|
Ortho elbow w/lock w/ft&adj
|
$686.40 |
$686.40 |
$686.40 |
$536.90
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$396.60 |
$396.60 |
$396.60 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$499.20 |
$499.20 |
$499.20 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$176.40 |
$176.40 |
$176.40 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$585.60 |
$585.60 |
$585.60 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$148.20 |
$148.20 |
$148.20 |
$231.00
|
|
Orthopantogram
|
$364.80 |
$364.80 |
$364.80 |
$241.50
|
|
Orthop traing pfrmd phys/qhp
|
$115.20 |
$115.20 |
$115.20 |
$148.20
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$326.40 |
$326.40 |
$326.40 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$538.80 |
$538.80 |
$538.80 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$78.00 |
$78.00 |
$332.40 |
$195.00
|
|
Osmolality blood
|
$54.60 |
$54.60 |
$214.80 |
$67.60
|
|
Osmolality urine
|
$57.60 |
$57.60 |
$214.80 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$278.40 |
$278.40 |
$278.40 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$231.60 |
$231.60 |
$231.60 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$247.20 |
$247.20 |
$247.20 |
$263.50
|
|
Oth resp proc, group
|
$114.00 |
$114.00 |
$114.00 |
$123.05
|
|
Oth resp proc, indiv
|
$111.60 |
$111.60 |
$111.60 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$108.00 |
$108.00 |
$108.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$105.00 |
$105.00 |
$105.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$105.00 |
$105.00 |
$105.00 |
$105.00
|
|
Ot re-evaluation patient/family
|
$160.80 |
$160.80 |
$160.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$105.00 |
$105.00 |
$159.60 |
$101.38
|
|
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 |
$133.80 |
$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
|
$232.20 |
$232.20 |
$232.20 |
$29.60
|
|
Parathormone (pth) intact
|
$182.40 |
$182.40 |
$355.20 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$2,652.00 |
$2,652.00 |
$2,652.00 |
$1,574.40
|
|
Parathyroid planar imaging
|
$819.00 |
$819.00 |
$1,125.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,204.20 |
$1,204.20 |
$1,204.20 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$468.60 |
$468.60 |
$468.60 |
$245.00
|
|
Patient recorded spirometry
|
$276.60 |
$276.60 |
$276.60 |
$338.52
|
|
Ped home apnea mntr dl&alys
|
$337.20 |
$337.20 |
$337.20 |
$296.92
|
|
Pelvic CT scan (with and without contrast)
|
$1,788.60 |
$1,788.60 |
$2,424.60 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,671.00 |
$1,671.00 |
$2,264.40 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,632.60 |
$1,632.60 |
$2,253.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$2,665.80 |
$2,665.80 |
$3,613.20 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,448.00 |
$2,448.00 |
$3,379.80 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,448.00 |
$2,448.00 |
$3,379.80 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$549.00 |
$549.00 |
$1,282.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$355.20 |
$355.20 |
$617.40 |
$430.00
|
|
Penile injection
|
$2,595.00 |
$2,595.00 |
$2,595.00 |
$418.00
|
|
Penile vascular study
|
$1,658.40 |
$1,658.40 |
$1,658.40 |
$576.40
|
|
Penile vascular study
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$574.60
|
|
Perc cryo ablate renal tum
|
$10,543.80 |
$10,543.80 |
$10,543.80 |
$11,458.04
|
|
Perc rf ablate renal tumor
|
$15,810.60 |
$15,810.60 |
$15,810.60 |
$7,243.60
|
|
Percut ablate liver rf
|
$5,865.60 |
$5,865.60 |
$5,865.60 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$3,163.20 |
$3,163.20 |
$3,163.20 |
$2,251.20
|
|
Peripheral vascular rehab
|
$148.20 |
$148.20 |
$148.20 |
$132.50
|
|
Peri-proc device eval icd
|
$75.60 |
$75.60 |
$75.60 |
$192.40
|
|
Peri-proc device eval pm
|
$103.80 |
$103.80 |
$103.80 |
$159.90
|
|
Peritoneal cath sub q resv per
|
$20,410.80 |
$20,410.80 |
$20,410.80 |
$5,625.74
|
|
Peritoneogram rs&i
|
$513.00 |
$513.00 |
$513.00 |
$695.89
|
|
Perit-vens shunt pat tst
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$1,324.20 |
$1,324.20 |
$1,324.20 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$25,836.00 |
$25,836.00 |
$25,836.00 |
$9,509.53
|
|
Perq dev breast 1st mr guide
|
$8,727.60 |
$8,727.60 |
$8,727.60 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$5,207.40 |
$5,207.40 |
$5,207.40 |
$1,456.00
|
|
Perq nl/pl lithotrp smpl<2cm
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
$9,442.38
|
|
Perq p-art revsc 1 abnor bi
|
$33,939.00 |
$33,939.00 |
$33,939.00 |
$17,321.20
|
|
Perq p-art revsc 1 abnor uni
|
$22,626.00 |
$22,626.00 |
$22,626.00 |
$21,321.00
|
|
Perq p-art revsc 1 nm nt uni
|
$21,433.80 |
$21,433.80 |
$21,433.80 |
$17,321.20
|
|
Perq plmt bile duct stent
|
$14,583.00 |
$14,583.00 |
$14,583.00 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$14,313.60 |
$14,313.60 |
$14,313.60 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$14,313.60 |
$14,313.60 |
$14,313.60 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$368.40 |
$368.40 |
$368.40 |
$625.93
|
|
Perq transcath closure each
|
$11,483.40 |
$11,483.40 |
$11,483.40 |
$9,204.00
|
|
Perq transcath closure pda
|
$34,449.00 |
$34,449.00 |
$34,449.00 |
$18,408.00
|
|
Perq transcath cls aortic
|
$34,449.00 |
$34,449.00 |
$34,449.00 |
$22,633.26
|
|
Perq transcath cls mitral
|
$34,449.00 |
$34,449.00 |
$34,449.00 |
$23,617.60
|
|
Perq transcath septal reduxn
|
$38,341.20 |
$38,341.20 |
$38,341.20 |
$8,605.90
|
|
Perq trluml angp nt/recr coa
|
$27,241.80 |
$27,241.80 |
$27,241.80 |
$7,398.00
|
|
Pet CT skull-mid thgh initial
|
$3,603.00 |
$3,603.00 |
$8,011.80 |
$4,707.00
|
|
Pet CT whole body initial
|
$3,588.00 |
$3,588.00 |
$8,011.80 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$3,459.00 |
$3,459.00 |
$8,011.80 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$3,198.00 |
$3,198.00 |
$8,011.80 |
$4,305.60
|
|
Pet not otherwise specified
|
$8,011.80 |
$8,011.80 |
$8,011.80 |
$1,070.40
|
|
Pet scan brain perf study
|
$8,011.80 |
$8,011.80 |
$8,011.80 |
$3,832.80
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$89.40 |
$89.40 |
$89.40 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$132.60 |
$132.60 |
$132.60 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$46.20 |
$46.20 |
$46.20 |
$33.30
|
|
Ph body fluid
|
$37.80 |
$37.80 |
$96.00 |
$41.28
|
|
Phencyclidine (pcp)
|
$393.60 |
$393.60 |
$393.60 |
$96.00
|
|
Phenobarbital therapeutic drug level
|
$362.40 |
$362.40 |
$362.40 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$67.80 |
$67.80 |
$332.40 |
$110.88
|
|
Phlebotomy therapeutic
|
$142.20 |
$142.20 |
$257.40 |
$231.66
|
|
Phosphorus
|
$42.60 |
$42.60 |
$79.20 |
$48.80
|
|
Phosphorus 24 hour urine
|
$15.00 |
$15.00 |
$193.20 |
$41.51
|
|
Phys blood bank serv reactj
|
$268.20 |
$268.20 |
$268.20 |
$207.50
|
|
Pillow shldr abduc inflat univ
|
$307.80 |
$307.80 |
$307.80 |
$614.36
|
|
Pin service 60m per month
|
$141.00 |
$141.00 |
$183.60 |
$114.00
|
|
Pinworm exam
|
$152.40 |
$152.40 |
$152.40 |
$39.75
|
|
Place breast cath for rad
|
$18,388.20 |
$18,388.20 |
$18,388.20 |
$3,332.00
|
|
Place breast rad tube/caths
|
$20,308.20 |
$20,308.20 |
$20,308.20 |
$7,680.06
|
|
Place cath intracranial art
|
$4,471.80 |
$4,471.80 |
$4,471.80 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$13,630.80 |
$13,630.80 |
$13,630.80 |
$4,202.90
|
|
Place cecostomy tube perc
|
$10,325.40 |
$10,325.40 |
$10,325.40 |
$2,580.90
|
