|
Clsd tx elbow dislocation child 24640
|
$205.50 |
$205.50 |
$205.50 |
$460.96
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$864.75 |
$864.75 |
$864.75 |
$2,184.00
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$66.60 |
$66.60 |
$66.60 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$87.30 |
$87.30 |
$87.30 |
$404.00
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$236.55 |
$236.55 |
$236.55 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$378.15 |
$378.15 |
$378.15 |
$1,642.71
|
|
Clsd tx fx radius/ulna without manip 25560
|
$185.25 |
$185.25 |
$185.25 |
$456.55
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$275.25 |
$275.25 |
$275.25 |
$1,592.00
|
|
Clsd tx hip disloc without anes 27265
|
$205.50 |
$205.50 |
$205.50 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$63.30 |
$63.30 |
$63.30 |
$534.00
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$233.25 |
$233.25 |
$233.25 |
$495.20
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$283.95 |
$283.95 |
$283.95 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$111.30 |
$111.30 |
$111.30 |
$497.90
|
|
Clsd tx/metatarsal fx without manip 28470
|
$66.60 |
$66.60 |
$66.60 |
$414.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$283.95 |
$283.95 |
$283.95 |
$3,648.50
|
|
Clsd tx of ankle fracture w/manip 28435
|
$283.95 |
$283.95 |
$283.95 |
$1,843.91
|
|
Clsd tx patella disloc without anes 27560
|
$205.50 |
$205.50 |
$205.50 |
$560.00
|
|
Clsd tx/patellar fx without manip 27520
|
$109.20 |
$109.20 |
$109.20 |
$466.14
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$245.85 |
$245.85 |
$245.85 |
$2,211.05
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$39.45 |
$39.45 |
$39.45 |
$397.60
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$63.30 |
$63.30 |
$63.30 |
$434.25
|
|
Clsd tx radius fracture w/manip 24655
|
$205.50 |
$205.50 |
$205.50 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$406.35 |
$406.35 |
$406.35 |
$1,815.75
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$723.45 |
$723.45 |
$723.45 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$637.35 |
$637.35 |
$637.35 |
$2,184.60
|
|
Clsd tx temporomandibular dislocat 21480
|
$205.50 |
$205.50 |
$205.50 |
$362.50
|
|
Clsd tx toe dislocation without anes28660
|
$72.75 |
$72.75 |
$72.75 |
$392.50
|
|
Clsd tx trimall ankle fx without manip 27816
|
$229.20 |
$229.20 |
$229.20 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$337.05 |
$337.05 |
$337.05 |
$1,565.74
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$191.10 |
$191.10 |
$191.10 |
$602.00
|
|
Cls tx of heel fracture w/manip 28405
|
$283.95 |
$283.95 |
$283.95 |
$716.95
|
|
Cltx carpl scphd fx w/mnpj
|
$283.95 |
$283.95 |
$283.95 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$211.95 |
$211.95 |
$211.95 |
$1,815.75
|
|
Cltx post ankle fx w/mnpj
|
$659.25 |
$659.25 |
$659.25 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$723.45 |
$723.45 |
$723.45 |
$2,030.33
|
|
Cltx thigh fx
|
$1,444.95 |
$1,444.95 |
$1,444.95 |
$3,958.50
|
|
C motor evoked lwr limbs
|
$413.85 |
$413.85 |
$413.85 |
$627.89
|
|
C motor evoked uppr limbs
|
$413.85 |
$413.85 |
$413.85 |
$824.67
|
|
C motor evoked upr&lwr limbs
|
$347.85 |
$347.85 |
$347.85 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$34.20 |
$34.20 |
$34.20 |
$91.00
|
|
Cmv pcr-sendout
|
$61.50 |
$61.50 |
$61.50 |
$172.25
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$2,155.62 |
$2,155.62 |
$11,735.79 |
$6,203.02
|
|
Coagulation time activated teg
|
$7.35 |
$7.35 |
$7.35 |
$53.55
|
|
Cold agglutinin titer
|
$13.95 |
$13.95 |
$13.95 |
$50.00
|
|
Colistimethate sodium inj
|
$68.47 |
$68.47 |
$68.47 |
$68.47
|
|
Collagen based wound filler
|
$4,635.84 |
$4,635.84 |
$4,635.84 |
$1,788.15
|
|
Collection blood specimen from completely implantable venous access device
|
$33.90 |
$33.90 |
$33.90 |
$157.80
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$25.50 |
$25.50 |
$25.50 |
$152.54
|
|
Collection of venous blood by venipuncture
|
$6.90 |
$6.90 |
$6.90 |
$21.00
|
|
Colonoscopy (with biopsy)
|
$484.05 |
$484.05 |
$484.05 |
$2,080.00
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$246.60 |
$246.60 |
$246.60 |
$1,030.40
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$37.20 |
$37.20 |
$37.20 |
$309.40
|
|
Colposcopy w/biopsy of cervix 57455
|
$61.65 |
$61.65 |
$61.65 |
$474.65
|
|
Compatibility test each unit antiglobulin technique
|
$62.25 |
$62.25 |
$62.25 |
$168.72
|
|
Compatibility test each unit electronic
|
$31.20 |
$31.20 |
$31.20 |
$176.70
|
|
Compatibility test each unit immediate spin technique
|
$62.25 |
$62.25 |
$62.25 |
$169.52
|
|
Comp cystometrogram/void presssure 51728
|
$300.15 |
$300.15 |
$300.15 |
$933.75
|
|
Complement antigen each component c3
|
$21.00 |
$21.00 |
$21.00 |
$110.40
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$416.40 |
$416.40 |
$416.40 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$424.65 |
$424.65 |
$424.65 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$47.10 |
$47.10 |
$47.10 |
$346.71
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$441.75 |
$441.75 |
$441.75 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$473.55 |
$473.55 |
$473.55 |
$1,193.40
|
|
Complx repair enel addl 5cm/< 13153
|
$417.00 |
$417.00 |
$417.00 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$429.00 |
$429.00 |
$429.00 |
$805.20
|
|
Complx repair fccmnaxghf 13132
|
$430.50 |
$430.50 |
$430.50 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$312.60 |
$312.60 |
$312.60 |
$532.40
|
|
Complx repair sal addl 5 cm/> 13122
|
$387.00 |
$387.00 |
$387.00 |
$506.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$387.00 |
$387.00 |
$387.00 |
$537.00
|
|
Concentration infection agents any type
|
$11.85 |
$11.85 |
$11.85 |
$49.95
|
|
Condylomata destruction 56420
|
$222.45 |
$222.45 |
$222.45 |
$469.80
|
|
Conjugated estrogens 25 mg solution for injection
|
$490.81 |
$490.81 |
$490.81 |
$871.08
|
|
Consultation pathology during surgery
|
$52.05 |
$52.05 |
$52.05 |
$97.29
|
|
Consultation pathology during surgery cytological exam initial site
|
$207.75 |
$207.75 |
$207.75 |
$434.60
|
|
Consultation pathology during surgery frozen section each additional block
|
$14.25 |
$14.25 |
$14.25 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$47.40 |
$47.40 |
$47.40 |
$223.86
|
|
Consultation/report referred material w/preparation of slides
|
$68.40 |
$68.40 |
$68.40 |
$223.19
|
|
Consult comp w/report rfrd material
|
$135.15 |
$135.15 |
$135.15 |
$352.50
|
|
Contrast baths charges
|
$17.40 |
$17.40 |
$17.40 |
$70.50
|
|
Contrast exam abdominl aorta 75625-26
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,401.31
|
|
Contrast exam thoracic aorta 75605-26
|
$1,357.80 |
$1,357.80 |
$1,357.80 |
$3,663.60
|
|
Contrast x-ray of elbow
|
$182.55 |
$182.55 |
$182.55 |
$637.14
|
|
Contrast x-ray of hip
|
$182.55 |
$182.55 |
$182.55 |
$752.76
|
|
Contrast x-ray of knee joint
|
$182.55 |
$182.55 |
$182.55 |
$722.40
|
|
Contrast x-ray of wrist
|
$182.55 |
$182.55 |
$182.55 |
$616.70
|
|
Controller infinity pt dbs
|
$2,177.91 |
$2,177.91 |
$2,177.91 |
$4,507.75
|
|
Control nosebleed pack+caut 30905
|
$245.85 |
$245.85 |
$245.85 |
$385.45
|
|
Control of nosebleed ant comp 30903
|
$211.95 |
$211.95 |
$211.95 |
$397.98
|
|
Control of nosebleedantersmpl 30901
|
$77.40 |
$77.40 |
$77.40 |
$342.24
|
|
Control oropharyngeal hemorr/simp 42960
|
$211.95 |
$211.95 |
$211.95 |
$624.78
|
|
Conversion ext bil drg cath
|
$1,105.80 |
$1,105.80 |
$1,105.80 |
$4,156.03
|
|
Convert nephrostomy catheter
|
$369.60 |
$369.60 |
$369.60 |
$2,777.60
|
|
Coombs direct
|
$16.65 |
$16.65 |
$16.65 |
$73.26
|
|
Coombs indirect titer reference
|
$44.85 |
$44.85 |
$44.85 |
$146.00
|
|
Core ndl bx lng/med perq
|
$667.95 |
$667.95 |
$667.95 |
$2,661.00
|
|
Coronary angio/cath placement bypass graft/lv gram/lt heart
|
$2,405.40 |
$2,405.40 |
$2,405.40 |
$10,540.92
|
|
Coronary angio/lv gram/lt heart
|
$2,405.40 |
$2,405.40 |
$2,405.40 |
$10,165.00
|
|
Coronary angio/lv gram/rt< heart
|
$2,576.70 |
$2,576.70 |
$2,576.70 |
$11,228.50
|
|
Coronary art/grft angio s&i
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$8,006.25
|
|
Coronary catheterization w/angiography supervision & interpretation
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$7,769.30
|