|
Clsd tx radius fracture w/manip 24655
|
$8,546.69 |
$8,546.69 |
$8,546.69 |
$1,884.74
|
|
Clsd tx/scapular fx without manip 23570
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$454.50
|
|
Clsd tx shoulder dislc/fx 23665
|
$8,546.69 |
$8,546.69 |
$8,546.69 |
$2,055.00
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,828.80
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$10,650.84 |
$10,650.84 |
$10,650.84 |
$2,466.40
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$16,720.23 |
$16,720.23 |
$16,720.23 |
$3,842.58
|
|
Clsd tx temporomandibular dislocat 21480
|
$3,493.81 |
$3,493.81 |
$3,493.81 |
$511.70
|
|
Clsd tx toe dislocation without anes28660
|
$1,924.32 |
$1,924.32 |
$1,924.32 |
$436.70
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$594.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,707.42
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$487.80
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$705.60
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,348.71 |
$1,348.71 |
$1,348.71 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$1,361.97 |
$1,361.97 |
$1,361.97 |
$543.23
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$1,814.51 |
$1,814.51 |
$1,814.51 |
$579.88
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$692.03
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$494.40
|
|
Cls tx of heel fracture w/manip 28405
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$857.50
|
|
Cltx carpl scphd fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,316.80
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,558.00
|
|
Cltx hum epcndylr fx wo mnpj
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$523.25
|
|
Cltx humrl cndylr fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$1,893.86
|
|
Cltx humrl cndylr fx wo mnpj
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$563.00
|
|
Cltx lunate dislc w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,893.80
|
|
Cltx mndblr fx ntrdntl fixj
|
$30,179.24 |
$30,179.24 |
$30,179.24 |
$6,776.64
|
|
Cltx mndblr fx w/mnpj
|
$15,981.75 |
$15,981.75 |
$15,981.75 |
$2,503.20
|
|
Cltx mndblr/max alv ridge fx
|
$16,435.01 |
$16,435.01 |
$16,435.01 |
$3,990.33
|
|
Cltx palatal/max fx wire fix
|
$16,435.01 |
$16,435.01 |
$16,435.01 |
$4,199.49
|
|
Cltx post ankle fx
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$497.00
|
|
Cltx post ankle fx w/mnpj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,621.64
|
|
Cltx scap fx w/mnpj +-tractj
|
$8,627.31 |
$8,627.31 |
$8,627.31 |
$2,320.50
|
|
Cltx strnclav dislc w/mnpj
|
$1,320.65 |
$1,320.65 |
$1,320.65 |
$722.16
|
|
Cltx thigh fx
|
$16,720.23 |
$16,720.23 |
$16,720.23 |
$3,881.76
|
|
Cltx tmprmand dislc comp
|
$8,243.52 |
$8,243.52 |
$8,243.52 |
$3,986.00
|
|
C motor evoked lwr limbs
|
$4,269.97 |
$4,269.97 |
$4,269.97 |
$627.89
|
|
C motor evoked uppr limbs
|
$7,445.42 |
$7,445.42 |
$7,445.42 |
$780.00
|
|
C motor evoked upr&lwr limbs
|
$1,838.48 |
$1,838.48 |
$1,838.48 |
$1,308.00
|
|
#cmvcul-virus inoculation shell
|
$1,486.48 |
$1,486.48 |
$1,486.48 |
$102.57
|
|
Cmv pcr-sendout
|
$602.67 |
$602.67 |
$602.67 |
$173.25
|
|
Coagulation time activated teg
|
$396.06 |
$396.06 |
$396.06 |
$50.05
|
|
Cocaine 4 % nasal solution
|
$737.60 |
$737.60 |
$737.60 |
$807.71
|
|
Cochlear implt f/up exam <7
|
$1,103.72 |
$1,103.72 |
$1,103.72 |
$369.60
|
|
Cochlear implt f/up exam 7/>
|
$1,103.72 |
$1,103.72 |
$1,103.72 |
$345.60
|
|
Cold agglutinin screen (arc)
|
$243.03 |
$243.03 |
$243.03 |
$47.19
|
|
Cold agglutinin titer
|
$314.63 |
$314.63 |
$314.63 |
$48.57
|
|
Collection blood specimen from completely implantable venous access device
|
$261.45 |
$261.45 |
$261.45 |
$164.50
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$411.82 |
$411.82 |
$411.82 |
$170.68
|
|
Collection of venous blood by venipuncture
|
$64.18 |
$64.18 |
$64.18 |
$22.00
|
|
Colonoscopy (diagnostic)
|
$8,607.73 |
$8,607.73 |
$8,607.73 |
$1,612.62
|
|
Colonoscopy submucous njx
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,063.25
|
|
Colonoscopy w/ablation
|
$8,621.61 |
$8,621.61 |
$8,621.61 |
$2,571.00
|
|
Colonoscopy w/balloon dilat
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$1,645.43
|
|
Colonoscopy w/control bleed
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,101.71
|
|
Colonoscopy (with biopsy)
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,512.42
|
|
Colonoscopy (with polyp removal)
|
$8,895.96 |
$8,895.96 |
$8,895.96 |
$2,205.33
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$4,018.10 |
$4,018.10 |
$4,018.10 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$16,095.68 |
$16,095.68 |
$16,095.68 |
$3,519.29
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$2,152.71 |
$2,152.71 |
$2,152.71 |
$326.30
|
|
Colposcopy vulva 56820
|
$1,859.17 |
$1,859.17 |
$1,859.17 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$3,085.00 |
$3,085.00 |
$3,085.00 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$3,572.10 |
$3,572.10 |
$3,572.10 |
$544.70
|
|
Compatibility test each unit antiglobulin technique
|
$329.67 |
$329.67 |
$329.67 |
$173.25
|
|
Compatibility test each unit electronic
|
$257.49 |
$257.49 |
$257.49 |
$180.00
|
|
Compatibility test each unit immediate spin technique
|
$245.22 |
$245.22 |
$245.22 |
$169.52
|
|
Comp cystometrogram/void presssure 51728
|
$3,696.58 |
$3,696.58 |
$3,696.58 |
$958.81
|
|
Comp cystometrogram/void/uret pres 51729
|
$3,836.42 |
$3,836.42 |
$3,836.42 |
$1,099.00
|
|
Complement antigen each component c3
|
$478.51 |
$478.51 |
$478.51 |
$111.15
|
|
Complement fixation each
|
$114.76 |
$114.76 |
$114.76 |
$24.00
|
|
Complex cystometrogram 51726
|
$1,161.93 |
$1,161.93 |
$1,161.93 |
$727.35
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$3,562.63 |
$3,562.63 |
$3,562.63 |
$940.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$4,930.74 |
$4,930.74 |
$4,930.74 |
$1,357.20
|
|
Complex uroflowmetry (electronic) 51741
|
$890.65 |
$890.65 |
$890.65 |
$353.50
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$3,485.42 |
$3,485.42 |
$3,485.42 |
$1,206.00
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$3,485.42 |
$3,485.42 |
$3,485.42 |
$1,388.40
|
|
Complx repair enel addl 5cm/< 13153
|
$1,779.00 |
$1,779.00 |
$1,779.00 |
$541.50
|
|
Complx repair fccmnaxghf 13131
|
$2,719.07 |
$2,719.07 |
$2,719.07 |
$942.00
|
|
Complx repair fccmnaxghf 13132
|
$2,397.32 |
$2,397.32 |
$2,397.32 |
$1,244.09
|
|
Complx repair fccmnaxghf 13133
|
$1,790.09 |
$1,790.09 |
$1,790.09 |
$753.35
|
|
Complx repair sal addl 5 cm/> 13122
|
$2,085.05 |
$2,085.05 |
$2,085.05 |
$576.66
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$6,478.98 |
$6,478.98 |
$6,478.98 |
$1,193.40
|
|
Complx repair trunk addl 5cm/< 13102
|
$2,477.68 |
$2,477.68 |
$2,477.68 |
$683.25
|
|
Comprehensive hearing test
|
$861.44 |
$861.44 |
$861.44 |
$224.40
|
|
Concentration infection agents any type
|
$233.15 |
$233.15 |
$233.15 |
$51.32
|
|
Conditioning play audiometry 92582
|
$834.00 |
$834.00 |
$834.00 |
$185.15
|
|
Condylomata destruction 56420
|
$2,257.44 |
$2,257.44 |
$2,257.44 |
$509.81
|
|
Conization/cerv/loop electrode exc 57522
|
$18,087.25 |
$18,087.25 |
$18,087.25 |
$3,986.00
|
|
Conization of cervix
|
$18,570.84 |
$18,570.84 |
$18,570.84 |
$3,577.50
|
|
Consultation pathology during surgery
|
$304.56 |
$304.56 |
$304.56 |
$123.75
|
|
Consultation pathology during surgery cytological exam initial site
|
$178.03 |
$178.03 |
$178.03 |
$428.00
|
|
Consultation pathology during surgery frozen section each additional block
|
$389.66 |
$389.66 |
$389.66 |
$112.20
|
|
Consultation pathology during surgery frozen section first tissue block
|
$610.05 |
$610.05 |
$610.05 |
$214.00
|
|
Consultation/report referred material w/preparation of slides
|
$1,582.45 |
$1,582.45 |
$1,582.45 |
$239.85
|
|
Consultation/report referred slides prepared elsewhere
|
$990.06 |
$990.06 |
$990.06 |
$176.15
|
|
Consult comp w/report rfrd material
|
$1,023.38 |
$1,023.38 |
$1,023.38 |
$359.87
|
|
Contrast baths charges
|
$190.93 |
$190.93 |
$190.93 |
$75.35
|
|
Contrast exam abdominl aorta 75625-26
|
$3,372.60 |
$3,372.60 |
$3,372.60 |
$3,458.54
|
|
Contrast exam thoracic aorta
|
$6,318.51 |
$6,318.51 |
$6,318.51 |
$3,724.63
|
|
Contrast exam thoracic aorta 75605-26
|
$3,550.56 |
$3,550.56 |
$3,550.56 |
$4,178.00
|
|
Contrast x-ray gallbladder
|
$1,695.86 |
$1,695.86 |
$1,695.86 |
$312.00
|
|
Contrast x-ray of ankle
|
$4,025.49 |
$4,025.49 |
$4,025.49 |
$602.40
|