|
Clsd tx fx radius/ulna dist w/manip 25605
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$930.00 |
$930.00 |
$930.00 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$993.00 |
$993.00 |
$993.00 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$1,272.60 |
$1,272.60 |
$1,272.60 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$759.00 |
$759.00 |
$759.00 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$759.00 |
$759.00 |
$759.00 |
$492.99
|
|
Clsd tx mandibular fx without manip 21450
|
$669.60 |
$669.60 |
$669.60 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$370.80 |
$370.80 |
$370.80 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$470.40 |
$470.40 |
$470.40 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$808.20 |
$808.20 |
$808.20 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$759.00 |
$759.00 |
$759.00 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$520.80 |
$520.80 |
$520.80 |
$429.00
|
|
Clsd tx of ankle fracture w/manip 28435
|
$2,440.80 |
$2,440.80 |
$2,440.80 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$1,225.20 |
$1,225.20 |
$1,225.20 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$759.00 |
$759.00 |
$759.00 |
$498.85
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$2,322.60 |
$2,322.60 |
$2,322.60 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$366.60 |
$366.60 |
$366.60 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$370.80 |
$370.80 |
$370.80 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$496.20 |
$496.20 |
$496.20 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,184.60 |
$2,184.60 |
$2,184.60 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$1,225.20 |
$1,225.20 |
$1,225.20 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$520.80 |
$520.80 |
$520.80 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$488.40 |
$488.40 |
$488.40 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$445.80 |
$445.80 |
$445.80 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$759.00 |
$759.00 |
$759.00 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$370.80 |
$370.80 |
$370.80 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$520.80 |
$520.80 |
$520.80 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$597.60 |
$597.60 |
$597.60 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$520.80 |
$520.80 |
$520.80 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$494.40 |
$494.40 |
$494.40 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$759.00 |
$759.00 |
$759.00 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$2,440.80 |
$2,440.80 |
$2,440.80 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$856.20 |
$856.20 |
$856.20 |
$525.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$759.00 |
$759.00 |
$759.00 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,055.00 |
$2,055.00 |
$2,055.00 |
$2,384.00
|
|
Cltx post ankle fx
|
$1,642.80 |
$1,642.80 |
$1,642.80 |
$497.00
|
|
C motor evoked lwr limbs
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$627.89
|
|
C motor evoked uppr limbs
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$2,029.20 |
$2,029.20 |
$2,029.20 |
$1,333.36
|
|
#cmvcul-virus inoculation shell
|
$109.80 |
$109.80 |
$109.80 |
$89.76
|
|
Cmv pcr-sendout
|
$195.60 |
$195.60 |
$195.60 |
$175.70
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$8,040.00 |
$8,040.00 |
$8,040.00 |
$11,888.50
|
|
Coagulation time activated teg
|
$13.20 |
$13.20 |
$13.20 |
$52.47
|
|
Cocaine hcl nasal (numbrino)
|
$84.60 |
$84.60 |
$84.60 |
$512.30
|
|
Cold agglutinin screen (arc)
|
$45.00 |
$45.00 |
$45.00 |
$48.10
|
|
Cold agglutinin titer
|
$45.00 |
$45.00 |
$45.00 |
$52.00
|
|
Colistimethate sodium inj
|
$16.80 |
$16.80 |
$16.80 |
$82.71
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$188.40 |
$188.40 |
$188.40 |
$303.73
|
|
Collection blood specimen from completely implantable venous access device
|
$155.40 |
$155.40 |
$155.40 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$537.00 |
$537.00 |
$537.00 |
$155.40
|
|
Colonoscopy w/control bleed
|
$2,019.60 |
$2,019.60 |
$2,019.60 |
$2,101.71
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$6,660.60 |
$6,660.60 |
$6,660.60 |
$3,907.93
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$378.00 |
$378.00 |
$378.00 |
$314.00
|
|
Colposcopy vulva 56820
|
$378.00 |
$378.00 |
$378.00 |
$333.20
|
|
Colposcopy w/biopsy of cervix 57455
|
$615.60 |
$615.60 |
$615.60 |
$485.50
|
|
Compatibility test each unit antiglobulin technique
|
$203.40 |
$203.40 |
$203.40 |
$173.50
|
|
Compatibility test each unit electronic
|
$203.40 |
$203.40 |
$203.40 |
$171.00
|
|
Compatibility test each unit immediate spin technique
|
$203.40 |
$203.40 |
$203.40 |
$169.52
|
|
Complement antigen each component c3
|
$66.60 |
$66.60 |
$66.60 |
$110.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,927.80 |
$1,927.80 |
$1,927.80 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,357.20 |
$1,357.20 |
$1,357.20 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,332.60 |
$1,332.60 |
$1,332.60 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$319.20 |
$319.20 |
$319.20 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$911.40 |
$911.40 |
$911.40 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,212.00 |
$1,212.00 |
$1,212.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$828.60 |
$828.60 |
$828.60 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,927.80 |
$1,927.80 |
$1,927.80 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$741.60 |
$741.60 |
$741.60 |
$537.00
|
|
Concentration infection agents any type
|
$38.40 |
$38.40 |
$38.40 |
$51.32
|
|
Condylomata destruction 56420
|
$831.60 |
$831.60 |
$831.60 |
$467.35
|
|
Conjugated estrogens 25 mg solution for injection
|
$220.80 |
$220.80 |
$220.80 |
$860.00
|
|
Consultation pathology during surgery
|
$78.60 |
$78.60 |
$78.60 |
$100.89
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,472.40 |
$1,472.40 |
$1,472.40 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$112.20 |
$112.20 |
$112.20 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$337.20 |
$337.20 |
$337.20 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$116.40 |
$116.40 |
$116.40 |
$224.83
|
|
Consultation/report referred slides prepared elsewhere
|
$78.60 |
$78.60 |
$78.60 |
$176.28
|
|
Contrast exam abdominl aorta 75625-26
|
$5,906.40 |
$5,906.40 |
$5,906.40 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$5,906.40 |
$5,906.40 |
$5,906.40 |
$3,616.90
|
|
Contrast exam thoracic aorta 75605-26
|
$9,796.20 |
$9,796.20 |
$9,796.20 |
$3,745.00
|
|
Contrast x-ray gallbladder
|
$427.80 |
$427.80 |
$427.80 |
$341.00
|
|
Contrast x-ray of ankle
|
$896.40 |
$896.40 |
$896.40 |
$684.00
|
|
Contrast x-ray of elbow
|
$814.20 |
$814.20 |
$814.20 |
$708.00
|
|
Contrast x-ray of hip
|
$814.20 |
$814.20 |
$814.20 |
$796.38
|
|
Contrast x-ray of knee joint
|
$896.40 |
$896.40 |
$896.40 |
$790.50
|
|
Contrast x-ray of wrist
|
$896.40 |
$896.40 |
$896.40 |
$667.50
|
|
Control nosebleed pack+caut 30905
|
$992.40 |
$992.40 |
$992.40 |
$383.52
|
|
Control of nosebleed ant comp 30903
|
$896.40 |
$896.40 |
$896.40 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$520.80 |
$520.80 |
$520.80 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$1,349.40 |
$1,349.40 |
$1,349.40 |
$620.00
|
|
Conversion ext bil drg cath
|
$7,502.40 |
$7,502.40 |
$7,502.40 |
$4,122.00
|
