|
Clsd tx dist fib fx w/manip 27788
|
$456.50 |
$456.50 |
$456.50 |
$653.60
|
|
Clsd tx/dis tib/wt bear no manip 27824
|
$346.00 |
$346.00 |
$346.00 |
$454.30
|
|
Clsd tx elbow dislocation child 24640
|
$328.50 |
$328.50 |
$328.50 |
$462.80
|
|
Clsd tx/fem shaft fx/manipulation 27502
|
$858.50 |
$858.50 |
$858.50 |
$2,184.08
|
|
Clsd tx fracture of radius 25500
|
$295.00 |
$295.00 |
$295.00 |
$442.50
|
|
Clsd tx/fx grt toe/phalanx/phalang 28490
|
$141.00 |
$141.00 |
$141.00 |
$376.11
|
|
Clsd tx/fx/phalanx/phalang/manip 28515
|
$156.00 |
$156.00 |
$156.00 |
$411.73
|
|
Clsd tx fx radius/ulna dist without manip 25600
|
$365.50 |
$365.50 |
$365.50 |
$520.80
|
|
Clsd tx fx radius/ulna dist w/manip 25605
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
$1,656.90
|
|
Clsd tx fx radius/ulna without manip 25560
|
$296.00 |
$296.00 |
$296.00 |
$459.00
|
|
Clsd tx fx radius/ulna w/manip 25565
|
$2,272.50 |
$2,272.50 |
$2,272.50 |
$1,571.25
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$293.50 |
$293.50 |
$293.50 |
$445.80
|
|
Clsd tx hip disloc without anes 27265
|
$543.00 |
$543.00 |
$543.00 |
$630.00
|
|
Clsd tx humeral fract without manip 24530
|
$392.00 |
$392.00 |
$392.00 |
$538.45
|
|
Clsd tx humerus fract without manip 24500
|
$378.50 |
$378.50 |
$378.50 |
$492.99
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$391.00 |
$391.00 |
$391.00 |
$883.00
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$244.00 |
$244.00 |
$244.00 |
$506.10
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$322.50 |
$322.50 |
$322.50 |
$496.80
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$423.00 |
$423.00 |
$423.00 |
$606.00
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$246.50 |
$246.50 |
$246.50 |
$520.38
|
|
Clsd tx/metatarsal fx without manip 28470
|
$224.00 |
$224.00 |
$224.00 |
$418.20
|
|
Clsd tx of ankle fracture w/manip 28435
|
$360.50 |
$360.50 |
$360.50 |
$1,893.86
|
|
Clsd tx patella disloc without anes 27560
|
$435.50 |
$435.50 |
$435.50 |
$566.72
|
|
Clsd tx/patellar fx without manip 27520
|
$337.50 |
$337.50 |
$337.50 |
$475.68
|
|
Clsd tx pelvic ring fx
|
$137.00 |
$137.00 |
$137.00 |
$416.35
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$220.50 |
$220.50 |
$220.50 |
$412.00
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$278.00 |
$278.00 |
$278.00 |
$445.80
|
|
Clsd tx radius fracture w/manip 24655
|
$484.50 |
$484.50 |
$484.50 |
$1,782.86
|
|
Clsd tx/scapular fx without manip 23570
|
$273.00 |
$273.00 |
$273.00 |
$452.40
|
|
Clsd tx shoulder dislc/fx 23665
|
$458.50 |
$458.50 |
$458.50 |
$1,839.54
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$567.50 |
$567.50 |
$567.50 |
$1,690.70
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$2,272.50 |
$2,272.50 |
$2,272.50 |
$2,211.05
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$373.00 |
$373.00 |
$373.00 |
$3,839.54
|
|
Clsd tx temporomandibular dislocat 21480
|
$328.50 |
$328.50 |
$328.50 |
$394.40
|
|
Clsd tx toe dislocation without anes28660
|
$112.50 |
$112.50 |
$112.50 |
$400.00
|
|
Clsd tx trimall ankle fx without manip 27816
|
$340.50 |
$340.50 |
$340.50 |
$488.40
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$2,218.50 |
$2,218.50 |
$2,218.50 |
$1,565.74
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$273.50 |
$273.50 |
$273.50 |
$452.40
|
|
Clsd tx wrist carpal fx without manip 25630
|
$316.50 |
$316.50 |
$316.50 |
$476.00
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$319.50 |
$319.50 |
$319.50 |
$523.53
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$353.50 |
$353.50 |
$353.50 |
$600.60
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$305.00 |
$305.00 |
$305.00 |
$474.50
|
|
Cltx hum epcndylr fx wo mnpj
|
$346.50 |
$346.50 |
$346.50 |
$520.80
|
|
Cltx humrl cndylr fx wo mnpj
|
$364.50 |
$364.50 |
$364.50 |
$535.60
|
|
Cltx lunate dislc w/mnpj
|
$533.50 |
$533.50 |
$533.50 |
$2,437.00
|
|
Cltx post ankle fx
|
$322.50 |
$322.50 |
$322.50 |
$483.60
|
|
Cltx post ankle fx w/mnpj
|
$488.00 |
$488.00 |
$488.00 |
$1,893.86
|
|
Cltx scap fx w/mnpj +-tractj
|
$417.00 |
$417.00 |
$417.00 |
$2,021.04
|
|
Cltx thigh fx w/mnpj
|
$580.00 |
$580.00 |
$580.00 |
$3,503.71
|
|
Cmptr ophth dx img ant segmt
|
$17.00 |
$17.00 |
$17.00 |
$115.95
|
|
Cmptr ophth img optic nerve
|
$18.00 |
$18.00 |
$18.00 |
$119.00
|
|
#cms hgb-sulfhemoglobin
|
$74.00 |
$74.00 |
$74.00 |
$74.00
|
|
#cmvcul-virus inoculation shell
|
$37.00 |
$37.00 |
$37.00 |
$100.80
|
|
Cold agglutinin screen (arc)
|
$26.00 |
$26.00 |
$26.00 |
$45.00
|
|
Cold agglutinin titer
|
$3.00 |
$3.00 |
$3.00 |
$50.00
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$1,359.00 |
$1,359.00 |
$1,359.00 |
$2,343.60
|
|
Collagenase, clost hist inj
|
$123.50 |
$123.50 |
$123.50 |
$12,906.28
|
|
Collection blood specimen from completely implantable venous access device
|
$127.50 |
$127.50 |
$127.50 |
$159.60
|
|
Collection of venous blood by venipuncture
|
$9.00 |
$9.00 |
$9.00 |
$21.00
|
|
Colonoscopy (diagnostic)
|
$188.50 |
$188.50 |
$188.50 |
$1,899.00
|
|
Colonoscopy (with biopsy)
|
$203.00 |
$203.00 |
$203.00 |
$2,080.00
|
|
Colonoscopy (with polyp removal)
|
$255.50 |
$255.50 |
$255.50 |
$2,288.00
|
|
Colposcopy/cervix/bx vagina/cervix 57421
|
$882.50 |
$882.50 |
$882.50 |
$1,030.40
|
|
Colposcopy/cervix/ conization 57461
|
$190.50 |
$190.50 |
$190.50 |
$3,744.41
|
|
Colposcopy/cervix/inc up/adjacent vag 57452
|
$194.00 |
$194.00 |
$194.00 |
$312.90
|
|
Colposcopy vulva 56820
|
$194.00 |
$194.00 |
$194.00 |
$295.20
|
|
Colposcopy vulva w/biopsy 56821
|
$292.00 |
$292.00 |
$292.00 |
$393.60
|
|
Colposcopy w/biopsy of cervix 57455
|
$292.00 |
$292.00 |
$292.00 |
$502.80
|
|
Compatibility test each unit antiglobulin technique
|
$101.00 |
$101.00 |
$101.00 |
$170.05
|
|
Compatibility test each unit immediate spin technique
|
$140.00 |
$140.00 |
$140.00 |
$169.52
|
|
Comp cystometrogram/void presssure 51728
|
$118.50 |
$118.50 |
$118.50 |
$958.81
|
|
Complement antigen each component c3
|
$79.00 |
$79.00 |
$79.00 |
$108.55
|
|
Complex repair trunk 1.1-2.5cm 13120
|
$221.50 |
$221.50 |
$221.50 |
$876.00
|
|
Complex repair trunk 2.6-7.5cm 13101
|
$234.50 |
$234.50 |
$234.50 |
$1,191.78
|
|
Complex uroflowmetry (electronic) 51741
|
$10.00 |
$10.00 |
$10.00 |
$346.71
|
|
Compl oph exam general anes
|
$127.50 |
$127.50 |
$127.50 |
$2,161.60
|
|
Complx repair enel 1.1-2.5 cm 13151
|
$264.00 |
$264.00 |
$264.00 |
$1,049.60
|
|
Complx repair enel 2.6-7.5 cm 13152
|
$316.50 |
$316.50 |
$316.50 |
$1,194.25
|
|
Complx repair enel addl 5cm/< 13153
|
$132.50 |
$132.50 |
$132.50 |
$490.50
|
|
Complx repair fccmnaxghf 13131
|
$623.00 |
$623.00 |
$623.00 |
$810.40
|
|
Complx repair fccmnaxghf 13132
|
$889.50 |
$889.50 |
$889.50 |
$1,107.60
|
|
Complx repair fccmnaxghf 13133
|
$118.00 |
$118.00 |
$118.00 |
$490.50
|
|
Complx repair sal addl 5 cm/> 13122
|
$471.50 |
$471.50 |
$471.50 |
$502.50
|
|
Complx repair trunk 1.1-2.5 cm 13100
|
$192.50 |
$192.50 |
$192.50 |
$1,000.00
|
|
Complx repair trunk addl 5cm/< 13102
|
$70.00 |
$70.00 |
$70.00 |
$537.00
|
|
Comprehensive hearing test
|
$29.00 |
$29.00 |
$29.00 |
$255.00
|
|
Compre oph exam est pt 1/>
|
$70.00 |
$70.00 |
$70.00 |
$207.20
|
|
Compre oph exam new pt 1/>
|
$87.50 |
$87.50 |
$87.50 |
$186.00
|
|
Computed tomographic angiography head and neck with contrast
|
$1,315.00 |
$1,315.00 |
$1,315.00 |
$2,237.25
|
|
Concentration infection agents any type
|
$57.50 |
$57.50 |
$57.50 |
$49.95
|
|
Conditioning play audiometry 92582
|
$86.50 |
$86.50 |
$86.50 |
$189.15
|
|
Condylomata destruction 56420
|
$282.00 |
$282.00 |
$282.00 |
$469.00
|
|
Conization/cerv/loop electrode exc 57522
|
$262.00 |
$262.00 |
$262.00 |
$4,840.07
|
|
Consultation pathology during surgery
|
$32.00 |
$32.00 |
$32.00 |
$100.00
|
|
Consultation pathology during surgery cytological exam initial site
|
$63.50 |
$63.50 |
$63.50 |
$441.95
|
|
Consultation pathology during surgery frozen section each additional block
|
$32.00 |
$32.00 |
$32.00 |
$113.68
|
|
Consultation pathology during surgery frozen section first tissue block
|
$63.50 |
$63.50 |
$63.50 |
$225.96
|
|
Consultation/report referred material w/preparation of slides
|
$91.50 |
$91.50 |
$91.50 |
$224.80
|
|
Consultation/report referred slides prepared elsewhere
|
$76.50 |
$76.50 |
$76.50 |
$171.65
|
|
Consult comp w/report rfrd material
|
$128.50 |
$128.50 |
$128.50 |
$365.60
|
