|
Pregnancy Ultrasound (complete, after first trimester)
|
$961.62 |
$961.62 |
$961.62 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$806.98 |
$806.98 |
$806.98 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$578.55 |
$578.55 |
$578.55 |
$459.00
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$103.19 |
$103.19 |
$103.19 |
$161.40
|
|
Pretreat rbc absorption reference
|
$144.60 |
$144.60 |
$144.60 |
$150.00
|
|
Pretreat rbc density gradient separation reference
|
$280.26 |
$280.26 |
$280.26 |
$182.31
|
|
Pretreat rbc w chem/drugs reference
|
$69.20 |
$69.20 |
$69.20 |
$114.00
|
|
Pretreat rbc w enzyme reference
|
$110.72 |
$110.72 |
$110.72 |
$168.50
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$309.68 |
$309.68 |
$309.68 |
$253.55
|
|
Procalcitonin
|
$56.97 |
$56.97 |
$56.97 |
$161.11
|
|
Progesterone
|
$8.76 |
$8.76 |
$8.76 |
$116.00
|
|
Prolactin
|
$16.28 |
$16.28 |
$16.28 |
$123.50
|
|
_propoxygc/msur
|
$3.76 |
$3.76 |
$3.76 |
$95.55
|
|
Prostate biopsy, any mthd
|
$192.85 |
$192.85 |
$192.85 |
$492.80
|
|
Protein c activity
|
$5.36 |
$5.36 |
$5.36 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$35.68 |
$35.68 |
$35.68 |
$84.00
|
|
Protein s total
|
$4.77 |
$4.77 |
$4.77 |
$85.10
|
|
Protein total 24 hour urine
|
$5.63 |
$5.63 |
$5.63 |
$52.50
|
|
Protein total body fluid
|
$35.06 |
$35.06 |
$35.06 |
$49.80
|
|
Protein total serum plasma whole blood
|
$35.06 |
$35.06 |
$35.06 |
$43.00
|
|
Prothrombin time substitution plasma fractions each
|
$34.57 |
$34.57 |
$34.57 |
$42.00
|
|
Pr removal intrauterine device
|
$270.22 |
$270.22 |
$270.22 |
$367.80
|
|
PSA (Prostate) Test
|
$35.06 |
$35.06 |
$35.06 |
$107.50
|
|
Pt application of modality >=1 area hot/cold packs
|
$50.61 |
$50.61 |
$50.61 |
$35.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$72.30 |
$72.30 |
$72.30 |
$103.20
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$80.98 |
$80.98 |
$80.98 |
$81.48
|
|
Pt application of modality traction mechanical
|
$88.93 |
$88.93 |
$88.93 |
$91.80
|
|
Pten gene dup/delet variant
|
$224.40 |
$224.40 |
$224.40 |
$330.00
|
|
Pten gene full sequence
|
$313.04 |
$313.04 |
$313.04 |
$826.00
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$53.50 |
$53.50 |
$53.50 |
$80.30
|
|
Pt wheelchair management each 15 minutes
|
$60.01 |
$60.01 |
$60.01 |
$88.00
|
|
Puncture arterial withdrawal blood for diagnosis
|
$48.44 |
$48.44 |
$48.44 |
$129.36
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$170.17 |
$170.17 |
$170.17 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$393.59 |
$393.59 |
$393.59 |
$1,060.47
|
|
Pyruvate
|
$13.15 |
$13.15 |
$13.15 |
$66.00
|
|
Pyruvate kinase
|
$85.76 |
$85.76 |
$85.76 |
$78.95
|
|
Quant diff pulm perf and vent w/imaging
|
$829.36 |
$829.36 |
$829.36 |
$1,547.04
|
|
Quest t3 uptake
|
$3.76 |
$3.76 |
$3.76 |
$53.20
|
|
Radphm lcl tmr plnr bdy two day img
|
$1,683.54 |
$1,683.54 |
$1,683.54 |
$2,719.20
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$1,158.82 |
$1,158.82 |
$1,158.82 |
$2,503.20
|
|
Radphm lcl tomogr sgl area sgl day
|
$803.86 |
$803.86 |
$803.86 |
$2,242.80
|
|
Radphm lcl tumor plr sgl day
|
$550.89 |
$550.89 |
$550.89 |
$1,126.32
|
|
Rbc count only automated
|
$13.11 |
$13.11 |
$13.11 |
$20.40
|
|
Rbc serum pretx incubj drugs
|
$108.93 |
$108.93 |
$108.93 |
$231.12
|
|
Red blood cells leukocytes reduced each unit
|
$353.43 |
$353.43 |
$353.43 |
$444.60
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$173.25 |
$173.25 |
$173.25 |
$534.15
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$168.92 |
$168.92 |
$168.92 |
$255.97
|
|
Removal sutr and stapl no anes
|
$90.04 |
$90.04 |
$90.04 |
$82.05
|
|
Removal sutr or stapl no anes
|
$90.04 |
$90.04 |
$90.04 |
$93.88
|
|
Remove esophagus obstruction
|
$228.94 |
$228.94 |
$228.94 |
$560.00
|
|
Renal function panel
|
$97.66 |
$97.66 |
$97.66 |
$114.37
|
|
Reptilase test
|
$23.84 |
$23.84 |
$23.84 |
$72.15
|
|
Resp virus 6-11 targets
|
$314.15 |
$314.15 |
$314.15 |
$479.20
|
|
Reticulocyte direct measurement automated
|
$10.13 |
$10.13 |
$10.13 |
$36.57
|
|
Rheumatoid factor qualitative
|
$44.59 |
$44.59 |
$44.59 |
$57.20
|
|
Rheumatoid factor quantitative
|
$11.47 |
$11.47 |
$11.47 |
$57.50
|
|
Rib and Chest X-ray (3 views, left side)
|
$434.93 |
$434.93 |
$434.93 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$547.10 |
$547.10 |
$547.10 |
$491.70
|
|
Rp loclzj tum 2+area 1+d img
|
$587.12 |
$587.12 |
$587.12 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$1,482.91 |
$1,482.91 |
$1,482.91 |
$2,556.60
|
|
Rp loclzj tum spect w/ct 2
|
$1,482.91 |
$1,482.91 |
$1,482.91 |
$3,176.00
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$882.18 |
$882.18 |
$882.18 |
$2,173.60
|
|
Rsv assay w/optic
|
$22.32 |
$22.32 |
$22.32 |
$76.32
|
|
Rubella antibody igg
|
$3.82 |
$3.82 |
$3.82 |
$77.40
|
|
Rubeola antibody igg
|
$7.01 |
$7.01 |
$7.01 |
$80.00
|
|
Russell viper venom diluted
|
$4.17 |
$4.17 |
$4.17 |
$73.03
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$404.75 |
$404.75 |
$404.75 |
$314.26
|
|
Salmonella antibody
|
$14.65 |
$14.65 |
$14.65 |
$37.58
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$632.66 |
$632.66 |
$632.66 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$313.30 |
$313.30 |
$313.30 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$467.83 |
$467.83 |
$467.83 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$714.47 |
$714.47 |
$714.47 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$666.60 |
$666.60 |
$666.60 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$699.93 |
$699.93 |
$699.93 |
$597.35
|
|
Screening Mammogram
|
$264.42 |
$264.42 |
$264.42 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$79,762.23 |
$79,762.23 |
$79,762.23 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$762.24 |
$762.24 |
$762.24 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$5.36 |
$5.36 |
$5.36 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$69.41 |
$69.41 |
$69.41 |
$96.00
|
|
Semen analysis w/count
|
$17.99 |
$17.99 |
$17.99 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$224.96 |
$224.96 |
$224.96 |
$316.68
|
|
Serpina1 gene
|
$166.06 |
$166.06 |
$166.06 |
$197.00
|
|
Sheath gldlight lasr 12fx50cm
|
$6,475.07 |
$6,475.07 |
$6,475.07 |
$6,570.70
|
|
Shot (Injection into Muscle or Under the Skin)
|
$83.08 |
$83.08 |
$83.08 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$211.89 |
$211.89 |
$211.89 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$218.45 |
$218.45 |
$218.45 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$2,153.11 |
$2,153.11 |
$2,153.11 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,794.49 |
$1,794.49 |
$1,794.49 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,435.17 |
$1,435.17 |
$1,435.17 |
$2,096.84
|
|
Shoulder X-ray
|
$388.35 |
$388.35 |
$388.35 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$156.13 |
$156.13 |
$156.13 |
$263.25
|
|
Sialography s&i
|
$528.74 |
$528.74 |
$528.74 |
$499.20
|
|
Sickling rbc
|
$24.44 |
$24.44 |
$24.44 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$1,220.10 |
$1,220.10 |
$1,220.10 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,016.66 |
$1,016.66 |
$1,016.66 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$813.21 |
$813.21 |
$813.21 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$331.28 |
$331.28 |
$331.28 |
$346.45
|
|
Sinus X-ray (limited)
|
$290.61 |
$290.61 |
$290.61 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$11.27 |
$11.27 |
$11.27 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$198.77 |
$198.77 |
$198.77 |
$294.45
|
