|
Clsd tx/scapular fx without manip 23570
|
$291.90 |
$291.90 |
$291.90 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$916.02 |
$916.02 |
$916.02 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$3,994.20 |
$3,994.20 |
$3,994.20 |
$2,466.40
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$4,192.86 |
$4,192.86 |
$4,192.86 |
$3,842.58
|
|
Clsd tx temporomandibular dislocat 21480
|
$614.04 |
$614.04 |
$614.04 |
$511.70
|
|
Clsd tx toe dislocation without anes28660
|
$291.90 |
$291.90 |
$291.90 |
$436.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$445.20 |
$445.20 |
$445.20 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,100.42 |
$2,100.42 |
$2,100.42 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$291.90 |
$291.90 |
$291.90 |
$487.80
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$299.88 |
$299.88 |
$299.88 |
$705.60
|
|
Clsd tx wrist carpal fx without manip 25630
|
$291.90 |
$291.90 |
$291.90 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$291.90 |
$291.90 |
$291.90 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$291.90 |
$291.90 |
$291.90 |
$579.88
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$291.90 |
$291.90 |
$291.90 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$291.90 |
$291.90 |
$291.90 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$291.90 |
$291.90 |
$291.90 |
$857.50
|
|
Cltx carpl scphd fx w/mnpj
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$291.90 |
$291.90 |
$291.90 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$291.90 |
$291.90 |
$291.90 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$7,520.94 |
$7,520.94 |
$7,520.94 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$1,955.10 |
$1,955.10 |
$1,955.10 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$4,122.30 |
$4,122.30 |
$4,122.30 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$4,122.30 |
$4,122.30 |
$4,122.30 |
$4,199.49
|
|
Cltx post ankle fx
|
$291.90 |
$291.90 |
$291.90 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$2,949.66 |
$2,949.66 |
$2,949.66 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$2,021.04 |
$2,021.04 |
$2,021.04 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$291.90 |
$291.90 |
$291.90 |
$722.16
|
|
Cltx thigh fx
|
$4,313.40 |
$4,313.40 |
$4,313.40 |
$3,881.76
|
|
C motor evoked lwr limbs
|
$537.60 |
$537.60 |
$537.60 |
$627.89
|
|
C motor evoked upr&lwr limbs
|
$793.80 |
$793.80 |
$793.80 |
$1,308.00
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$15,888.77 |
$15,888.77 |
$15,888.77 |
$2,950.68
|
|
Coagulation time activated teg
|
$105.84 |
$105.84 |
$105.84 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$884.18 |
$884.18 |
$884.18 |
$807.71
|
|
Colistimethate sodium inj
|
$82.71 |
$88.52 |
$88.52 |
$84.60
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$154.14 |
$154.14 |
$154.14 |
$66.69
|
|
Collar cerv adlt perfit ace extric
|
$49.90 |
$49.90 |
$49.90 |
$29.25
|
|
Collar cerv ascend 172 reg
|
$543.09 |
$543.09 |
$543.09 |
$241.88
|
|
Collar cerv patriot adlt
|
$268.74 |
$268.74 |
$268.74 |
$153.57
|
|
Collar extrication adult univ
|
$279.95 |
$279.95 |
$279.95 |
$567.53
|
|
Collection blood specimen from completely implantable venous access device
|
$198.24 |
$198.24 |
$198.24 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$153.30 |
$153.30 |
$153.30 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$108.36 |
$108.36 |
$108.36 |
$22.00
|
|
Colonoscopy (diagnostic)
|
$1,047.06 |
$1,047.06 |
$1,047.06 |
$1,612.62
|
|
Colonoscopy w/control bleed
|
$1,364.58 |
$1,364.58 |
$1,364.58 |
$2,101.71
|
|
Colpocentesis 57020
|
$6,528.48 |
$6,528.48 |
$6,528.48 |
$5,419.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$5,479.32 |
$5,479.32 |
$5,479.32 |
$3,907.93
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$292.32 |
$292.32 |
$292.32 |
$326.30
|
|
Colposcopy vulva 56820
|
$250.74 |
$250.74 |
$250.74 |
$295.20
|
|
Colpotomy drng of abscess 57010
|
$4,096.68 |
$4,096.68 |
$4,096.68 |
$3,744.41
|
|
Colpotomy w/exploration 57000
|
$4,096.68 |
$4,096.68 |
$4,096.68 |
$3,762.53
|
|
Compatibility test each unit antiglobulin technique
|
$488.88 |
$488.88 |
$488.88 |
$173.25
|
|
Compatibility test each unit electronic
|
$403.20 |
$403.20 |
$403.20 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$552.30 |
$552.30 |
$552.30 |
$169.52
|
|
Complement antigen each component c3
|
$363.30 |
$363.30 |
$363.30 |
$111.15
|
|
Complex cystometrogram 51726
|
$1,640.52 |
$1,640.52 |
$1,640.52 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$989.10 |
$989.10 |
$989.10 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$858.90 |
$858.90 |
$858.90 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$616.14 |
$616.14 |
$616.14 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$958.86 |
$958.86 |
$958.86 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,525.86 |
$1,525.86 |
$1,525.86 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$360.36 |
$360.36 |
$360.36 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$832.02 |
$832.02 |
$832.02 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$1,420.44 |
$1,420.44 |
$1,420.44 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$330.12 |
$330.12 |
$330.12 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$261.66 |
$261.66 |
$261.66 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$739.20 |
$739.20 |
$739.20 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$645.96 |
$645.96 |
$645.96 |
$683.25
|
|
Composite graft/pri close/don area 15760
|
$2,501.10 |
$2,501.10 |
$2,501.10 |
$2,692.80
|
|
Concentration infection agents any type
|
$9.66 |
$9.66 |
$9.66 |
$51.32
|
|
Condylomata destruction 56420
|
$861.84 |
$861.84 |
$861.84 |
$509.81
|
|
Conivaptan hcl
|
$4,997.82 |
$4,997.82 |
$4,997.82 |
$438.57
|
|
Conjugated estrogens 25 mg solution for injection
|
$2,728.54 |
$2,728.54 |
$2,728.54 |
$986.92
|
|
Connect omega .5mm
|
$2,063.25 |
$2,063.25 |
$2,063.25 |
$1,069.43
|
|
Connector tis 2x10mm
|
$4,727.06 |
$4,727.06 |
$4,727.06 |
$3,934.53
|
|
Consultation pathology during surgery cytological exam initial site
|
$154.14 |
$1,820.28 |
$1,820.28 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$269.64 |
$269.64 |
$269.64 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$614.88 |
$614.88 |
$614.88 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$610.26 |
$610.26 |
$610.26 |
$239.85
|
|
Consultation/report referred slides prepared elsewhere
|
$662.34 |
$662.34 |
$662.34 |
$176.15
|
|
Consult comp w/report rfrd material
|
$816.06 |
$816.06 |
$816.06 |
$359.87
|
|
Cont intraop neuro monitor
|
$341.88 |
$341.88 |
$341.88 |
$335.25
|
|
Contrast baths charges
|
$60.06 |
$60.06 |
$60.06 |
$75.35
|
|
Contrast exam abdominl aorta 75625-26
|
$7,103.46 |
$7,103.46 |
$7,103.46 |
$3,458.54
|
|
Contrast exam thoracic aorta
|
$4,596.90 |
$4,596.90 |
$4,596.90 |
$3,724.63
|
|
Contrast exam thoracic aorta 75605-26
|
$6,538.14 |
$6,538.14 |
$6,538.14 |
$4,178.00
|
|
Contrast x-ray gallbladder
|
$271.74 |
$271.74 |
$271.74 |
$312.00
|
|
Contrast x-ray of elbow
|
$637.14 |
$637.14 |
$637.14 |
$637.14
|
|
Contrast x-ray of hip
|
$2,160.90 |
$2,160.90 |
$2,160.90 |
$768.00
|
|
Contrast x-ray of knee joint
|
$1,294.86 |
$1,294.86 |
$1,294.86 |
$683.20
|
|
Contrast x-ray of wrist
|
$968.52 |
$968.52 |
$968.52 |
$623.50
|
|
Controler lvad heartmate 3 includes ebb
|
$11,451.13 |
$11,451.13 |
$11,451.13 |
$11,518.85
|
|
Controller infinity pt dbs
|
$6,148.80 |
$6,148.80 |
$6,148.80 |
$4,320.00
|
|
Control nosebleed pack+caut 30905
|
$1,035.30 |
$1,035.30 |
$1,035.30 |
$460.17
|
|
Control of nosebleed ant comp 30903
|
$204.54 |
$204.54 |
$204.54 |
$410.06
|
|
Control of nosebleedantersmpl 30901
|
$521.22 |
$521.22 |
$521.22 |
$385.45
|
|
Control oropharyngeal hemorr/simp 42960
|
$428.40 |
$428.40 |
$428.40 |
$618.80
|