|
Clsd tx fx radius/ulna w/manip 25565
|
$159.50 |
$1,702.80 |
$3,748.00 |
|
|
Clsd tx/grt hum tube fx without manip 23620
|
$441.18 |
$441.18 |
$2,100.00 |
|
|
Clsd tx hip disloc without anes 27265
|
$364.65 |
$780.78 |
$3,066.40 |
|
|
Clsd tx humeral fract without manip 24530
|
$2,762.40 |
$2,762.40 |
$2,762.40 |
|
|
Clsd tx humerus fract without manip 24500
|
$1,464.27 |
$1,464.27 |
$2,762.40 |
|
|
Clsd tx iphal jnt disl w/manip req anes
|
$174.90 |
$628.10 |
$2,323.75 |
|
|
Clsd tx mandibular fx without manip 21450
|
$1,152.80 |
$1,152.80 |
$1,152.80 |
|
|
Clsd tx/metacar/interphal artic fx 26740
|
$1,376.00 |
$1,376.00 |
$1,376.00 |
|
|
Clsd tx/metacarpal fx/sg without manip 26600
|
$450.12 |
$498.85 |
$1,202.40 |
|
|
Clsd tx/metacarpal fx/sng/w manip 26605
|
$189.75 |
$613.14 |
$2,036.10 |
|
|
Clsd tx metacarp fx w/manip&ext fix ea bone 26607
|
$3,345.60 |
$3,345.60 |
$3,345.60 |
|
|
Clsd tx metatarsal fracture w/manip 28475
|
$374.00 |
$549.78 |
$1,200.80 |
|
|
Clsd tx/metatarsal fx without manip 28470
|
$650.94 |
$650.94 |
$872.80 |
|
|
Clsd tx/nasal bone fx/stabilize 21320
|
$269.24 |
$1,017.50 |
$3,745.50 |
|
|
Clsd tx of ankle fracture w/manip 28435
|
$125.95 |
$3,152.05 |
$3,711.84 |
|
|
Clsd tx patella disloc without anes 27560
|
$174.90 |
$523.05 |
$1,226.40 |
|
|
Clsd tx/patellar fx without manip 27520
|
$473.67 |
$473.67 |
$1,738.40 |
|
|
Clsd tx pelvic ring fx
|
$240.09 |
$240.09 |
$700.00 |
|
|
Clsd tx prox fib/shaft fx w/manip 27781
|
$1,164.35 |
$3,240.60 |
$4,190.24 |
|
|
Clsd tx/prox/mid phalnx fx/no manp 26720
|
$159.50 |
$342.65 |
$1,112.20 |
|
|
Clsd tx/radial head/neck fx/no manip 24650
|
$473.67 |
$473.67 |
$2,117.60 |
|
|
Clsd tx radius fracture w/manip 24655
|
$1,597.20 |
$3,143.20 |
$3,841.86 |
|
|
Clsd tx/scapular fx without manip 23570
|
$311.30 |
$473.67 |
$1,836.00 |
|
|
Clsd tx shoulder dislc/fx 23665
|
$380.05 |
$3,069.00 |
$4,071.20 |
|
|
Clsd tx shoulder disloc w/anatom neck fx w/manip 23675
|
$1,690.70 |
$3,152.05 |
$4,366.40 |
|
|
Clsd tx/shoulder dislo/manip/anest 23655
|
$1,136.01 |
$2,098.80 |
$5,984.64 |
|
|
Clsd tx/talotarsal dislocat/anes 28575
|
$1,962.40 |
$1,962.40 |
$1,962.40 |
|
|
Clsd tx temporomandibular dislocat 21480
|
$137.80 |
$440.00 |
$886.40 |
|
|
Clsd tx toe dislocation without anes28660
|
$197.45 |
$507.10 |
$923.41 |
|
|
Clsd tx trimall ankle fx without manip 27816
|
$1,993.60 |
$1,993.60 |
$1,993.60 |
|
|
Clsd tx trimall ankle fx w/manip 27818
|
$380.05 |
$1,848.66 |
$4,101.60 |
|
|
Clsd tx/ulnar shaft fx without manip 25530
|
$473.67 |
$473.67 |
$1,718.40 |
|
|
Clsd tx vert body fx without manip req &w/csting/bracing
|
$441.18 |
$441.18 |
$1,693.60 |
|
|
Clsd tx wrist carpal fx without manip 25630
|
$1,875.20 |
$1,875.20 |
$1,875.20 |
|
|
Clsd tx wrist scaphoid fx without manip 25622
|
$2,080.80 |
$2,080.80 |
$2,080.80 |
|
|
Clsd tx wrist trans-scaph fx w/manip 25680
|
$2,916.80 |
$2,916.80 |
$2,916.80 |
|
|
Clsd tx wrist ulnar styloid fx 25650
|
$475.20 |
$475.20 |
$2,187.20 |
|
|
Clsd/ulnar fx/prox end without manip 24670
|
$473.67 |
$512.16 |
$2,609.60 |
|
|
Cls tx of heel fracture w/manip 28405
|
$872.38 |
$872.38 |
$2,834.40 |
|
|
Cltx carpl scphd fx w/mnpj
|
$2,858.90 |
$2,916.80 |
$2,957.90 |
|
|
Cltx craniofacial separation
|
$3,540.80 |
$3,540.80 |
$3,540.80 |
|
|
Cltx gr hmrl tbrs fx w/mnpj
|
$3,216.80 |
$3,216.80 |
$3,985.74 |
|
|
Cltx hum epcndylr fx wo mnpj
|
$2,685.60 |
$2,685.60 |
$2,685.60 |
|
|
Cltx humrl cndylr fx w/mnpj
|
$5,363.20 |
$5,363.20 |
$5,363.20 |
|
|
Cltx humrl cndylr fx wo mnpj
|
$2,225.60 |
$2,225.60 |
$2,225.60 |
|
|
Cltx lunate dislc w/mnpj
|
$1,903.00 |
$3,837.90 |
$4,577.48 |
|
|
Cltx mndblr fx ntrdntl fixj
|
$4,496.00 |
$4,496.00 |
$4,496.00 |
|
|
Cltx mndblr fx w/mnpj
|
$1,773.60 |
$1,773.60 |
$1,773.60 |
|
|
Cltx mndblr/max alv ridge fx
|
$3,254.40 |
$3,254.40 |
$7,269.90 |
|
|
Cltx palatal/max fx wire fix
|
$2,764.80 |
$2,764.80 |
$2,764.80 |
|
|
Cltx post ankle fx
|
$441.18 |
$441.18 |
$1,762.40 |
|
|
Cltx post ankle fx w/mnpj
|
$3,111.35 |
$3,111.35 |
$5,009.85 |
|
|
Cltx scap fx w/mnpj +-tractj
|
$3,056.00 |
$3,056.00 |
$3,056.00 |
|
|
Cltx strnclav dislc w/mnpj
|
$2,912.80 |
$2,912.80 |
$2,912.80 |
|
|
Cltx thigh fx
|
$3,796.80 |
$3,796.80 |
$3,796.80 |
|
|
Cltx thigh fx w/mnpj
|
$4,904.80 |
$4,904.80 |
$6,544.56 |
|
|
Cltx tmprmand dislc comp
|
$3,452.80 |
$3,732.96 |
$3,732.96 |
|
|
C motor evoked lwr limbs
|
$227.21 |
$407.55 |
$613.14 |
|
|
C motor evoked uppr limbs
|
$554.91 |
$707.30 |
$1,174.80 |
|
|
C motor evoked upr&lwr limbs
|
$599.50 |
$998.52 |
$1,650.72 |
|
|
Cmptr ophth img optic nerve
|
$50.60 |
$50.60 |
$97.50 |
|
|
#cms hgb-carboxyhemoglobin
|
$25.97 |
$25.97 |
$25.97 |
|
|
#cms hgb-sulfhemoglobin
|
$59.20 |
$59.20 |
$59.20 |
|
|
#cmvcul-virus inoculation shell
|
$39.90 |
$122.10 |
$197.84 |
|
|
Cmv pcr-sendout
|
$41.04 |
$170.00 |
$370.76 |
|
|
Cnbp gene detc abnor allele
|
$368.94 |
$368.94 |
$368.94 |
|
|
Co2 monitor per day
|
$677.16 |
$677.16 |
$677.16 |
|
|
Coagulation factor viia 1,000 mcg/ml inj 1 ml
|
$3.18 |
$4.68 |
$10,231.32 |
|
|
Coagulation time activated teg
|
$22.50 |
$32.45 |
$78.10 |
|
|
Cocaine 4 % nasal solution
|
$5.51 |
$5.59 |
$2,337.58 |
|
|
Cocaine hcl nasal (numbrino)
|
$1.48 |
$1.48 |
$1.48 |
|
|
Coccidioidomycosis skin test
|
$24.38 |
$24.38 |
$24.38 |
|
|
Cochlear implt f/up exam <7
|
$714.40 |
$714.40 |
$714.40 |
|
|
Cochlear implt f/up exam 7/>
|
$282.50 |
$282.50 |
$508.00 |
|
|
Coil axium 3d 14mmx40cm qc
|
$1,275.00 |
$1,275.00 |
$1,275.00 |
|
|
Cold agglutinin screen (arc)
|
$17.10 |
$44.80 |
$122.10 |
|
|
Cold agglutinin titer
|
$9.24 |
$50.00 |
$190.80 |
|
|
Colectomy/end colost/close dis seg 44143
|
$3,215.37 |
$3,215.37 |
$5,620.00 |
|
|
Colectomy/ ileostomy without prctect 44150
|
$6,665.60 |
$6,665.60 |
$6,665.60 |
|
|
Colectomy/ ileostomy w/prctect 44155
|
$10,324.00 |
$10,324.00 |
$10,324.00 |
|
|
Colectomy partial w/anastomosis 44140
|
$2,600.91 |
$2,600.91 |
$6,571.20 |
|
|
Colectomy prtl w/coloproctostomy 44145
|
$3,313.98 |
$3,313.98 |
$6,366.40 |
|
|
Colectomy prtl w/coloproctostomy + colostomy 44146
|
$7,415.20 |
$7,415.20 |
$7,415.20 |
|
|
Colectomy prtl w/remove terminal ileum+ileocolos 44160
|
$2,401.41 |
$2,401.41 |
$5,993.60 |
|
|
Colectomy prtl w/skin level cecost/colostomy 44141
|
$5,354.40 |
$5,354.40 |
$5,354.40 |
|
|
Colectomy/w colostomy or ileostomy 44144
|
$5,062.40 |
$5,062.40 |
$5,062.40 |
|
|
Colectomy w/neo-rectum pouch
|
$7,768.80 |
$7,768.80 |
$7,768.80 |
|
|
Colistimethate sodium inj
|
$0.25 |
$0.25 |
$0.43 |
|
|
Collagenase, clost hist inj
|
$71.82 |
$71.82 |
$71.82 |
|
|
Collagen based wound filler
|
$60.00 |
$60.00 |
$60.00 |
|
|
Collagen dressing <=16 sq in
|
$14.64 |
$42.50 |
$102.77 |
|
|
Collagen drsg>16<=48 sq in
|
$60.00 |
$60.00 |
$62.56 |
|
|
Collagen gel/paste wound fil
|
$142.50 |
$142.50 |
$142.50 |
|
|
Collarbone (Clavicle) X-ray (both sides)
|
$50.73 |
$333.96 |
$601.04 |
|
|
Collar cerv 18.25x3.5in serp firm density sm
|
$12.50 |
$12.50 |
$67.31 |
|
|
Collar cerv adlt perfit ace extric
|
$22.50 |
$22.50 |
$145.20 |
|
|
Collar cerv ascend 172 reg
|
$86.17 |
$115.00 |
$572.00 |
|
|
Collar cerv patriot adlt
|
$80.00 |
$80.00 |
$273.48 |
|
|
Collar extrication adult univ
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
|
|
Collection blood specimen from completely implantable venous access device
|
$81.51 |
$106.53 |
$549.83 |
|
