|
Clsd tx radius fracture w/manip 24655
|
$952.20 |
$952.20 |
$952.20 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$539.40 |
$539.40 |
$539.40 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$952.20 |
$952.20 |
$952.20 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$952.20 |
$952.20 |
$952.20 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,394.80 |
$3,394.80 |
$3,394.80 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$378.60 |
$378.60 |
$378.60 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$378.60 |
$378.60 |
$378.60 |
$400.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$960.60 |
$960.60 |
$960.60 |
$1,565.74
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$378.60 |
$378.60 |
$378.60 |
$496.61
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$576.00 |
$576.00 |
$576.00 |
$600.60
|
|
Cls tx of heel fracture w/manip 28405
|
$378.60 |
$378.60 |
$378.60 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$952.20 |
$952.20 |
$952.20 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$952.20 |
$952.20 |
$952.20 |
$1,815.75
|
|
Cltx lunate dislc w/mnpj
|
$952.20 |
$952.20 |
$952.20 |
$2,437.00
|
|
Cltx post ankle fx w/mnpj
|
$952.20 |
$952.20 |
$952.20 |
$1,893.86
|
|
Cltx thigh fx w/mnpj
|
$7,289.40 |
$7,289.40 |
$7,289.40 |
$3,503.71
|
|
Cmbn ant pst colprhy
|
$27,750.31 |
$27,750.31 |
$27,750.31 |
$4,928.00
|
|
#cmvcul-virus inoculation shell
|
$82.80 |
$82.80 |
$82.80 |
$100.80
|
|
Cmv pcr-sendout
|
$257.40 |
$257.40 |
$257.40 |
$177.50
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$59,010.00 |
$59,010.00 |
$67,440.00 |
$8,980.00
|
|
Coagulation time activated teg
|
$73.80 |
$73.80 |
$73.80 |
$53.72
|
|
Cocaine 4 % nasal solution
|
$1,918.62 |
$1,918.62 |
$2,393.43 |
$629.41
|
|
Coch imp ext proc/contr rplc
|
$74,907.69 |
$74,907.69 |
$74,907.69 |
$20,146.35
|
|
Coch implant microphone repl
|
$1,849.65 |
$1,849.65 |
$1,849.65 |
$977.17
|
|
Cold agglutinin titer
|
$45.60 |
$45.60 |
$45.60 |
$50.00
|
|
Colistimethate sodium inj
|
$232.60 |
$232.60 |
$260.31 |
$68.47
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$532.95 |
$532.95 |
$532.95 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$357.39 |
$357.39 |
$357.39 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$861.88 |
$861.88 |
$861.88 |
$213.89
|
|
Collar cerv patriot adlt
|
$590.69 |
$590.69 |
$590.69 |
$154.00
|
|
Collection blood specimen from completely implantable venous access device
|
$397.20 |
$397.20 |
$397.20 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$361.20 |
$361.20 |
$361.20 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$22.80 |
$22.80 |
$22.80 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$12,126.00 |
$12,126.00 |
$12,626.01 |
$1,899.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$8,104.57 |
$8,104.57 |
$9,012.43 |
$2,288.00
|
|
Colonoscopy submucous njx
|
$12,422.47 |
$12,422.47 |
$18,173.50 |
$2,080.00
|
|
Colonoscopy w/ablation
|
$14,364.34 |
$14,364.34 |
$14,364.34 |
$2,708.80
|
|
Colonoscopy w/control bleed
|
$8,222.18 |
$8,222.18 |
$8,222.18 |
$2,030.25
|
|
Colonoscopy w/fb removal
|
$6,490.80 |
$6,490.80 |
$6,490.80 |
$1,395.28
|
|
Colonoscopy (with biopsy)
|
$12,699.41 |
$12,699.41 |
$17,949.64 |
$2,080.00
|
|
Colonoscopy with biopsy
|
$5,562.66 |
$5,562.66 |
$5,562.66 |
$1,395.28
|
|
Colonoscopy (with polyp removal)
|
$11,253.80 |
$11,253.80 |
$12,726.85 |
$2,288.00
|
|
Colonoscopy w/resection
|
$17,708.85 |
$17,708.85 |
$17,708.85 |
$3,029.60
|
|
Colpopexy extraperitoneal
|
$42,989.65 |
$42,989.65 |
$46,347.40 |
$5,110.00
|
|
Colpopexy intraperitoneal
|
$34,215.58 |
$34,215.58 |
$34,215.58 |
$6,906.50
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$6,753.00 |
$6,753.00 |
$26,826.77 |
$3,762.53
|
|
Combination bilateral ho
|
$10,932.06 |
$10,932.06 |
$10,932.06 |
$4,575.46
|
|
Compatibility test each unit antiglobulin technique
|
$187.80 |
$187.80 |
$187.80 |
$170.05
|
|
Compatibility test each unit electronic
|
$128.40 |
$128.40 |
$128.40 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$121.20 |
$121.20 |
$121.20 |
$169.52
|
|
Compatibility test incubate
|
$136.80 |
$136.80 |
$136.80 |
$155.40
|
|
Complement antigen each component c3
|
$139.80 |
$139.80 |
$139.80 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$864.00 |
$864.00 |
$864.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$864.00 |
$864.00 |
$11,111.18 |
$1,191.78
|
|
Compl oph exam general anes
|
$14,077.85 |
$14,077.85 |
$14,077.85 |
$2,161.60
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$864.00 |
$864.00 |
$11,290.30 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$14,724.53 |
$14,724.53 |
$14,724.53 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$674.40 |
$674.40 |
$14,724.53 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$864.00 |
$864.00 |
$864.00 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$864.00 |
$864.00 |
$864.00 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$777.60 |
$777.60 |
$777.60 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$777.60 |
$777.60 |
$777.60 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$864.00 |
$864.00 |
$9,892.79 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$777.60 |
$777.60 |
$777.60 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$5,216.64 |
$5,216.64 |
$5,216.64 |
$1,350.27
|
|
Concentration infection agents any type
|
$173.40 |
$173.40 |
$173.40 |
$49.95
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$43,858.65 |
$43,858.65 |
$43,858.65 |
$3,322.20
|
|
Condylomata destruction 56420
|
$519.00 |
$519.00 |
$14,769.94 |
$469.00
|
|
Conization/cerv/loop electrode exc 57522
|
$10,691.10 |
$10,691.10 |
$10,691.10 |
$4,840.07
|
|
Conization of cervix
|
$11,321.72 |
$11,321.72 |
$11,321.72 |
$3,762.53
|
|
Conjugated estrogens 25 mg solution for injection
|
$3,131.87 |
$3,131.87 |
$3,504.98 |
$871.08
|
|
Connect omega .5mm
|
$18,334.55 |
$18,334.55 |
$18,334.55 |
$1,260.00
|
|
Connector tis 2x10mm
|
$19,386.84 |
$19,386.84 |
$19,386.84 |
$4,091.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,863.60 |
$1,863.60 |
$1,863.60 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$172.80 |
$172.80 |
$172.80 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$274.80 |
$274.80 |
$274.80 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$162.00 |
$162.00 |
$162.00 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$210.60 |
$210.60 |
$210.60 |
$171.65
|
|
Contour of face bone lesion
|
$10,359.45 |
$10,359.45 |
$10,359.45 |
$3,786.00
|
|
Contrast baths charges
|
$34.80 |
$34.80 |
$34.80 |
$70.50
|
|
Contrast exam abdominl aorta 75625-26
|
$4,657.20 |
$4,657.20 |
$4,657.20 |
$3,458.54
|
|
Contrast exam thoracic aorta 75605-26
|
$4,657.20 |
$4,657.20 |
$4,657.20 |
$3,728.24
|
|
Contrast x-ray of elbow
|
$615.00 |
$615.00 |
$615.00 |
$649.80
|
|
Contrast x-ray of hip
|
$645.60 |
$645.60 |
$645.60 |
$771.12
|
|
Controler lvad heartmate 3 includes ebb
|
$44,830.50 |
$44,830.50 |
$44,830.50 |
$13,218.75
|
|
Controller infinity pt dbs
|
$10,659.00 |
$10,659.00 |
$11,555.61 |
$4,611.60
|
|
Control nosebleed pack+caut 30905
|
$290.40 |
$290.40 |
$290.40 |
$392.60
|
|
Control of nosebleed ant comp 30903
|
$290.40 |
$290.40 |
$290.40 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$96.60 |
$96.60 |
$96.60 |
$355.50
|
|
Control oropharyngeal hemorr/simp 42960
|
$582.00 |
$582.00 |
$582.00 |
$634.80
|
|
Control throat bleeding
|
$7,041.00 |
$7,041.00 |
$7,041.00 |
$3,984.00
|
|
Conversion ext bil drg cath
|
$4,269.60 |
$4,269.60 |
$4,269.60 |
$4,176.15
|
|
Convert nephrostomy catheter
|
$2,076.00 |
$2,076.00 |
$2,076.00 |
$2,777.60
|
|
Coombs direct
|
$143.40 |
$143.40 |
$143.40 |
$75.00
|
|
Coombs indirect qualitative each reagent red cell reference
|
$377.40 |
$377.40 |
$377.40 |
$102.90
|
|
Copper cu 64 dotatate diag
|
$9,120.00 |
$9,120.00 |
$9,120.00 |
$2,417.86
|
|
Core ndl bx lng/med perq
|
$7,993.80 |
$7,993.80 |
$7,993.80 |
$2,678.00
|
|
Cor hlx vlgs double osteot
|
$40,362.06 |
$40,362.06 |
$40,362.06 |
$5,986.40
|
|
Cor hlx vlgs dstl mtar osteo
|
$33,368.40 |
$33,368.40 |
$33,368.40 |
$4,539.20
|
|
Cor hlx vlgs prx phlx osteot
|
$17,018.65 |
$17,018.65 |
$17,018.65 |
$4,627.00
|
