|
Closed tx humerus fx with manip 23605
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,211.05
|
|
Closed tx humerus fx without manip 23600
|
$445.80 |
$445.80 |
$445.80 |
$494.15
|
|
Closed tx humerus fx w/manip 24505
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,507.80
|
|
Closed tx metatarsophalangeal jnt disl without anes
|
$172.80 |
$172.80 |
$172.80 |
$376.96
|
|
Closed tx orbit without manipulj
|
$381.00 |
$381.00 |
$381.00 |
$998.40
|
|
Closed tx post hip arthroplasty disloc w/anes 27266
|
$3,039.00 |
$3,039.00 |
$3,039.00 |
$2,520.60
|
|
Close lac/mouth vest/2.5 cm or < 40830
|
$174.00 |
$174.00 |
$174.00 |
$481.80
|
|
Clos txnose fx without stablz 21315
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$2,326.08
|
|
Closure paravalvlr leak pq
|
$9,282.60 |
$9,282.60 |
$9,282.60 |
$7,723.17
|
|
Clot factor xii hageman
|
$150.60 |
$150.60 |
$150.60 |
$134.39
|
|
Clot factor xiii fibrin scrn
|
$83.40 |
$83.40 |
$83.40 |
$55.44
|
|
Clot factor xiii fibrin stab
|
$214.20 |
$214.20 |
$214.20 |
$105.00
|
|
Clsd/shoulder dislo/manip/no anest 23650
|
$172.80 |
$172.80 |
$172.80 |
$641.90
|
|
Clsd tx bimalleol ank fx without manip 27808
|
$172.80 |
$172.80 |
$172.80 |
$526.35
|
|
Clsd tx carpo/metacarpl disl thmb manip ea without anes
|
$172.80 |
$172.80 |
$172.80 |
$476.80
|
|
Clsd tx clavicle dislocation without manip 23540
|
$172.80 |
$172.80 |
$172.80 |
$419.29
|
|
Clsd tx clavicle fracture w/manip 23505
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,893.86
|
|
Clsd tx/clavicular fx without manip 23500
|
$476.40 |
$476.40 |
$476.40 |
$448.80
|
|
Clsd tx coccygeal fracture 27200
|
$172.80 |
$172.80 |
$172.80 |
$388.80
|
|
Clsd tx dist fib fx w/manip 27788
|
$172.80 |
$172.80 |
$172.80 |
$653.60
|
|
Clsd tx elbow dislocation child 24640
|
$172.80 |
$172.80 |
$172.80 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,184.08
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$172.80 |
$172.80 |
$172.80 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$172.80 |
$172.80 |
$172.80 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$36,990.37 |
$36,990.37 |
$36,990.37 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$172.80 |
$172.80 |
$172.80 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$5,796.08 |
$5,796.08 |
$5,796.08 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$172.80 |
$172.80 |
$172.80 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$172.80 |
$172.80 |
$172.80 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$445.80 |
$445.80 |
$445.80 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$453.60 |
$453.60 |
$453.60 |
$492.99
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$172.80 |
$172.80 |
$172.80 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$172.80 |
$172.80 |
$172.80 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$172.80 |
$172.80 |
$172.80 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$445.80 |
$445.80 |
$445.80 |
$418.20
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$6,284.15 |
$6,284.15 |
$6,284.15 |
$3,678.17
|
|
Clsd tx of ankle fracture w/manip 28435
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$172.80 |
$172.80 |
$172.80 |
$566.72
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,146.20
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$172.80 |
$172.80 |
$172.80 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,782.86
|
|
Clsd tx shoulder dislc/fx 23665
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$6,379.80 |
$6,379.80 |
$6,379.80 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$172.80 |
$172.80 |
$172.80 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$172.80 |
$172.80 |
$172.80 |
$400.00
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,565.74
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$172.80 |
$172.80 |
$172.80 |
$496.61
|
|
Cls tx of heel fracture w/manip 28405
|
$172.80 |
$172.80 |
$172.80 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,893.86
|
|
Cltx humrl cndylr fx w/mnpj
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$1,815.75
|
|
Cltx lunate dislc w/mnpj
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,437.00
|
|
Cltx post ankle fx w/mnpj
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$1,893.86
|
|
Cmbn ant pst colprhy
|
$28,492.69 |
$28,492.69 |
$28,492.69 |
$4,928.00
|
|
#cmvcul-virus inoculation shell
|
$35.40 |
$35.40 |
$35.40 |
$100.80
|
|
Cmv pcr-sendout
|
$537.60 |
$537.60 |
$537.60 |
$177.50
|
|
Coagulation time activated teg
|
$113.40 |
$113.40 |
$113.40 |
$53.72
|
|
Coch imp ext proc/contr rplc
|
$62,112.46 |
$62,112.46 |
$62,112.46 |
$20,146.35
|
|
Coch implant microphone repl
|
$1,533.71 |
$1,533.71 |
$1,533.71 |
$977.17
|
|
Cold agglutinin screen (arc)
|
$48.00 |
$48.00 |
$48.00 |
$45.00
|
|
Cold agglutinin titer
|
$57.00 |
$57.00 |
$57.00 |
$50.00
|
|
Colistimethate sodium inj
|
$294.00 |
$294.00 |
$294.00 |
$68.47
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$441.92 |
$441.92 |
$441.92 |
$60.84
|
|
Collar cerv adlt perfit ace extric
|
$296.35 |
$296.35 |
$296.35 |
$70.00
|
|
Collar cerv ascend 172 reg
|
$714.65 |
$714.65 |
$714.65 |
$213.89
|
|
Collar cerv patriot adlt
|
$489.80 |
$489.80 |
$489.80 |
$154.00
|
|
Collection blood specimen from completely implantable venous access device
|
$165.60 |
$165.60 |
$165.60 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$96.00 |
$96.00 |
$96.00 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$37.80 |
$37.80 |
$37.80 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$6,028.29 |
$6,028.29 |
$6,028.29 |
$1,899.00
|
|
Colonoscopy submucous njx
|
$6,630.58 |
$6,630.58 |
$6,630.58 |
$2,080.00
|
|
Colonoscopy w/ablation
|
$15,366.89 |
$15,366.89 |
$15,366.89 |
$2,708.80
|
|
Colonoscopy w/control bleed
|
$8,651.90 |
$8,651.90 |
$8,651.90 |
$2,030.25
|
|
Colonoscopy (with biopsy)
|
$6,683.09 |
$6,683.09 |
$6,683.09 |
$2,080.00
|
|
Colonoscopy (with polyp removal)
|
$7,055.55 |
$7,055.55 |
$7,055.55 |
$2,288.00
|
|
Colonoscopy w/resection
|
$11,716.91 |
$11,716.91 |
$11,716.91 |
$3,029.60
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$2,356.80 |
$2,356.80 |
$2,356.80 |
$3,762.53
|
|
Colposcopy/cervix/ conization 57461
|
$11,271.46 |
$11,271.46 |
$11,271.46 |
$3,744.41
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$370.80 |
$370.80 |
$370.80 |
$312.90
|
|
Combination bilateral ho
|
$9,064.72 |
$9,064.72 |
$9,064.72 |
$4,575.46
|
|
Compatibility test each unit antiglobulin technique
|
$205.80 |
$205.80 |
$205.80 |
$170.05
|
|
Compatibility test each unit electronic
|
$210.60 |
$210.60 |
$210.60 |
$172.26
|
|
Compatibility test each unit immediate spin technique
|
$204.00 |
$204.00 |
$204.00 |
$169.52
|
|
Compatibility test incubate
|
$203.40 |
$203.40 |
$203.40 |
$155.40
|
|
Complement antigen each component c3
|
$142.20 |
$142.20 |
$142.20 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$1,921.80 |
$1,921.80 |
$1,921.80 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$30,633.69 |
$30,633.69 |
$30,633.69 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,921.80 |
$1,921.80 |
$1,921.80 |
$1,049.60
|
|
Complx repair fccmnaxghf 13133
|
$1,210.80 |
$1,210.80 |
$1,210.80 |
$490.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$1,921.80 |
$1,921.80 |
$1,921.80 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$1,921.80 |
$1,921.80 |
$1,921.80 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$4,325.57 |
$4,325.57 |
$4,325.57 |
$1,350.27
|
|
Concentration infection agents any type
|
$69.60 |
$69.60 |
$69.60 |
$49.95
|
|
Conduit wrap neuomend 3mmx2.5cm
|
$36,367.01 |
$36,367.01 |
$36,367.01 |
$3,322.20
|
|
Condylomata destruction 56420
|
$600.00 |
$600.00 |
$600.00 |
$469.00
|
|
Conization/cerv/loop electrode exc 57522
|
$8,686.05 |
$8,686.05 |
$8,686.05 |
$4,840.07
|
|
Conjugated estrogens 25 mg solution for injection
|
$3,957.24 |
$3,957.24 |
$3,957.24 |
$871.08
|
|
Connect omega .5mm
|
$15,202.76 |
$15,202.76 |
$15,202.76 |
$1,260.00
|
|
Connector tis 2x10mm
|
$16,075.31 |
$16,075.31 |
$16,075.31 |
$4,091.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$312.00 |
$312.00 |
$312.00 |
$441.95
|