|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,687.50 |
$1,687.50 |
$1,687.50 |
$1,687.50
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,534.50 |
$1,534.50 |
$1,534.50 |
$2,211.05
|
|
Clsd tx temporomandibular dislocat 21480
|
$148.50 |
$148.50 |
$148.50 |
$399.50
|
|
Clsd tx toe dislocation without anes28660
|
$221.50 |
$221.50 |
$221.50 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$263.00 |
$263.00 |
$263.00 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$1,252.50 |
$1,252.50 |
$1,252.50 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$376.00 |
$376.00 |
$376.00 |
$452.40
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$493.50 |
$493.50 |
$493.50 |
$674.68
|
|
Clsd tx wrist carpal fx without manip 25630
|
$344.50 |
$344.50 |
$344.50 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$198.00 |
$198.00 |
$198.00 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$360.00 |
$360.00 |
$360.00 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$198.00 |
$198.00 |
$198.00 |
$474.50
|
|
Cls tx of heel fracture w/manip 28405
|
$566.00 |
$566.00 |
$566.00 |
$748.00
|
|
Cltx carpl scphd fx w/mnpj
|
$1,352.50 |
$1,352.50 |
$1,352.50 |
$1,893.86
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$1,384.50 |
$1,384.50 |
$1,384.50 |
$2,490.60
|
|
Cltx hum epcndylr fx wo mnpj
|
$257.50 |
$257.50 |
$257.50 |
$520.80
|
|
Cltx humrl cndylr fx w/mnpj
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$1,815.75
|
|
Cltx humrl cndylr fx wo mnpj
|
$401.00 |
$401.00 |
$401.00 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$2,437.00 |
$2,437.00 |
$2,437.00 |
$2,437.00
|
|
Cltx mndblr fx ntrdntl fixj
|
$5,357.50 |
$5,357.50 |
$5,357.50 |
$6,776.64
|
|
Cltx mndblr/max alv ridge fx
|
$1,986.00 |
$1,986.00 |
$1,986.00 |
$3,990.33
|
|
Cltx post ankle fx w/mnpj
|
$2,564.50 |
$2,564.50 |
$2,564.50 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$2,021.04
|
|
Cltx strnclav dislc w/mnpj
|
$780.50 |
$780.50 |
$780.50 |
$619.30
|
|
Cltx thigh fx
|
$4,598.50 |
$4,598.50 |
$4,598.50 |
$4,008.00
|
|
C motor evoked lwr limbs
|
$859.50 |
$859.50 |
$859.50 |
$627.89
|
|
C motor evoked uppr limbs
|
$859.50 |
$859.50 |
$859.50 |
$824.67
|
|
C motor evoked upr&lwr limbs
|
$1,429.50 |
$1,429.50 |
$1,429.50 |
$1,308.00
|
|
Cmptr ophth dx img ant segmt
|
$243.00 |
$243.00 |
$243.00 |
$115.95
|
|
Cmptr ophth img optic nerve
|
$93.00 |
$93.00 |
$93.00 |
$119.00
|
|
#cmvcul-virus inoculation shell
|
$102.50 |
$102.50 |
$102.50 |
$100.20
|
|
Cmv pcr-sendout
|
$79.50 |
$79.50 |
$79.50 |
$177.10
|
|
Co2 monitor per day
|
$409.50 |
$409.50 |
$409.50 |
$450.60
|
|
Coagulation time activated teg
|
$69.50 |
$69.50 |
$69.50 |
$53.72
|
|
Coil axium 3d 14mmx40cm qc
|
$294.98 |
$294.98 |
$294.98 |
$308.00
|
|
Cold agglutinin screen (arc)
|
$37.50 |
$37.50 |
$37.50 |
$45.00
|
|
Cold agglutinin titer
|
$80.00 |
$80.00 |
$80.00 |
$50.00
|
|
Collagen dressing <=16 sq in
|
$23.29 |
$23.29 |
$23.29 |
$42.50
|
|
Collagen drsg>16<=48 sq in
|
$23.29 |
$23.29 |
$23.29 |
$24.71
|
|
Collagen imp urinary 2.5 ml
|
$1,097.68 |
$1,097.68 |
$1,097.68 |
$1,949.63
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$30.54 |
$30.54 |
$30.54 |
$58.65
|
|
Collar cerv ascend 172 reg
|
$109.71 |
$109.71 |
$109.71 |
$213.89
|
|
Collar extrication adult univ
|
$297.56 |
$297.56 |
$297.56 |
$764.15
|
|
Collection blood specimen from completely implantable venous access device
|
$168.00 |
$168.00 |
$168.00 |
$159.60
|
|
Collection blood specimen using established central/peripheral catheter venous nos
|
$168.00 |
$168.00 |
$168.00 |
$153.30
|
|
Collection of venous blood by venipuncture
|
$19.50 |
$19.50 |
$19.50 |
$21.00
|
|
Collj & interpj data ea 30 d
|
$90.50 |
$90.50 |
$90.50 |
$172.35
|
|
Colonoscopy (diagnostic)
|
$1,164.50 |
$1,164.50 |
$1,164.50 |
$1,899.00
|
|
Colporrhapy/vag injury sut/non ob 57200
|
$1,716.00 |
$1,716.00 |
$1,716.00 |
$3,762.53
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$1,359.50 |
$1,359.50 |
$1,359.50 |
$312.90
|
|
Colposcopy w/biopsy of cervix 57455
|
$2,031.00 |
$2,031.00 |
$2,031.00 |
$502.80
|
|
Compatibility test each unit antiglobulin technique
|
$173.50 |
$173.50 |
$173.50 |
$170.25
|
|
Compatibility test each unit electronic
|
$202.50 |
$202.50 |
$202.50 |
$174.00
|
|
Compatibility test each unit immediate spin technique
|
$213.00 |
$213.00 |
$213.00 |
$169.52
|
|
Compatibility test incubate
|
$92.00 |
$92.00 |
$92.00 |
$155.40
|
|
Comp cystometrogram/void presssure 51728
|
$1,169.50 |
$1,169.50 |
$1,169.50 |
$958.81
|
|
Complement antigen each component c3
|
$191.00 |
$191.00 |
$191.00 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$644.00 |
$644.00 |
$644.00 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$1,039.50 |
$1,039.50 |
$1,039.50 |
$1,191.78
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$1,014.50 |
$1,014.50 |
$1,014.50 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$1,165.50 |
$1,165.50 |
$1,165.50 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$1,340.00 |
$1,340.00 |
$1,340.00 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$660.50 |
$660.50 |
$660.50 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$761.50 |
$761.50 |
$761.50 |
$1,108.88
|
|
Complx repair fccmnaxghf 13133
|
$374.00 |
$374.00 |
$374.00 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$165.50 |
$165.50 |
$165.50 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$483.50 |
$483.50 |
$483.50 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$537.00 |
$537.00 |
$537.00 |
$537.00
|
|
Component ankle afo plastic jt mold to pt mdl foot cup
|
$733.30 |
$733.30 |
$733.30 |
$1,350.27
|
|
Composite drsg <= 16 sq in
|
$3.18 |
$3.18 |
$3.18 |
$6.62
|
|
Comprehensive hearing test
|
$354.00 |
$354.00 |
$354.00 |
$255.00
|
|
Compre oph exam est pt 1/>
|
$171.00 |
$171.00 |
$171.00 |
$207.20
|
|
Concentration infection agents any type
|
$22.00 |
$22.00 |
$22.00 |
$49.95
|
|
Condylomata destruction 56420
|
$1,053.50 |
$1,053.50 |
$1,053.50 |
$469.00
|
|
Conform band n/s w>=3"<5"/yd
|
$9.32 |
$9.32 |
$9.32 |
$1.04
|
|
Consultation pathology during surgery
|
$84.50 |
$84.50 |
$84.50 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$394.50 |
$394.50 |
$394.50 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$37.00 |
$37.00 |
$37.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$97.00 |
$97.00 |
$97.00 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$157.00 |
$157.00 |
$157.00 |
$224.80
|
|
Contact layer >16<= 48 sq in
|
$41.92 |
$41.92 |
$41.92 |
$36.17
|
|
Contact lens fitg aphakia 1
|
$165.50 |
$165.50 |
$165.50 |
$472.21
|
|
Contact lens fitg aphakia ou
|
$107.50 |
$107.50 |
$107.50 |
$170.00
|
|
Contact lens fitting for tx
|
$127.00 |
$127.00 |
$127.00 |
$92.96
|
|
Contact lens fitting ou
|
$40.00 |
$40.00 |
$40.00 |
$40.00
|
|
Contrast baths charges
|
$50.50 |
$50.50 |
$50.50 |
$70.50
|
|
Contrast exam abdominl aorta 75625-26
|
$2,939.00 |
$2,939.00 |
$2,939.00 |
$3,458.54
|
|
Contrast exam thoracic aorta
|
$2,939.00 |
$2,939.00 |
$2,939.00 |
$3,648.84
|
|
Contrast exam thoracic aorta 75605-26
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$3,728.24
|
|
Contrast x-ray of ankle
|
$790.50 |
$790.50 |
$790.50 |
$612.30
|
|
Contrast x-ray of brain
|
$1,217.50 |
$1,217.50 |
$1,217.50 |
$981.75
|
|
Contrast x-ray of elbow
|
$798.00 |
$798.00 |
$798.00 |
$649.80
|
|
Contrast x-ray of hip
|
$798.00 |
$798.00 |
$798.00 |
$781.13
|
|
Contrast x-ray of knee joint
|
$790.50 |
$790.50 |
$790.50 |
$769.88
|
|
Contrast x-ray of wrist
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$639.00
|
|
Controler lvad heartmate 3 includes ebb
|
$7,010.58 |
$7,010.58 |
$7,010.58 |
$13,218.75
|
|
Controller infinity pt dbs
|
$1,615.00 |
$1,615.00 |
$1,615.00 |
$4,611.60
|
|
Control nosebleed pack+caut 30905
|
$273.00 |
$273.00 |
$273.00 |
$396.00
|
|
Control of nosebleed ant comp 30903
|
$501.00 |
$501.00 |
$501.00 |
$396.00
|
|
Control of nosebleedantersmpl 30901
|
$469.00 |
$469.00 |
$469.00 |
$355.50
|
