|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$108.00 |
$108.00 |
$108.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$108.00 |
$108.00 |
$108.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$105.00 |
$105.00 |
$105.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$108.00 |
$108.00 |
$108.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$105.00 |
$105.00 |
$105.00 |
$94.25
|
|
Ovulation tests
|
$206.40 |
$206.40 |
$206.40 |
$29.60
|
|
Parathormone (pth) intact
|
$253.80 |
$253.80 |
$253.80 |
$204.87
|
|
Parathyroid planar imaging
|
$587.40 |
$587.40 |
$587.40 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$223.20 |
$223.20 |
$223.20 |
$245.00
|
|
Pelvic CT scan (with and without contrast)
|
$2,647.20 |
$2,647.20 |
$2,647.20 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,580.60 |
$2,580.60 |
$2,580.60 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$2,157.60 |
$2,157.60 |
$2,157.60 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$4,062.60 |
$4,062.60 |
$4,062.60 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,589.20 |
$3,589.20 |
$3,589.20 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,188.40 |
$3,188.40 |
$3,188.40 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$720.00 |
$720.00 |
$720.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$699.60 |
$699.60 |
$699.60 |
$430.00
|
|
Penile vascular study
|
$751.20 |
$751.20 |
$751.20 |
$576.40
|
|
Pericardiocentesis wwo imaging
|
$1,927.80 |
$1,927.80 |
$1,927.80 |
$2,251.20
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$821.40 |
$821.40 |
$821.40 |
$625.93
|
|
Pertussis ag if
|
$96.00 |
$96.00 |
$96.00 |
$69.05
|
|
Pet CT skull-mid thgh initial
|
$6,702.60 |
$6,702.60 |
$6,702.60 |
$4,707.00
|
|
Pet CT whole body initial
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$3,196.80 |
$3,196.80 |
$3,196.80 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$6,279.60 |
$6,279.60 |
$6,279.60 |
$4,305.60
|
|
Pet not otherwise specified
|
$4,814.40 |
$4,814.40 |
$4,814.40 |
$1,070.40
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$91.80 |
$91.80 |
$91.80 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$136.20 |
$136.20 |
$136.20 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$47.40 |
$47.40 |
$47.40 |
$33.30
|
|
Ph body fluid
|
$76.20 |
$76.20 |
$76.20 |
$41.28
|
|
Phencyclidine (pcp)
|
$322.80 |
$322.80 |
$322.80 |
$96.00
|
|
Phenobarbital therapeutic drug level
|
$125.40 |
$125.40 |
$125.40 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$227.40 |
$227.40 |
$227.40 |
$110.88
|
|
Phlebotomy therapeutic
|
$378.60 |
$378.60 |
$378.60 |
$231.66
|
|
Phosphorus
|
$65.40 |
$65.40 |
$65.40 |
$48.80
|
|
Phosphorus 24 hour urine
|
$114.00 |
$114.00 |
$114.00 |
$41.51
|
|
Phys blood bank serv reactj
|
$108.00 |
$108.00 |
$108.00 |
$207.50
|
|
Pillow shldr abduc inflat univ
|
$307.80 |
$307.80 |
$307.80 |
$614.36
|
|
Pin service 60m per month
|
$160.80 |
$160.80 |
$160.80 |
$114.00
|
|
Pinworm exam
|
$49.20 |
$49.20 |
$49.20 |
$39.75
|
|
Place gastrostomy tube perc
|
$2,506.20 |
$2,506.20 |
$2,506.20 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$2,307.00 |
$2,307.00 |
$2,307.00 |
$1,517.21
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$2,202.00 |
$2,202.00 |
$2,202.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$2,161.80 |
$2,161.80 |
$2,161.80 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$3,518.40 |
$3,518.40 |
$3,518.40 |
$3,873.65
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$3,878.40 |
$3,878.40 |
$3,878.40 |
$13,964.50
|
|
Place non-slctv cath thoracic arta
|
$4,539.00 |
$4,539.00 |
$4,539.00 |
$5,053.33
|
|
Place right device/marker pros
|
$2,008.20 |
$2,008.20 |
$2,008.20 |
$2,195.93
|
|
Place slctv cath carotid/inom art excrn uni
|
$5,190.00 |
$5,190.00 |
$5,190.00 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$5,114.40 |
$5,114.40 |
$5,114.40 |
$8,538.00
|
|
Place slctv cath subclavian art
|
$5,271.00 |
$5,271.00 |
$5,271.00 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$4,583.40 |
$4,583.40 |
$4,583.40 |
$8,971.00
|
|
Plasma cryoprecipitate reduced each unit
|
$259.20 |
$259.20 |
$259.20 |
$157.95
|
|
Platelet aggregation each agent teg
|
$570.60 |
$570.60 |
$570.60 |
$148.80
|
|
Platelet automated
|
$51.60 |
$51.60 |
$51.60 |
$45.60
|
|
Platelet pheresis each unit
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$961.70
|
|
Platelet pheresis irr ea
|
$743.40 |
$743.40 |
$743.40 |
$1,082.25
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$555.00 |
$555.00 |
$555.00 |
$1,504.10
|
|
Platelets leukocytes reduced each unit
|
$1,457.40 |
$1,457.40 |
$1,457.40 |
$302.25
|
|
Platelets leukoreduced cmv negative apheresis/phresis each unit
|
$2,382.60 |
$2,382.60 |
$2,382.60 |
$1,094.60
|
|
Platelets pheresis leukocytes reduced cmv negative irradiated each unit
|
$835.80 |
$835.80 |
$835.80 |
$1,170.65
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,782.60 |
$1,782.60 |
$1,782.60 |
$1,139.20
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,970.40 |
$1,970.40 |
$1,970.40 |
$1,278.55
|
|
Platelets pheresis pathogen-reduced each unit
|
$2,072.40 |
$2,072.40 |
$2,072.40 |
$1,004.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$1,082.40 |
$1,082.40 |
$1,082.40 |
$758.52
|
|
Plethysmography lung volumes/airway resistance
|
$504.00 |
$504.00 |
$504.00 |
$405.00
|
|
Plmt nephroureteral catheter
|
$3,518.40 |
$3,518.40 |
$3,518.40 |
$4,081.37
|
|
Pmp22 gene dup/delet
|
$1,242.60 |
$1,242.60 |
$1,242.60 |
$1,029.75
|
|
Pms2 gene dup/delet variants
|
$580.20 |
$580.20 |
$580.20 |
$407.20
|
|
Pms2 gene full seq analysis
|
$978.00 |
$978.00 |
$978.00 |
$1,002.60
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$241.20 |
$241.20 |
$241.20 |
$187.32
|
|
Polysom <6 yrs cpap/bilvl
|
$4,681.20 |
$4,681.20 |
$4,681.20 |
$3,494.55
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$5,935.20 |
$5,935.20 |
$5,935.20 |
$3,751.48
|
|
Potassium 24 hour urine
|
$55.20 |
$55.20 |
$55.20 |
$50.40
|
|
Potassium serum/plasma/whole blood
|
$55.20 |
$55.20 |
$55.20 |
$46.75
|
|
Pq dr cath chg w cont s&i
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$720.00
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$8,971.80 |
$8,971.80 |
$8,971.80 |
$9,977.57
|
|
Pq thr inj ext pse
|
$945.00 |
$945.00 |
$945.00 |
$775.00
|
|
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl
|
$3,085.20 |
$3,085.20 |
$3,085.20 |
$2,925.65
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$3,931.20 |
$3,931.20 |
$3,931.20 |
$4,565.03
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$4,740.00 |
$4,740.00 |
$4,740.00 |
$4,811.54
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$2,044.20 |
$2,044.20 |
$2,044.20 |
$3,738.90
|
|
Pr application of long arm splint
|
$492.60 |
$492.60 |
$492.60 |
$329.00
|
|
Pr application splint static short arm
|
$828.00 |
$828.00 |
$828.00 |
$287.70
|
|
Pr biopsy skin punch single lesion
|
$311.40 |
$311.40 |
$311.40 |
$458.25
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$44.40 |
$44.40 |
$44.40 |
$46.56
|
|
Prcrd drg 6+yr without anomly
|
$2,229.60 |
$2,229.60 |
$2,229.60 |
$2,253.00
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$612.00 |
$612.00 |
$612.00 |
$351.60
|
|
Prealbumin
|
$115.20 |
$115.20 |
$115.20 |
$93.36
|
|
Pr ecg 12 lead report only
|
$18.60 |
$18.60 |
$18.60 |
$20.40
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$1,831.20 |
$1,831.20 |
$1,831.20 |
$2,246.75
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$596.40 |
$596.40 |
$596.40 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$596.40 |
$596.40 |
$596.40 |
$539.37
|
|
Prep skin to 100cm2 other
|
$1,354.20 |
$1,354.20 |
$1,354.20 |
$1,193.40
|
|
Prep skin to 100cm2 trk/ext
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$2,164.64
|
|
Prep skn trk/ext adl 100cm2
|
$1,030.80 |
$1,030.80 |
$1,030.80 |
$1,018.50
|
|
Pressure velocity wire add ves
|
$521.40 |
$521.40 |
$521.40 |
$1,579.40
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$444.60 |
$444.60 |
$444.60 |
$152.85
|
|
Pretreat rbc absorption reference
|
$234.00 |
$234.00 |
$234.00 |
$150.00
|
