|
Clot factor xii hageman
|
$264.15 |
$264.15 |
$264.15 |
$126.39
|
|
Clot factor xiii fibrin scrn
|
$82.35 |
$82.35 |
$82.35 |
$51.91
|
|
Clsd ostomy pouch without barr
|
$1.33 |
$1.33 |
$1.33 |
$1.33
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$211.95 |
$211.95 |
$211.95 |
$700.00
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$279.90 |
$279.90 |
$279.90 |
$535.60
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$279.90 |
$279.90 |
$279.90 |
$509.60
|
|
Clsd tx clavicle dislocation without manip 23540
|
$194.40 |
$194.40 |
$194.40 |
$444.71
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,021.04
|
|
Clsd tx/clavicular fx without manip 23500
|
$211.95 |
$211.95 |
$211.95 |
$452.40
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$211.95 |
$211.95 |
$211.95 |
$426.82
|
|
Clsd tx dist fib fx w/manip 27788
|
$279.90 |
$279.90 |
$279.90 |
$691.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$279.90 |
$279.90 |
$279.90 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$279.90 |
$279.90 |
$279.90 |
$507.20
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,329.60
|
|
Clsd tx fracture of radius 25500
|
$256.95 |
$256.95 |
$256.95 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$194.40 |
$194.40 |
$194.40 |
$390.40
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$211.95 |
$211.95 |
$211.95 |
$480.48
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$279.90 |
$279.90 |
$279.90 |
$551.20
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,163.85 |
$1,163.85 |
$1,163.85 |
$1,776.04
|
|
Clsd tx fx radius/ulna without manip 25560
|
$279.90 |
$279.90 |
$279.90 |
$511.80
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$1,668.00
|
|
Clsd tx hip disloc without anes 27265
|
$256.95 |
$256.95 |
$256.95 |
$665.60
|
|
Clsd tx humeral fract without manip 24530
|
$279.90 |
$279.90 |
$279.90 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$279.90 |
$279.90 |
$279.90 |
$520.80
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$389.40 |
$389.40 |
$389.40 |
$944.80
|
|
Clsd tx mandibular fx without manip 21450
|
$523.95 |
$523.95 |
$523.95 |
$987.60
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$279.90 |
$279.90 |
$279.90 |
$519.12
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$279.90 |
$279.90 |
$279.90 |
$688.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$429.45 |
$429.45 |
$429.45 |
$580.30
|
|
Clsd tx/metatarsal fx without manip 28470
|
$279.90 |
$279.90 |
$279.90 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$4,616.10 |
$4,616.10 |
$4,616.10 |
$3,678.17
|
|
Clsd tx patella disloc without anes 27560
|
$279.90 |
$279.90 |
$279.90 |
$599.00
|
|
Clsd tx/patellar fx without manip 27520
|
$256.95 |
$256.95 |
$256.95 |
$495.80
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,322.60
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$211.95 |
$211.95 |
$211.95 |
$419.73
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$279.90 |
$279.90 |
$279.90 |
$470.08
|
|
Clsd tx radius fracture w/manip 24655
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$1,806.10
|
|
Clsd tx/scapular fx without manip 23570
|
$211.95 |
$211.95 |
$211.95 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,396.80 |
$1,396.80 |
$1,396.80 |
$1,893.86
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$1,790.00
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$2,422.40
|
|
Clsd tx temporomandibular dislocat 21480
|
$217.20 |
$217.20 |
$217.20 |
$450.24
|
|
Clsd tx toe dislocation without anes28660
|
$211.95 |
$211.95 |
$211.95 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$279.90 |
$279.90 |
$279.90 |
$515.20
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,163.85 |
$1,163.85 |
$1,163.85 |
$1,602.79
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$279.90 |
$279.90 |
$279.90 |
$469.20
|
|
Clsd tx wrist carpal fx without manip 25630
|
$256.95 |
$256.95 |
$256.95 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$279.90 |
$279.90 |
$279.90 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$256.95 |
$256.95 |
$256.95 |
$513.80
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$279.90 |
$279.90 |
$279.90 |
$636.49
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$256.95 |
$256.95 |
$256.95 |
$487.15
|
|
Cltx carpl scphd fx w/mnpj
|
$1,023.90 |
$1,023.90 |
$1,023.90 |
$2,090.40
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,317.60
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$1,877.71
|
|
Cltx lunate dislc w/mnpj
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,626.00
|
|
Cltx post ankle fx w/mnpj
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$2,172.80
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,327.55 |
$2,327.55 |
$2,327.55 |
$2,030.33
|
|
Cltx strnclav dislc w/mnpj
|
$500.70 |
$500.70 |
$500.70 |
$722.16
|
|
Cltx tmprmand dislc comp
|
$2,247.45 |
$2,247.45 |
$2,247.45 |
$3,986.00
|
|
C motor evoked upr&lwr limbs
|
$758.10 |
$758.10 |
$758.10 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$160.95 |
$160.95 |
$160.95 |
$102.40
|
|
Cmv pcr-sendout
|
$226.05 |
$226.05 |
$226.05 |
$172.25
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$7,332.48 |
$7,332.48 |
$7,332.48 |
$6.90
|
|
Coagulation time activated teg
|
$97.05 |
$97.05 |
$97.05 |
$52.00
|
|
Cocaine 4 % nasal solution
|
$529.20 |
$529.20 |
$529.20 |
$624.55
|
|
Cold agglutinin screen (arc)
|
$156.90 |
$156.90 |
$156.90 |
$45.00
|
|
Cold agglutinin titer
|
$34.50 |
$34.50 |
$34.50 |
$50.00
|
|
Colistimethate sodium inj
|
$35.27 |
$35.27 |
$35.27 |
$68.47
|
|
Collagen based wound filler
|
$3,108.00 |
$3,108.00 |
$3,108.00 |
$1,788.15
|
|
Collagen dressing <=16 sq in
|
$56.02 |
$56.02 |
$56.02 |
$42.50
|
|
Collagen drsg>16<=48 sq in
|
$3,348.00 |
$3,348.00 |
$3,348.00 |
$24.71
|
|
Collagen gel/paste wound fil
|
$9.65 |
$9.65 |
$9.65 |
$9.65
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$86.48 |
$86.48 |
$86.48 |
$52.78
|
|
Collar cerv ascend 172 reg
|
$136.56 |
$136.56 |
$136.56 |
$189.95
|
|
Collar cerv patriot adlt
|
$16.50 |
$16.50 |
$16.50 |
$154.00
|
|
Collar extrication adult univ
|
$1,370.20 |
$1,370.20 |
$1,370.20 |
$728.00
|
|
Collection blood specimen from completely implantable venous access device
|
$77.40 |
$77.40 |
$77.40 |
$159.60
|
|
Collection of venous blood by venipuncture
|
$23.85 |
$23.85 |
$23.85 |
$20.90
|
|
Coll-e-derm 1 sq cm
|
$342.21 |
$342.21 |
$342.21 |
$171.12
|
|
Colonoscopy (diagnostic)
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$1,899.00
|
|
Colonoscopy flex with decompression 45393
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy flex w/rem of tumor(s)/polyp(s)/lesion(s) by hot biopsy(s) forceps (rest meth ii cah)
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy stoma w/endo mucosal rescj 44403
|
$1,671.30 |
$1,671.30 |
$1,671.30 |
$1,645.43
|
|
Colonoscopy stoma w/snare 44394
|
$760.95 |
$760.95 |
$760.95 |
$1,645.43
|
|
Colonoscopy submucous njx
|
$760.95 |
$760.95 |
$760.95 |
$2,080.00
|
|
Colonoscopy thru stoma spx
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$2,064.92
|
|
Colonoscopy w/ablation
|
$760.95 |
$760.95 |
$760.95 |
$2,975.70
|
|
Colonoscopy w/balloon dilat
|
$760.95 |
$760.95 |
$760.95 |
$1,876.80
|
|
Colonoscopy w/band ligation
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy w/control bleed
|
$760.95 |
$760.95 |
$760.95 |
$2,139.80
|
|
Colonoscopy w/endoscope Ultrasound
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy w/endoscopic fnb
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy/w endoscopic stent 45389
|
$3,571.80 |
$3,571.80 |
$3,571.80 |
$4,075.50
|
|
Colonoscopy w/fb removal
|
$760.95 |
$760.95 |
$760.95 |
$1,764.60
|
|
Colonoscopy w/injection
|
$760.95 |
$760.95 |
$760.95 |
$2,495.25
|
|
Colonoscopy (with biopsy)
|
$760.95 |
$760.95 |
$760.95 |
$2,132.40
|
|
Colonoscopy with biopsy
|
$760.95 |
$760.95 |
$760.95 |
$1,645.43
|
|
Colonoscopy (with polyp removal)
|
$760.95 |
$760.95 |
$760.95 |
$2,472.75
|
|
Colonoscopy w/resection
|
$1,671.30 |
$1,671.30 |
$1,671.30 |
$3,245.23
|
|
Colonoscopy w/stent plcmt
|
$3,571.80 |
$3,571.80 |
$3,571.80 |
$5,824.00
|