|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$211.95 |
$211.95 |
$798.36 |
$464.20
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$279.90 |
$279.90 |
$674.18 |
$541.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,163.85 |
$1,163.85 |
$2,053.56 |
$1,726.01
|
|
Clsd tx fx radius/ulna without manip 25560
|
$279.90 |
$279.90 |
$715.30 |
$488.88
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$1,396.80 |
$1,396.80 |
$1,827.71 |
$1,592.00
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$424.50 |
$424.50 |
$424.50 |
$452.00
|
|
Clsd tx hip disloc without anes 27265
|
$256.95 |
$256.95 |
$889.94 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$279.90 |
$279.90 |
$623.93 |
$577.20
|
|
Clsd tx humerus fract without manip 24500
|
$279.90 |
$279.90 |
$466.10 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$389.40 |
$389.40 |
$2,226.22 |
$883.00
|
|
Clsd tx mandibular fx without manip 21450
|
$523.95 |
$523.95 |
$523.95 |
$987.60
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$424.50 |
$424.50 |
$424.50 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$279.90 |
$279.90 |
$519.12 |
$498.85
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$279.90 |
$279.90 |
$908.24 |
$620.32
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$429.45 |
$429.45 |
$580.30 |
$522.78
|
|
Clsd tx/metatarsal fx without manip 28470
|
$279.90 |
$279.90 |
$279.90 |
$429.00
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$3,678.17 |
$3,678.17 |
$4,616.10 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,843.91 |
$1,843.91 |
$2,327.55 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$279.90 |
$279.90 |
$814.21 |
$573.52
|
|
Clsd tx/patellar fx without manip 27520
|
$256.95 |
$256.95 |
$600.60 |
$498.85
|
|
Clsd tx pelvic ring fx
|
$241.88 |
$241.88 |
$424.50 |
$424.50
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,650.90 |
$1,650.90 |
$3,028.68 |
$2,222.00
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$211.95 |
$211.95 |
$491.88 |
$414.40
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$279.90 |
$279.90 |
$279.90 |
$466.14
|
|
Clsd tx radius fracture w/manip 24655
|
$1,782.86 |
$1,782.86 |
$2,327.55 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$211.95 |
$211.95 |
$658.00 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,396.80 |
$1,396.80 |
$2,066.17 |
$1,828.80
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,797.83 |
$1,797.83 |
$2,327.55 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,408.80 |
$1,408.80 |
$3,062.63 |
$2,331.50
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$3,848.69 |
$3,848.69 |
$3,848.69 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$217.20 |
$217.20 |
$512.40 |
$424.38
|
|
Clsd tx toe dislocation without anes28660
|
$211.95 |
$211.95 |
$598.58 |
$412.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$279.90 |
$279.90 |
$713.23 |
$489.60
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,163.85 |
$1,163.85 |
$1,565.74 |
$1,592.00
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$279.90 |
$279.90 |
$593.29 |
$473.00
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$408.15 |
$408.15 |
$408.15 |
$648.34
|
|
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 |
$543.23 |
$535.60
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$256.95 |
$256.95 |
$256.95 |
$490.00
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$279.90 |
$279.90 |
$705.55 |
$612.80
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$256.95 |
$256.95 |
$256.95 |
$487.15
|
|
Cls tx of heel fracture w/manip 28405
|
$1,650.90 |
$1,650.90 |
$5,766.26 |
$725.40
|
|
Cltx carpl scphd fx w/mnpj
|
$1,023.90 |
$1,023.90 |
$2,128.12 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,650.90 |
$1,650.90 |
$1,650.90 |
$2,274.40
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,534.94 |
$1,534.94 |
$2,327.55 |
$1,851.78
|
|
Cltx lunate dislc w/mnpj
|
$1,650.90 |
$1,650.90 |
$2,952.64 |
$2,384.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$5,807.49 |
$5,807.49 |
$5,807.49 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$3,847.80 |
$3,847.80 |
$3,847.80 |
$2,343.00
|
|
Cltx mndblr/max alv ridge fx
|
$4,811.92 |
$4,811.92 |
$4,811.92 |
$3,986.00
|
|
Cltx palatal/max fx wire fix
|
$4,377.24 |
$4,377.24 |
$4,377.24 |
$4,377.24
|
|
Cltx post ankle fx w/mnpj
|
$2,621.81 |
$2,621.81 |
$2,621.81 |
$1,939.00
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,050.29 |
$2,050.29 |
$2,327.55 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$500.70 |
$500.70 |
$722.16 |
$619.30
|
|
Cltx thigh fx w/mnpj
|
$3,503.71 |
$3,503.71 |
$3,503.71 |
$3,276.70
|
|
Cltx tmprmand dislc comp
|
$2,247.45 |
$2,247.45 |
$3,445.34 |
$3,740.85
|
|
C motor evoked lwr limbs
|
$621.00 |
$621.00 |
$621.00 |
$627.89
|
|
C motor evoked uppr limbs
|
$649.09 |
$649.09 |
$649.09 |
$859.50
|
|
C motor evoked upr&lwr limbs
|
$1,568.20 |
$1,568.20 |
$1,568.20 |
$1,333.36
|
|
Cmptr ophth dx img ant segmt
|
$130.41 |
$130.41 |
$130.41 |
$83.20
|
|
Cmptr ophth img optic nerve
|
$207.29 |
$207.29 |
$207.29 |
$98.00
|
|
#cms hgb-sulfhemoglobin
|
$75.58 |
$75.58 |
$75.58 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$133.00 |
$133.00 |
$162.36 |
$89.76
|
|
Cmv pcr-sendout
|
$226.05 |
$226.05 |
$786.79 |
$175.70
|
|
Cnbp gene detc abnor allele
|
$7,487.95 |
$7,487.95 |
$7,487.95 |
$313.60
|
|
Co2 monitor per day
|
$483.66 |
$483.66 |
$555.00 |
$459.20
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$26.45 |
$26.45 |
$7,332.48 |
$11,888.50
|
|
Coagulation time activated teg
|
$99.66 |
$99.66 |
$113.70 |
$52.47
|
|
Cocaine 4 % nasal solution
|
$529.20 |
$529.20 |
$529.20 |
$630.04
|
|
Cocm by rhc/fqhc 60 min mo
|
$87.13 |
$87.13 |
$87.13 |
$87.13
|
|
Cogenex amnio memb per sq cm
|
$0.01 |
$0.01 |
$0.01 |
$1.00
|
|
Cold agglutinin screen (arc)
|
$128.26 |
$128.26 |
$156.90 |
$48.10
|
|
Cold agglutinin titer
|
$83.66 |
$83.66 |
$209.85 |
$52.00
|
|
Colistimethate sodium inj
|
$35.27 |
$35.27 |
$103.76 |
$82.71
|
|
Collagen based wound filler
|
$1,096.43 |
$1,096.43 |
$3,108.00 |
$1,794.78
|
|
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 |
$25.75
|
|
Collagen gel/paste wound fil
|
$9.65 |
$9.65 |
$9.65 |
$9.65
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$236.29 |
$236.29 |
$371.85 |
$303.73
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$86.48 |
$86.48 |
$482.43 |
$61.20
|
|
Collar cerv ascend 172 reg
|
$136.56 |
$136.56 |
$286.37 |
$224.11
|
|
Collar cerv patriot adlt
|
$16.50 |
$16.50 |
$16.50 |
$134.66
|
|
Collar extrication adult univ
|
$907.63 |
$907.63 |
$1,370.20 |
$766.23
|
|
Collection blood specimen from completely implantable venous access device
|
$202.31 |
$202.31 |
$202.31 |
$162.00
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$192.03 |
$192.03 |
$192.03 |
$155.40
|
|
Coll-e-derm 1 sq cm
|
$342.21 |
$342.21 |
$342.21 |
$1.00
|
|
Collj & interpj data ea 30 d
|
$174.20 |
$174.20 |
$174.20 |
$172.35
|
|
Colonoscopy (diagnostic)
|
$1,899.00 |
$1,899.00 |
$1,899.00 |
$1,899.00
|
|
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/snare 44394
|
$760.95 |
$760.95 |
$760.95 |
$1,395.28
|
|
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 |
$1,899.00
|
|
Colonoscopy w/ablation
|
$760.95 |
$760.95 |
$760.95 |
$3,029.00
|
|
Colonoscopy w/balloon dilat
|
$760.95 |
$760.95 |
$760.95 |
$1,681.30
|
|
Colonoscopy w/band ligation
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy w/control bleed
|
$760.95 |
$760.95 |
$760.95 |
$2,101.71
|
|
Colonoscopy w/endoscope Ultrasound
|
$760.95 |
$760.95 |
$760.95 |
$2,288.00
|
|
Colonoscopy w/endoscopic fnb
|
$760.95 |
$760.95 |
$760.95 |
$2,004.81
|
|
Colonoscopy/w endoscopic stent 45389
|
$3,571.80 |
$3,571.80 |
$3,571.80 |
$3,571.80
|
|
Colonoscopy w/fb removal
|
$760.95 |
$760.95 |
$760.95 |
$1,645.43
|
|
Colonoscopy (with biopsy)
|
$760.95 |
$760.95 |
$760.95 |
$2,214.00
|
