|
Peritoneogram rs&i
|
$1,021.80 |
$1,021.80 |
$1,021.80 |
$695.89
|
|
Perit-vens shunt pat tst
|
$787.20 |
$787.20 |
$787.20 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$1,066.80 |
$1,066.80 |
$1,066.80 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$27,596.40 |
$27,596.40 |
$27,596.40 |
$9,509.53
|
|
Perq dev breast 1st mr guide
|
$5,169.00 |
$5,169.00 |
$5,169.00 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$1,724.40 |
$1,724.40 |
$1,724.40 |
$1,456.00
|
|
Perq nl/pl lithotrp smpl<2cm
|
$2,131.80 |
$2,131.80 |
$2,131.80 |
$9,442.38
|
|
Perq plmt bile duct stent
|
$7,302.60 |
$7,302.60 |
$7,302.60 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$8,455.80 |
$8,455.80 |
$8,455.80 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$8,455.80 |
$8,455.80 |
$8,455.80 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$249.00 |
$249.00 |
$249.00 |
$625.93
|
|
Perq transcath closure each
|
$9,199.20 |
$9,199.20 |
$9,199.20 |
$9,204.00
|
|
Perq transcath closure pda
|
$27,596.40 |
$27,596.40 |
$27,596.40 |
$18,408.00
|
|
Perq transcath cls aortic
|
$27,596.40 |
$27,596.40 |
$27,596.40 |
$22,633.26
|
|
Perq transcath cls mitral
|
$27,596.40 |
$27,596.40 |
$27,596.40 |
$23,617.60
|
|
Perq transcath septal reduxn
|
$30,714.00 |
$30,714.00 |
$30,714.00 |
$8,605.90
|
|
Pet CT skull-mid thgh initial
|
$4,857.00 |
$4,857.00 |
$4,857.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$4,857.00 |
$4,857.00 |
$4,857.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,857.00 |
$4,857.00 |
$4,857.00 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$4,857.00 |
$4,857.00 |
$4,857.00 |
$4,305.60
|
|
Pet not otherwise specified
|
$12,402.00 |
$12,402.00 |
$12,402.00 |
$1,070.40
|
|
Pet scan brain perf study
|
$9,563.40 |
$9,563.40 |
$9,563.40 |
$3,832.80
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$90.60 |
$90.60 |
$90.60 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$134.40 |
$134.40 |
$134.40 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$46.80 |
$46.80 |
$46.80 |
$33.30
|
|
Ph body fluid
|
$100.80 |
$100.80 |
$100.80 |
$41.28
|
|
Phencyclidine (pcp)
|
$349.80 |
$349.80 |
$349.80 |
$96.00
|
|
Phenobarbital therapeutic drug level
|
$167.40 |
$167.40 |
$167.40 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$317.40 |
$317.40 |
$317.40 |
$110.88
|
|
Phlebotomy therapeutic
|
$340.20 |
$340.20 |
$340.20 |
$231.66
|
|
Phleb veins 1 extrm 10-20 stab
|
$3,985.20 |
$3,985.20 |
$3,985.20 |
$4,599.65
|
|
Phleb veins 1 extrm >20 stab
|
$3,985.20 |
$3,985.20 |
$3,985.20 |
$4,453.46
|
|
Phosphorus
|
$74.40 |
$74.40 |
$74.40 |
$48.80
|
|
Phosphorus 24 hour urine
|
$160.20 |
$160.20 |
$160.20 |
$41.51
|
|
Pin service 60m per month
|
$165.00 |
$165.00 |
$165.00 |
$114.00
|
|
Pinworm exam
|
$79.80 |
$79.80 |
$79.80 |
$39.75
|
|
Place breast cath for rad
|
$15,290.40 |
$15,290.40 |
$15,290.40 |
$3,332.00
|
|
Place breast rad tube/caths
|
$16,887.60 |
$16,887.60 |
$16,887.60 |
$7,680.06
|
|
Place cath intracranial art
|
$1,246.20 |
$1,246.20 |
$1,246.20 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$8,396.40 |
$8,396.40 |
$8,396.40 |
$4,202.90
|
|
Place cecostomy tube perc
|
$7,420.20 |
$7,420.20 |
$7,420.20 |
$2,580.90
|
|
Place device/marker, non pro
|
$1,531.20 |
$1,531.20 |
$1,531.20 |
$1,969.20
|
|
Place duod/jej tube perc
|
$5,296.80 |
$5,296.80 |
$5,296.80 |
$2,473.10
|
|
Place gastrostomy tube perc
|
$2,673.60 |
$2,673.60 |
$2,673.60 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,724.40 |
$1,724.40 |
$1,724.40 |
$1,517.21
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$999.60 |
$999.60 |
$999.60 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,913.40 |
$1,913.40 |
$1,913.40 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$4,639.80 |
$4,639.80 |
$4,639.80 |
$3,873.65
|
|
Placement occlusive device venous/arterial access site post procedure
|
$2,007.00 |
$2,007.00 |
$2,007.00 |
$571.45
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$17,420.40 |
$17,420.40 |
$17,420.40 |
$13,964.50
|
|
Place ndl musc/tis for right
|
$567.00 |
$567.00 |
$567.00 |
$3,591.33
|
|
Place needles h&n for right
|
$6,875.40 |
$6,875.40 |
$6,875.40 |
$7,000.36
|
|
Place needles pelvic for right
|
$9,743.40 |
$9,743.40 |
$9,743.40 |
$6,624.80
|
|
Place non-slctv cath thoracic arta
|
$8,225.40 |
$8,225.40 |
$8,225.40 |
$5,053.33
|
|
Place po breast cath for rad
|
$19,155.60 |
$19,155.60 |
$19,155.60 |
$11,066.55
|
|
Place right device/marker pros
|
$2,858.40 |
$2,858.40 |
$2,858.40 |
$2,195.93
|
|
Place slctv cath carotd art uni
|
$11,481.60 |
$11,481.60 |
$11,481.60 |
$10,014.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$8,225.40 |
$8,225.40 |
$8,225.40 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$11,481.60 |
$11,481.60 |
$11,481.60 |
$8,538.00
|
|
Place slctv cath subclavian art
|
$8,225.40 |
$8,225.40 |
$8,225.40 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$11,481.60 |
$11,481.60 |
$11,481.60 |
$8,971.00
|
|
Plasma cryoprecipitate reduced each unit
|
$127.20 |
$127.20 |
$127.20 |
$157.95
|
|
Platelet aggregation each agent teg
|
$208.80 |
$208.80 |
$208.80 |
$148.80
|
|
Platelet automated
|
$63.60 |
$63.60 |
$63.60 |
$45.60
|
|
Platelet pheresis each unit
|
$1,101.60 |
$1,101.60 |
$1,101.60 |
$961.70
|
|
Platelet pheresis irr ea
|
$1,329.00 |
$1,329.00 |
$1,329.00 |
$1,082.25
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$1,910.40 |
$1,910.40 |
$1,910.40 |
$1,504.10
|
|
Platelets leukocytes reduced each unit
|
$1,498.20 |
$1,498.20 |
$1,498.20 |
$302.25
|
|
Platelets leukocytes reduced irradiated each unit
|
$1,930.80 |
$1,930.80 |
$1,930.80 |
$411.20
|
|
Platelets leukoreduced cmv negative apheresis/phresis each unit
|
$1,554.00 |
$1,554.00 |
$1,554.00 |
$1,094.60
|
|
Platelets pheresis leukocytes reduced cmv negative irradiated each unit
|
$1,552.20 |
$1,552.20 |
$1,552.20 |
$1,170.65
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,329.00 |
$1,329.00 |
$1,329.00 |
$1,139.20
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,329.00 |
$1,329.00 |
$1,329.00 |
$1,278.55
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,930.80 |
$1,930.80 |
$1,930.80 |
$1,004.00
|
|
Plcmnt biliary drainage cath w/img ext
|
$4,990.80 |
$4,990.80 |
$4,990.80 |
$4,482.60
|
|
Plcmnt stent transcath ctrl dialysis seg add-on
|
$18,330.00 |
$18,330.00 |
$18,330.00 |
$6,927.20
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$5,967.00 |
$5,967.00 |
$5,967.00 |
$5,074.68
|
|
Plcmnt ureteral stent pq w/img new w/cath
|
$5,967.00 |
$5,967.00 |
$5,967.00 |
$5,589.75
|
|
Plcmt dlyd xtn pros 1st vsl
|
$8,490.60 |
$8,490.60 |
$8,490.60 |
$3,793.50
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$961.20 |
$961.20 |
$961.20 |
$1,230.00
|
|
Plcmt sft tiss loc pq w/img ea addl lsn
|
$961.20 |
$961.20 |
$961.20 |
$751.30
|
|
Plcmt xtn pros evasc rpr per vsl
|
$12,775.20 |
$12,775.20 |
$12,775.20 |
$3,579.75
|
|
Plc pq device breast ea addl lesion MRI guide
|
$5,169.00 |
$5,169.00 |
$5,169.00 |
$1,482.50
|
|
Plc pq device breast ea addl lesion stereo guide
|
$999.60 |
$999.60 |
$999.60 |
$691.20
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$999.60 |
$999.60 |
$999.60 |
$758.52
|
|
Plethysmography lung volumes/airway resistance
|
$488.40 |
$488.40 |
$488.40 |
$405.00
|
|
Plmt access bil tree sm bwl
|
$5,779.20 |
$5,779.20 |
$5,779.20 |
$4,661.80
|
|
Plmt biliary drainage cath
|
$4,990.80 |
$4,990.80 |
$4,990.80 |
$4,762.80
|
|
Plmt nephroureteral catheter
|
$4,639.80 |
$4,639.80 |
$4,639.80 |
$4,081.37
|
|
Plmt ureteral stent prq
|
$5,967.00 |
$5,967.00 |
$5,967.00 |
$5,104.20
|
|
Pm device progr eval dual
|
$459.60 |
$459.60 |
$459.60 |
$148.00
|
|
Pm device progr eval multi
|
$459.60 |
$459.60 |
$459.60 |
$139.00
|
|
Pmp22 gene dup/delet
|
$2,274.00 |
$2,274.00 |
$2,274.00 |
$1,029.75
|
|
Pmp22 gene full sequence
|
$2,274.00 |
$2,274.00 |
$2,274.00 |
$986.40
|
|
Pm phone r-strip device eval
|
$423.00 |
$423.00 |
$423.00 |
$139.10
|
|
Pms2 gene dup/delet variants
|
$598.20 |
$598.20 |
$598.20 |
$407.20
|
|
Pms2 gene full seq analysis
|
$1,045.80 |
$1,045.80 |
$1,045.80 |
$1,002.60
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$259.80 |
$259.80 |
$259.80 |
$187.32
|
|
Polysom <6 yrs cpap/bilvl
|
$6,829.80 |
$6,829.80 |
$6,829.80 |
$3,494.55
|
|
Polysom any age 1-3> param
|
$3,551.40 |
$3,551.40 |
$3,551.40 |
$1,424.80
|
