|
Non-sterile gauze<=16 sq in
|
$6.60 |
$6.60 |
$7.20 |
$32.08
|
|
Nose (Nasal Bone) X-ray (complete)
|
$180.60 |
$180.60 |
$197.40 |
$274.65
|
|
Npsy tst eval phsy/qhp 1st hr
|
$236.40 |
$236.40 |
$740.40 |
$410.00
|
|
Npsy tst eval phsy/qhp ea l hr
|
$181.20 |
$181.20 |
$365.40 |
$252.54
|
|
Nr lnr acclrtr tx max 5 sessions
|
$3,981.60 |
$3,981.60 |
$4,348.20 |
$6,930.00
|
|
Nsl/sins ndsc surg frnt sins
|
$5,233.80 |
$5,233.80 |
$5,495.40 |
$5,495.40
|
|
Nsl/sins ndsc surg max sins
|
$3,856.80 |
$3,856.80 |
$4,049.40 |
$5,695.20
|
|
Nsl/sins ndsc surg sphn sins
|
$5,185.20 |
$5,185.20 |
$5,444.40 |
$4,881.00
|
|
Ntrprof ph1/ntrnet/ehr 5/>
|
$43.80 |
$43.80 |
$46.20 |
$46.20
|
|
Ntrprof ph1/ntrnet/ehr 5-10
|
$24.00 |
$24.00 |
$25.20 |
$32.80
|
|
Ntrprof ph1/ntrnet/ehr rfrl
|
$43.80 |
$43.80 |
$46.20 |
$66.40
|
|
Ntsty modul rad tx dlvr cplx
|
$1,778.40 |
$1,778.40 |
$2,053.80 |
$2,494.40
|
|
Ntsty modul rad tx dlvr smpl
|
$1,564.20 |
$1,564.20 |
$1,807.20 |
$2,165.29
|
|
Nuclear Stress Test (Heart)
|
$2,021.40 |
$2,021.40 |
$2,208.00 |
$3,858.20
|
|
Nursing fac care supervision
|
$186.60 |
$186.60 |
$196.20 |
$124.80
|
|
Nursing fac care supervision
|
$174.00 |
$174.00 |
$183.00 |
$187.20
|
|
Nursing facility discharge management > 30 min 99316
|
$192.00 |
$192.00 |
$201.60 |
$166.25
|
|
Nursing facility discharge management 30 min/less than 99315
|
$132.60 |
$132.60 |
$139.20 |
$119.60
|
|
Nushield 1 square cm
|
$2,981.40 |
$2,981.40 |
$2,981.40 |
$914.95
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$13,801.25 |
$13,801.25 |
$15,284.46 |
$14,865.31
|
|
Observation care discharge
|
$137.40 |
$137.40 |
$144.00 |
$144.00
|
|
Observation direct referral from physician office for admission
|
$135.60 |
$135.60 |
$148.20 |
$385.00
|
|
Observation/inpatient hospital care hi severity 99236
|
$417.60 |
$417.60 |
$438.60 |
$390.40
|
|
Observation/inpatient hospital care low severity 99234
|
$256.80 |
$256.80 |
$269.40 |
$239.20
|
|
Observation/inpatient hospital care mod severity 99235
|
$324.60 |
$324.60 |
$340.80 |
$303.20
|
|
Obstetrical care 59410
|
$2,030.40 |
$2,030.40 |
$2,131.80 |
$2,112.80
|
|
Obstetrics panel
|
$84.00 |
$84.00 |
$90.60 |
$214.50
|
|
Obtaining screen pap smear
|
$82.80 |
$82.80 |
$87.00 |
$38.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$220.80 |
$220.80 |
$220.80 |
$356.59
|
|
Occlude fallopian tube(s) device 58615
|
$454.20 |
$454.20 |
$477.00 |
$3,744.41
|
|
Occupational Therapy Evaluation (high complexity)
|
$223.80 |
$223.80 |
$258.60 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$202.80 |
$202.80 |
$213.00 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$213.00 |
$213.00 |
$223.80 |
$264.55
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$31,534.07 |
$31,534.07 |
$36,571.69 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$246.34 |
$246.34 |
$246.34 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$11,780.53 |
$11,780.53 |
$12,255.94 |
$12,080.43
|
|
Office consultation
|
$70.80 |
$70.80 |
$74.40 |
$121.55
|
|
Office emergency care
|
$99.60 |
$99.60 |
$104.40 |
$50.40
|
|
Off/op cnsltj new/est low 30
|
$174.00 |
$174.00 |
$183.00 |
$183.00
|
|
Off/op cnsltj new/est mod 40
|
$260.40 |
$260.40 |
$273.60 |
$273.60
|
|
Off/op consltj new/est hi 55
|
$316.20 |
$316.20 |
$331.80 |
$349.80
|
|
Off/op consltj new/est sf 20
|
$127.20 |
$127.20 |
$133.80 |
$133.80
|
|
Olanzapine 10 mg intramuscular solution
|
$101.44 |
$101.44 |
$101.44 |
$109.62
|
|
Ol dig e/m svc 11-20 min
|
$29.40 |
$29.40 |
$30.60 |
$35.00
|
|
Ol dig e/m svc 21+ min
|
$49.80 |
$49.80 |
$52.20 |
$52.20
|
|
Ol dig e/m svc 5-10 min
|
$20.40 |
$20.40 |
$21.60 |
$21.60
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$2,326.61 |
$2,326.61 |
$2,520.65 |
$4,595.01
|
|
Omental flap extra-abdom 49904
|
$2,635.20 |
$2,635.20 |
$2,767.20 |
$3,446.40
|
|
Omental flap intra-abdom 49905
|
$705.60 |
$705.60 |
$741.00 |
$871.20
|
|
Ondansetron 4 mg s0119
|
$0.60 |
$0.60 |
$0.60 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$50.26 |
$50.26 |
$50.26 |
$22.62
|
|
One-way allow prorated trip
|
$15.60 |
$15.60 |
$18.00 |
$18.57
|
|
Oophorectomy partial or total 58943
|
$2,092.20 |
$2,092.20 |
$2,196.60 |
$2,901.60
|
|
Open aortic tube prosth repair 34830
|
$3,387.00 |
$3,387.00 |
$3,556.20 |
$4,289.60
|
|
Open aortoiliac prosth repr 34831
|
$3,209.40 |
$3,209.40 |
$3,369.60 |
$3,414.40
|
|
Open bx/exc inguinofem nodes
|
$816.60 |
$816.60 |
$857.40 |
$4,992.00
|
|
Open bx of lung pleura 32098
|
$1,124.40 |
$1,124.40 |
$1,180.80 |
$1,852.00
|
|
Open cor endarterect w cabg/ea ves 33572
|
$429.60 |
$429.60 |
$451.20 |
$1,154.40
|
|
Open periprosthetic breast capsule 19370
|
$1,260.60 |
$1,260.60 |
$1,323.60 |
$4,520.16
|
|
Open skull for drainage 61312
|
$3,645.00 |
$3,645.00 |
$3,827.40 |
$4,872.80
|
|
Open tenotomy tendon flexor foot single or multiple 28230
|
$783.60 |
$783.60 |
$822.60 |
$2,180.80
|
|
Open thrombectomy of av fistula without revision 36831
|
$860.40 |
$860.40 |
$903.60 |
$6,311.00
|
|
Open tx rib 1-3 fx w/fix 21811
|
$1,243.80 |
$1,243.80 |
$1,306.20 |
$5,855.00
|
|
Open tx rib 4-6 fx w/fix 21812
|
$1,491.60 |
$1,491.60 |
$1,566.00 |
$5,112.80
|
|
Open tx rib 7+ fx w/fix 21813
|
$2,029.80 |
$2,029.80 |
$2,131.20 |
$3,986.00
|
|
Open tx/sternum fracture 21825
|
$1,003.80 |
$1,003.80 |
$1,054.20 |
$1,323.20
|
|
Open wedge bx lung nodule 32097
|
$1,479.60 |
$1,479.60 |
$1,553.40 |
$1,955.20
|
|
Ophth Ultrasound b & quant a
|
$190.20 |
$190.20 |
$208.20 |
$301.60
|
|
Opn exc/dst ntra-abd
|
$2,880.00 |
$2,880.00 |
$2,880.00 |
$3,221.64
|
|
Opn fem art expos cndt crtj 34714
|
$540.00 |
$540.00 |
$567.00 |
$2,041.65
|
|
Opn tx complx malar fx
|
$2,053.20 |
$2,053.20 |
$2,155.80 |
$6,605.19
|
|
Opn tx depress front sinus fx 21343
|
$2,229.00 |
$2,229.00 |
$2,340.60 |
$3,723.20
|
|
Opn tx dprsd zygomatic arch
|
$915.60 |
$915.60 |
$961.20 |
$5,110.00
|
|
Opn tx orbit fx without impl 21406
|
$1,033.20 |
$1,033.20 |
$1,084.80 |
$6,430.79
|
|
Opn tx orbit periorbtl implt
|
$1,465.20 |
$1,465.20 |
$1,538.40 |
$6,553.49
|
|
Oprelvekin injection
|
$464.08 |
$464.08 |
$464.08 |
$574.00
|
|
Optokinetic nystagmus test
|
$39.00 |
$39.00 |
$40.80 |
$40.80
|
|
Optx complicated mndblr fx
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$6,553.49
|
|
Optx medial ankle fx
|
$848.40 |
$848.40 |
$848.40 |
$6,653.00
|
|
Oral aprepitant
|
$203.86 |
$203.86 |
$302.47 |
$410.20
|
|
Oral busulfan
|
$8.03 |
$8.03 |
$8.03 |
$176.80
|
|
Oral everolimus
|
$1,044.92 |
$1,044.92 |
$1,182.59 |
$30.30
|
|
Orchiopexy ingun/scrot appr
|
$627.00 |
$627.00 |
$658.20 |
$4,176.15
|
|
Organic acids total quant ea spec
|
$189.00 |
$189.00 |
$210.60 |
$152.50
|
|
Oritavancin 400 mg intravenous solution
|
$1,741.77 |
$1,741.77 |
$1,741.77 |
$3,311.06
|
|
Oropharyngeal biopsy 42800
|
$297.60 |
$297.60 |
$312.60 |
$2,443.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$56.42 |
$56.42 |
$56.42 |
$50.63
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$78.00 |
$78.00 |
$82.20 |
$174.40
|
|
Orthopantogram
|
$151.20 |
$151.20 |
$173.40 |
$241.50
|
|
Orthovisc inj per dose
|
$859.06 |
$859.06 |
$859.06 |
$537.58
|
|
Osmolality blood
|
$57.00 |
$57.00 |
$64.20 |
$69.55
|
|
Osmolality urine
|
$61.80 |
$61.80 |
$69.00 |
$65.50
|
|
Ostectomy complete 1st metatarsal head 28111
|
$918.60 |
$918.60 |
$964.80 |
$3,266.96
|
|
Osteopath manip tx/5-6 body region 98927
|
$128.40 |
$128.40 |
$135.00 |
$67.84
|
|
Osteopath manip tx/7-8 body region 98928
|
$133.20 |
$133.20 |
$139.80 |
$83.27
|
|
Osteopath manip tx/9-10 body region98929
|
$159.60 |
$159.60 |
$167.40 |
$89.00
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$1,377.60 |
$1,377.60 |
$1,446.60 |
$7,906.00
|
|
Oth resp proc, group
|
$124.20 |
$124.20 |
$139.80 |
$126.00
|
|
Oth resp proc, indiv
|
$52.80 |
$52.80 |
$58.80 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$84.00 |
$84.00 |
$88.20 |
$98.40
|
