|
Ortho elbow without jnt cstm w/fit&adj
|
$291.20 |
$291.20 |
$291.20 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$504.00 |
$504.00 |
$504.00 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$1,288.00 |
$1,288.00 |
$1,288.00 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$911.68 |
$911.68 |
$911.68 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$271.60 |
$271.60 |
$271.60 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$324.80 |
$324.80 |
$324.80 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$106.40 |
$106.40 |
$106.40 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$271.60 |
$271.60 |
$271.60 |
$231.00
|
|
Orthopantogram
|
$364.00 |
$364.00 |
$364.00 |
$241.50
|
|
Orthopedic shoe add rub insl
|
$33.60 |
$33.60 |
$33.60 |
$70.40
|
|
Orthop traing pfrmd phys/qhp
|
$256.48 |
$256.48 |
$256.48 |
$148.20
|
|
Orthop traing supvj phys/qhp
|
$127.68 |
$127.68 |
$127.68 |
$112.32
|
|
Ortho shoe add full sole
|
$58.80 |
$58.80 |
$58.80 |
$109.93
|
|
Ortho shoe add half sole
|
$36.40 |
$36.40 |
$36.40 |
$36.40
|
|
Ortho shoe add leather insol
|
$33.60 |
$33.60 |
$33.60 |
$63.22
|
|
Ortho shoe add march bar
|
$47.60 |
$47.60 |
$47.60 |
$90.66
|
|
Ortho sidebar disconnect
|
$145.60 |
$145.60 |
$145.60 |
$145.60
|
|
Orthosis lso rigd frm hyperex
|
$571.20 |
$571.20 |
$571.20 |
$816.00
|
|
Orthovisc inj per dose
|
$61.65 |
$61.65 |
$837.96 |
$537.58
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$491.68 |
$491.68 |
$491.68 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$996.80 |
$996.80 |
$996.80 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$532.00 |
$532.00 |
$532.00 |
$195.00
|
|
O shoe add felt w leath insl
|
$36.40 |
$36.40 |
$36.40 |
$36.40
|
|
O shoe add horseshoe toe tap
|
$28.00 |
$28.00 |
$28.00 |
$49.45
|
|
O shoe add instep extension
|
$95.20 |
$95.20 |
$95.20 |
$201.67
|
|
O shoe add instep velcro clo
|
$72.80 |
$72.80 |
$72.80 |
$140.22
|
|
O shoe add standard toe tap
|
$11.20 |
$11.20 |
$11.20 |
$19.38
|
|
O shoe convert to sof counte
|
$61.60 |
$61.60 |
$61.60 |
$115.53
|
|
Osmolality blood
|
$42.30 |
$42.30 |
$114.80 |
$67.60
|
|
Osmolality urine
|
$42.30 |
$42.30 |
$105.84 |
$65.00
|
|
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
|
$111.45 |
$111.45 |
$700.00 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$106.05 |
$106.05 |
$414.40 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$108.75 |
$108.75 |
$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
|
$41.25 |
$41.25 |
$196.56 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$43.65 |
$43.65 |
$193.76 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$39.15 |
$39.15 |
$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
|
$57.15 |
$57.15 |
$319.20 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$46.20 |
$46.20 |
$191.52 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$34.35 |
$34.35 |
$171.92 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$36.45 |
$36.45 |
$198.24 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$42.00 |
$42.00 |
$145.04 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$42.60 |
$42.60 |
$229.04 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$44.40 |
$44.40 |
$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
|
$81.00 |
$81.00 |
$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
|
$1.62 |
$1.62 |
$168.92 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$879.90 |
$879.90 |
$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
|
$2,891.01 |
$2,891.01 |
$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
|
$27.86 |
$27.86 |
$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
|
|
Pancreatectomy 48153
|
$266.70 |
$266.70 |
$266.70 |
$7,609.60
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$4,304.48 |
$4,304.48 |
$12,686.46 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$8.16 |
$8.16 |
$14.40 |
$29.31
|
|
Papaverin hcl injection
|
$50.11 |
$50.11 |
$50.31 |
$77.05
|
|
Parathormone (pth) intact
|
$90.75 |
$90.75 |
$240.80 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$446.25 |
$446.25 |
$2,480.80 |
$1,574.40
|
|
Parathyroid autotransplantation 60512
|
$5,331.20 |
$5,331.20 |
$5,331.20 |
$4,080.85
|
|
Parathyroid planar imaging
|
$603.15 |
$603.15 |
$1,948.80 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,306.50 |
$1,306.50 |
$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
|
$504.75 |
$504.75 |
$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
|
