265.00 |
$265.00 |
$469.00
|
|
Conization/cerv/loop electrode exc 57522
|
$818.50 |
$818.50 |
$818.50 |
$4,840.07
|
|
Consultation pathology during surgery
|
$90.50 |
$90.50 |
$90.50 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,265.00 |
$1,265.00 |
$1,265.00 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$74.50 |
$74.50 |
$74.50 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$882.00 |
$882.00 |
$882.00 |
$225.96
|
|
Consultation/report referred slides prepared elsewhere
|
$254.50 |
$254.50 |
$254.50 |
$171.65
|
|
Contact lens fitg aphakia 1
|
$513.50 |
$513.50 |
$513.50 |
$472.21
|
|
Contact lens fitg aphakia ou
|
$153.00 |
$153.00 |
$153.00 |
$170.00
|
|
Contrast baths charges
|
$40.50 |
$40.50 |
$40.50 |
$70.50
|
|
Contrast exam abdominl aorta 75625-26
|
$3,687.00 |
$3,687.00 |
$3,687.00 |
$3,458.54
|
|
Contrast exam thoracic aorta
|
$2,669.50 |
$2,669.50 |
$2,669.50 |
$3,648.84
|
|
Contrast exam thoracic aorta 75605-26
|
$4,687.50 |
$4,687.50 |
$4,687.50 |
$3,728.24
|
|
Contrast x-ray of ankle
|
$262.50 |
$262.50 |
$262.50 |
$612.30
|
|
Contrast x-ray of elbow
|
$248.00 |
$248.00 |
$248.00 |
$649.80
|
|
Contrast x-ray of hip
|
$909.00 |
$909.00 |
$909.00 |
$771.12
|
|
Contrast x-ray of knee joint
|
$736.50 |
$736.50 |
$736.50 |
$769.88
|
|
Contrast x-ray of wrist
|
$320.50 |
$320.50 |
$320.50 |
$637.00
|
|
Controller infinity pt dbs
|
$2,578.00 |
$2,578.00 |
$2,578.00 |
$4,611.60
|
|
Control nosebleed pack+caut 30905
|
$316.50 |
$316.50 |
$316.50 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$374.00 |
$374.00 |
$374.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$458.50 |
$458.50 |
$458.50 |
$355.50
|
|
Control oropharyngeal hemorr/simp 42960
|
$620.00 |
$620.00 |
$620.00 |
$634.80
|
|
Convert nephrostomy catheter
|
$2,215.50 |
$2,215.50 |
$2,215.50 |
$2,777.60
|
|
Coombs direct
|
$84.00 |
$84.00 |
$84.00 |
$75.00
|
|
Coombs indirect titer reference
|
$166.50 |
$166.50 |
$166.50 |
$146.40
|
|
Copper intrauterine device
|
$2,345.00 |
$2,345.00 |
$2,345.00 |
$1,953.00
|
