|
MRI breast c- unilateral
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$1,084.20
|
|
MRI breast c-+ w/cad uni
|
$4,828.00 |
$4,828.00 |
$4,828.00 |
$1,704.95
|
|
MRI breast without cont bi
|
$4,158.40 |
$4,158.40 |
$4,158.40 |
$1,778.00
|
|
MRI breast w IV cont bi
|
$7,242.40 |
$7,242.40 |
$7,242.40 |
$1,875.95
|
|
MRI chest without contrast
|
$3,140.80 |
$3,140.80 |
$3,140.80 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$4,121.60 |
$4,121.60 |
$4,121.60 |
$2,652.73
|
|
MRI chest w IV cont
|
$3,533.60 |
$3,533.60 |
$3,533.60 |
$2,210.00
|
|
MRI loex nonjt w IV cont
|
$4,849.60 |
$4,849.60 |
$4,849.60 |
$2,092.50
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$4,767.20 |
$4,767.20 |
$4,767.20 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$5,399.20 |
$5,399.20 |
$5,399.20 |
$2,790.45
|
|
MRI orbit/face/neck without contrast
|
$2,361.60 |
$2,361.60 |
$2,361.60 |
$1,883.25
|
|
MRI orbit/face/neck without & w/contrast
|
$3,114.40 |
$3,114.40 |
$3,114.40 |
$2,830.10
|
|
MRI orbit fac&nck w IV cont
|
$2,648.80 |
$2,648.80 |
$2,648.80 |
$2,165.00
|
|
MRI tmj
|
$2,309.60 |
$2,309.60 |
$2,309.60 |
$1,736.28
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$4,204.80 |
$4,204.80 |
$4,204.80 |
$2,001.40
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$5,565.60 |
$5,565.60 |
$5,565.60 |
$2,710.40
|
|
MRI upper extremity w/dye
|
$4,712.00 |
$4,712.00 |
$4,712.00 |
$2,011.63
|
|
Mr safety determination physician/other qhp
|
$152.00 |
$152.00 |
$152.00 |
$161.40
|
|
Mr safety implant elec prepj
|
$159.20 |
$159.20 |
$159.20 |
$168.60
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$85.60 |
$85.60 |
$85.60 |
$55.00
|
|
Mr safety implt pos&/immoblj
|
$102.40 |
$102.40 |
$102.40 |
$120.95
|
|
Mr sfty implt&/fb asmt stf 1
|
$43.20 |
$43.20 |
$43.20 |
$45.58
|
|
Mr sfty med physics xm cstmz
|
$419.20 |
$419.20 |
$419.20 |
$444.00
|
|
Msh2 gene full seq
|
$1,336.80 |
$1,336.80 |
$1,336.80 |
$764.00
|
|
Msh6 gene full seq
|
$2,247.20 |
$2,247.20 |
$2,247.20 |
$1,194.60
|
|
Mthfr gene analy common variants
|
$732.80 |
$732.80 |
$732.80 |
$168.85
|
|
Mucopolysaccharides
|
$978.40 |
$978.40 |
$978.40 |
$178.36
|
|
Multiple sleep latency test
|
$3,221.60 |
$3,221.60 |
$3,221.60 |
$2,484.96
|
|
Mumps antibody igg
|
$233.60 |
$233.60 |
$233.60 |
$78.00
|
|
Mycoplasma antibody igm
|
$153.60 |
$153.60 |
$153.60 |
$78.40
|
|
Myd88 gene p.leu265pro vrnt
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$414.05
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$4,194.40 |
$4,194.40 |
$4,194.40 |
$135.50
|
|
Nasopharyngoscopy w/endoscope
|
$495.20 |
$495.20 |
$495.20 |
$292.79
|
|
Natriuretic peptide
|
$208.80 |
$208.80 |
$208.80 |
$176.15
|
|
N block inj hypogas plxs
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,912.00
|
|
Ndl insj without njx 1 or 2 musc
|
$40.00 |
$40.00 |
$40.00 |
$39.77
|
|
Ndl insj without njx 3+ musc
|
$40.00 |
$40.00 |
$40.00 |
$45.00
|
|
Ndl round specialty proguide
|
$410.40 |
$410.40 |
$410.40 |
$329.50
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,573.60 |
$2,573.60 |
$2,573.60 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,363.20 |
$2,363.20 |
$2,363.20 |
$1,498.90
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,398.40 |
$4,398.40 |
$4,398.40 |
$2,854.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,337.60 |
$3,337.60 |
$3,337.60 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$3,301.60 |
$3,301.60 |
$3,301.60 |
$2,000.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,381.60 |
$3,381.60 |
$3,381.60 |
$2,708.10
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,966.40 |
$2,966.40 |
$2,966.40 |
$2,051.40
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,706.40 |
$2,706.40 |
$2,706.40 |
$1,790.58
|
|
Nerve conduction studies 1-2
|
$415.20 |
$415.20 |
$415.20 |
$334.80
|
|
Nerve conduction studies 3-4
|
$831.20 |
$831.20 |
$831.20 |
$466.05
|
|
Neurolysis celiac plexus
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,754.00
|
|
Neurolysis trigeminal nerve
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$2,054.00
|
|
New Patient Office Visit (level 2)
|
$237.60 |
$237.60 |
$237.60 |
$151.56
|
|
New Patient Office Visit (level 3)
|
$345.60 |
$345.60 |
$345.60 |
$208.20
|
|
New Patient Office Visit (level 4)
|
$437.60 |
$437.60 |
$437.60 |
$289.60
|
|
New Patient Office Visit (level 5)
|
$546.40 |
$546.40 |
$546.40 |
$348.60
|
|
Nfct ds bv&vaginitis dna alg
|
$646.40 |
$646.40 |
$646.40 |
$400.00
|
|
Njx interlaminar crv/thrc
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,586.71
|
|
Njx interlaminar crv/thrc
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,788.00
|
|
Njx interlaminar lmbr/sac
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,493.92
|
|
Njx interlaminar lmbr/sac
|
$1,393.60 |
$1,393.60 |
$1,393.60 |
$1,927.39
|
|
Nm imaging bone/joint 3 phase study
|
$1,970.40 |
$1,970.40 |
$1,970.40 |
$1,704.00
|
|
Nm imaging bone/joint whole body
|
$1,537.60 |
$1,537.60 |
$1,537.60 |
$1,570.65
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$1,401.00
|
|
Nm imaging gastric emptying study
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$1,345.40
|
|
Nm imaging gastrointestinal acute blood loss
|
$1,456.80 |
$1,456.80 |
$1,456.80 |
$1,208.93
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$1,464.80 |
$1,464.80 |
$1,464.80 |
$1,612.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,404.00 |
$1,404.00 |
$1,404.00 |
$1,547.04
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,775.20 |
$1,775.20 |
$1,775.20 |
$1,580.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,278.40 |
$1,278.40 |
$1,278.40 |
$1,091.00
|
|
Non-card vasc flow imaging
|
$662.40 |
$662.40 |
$662.40 |
$608.56
|
|
Noonan spectrum disorders
|
$4,999.20 |
$4,999.20 |
$4,999.20 |
$2,452.80
|
|
Npm1 gene
|
$1,158.40 |
$1,158.40 |
$1,158.40 |
$457.50
|
|
Nras gene variants exon 2&3
|
$724.80 |
$724.80 |
$724.80 |
$621.87
|
|
Nuclear Stress Test (Heart)
|
$4,462.40 |
$4,462.40 |
$4,462.40 |
$3,801.60
|
|
Nushield 1 square cm
|
$1,569.60 |
$1,569.60 |
$1,569.60 |
$937.50
|
|
Observation direct referral from physician office for admission
|
$763.20 |
$763.20 |
$763.20 |
$387.00
|
|
Observation per hour
|
$625.60 |
$625.60 |
$625.60 |
$80.73
|
|
Off/op cnsltj new/est low 30
|
$513.60 |
$513.60 |
$513.60 |
$180.00
|
|
Off/op cnsltj new/est mod 40
|
$663.20 |
$663.20 |
$663.20 |
$269.60
|
|
Off/op consltj new/est hi 55
|
$847.20 |
$847.20 |
$847.20 |
$339.30
|
|
Off/op consltj new/est sf 20
|
$384.00 |
$384.00 |
$384.00 |
$133.80
|
|
Organic acids total quant ea spec
|
$472.80 |
$472.80 |
$472.80 |
$149.40
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$780.80 |
$780.80 |
$780.80 |
$174.40
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$113.60 |
$113.60 |
$113.60 |
$461.28
|
|
Oscillation chest wall mechanical per session
|
$98.40 |
$98.40 |
$98.40 |
$196.70
|
|
Osmolality blood
|
$149.60 |
$149.60 |
$149.60 |
$68.40
|
|
Osmolality urine
|
$156.00 |
$156.00 |
$156.00 |
$65.52
|
|
Ot evaluation high complexity patient/family
|
$371.20 |
$371.20 |
$371.20 |
$292.00
|
|
Ot evaluation low complexity patient/family
|
$308.80 |
$308.80 |
$308.80 |
$228.58
|
|
Ot evaluation moderate complexity patient/family
|
$329.60 |
$329.60 |
$329.60 |
$257.74
|
|
Oth resp proc, group
|
$63.20 |
$63.20 |
$63.20 |
$122.84
|
|
Oth resp proc, indiv
|
$69.60 |
$69.60 |
$69.60 |
$81.73
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$144.00 |
$144.00 |
$144.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$104.97
|
|
Ot re-evaluation patient/family
|
$214.40 |
$214.40 |
$214.40 |
$158.40
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$99.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$144.00 |
$144.00 |
$144.00 |
$86.69
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$144.00 |
$144.00 |
$144.00 |
$91.20
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$97.44
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$144.00 |
$144.00 |
$144.00 |
$100.65
|