|
Clsd tx humeral fract without manip 24530
|
$400.00 |
$400.00 |
$400.00 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$406.40 |
$406.40 |
$406.40 |
$492.99
|
|
Clsd tx mandibular fx without manip 21450
|
$612.80 |
$612.80 |
$612.80 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$404.80 |
$404.80 |
$404.80 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$373.60 |
$373.60 |
$373.60 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$533.60 |
$533.60 |
$533.60 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$611.20 |
$611.20 |
$611.20 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$344.80 |
$344.80 |
$344.80 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,056.00 |
$3,056.00 |
$3,056.00 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,231.20 |
$1,231.20 |
$1,231.20 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$505.60 |
$505.60 |
$505.60 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$408.80 |
$408.80 |
$408.80 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$358.40 |
$358.40 |
$358.40 |
$424.50
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$384.00 |
$384.00 |
$384.00 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$388.00 |
$388.00 |
$388.00 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$344.00 |
$344.00 |
$344.00 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,221.60 |
$1,221.60 |
$1,221.60 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,127.20 |
$1,127.20 |
$1,127.20 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,873.60 |
$1,873.60 |
$1,873.60 |
$2,331.50
|
|
Clsd tx temporomandibular dislocat 21480
|
$454.40 |
$454.40 |
$454.40 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$415.20 |
$415.20 |
$415.20 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$499.20 |
$499.20 |
$499.20 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,129.60 |
$1,129.60 |
$1,129.60 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$348.00 |
$348.00 |
$348.00 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$518.40 |
$518.40 |
$518.40 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$368.80 |
$368.80 |
$368.80 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$423.20 |
$423.20 |
$423.20 |
$535.60
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$606.40 |
$606.40 |
$606.40 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$407.20 |
$407.20 |
$407.20 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$613.60 |
$613.60 |
$613.60 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$1,572.80 |
$1,572.80 |
$1,572.80 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,793.60 |
$1,793.60 |
$1,793.60 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$396.00 |
$396.00 |
$396.00 |
$525.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$443.20 |
$443.20 |
$443.20 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,502.40 |
$2,502.40 |
$2,502.40 |
$2,384.00
|
|
Cltx strnclav dislc w/mnpj
|
$229.60 |
$229.60 |
$229.60 |
$619.30
|
|
Collagen based wound filler
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$1,794.78
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$314.40 |
$314.40 |
$314.40 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$32.00 |
$32.00 |
$32.00 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$224.11 |
$224.11 |
$224.11 |
$224.11
|
|
Collection blood specimen from completely implantable venous access device
|
$121.60 |
$121.60 |
$121.60 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$124.00 |
$124.00 |
$124.00 |
$155.40
|
|
Colpocentesis 57020
|
$880.00 |
$880.00 |
$880.00 |
$4,232.80
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$4,592.80 |
$4,592.80 |
$4,592.80 |
$3,907.93
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$323.20 |
$323.20 |
$323.20 |
$314.00
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$980.80 |
$980.80 |
$980.80 |
$893.41
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$2,527.20 |
$2,527.20 |
$2,527.20 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,071.20 |
$1,071.20 |
$1,071.20 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,283.20 |
$1,283.20 |
$1,283.20 |
$1,212.00
|
|
Complx repair enel addl 5cm/< 13153
|
$789.60 |
$789.60 |
$789.60 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$811.20 |
$811.20 |
$811.20 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$1,255.20 |
$1,255.20 |
$1,255.20 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$725.60 |
$725.60 |
$725.60 |
$521.16
|
|
Complx repair sal addl 5 cm/> 13122
|
$658.40 |
$658.40 |
$658.40 |
$508.44
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$1,012.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$1,233.60 |
$1,233.60 |
$1,233.60 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$1,388.80 |
$1,388.80 |
$1,388.80 |
$1,350.27
|
|
Computed tomographic angiography head and neck with contrast
|
$3,008.00 |
$3,008.00 |
$3,008.00 |
$2,247.00
|
|
Condylomata destruction 56420
|
$389.60 |
$389.60 |
$389.60 |
$467.35
|
|
Consultation pathology during surgery cytological exam initial site
|
$1,336.00 |
$1,336.00 |
$1,336.00 |
$430.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$164.00 |
$164.00 |
$164.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$265.60 |
$265.60 |
$265.60 |
$226.50
|
|
Consultation/report referred material w/preparation of slides
|
$224.80 |
$224.80 |
$224.80 |
$224.83
|
|
Contrast baths charges
|
$132.00 |
$132.00 |
$132.00 |
$75.60
|
|
Contrast exam abdominl aorta 75625-26
|
$4,728.80 |
$4,728.80 |
$4,728.80 |
$3,480.00
|
|
Contrast exam thoracic aorta
|
$2,601.60 |
$2,601.60 |
$2,601.60 |
$3,616.90
|
|
Contrast exam thoracic aorta 75605-26
|
$4,795.20 |
$4,795.20 |
$4,795.20 |
$3,745.00
|
|
Contrast x-ray of elbow
|
$989.60 |
$989.60 |
$989.60 |
$708.00
|
|
Contrast x-ray of hip
|
$785.60 |
$785.60 |
$785.60 |
$796.38
|
|
Contrast x-ray of knee joint
|
$1,105.60 |
$1,105.60 |
$1,105.60 |
$790.50
|
|
Contrast x-ray of wrist
|
$927.20 |
$927.20 |
$927.20 |
$667.50
|
|
Controller infinity pt dbs
|
$2,464.00 |
$2,464.00 |
$2,464.00 |
$4,836.44
|
|
Control nosebleed pack+caut 30905
|
$335.20 |
$335.20 |
$335.20 |
$383.52
|
|
Control nose/throat bleeding w/pst nsl packs 42970
|
$260.00 |
$260.00 |
$260.00 |
$644.80
|
|
Control of nosebleed ant comp 30903
|
$320.00 |
$320.00 |
$320.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$333.60 |
$333.60 |
$333.60 |
$352.80
|
|
Control oropharyngeal hemorr/simp 42960
|
$2,567.20 |
$2,567.20 |
$2,567.20 |
$620.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$14,168.80 |
$14,168.80 |
$14,168.80 |
$10,695.40
|
|
Coronary angio/lv gram/lt heart
|
$15,180.80 |
$15,180.80 |
$15,180.80 |
$10,353.29
|
|
Coronary angio/lv gram/rt< heart
|
$16,595.20 |
$16,595.20 |
$16,595.20 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$11,132.00 |
$11,132.00 |
$11,132.00 |
$8,191.00
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$10,640.80 |
$10,640.80 |
$10,640.80 |
$7,988.40
|
|
Co-treatment - group 15 mins, st
|
$221.60 |
$221.60 |
$221.60 |
$112.00
|
|
Covid-19 convalescent plasma
|
$786.40 |
$786.40 |
$786.40 |
$590.80
|
|
CPAP or BiPAP Setup (first day)
|
$708.80 |
$708.80 |
$708.80 |
$584.50
|
|
CPR (Cardiopulmonary Resuscitation)
|
$899.20 |
$899.20 |
$899.20 |
$777.71
|
|
Crbrospnl fld flw imag cistern
|
$1,984.00 |
$1,984.00 |
$1,984.00 |
$1,330.02
|
|
Critical care each additional 30 minutes
|
$541.60 |
$541.60 |
$541.60 |
$686.86
|
|
Critical Care (first 30 to 74 minutes)
|
$2,851.20 |
$2,851.20 |
$2,851.20 |
$2,535.00
|
|
Cryoprecipitate each unit
|
$199.20 |
$199.20 |
$199.20 |
$144.78
|
|
Csf leakage imaging
|
$1,678.40 |
$1,678.40 |
$1,678.40 |
$1,564.11
|
|
CT 3d report other modality w/workstation
|
$785.60 |
$785.60 |
$785.60 |
$661.13
|
|
Cta lower extremity without & w/contrast (both sides)
|
$2,553.60 |
$2,553.60 |
$2,553.60 |
$1,986.77
|
|
CT Angiogram of Abdomen and Pelvis
|
$4,349.60 |
$4,349.60 |
$4,349.60 |
$2,839.85
|
|
CT Angiogram of the Abdomen
|
$3,160.00 |
$3,160.00 |
$3,160.00 |
$1,994.52
|
|
CT Angiogram of the Abdomen and Both Legs
|
$3,191.20 |
$3,191.20 |
$3,191.20 |
$1,909.90
|
|
CT Angiogram of the Chest (for blood clot)
|
$2,884.00 |
$2,884.00 |
$2,884.00 |
$1,915.30
|
|
CT Angiogram of the Head
|
$3,008.00 |
$3,008.00 |
$3,008.00 |
$1,940.00
|
|
CT Angiogram of the Neck
|
$3,191.20 |
$3,191.20 |
$3,191.20 |
$1,881.75
|