|
Ostectomy complete 1st metatarsal head 28111
|
$2,811.20 |
$2,811.20 |
$2,811.20 |
$3,542.56
|
|
Ostectomy scapula partial
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Osteoart algrft w/surf & b1
|
$1,864.80 |
$1,864.80 |
$1,864.80 |
$1,864.80
|
|
Osteochondral knee allograft
|
$20,809.60 |
$20,809.60 |
$20,809.60 |
$10,629.07
|
|
Osteochondral knee autograft
|
$14,162.40 |
$14,162.40 |
$14,162.40 |
$7,952.51
|
|
Osteochondral talus autogrft
|
$17,382.40 |
$17,382.40 |
$17,382.40 |
$6,982.66
|
|
Osteopath manip tx/5-6 body region 98927
|
$141.12 |
$141.12 |
$141.12 |
$68.25
|
|
Osteopath manip tx/7-8 body region 98928
|
$127.12 |
$127.12 |
$127.12 |
$84.22
|
|
Osteopath manip tx/9-10 body region98929
|
$151.20 |
$151.20 |
$151.20 |
$92.42
|
|
Osteoplasty humerus
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$8,412.89
|
|
Osteot dsc ant 1vrt sgm thrc
|
$8,820.00 |
$8,820.00 |
$8,820.00 |
$6,063.98
|
|
Osteot humerus w/wo int fixj
|
$16,990.40 |
$16,990.40 |
$16,990.40 |
$7,807.24
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$17,382.40 |
$17,382.40 |
$17,382.40 |
$7,907.11
|
|
Ot evaluation high complexity patient/family
|
$700.00 |
$700.00 |
$700.00 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$414.40 |
$414.40 |
$414.40 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$571.20 |
$571.20 |
$571.20 |
$263.50
|
|
Other immunoelectrophoresis
|
$107.52 |
$107.52 |
$107.52 |
$107.52
|
|
Oth resp proc, group
|
$164.08 |
$164.08 |
$164.08 |
$123.05
|
|
Oth resp proc, indiv
|
$194.88 |
$194.88 |
$194.88 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$196.56 |
$196.56 |
$196.56 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$193.76 |
$193.76 |
$193.76 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$155.68 |
$155.68 |
$155.68 |
$105.00
|
|
Otolaryngo binocular microscopy 92504
|
$61.04 |
$61.04 |
$61.04 |
$60.45
|
|
Otoplasty 69300
|
$8,820.00 |
$8,820.00 |
$8,820.00 |
$3,589.62
|
|
Ot re-evaluation patient/family
|
$319.20 |
$319.20 |
$319.20 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$191.52 |
$191.52 |
$191.52 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$171.92 |
$171.92 |
$171.92 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$198.24 |
$198.24 |
$198.24 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$145.04 |
$145.04 |
$145.04 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$229.04 |
$229.04 |
$229.04 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$201.04 |
$201.04 |
$201.04 |
$94.25
|
|
Outrigger
|
$70.00 |
$70.00 |
$70.00 |
$123.81
|
|
Outrigger bil with vert extens
|
$218.40 |
$218.40 |
$218.40 |
$378.67
|
|
Ovarian cystectomy 58925
|
$13,311.20 |
$13,311.20 |
$13,311.20 |
$5,841.60
|
|
Ovulation tests
|
$78.96 |
$78.96 |
$78.96 |
$29.60
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$203.73 |
$203.73 |
$203.73 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$2,185.79 |
$2,185.79 |
$2,185.79 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$72.18 |
$72.18 |
$72.18 |
$50.40
|
|
P-32 chromic phos ther per mci
|
$290.64 |
$290.64 |
$290.64 |
$290.64
|
|
P-32 sod phosphate ther per mci
|
$758.80 |
$758.80 |
$758.80 |
$469.34
|
|
Pabpn1 gene detc abnor allel
|
$313.60 |
$313.60 |
$313.60 |
$225.42
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$168.92 |
$168.92 |
$168.92 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$2,785.88 |
$2,785.88 |
$2,785.88 |
$3,435.42
|
|
Palb2 gene full gene seq
|
$2,469.60 |
$2,469.60 |
$2,469.60 |
$672.50
|
|
Palb2 gene known famil vrnt
|
$2,469.60 |
$2,469.60 |
$2,469.60 |
$496.86
|
|
Palifermin injection
|
$5,464.63 |
$5,464.63 |
$5,464.63 |
$5,464.63
|
|
Palingen or palingen xplus
|
$0.56 |
$0.56 |
$0.56 |
$656.01
|
|
Palingen or promatrx
|
$5,530.00 |
$5,530.00 |
$5,530.00 |
$691.88
|
|
Paliperidone 117 mg/0.75 ml inj
|
$6,238.82 |
$6,238.82 |
$6,238.82 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$6,009.53 |
$6,009.53 |
$6,009.53 |
$5,569.20
|
|
Palonosetron hcl
|
$103.60 |
$103.60 |
$103.60 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$116.44 |
$116.44 |
$116.44 |
$128.07
|
|
Pancreas removal/transplant
|
$7,644.00 |
$7,644.00 |
$7,644.00 |
$7,644.00
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$12,686.46 |
$12,686.46 |
$12,686.46 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$14.40 |
$14.40 |
$14.40 |
$29.31
|
|
Papaverin hcl injection
|
$50.11 |
$50.11 |
$50.11 |
$77.05
|
|
Parathormone (pth) intact
|
$240.80 |
$240.80 |
$240.80 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$2,480.80 |
$2,480.80 |
$2,480.80 |
$1,574.40
|
|
Parathyroid autotransplantation 60512
|
$5,331.20 |
$5,331.20 |
$5,331.20 |
$4,080.85
|
|
Parathyroid planar imaging
|
$1,948.80 |
$1,948.80 |
$1,948.80 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,517.60 |
$1,517.60 |
$1,517.60 |
$1,350.60
|
|
Paravaginal defect repair 57284
|
$11,183.20 |
$11,183.20 |
$11,183.20 |
$5,841.60
|
|
Parial mast w/lymph removal 19302
|
$15,131.20 |
$15,131.20 |
$15,131.20 |
$5,509.55
|
|
Paricalcitol
|
$50.78 |
$50.78 |
$50.78 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$515.20 |
$515.20 |
$515.20 |
$245.00
|
|
Parotid duct diversion
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,547.81
|
|
Parotid duct diversion
|
$11,933.60 |
$11,933.60 |
$11,933.60 |
$6,966.64
|
|
Parotid duct diversion
|
$8,181.60 |
$8,181.60 |
$8,181.60 |
$3,837.72
|
|
Part exc/post vert comp/sng/thorac 22101
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$6,028.71
|
|
Part hymenectomy/revi hymenal ring 56700
|
$2,150.40 |
$2,150.40 |
$2,150.40 |
$3,762.53
|
|
Partial exc bone humerus
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$8,915.20 |
$8,915.20 |
$8,915.20 |
$4,914.00
|
|
Partial excision of lip
|
$8,008.00 |
$8,008.00 |
$8,008.00 |
$3,837.72
|
|
Partial removal finger bone
|
$6,137.60 |
$6,137.60 |
$6,137.60 |
$2,021.04
|
|
Partial removal finger bone
|
$1,276.80 |
$1,276.80 |
$1,276.80 |
$2,049.27
|
|
Partial removal foot fascia
|
$8,618.40 |
$8,618.40 |
$8,618.40 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$4,315.20
|
|
Partial removal of eye fluid
|
$6,529.60 |
$6,529.60 |
$6,529.60 |
$2,698.92
|
|
Partial removal of eye fluid
|
$4,172.00 |
$4,172.00 |
$4,172.00 |
$2,698.92
|
|
Partial removal of fibula
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,786.00
|
|
Partial removal of foot bone
|
$4,894.40 |
$4,894.40 |
$4,894.40 |
$3,839.54
|
|
Partial removal of hand bone
|
$8,741.60 |
$8,741.60 |
$8,741.60 |
$3,839.54
|
|
Partial removal of lip
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$3,544.29
|
|
Partial removal of nose
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,603.11
|
|
Partial removal of penis
|
$11,508.00 |
$11,508.00 |
$11,508.00 |
$4,081.37
|
|
Partial removal of pharynx 42890
|
$14,319.20 |
$14,319.20 |
$14,319.20 |
$6,465.11
|
|
Partial removal of radius
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Partial removal of radius
|
$3,472.00 |
$3,472.00 |
$3,472.00 |
$3,472.00
|
|
Partial removal of rib
|
$5,376.00 |
$5,376.00 |
$5,376.00 |
$5,376.00
|
|
Partial removal of thyroid
|
$28,800.80 |
$28,800.80 |
$28,800.80 |
$6,457.82
|
|
Partial removal of thyroid
|
$14,336.00 |
$14,336.00 |
$14,336.00 |
$5,855.00
|
|
Partial removal of tibia
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$4,108.80
|
|
Partial removal of toe
|
$9,788.80 |
$9,788.80 |
$9,788.80 |
$3,674.58
|
|
Partial removal of tongue
|
$9,828.00 |
$9,828.00 |
$9,828.00 |
$5,978.70
|
|
Partial removal of ulna
|
$7,968.80 |
$7,968.80 |
$7,968.80 |
$3,839.54
|
|
Partial removal of ulna
|
$3,186.40 |
$3,186.40 |
$3,186.40 |
$3,594.44
|
|
Partial removal of ulna
|
$9,564.80 |
$9,564.80 |
$9,564.80 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$8,573.60 |
$8,573.60 |
$8,573.60 |
$3,762.53
|
|
Partial removal tear gland
|
$8,562.40 |
$8,562.40 |
$8,562.40 |
$5,006.40
|
|
Partial thyroid excision
|
$16,576.00 |
$16,576.00 |
$16,576.00 |
$6,457.82
|
