|
Clsd tx/clavicular fx without manip 23500
|
$52.85 |
$52.85 |
$581.99 |
$452.40
|
|
Clsd tx coccygeal fracture 27200
|
$43.40 |
$43.40 |
$286.90 |
$378.60
|
|
Clsd tx/dis phalan fx without manip/ea 26750
|
$67.03 |
$67.03 |
$517.10 |
$417.90
|
|
Clsd tx dist fib fx w/manip 27788
|
$121.98 |
$121.98 |
$575.33 |
$676.65
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$110.60 |
$110.60 |
$440.26 |
$473.00
|
|
Clsd tx elbow dislocation child 24640
|
$64.93 |
$64.93 |
$565.51 |
$465.21
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$705.60 |
$705.60 |
$2,778.91 |
$2,211.05
|
|
Clsd tx finger tendon w/wo perq pin 26432
|
$819.88 |
$819.88 |
$4,367.95 |
$2,630.50
|
|
Clsd tx fracture of radius 25500
|
$48.65 |
$48.65 |
$581.99 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$80.85 |
$80.85 |
$474.05 |
$373.15
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$52.68 |
$52.68 |
$764.75 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$118.83 |
$118.83 |
$567.08 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$473.20 |
$473.20 |
$1,320.57 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$52.15 |
$52.15 |
$638.99 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$283.33 |
$283.33 |
$1,379.01 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$43.40 |
$43.40 |
$387.39 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$102.55 |
$102.55 |
$657.52 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$48.48 |
$48.48 |
$650.51 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$113.75 |
$113.75 |
$593.27 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$84.88 |
$84.88 |
$1,978.91 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$121.63 |
$121.63 |
$777.86 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$43.40 |
$43.40 |
$439.41 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$97.83 |
$97.83 |
$399.04 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$65.98 |
$65.98 |
$657.22 |
$620.32
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$110.25 |
$110.25 |
$2,248.36 |
$3,839.54
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$48.48 |
$48.48 |
$522.78 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$52.85 |
$52.85 |
$418.20 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$110.95 |
$110.95 |
$3,474.95 |
$3,678.17
|
|
Clsd tx nose fx without manip 21310
|
$323.95 |
$323.95 |
$323.95 |
$323.95
|
|
Clsd tx of ankle fracture w/manip 28435
|
$258.65 |
$258.65 |
$1,947.75 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$173.78 |
$173.78 |
$748.39 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$75.60 |
$75.60 |
$612.52 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$80.85 |
$80.85 |
$479.44 |
$424.50
|
|
Clsd tx pelvic ring fx
|
$2,216.99 |
$2,216.99 |
$2,216.99 |
$660.40
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$545.30 |
$545.30 |
$2,870.01 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$45.50 |
$45.50 |
$550.27 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$112.00 |
$112.00 |
$517.10 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$653.45 |
$653.45 |
$1,868.38 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$94.68 |
$94.68 |
$629.56 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$180.08 |
$180.08 |
$2,110.45 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$249.03 |
$249.03 |
$742.58 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,316.31 |
$3,316.31 |
$3,316.31 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$2,086.57 |
$2,086.57 |
$2,086.57 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$70.35 |
$70.35 |
$445.15 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$43.40 |
$43.40 |
$662.02 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$72.10 |
$72.10 |
$735.14 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$754.95 |
$754.95 |
$1,602.79 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$57.75 |
$57.75 |
$443.43 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$648.34 |
$648.34 |
$648.34 |
$648.34
|
|
Clsd tx wrist carpal fx without manip 25630
|
$104.65 |
$104.65 |
$575.05 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$86.45 |
$86.45 |
$673.55 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$43.40 |
$43.40 |
$496.61 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$74.90 |
$74.90 |
$636.49 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$50.93 |
$50.93 |
$568.81 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$462.70 |
$462.70 |
$2,635.14 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$157.68 |
$157.68 |
$1,501.09 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$502.08 |
$502.08 |
$2,072.29 |
$2,274.40
|
|
Cltx hum epcndylr fx wo mnpj
|
$52.68 |
$52.68 |
$735.14 |
$525.75
|
|
Cltx humrl cndylr fx w/mnpj
|
$545.30 |
$545.30 |
$1,877.71 |
$1,851.78
|
|
Cltx humrl cndylr fx wo mnpj
|
$48.48 |
$48.48 |
$581.99 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$610.58 |
$610.58 |
$3,367.63 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$5,741.68 |
$5,741.68 |
$5,741.68 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$2,963.90 |
$2,963.90 |
$2,963.90 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$4,419.42 |
$4,419.42 |
$4,419.42 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$4,199.49 |
$4,199.49 |
$4,199.49 |
$4,377.24
|
|
Cltx post ankle fx
|
$111.48 |
$111.48 |
$339.17 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$94.68 |
$94.68 |
$661.84 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$94.68 |
$94.68 |
$1,271.75 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$94.68 |
$94.68 |
$804.79 |
$619.30
|
|
Cltx thigh fx
|
$110.60 |
$110.60 |
$1,996.56 |
$3,986.00
|
|
Cltx thigh fx w/mnpj
|
$989.98 |
$989.98 |
$989.98 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$4,040.04 |
$4,040.04 |
$4,040.04 |
$3,740.85
|
|
Cmbn ant pst colprhy
|
$5,194.98 |
$5,194.98 |
$5,194.98 |
$4,928.00
|
|
C motor evoked lwr limbs
|
$648.00 |
$648.00 |
$648.00 |
$627.89
|
|
C motor evoked uppr limbs
|
$677.30 |
$677.30 |
$677.30 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$922.79 |
$922.79 |
$922.79 |
$1,333.36
|
|
Cmptr ophth dx img ant segmt
|
$144.13 |
$144.13 |
$144.13 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$166.21 |
$166.21 |
$166.21 |
$98.00
|
|
#cms hgb-carboxyhemoglobin
|
$67.80 |
$67.80 |
$67.80 |
$61.60
|
|
#cms hgb-sulfhemoglobin
|
$21.53 |
$21.53 |
$75.58 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$124.00 |
$124.00 |
$124.00 |
$89.76
|
|
Cmv pcr-sendout
|
$173.25 |
$173.25 |
$568.11 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$7,487.95 |
$7,487.95 |
$7,487.95 |
$313.60
|
|
Co2 monitor per day
|
$450.60 |
$450.60 |
$450.60 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$26.45 |
$26.45 |
$764.40 |
$11,888.50
|
|
Coagulation time activated teg
|
$40.95 |
$40.95 |
$84.58 |
$52.47
|
|
Coagulation time otr method
|
$36.01 |
$36.01 |
$36.01 |
$20.00
|
|
Coch imp ext proc/contr rplc
|
$20,146.35 |
$20,146.35 |
$20,146.35 |
$17,034.00
|
|
Coch implant headset replace
|
$1,083.39 |
$1,083.39 |
$1,083.39 |
$1,064.00
|
|
Coch implant microphone repl
|
$1,083.39 |
$1,083.39 |
$1,083.39 |
$890.83
|
|
Coch implant tran cable repl
|
$434.37 |
$434.37 |
$434.37 |
$193.52
|
|
Coch implant trans coil repl
|
$1,359.90 |
$1,359.90 |
$1,359.90 |
$677.57
|
|
Cochlear implt f/up exam <7
|
$853.70 |
$853.70 |
$853.70 |
$423.87
|
|
Cochlear implt f/up exam 7/>
|
$552.29 |
$552.29 |
$552.29 |
$386.64
|
|
Cocm by rhc/fqhc 60 min mo
|
$85.42 |
$85.42 |
$85.42 |
$87.13
|
|
Cogenex amnio memb per sq cm
|
$0.01 |
$0.01 |
$0.01 |
$1.00
|
|
Cold agglutinin screen (arc)
|
$91.12 |
$91.12 |
$91.12 |
$48.10
|
|
Cold agglutinin titer
|
$78.30 |
$78.30 |
$78.30 |
$52.00
|
|
Colistimethate sodium inj
|
$1.69 |
$1.69 |
$103.76 |
$82.71
|
|
Collagenase, clost hist inj
|
$1,027.33 |
$1,027.33 |
$1,027.33 |
$12,906.28
|
