|
Ortho shoe add full sole
|
$122.40 |
$122.40 |
$122.40 |
$109.15
|
|
Orthovisc inj per dose
|
$364.80 |
$364.80 |
$364.80 |
$537.58
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$750.40 |
$750.40 |
$750.40 |
$454.40
|
|
Oscillation chest wall mechanical per session
|
$61.60 |
$61.60 |
$61.60 |
$196.70
|
|
Osmolality blood
|
$33.57 |
$33.57 |
$33.57 |
$68.80
|
|
Osmolality urine
|
$33.57 |
$33.57 |
$33.57 |
$65.00
|
|
Ostectomy complete 1st metatarsal head 28111
|
$2,441.60 |
$2,441.60 |
$2,441.60 |
$3,266.96
|
|
Ostectomy scapula partial
|
$2,817.60 |
$2,817.60 |
$2,817.60 |
$3,821.05
|
|
Osteoart algrft w/surf & b1
|
$1,780.80 |
$1,780.80 |
$1,780.80 |
$1,864.80
|
|
Osteochondral knee allograft
|
$6,753.60 |
$6,753.60 |
$6,753.60 |
$10,629.07
|
|
Osteochondral knee autograft
|
$4,822.40 |
$4,822.40 |
$4,822.40 |
$7,952.51
|
|
Osteochondral talus autogrft
|
$6,019.20 |
$6,019.20 |
$6,019.20 |
$6,982.66
|
|
Osteopath manip tx/5-6 body region 98927
|
$132.00 |
$132.00 |
$132.00 |
$67.84
|
|
Osteopath manip tx/7-8 body region 98928
|
$161.60 |
$161.60 |
$161.60 |
$83.27
|
|
Osteopath manip tx/9-10 body region98929
|
$192.00 |
$192.00 |
$192.00 |
$89.00
|
|
Osteoplasty humerus
|
$5,048.00 |
$5,048.00 |
$5,048.00 |
$7,913.97
|
|
Osteot dsc ant 1 vrt sgm crv
|
$3,925.60 |
$3,925.60 |
$3,925.60 |
$3,925.60
|
|
Osteot dsc ant 1vrt sgm ea
|
$879.20 |
$879.20 |
$879.20 |
$562.44
|
|
Osteot dsc ant 1vrt sgm thrc
|
$4,100.00 |
$4,100.00 |
$4,100.00 |
$6,063.98
|
|
Osteot humerus w/wo int fixj
|
$4,049.60 |
$4,049.60 |
$4,049.60 |
$7,907.11
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$3,360.00 |
$3,360.00 |
$3,360.00 |
$7,906.00
|
|
Other immunoelectrophoresis
|
$46.40 |
$46.40 |
$46.40 |
$107.52
|
|
Oth resp proc, group
|
$228.75 |
$228.75 |
$228.75 |
$126.26
|
|
Oth resp proc, indiv
|
$205.86 |
$205.86 |
$205.86 |
$84.00
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$156.41 |
$156.41 |
$156.41 |
$98.40
|
|
Otolaryngo binocular microscopy 92504
|
$63.20 |
$63.20 |
$63.20 |
$59.40
|
|
Otoplasty 69300
|
$3,043.20 |
$3,043.20 |
$3,043.20 |
$3,592.74
|
|
Ot re-evaluation patient/family
|
$132.00 |
$132.00 |
$132.00 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$66.96 |
$66.96 |
$66.96 |
$88.50
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$66.96 |
$66.96 |
$66.96 |
$91.91
|
|
Out of office emerg med serv
|
$56.00 |
$56.00 |
$56.00 |
$56.00
|
|
Ovarian cystectomy 58925
|
$1,884.00 |
$1,884.00 |
$1,884.00 |
$5,841.60
|
|
Ovulation tests
|
$29.60 |
$29.60 |
$29.60 |
$29.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$0.80 |
$0.80 |
$0.80 |
$348.69
|
|
Oxytetracycline injection
|
$1.60 |
$1.60 |
$1.60 |
$1.60
|
|
Oxytocin 10 unit/ml injection solution
|
$32.67 |
$32.67 |
$32.67 |
$50.40
|
|
P-32 sod phosphate ther per mci
|
$436.00 |
$436.00 |
$436.00 |
$469.34
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$0.60 |
$0.60 |
$0.60 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$16.80 |
$16.80 |
$16.80 |
$3,435.42
|
|
Palb2 gene full gene seq
|
$649.44 |
$649.44 |
$649.44 |
$672.50
|
|
Paliperidone 117 mg/0.75 ml inj
|
$15.20 |
$15.20 |
$15.20 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$1,749.60 |
$1,749.60 |
$1,749.60 |
$5,569.20
|
|
Palonosetron hcl
|
$23.20 |
$23.20 |
$23.20 |
$162.89
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$17.60 |
$17.60 |
$17.60 |
$122.00
|
|
Pancreatectomy
|
$4,616.80 |
$4,616.80 |
$4,616.80 |
$4,616.80
|
|
Pancreatectomy
|
$7,116.00 |
$7,116.00 |
$7,116.00 |
$7,116.00
|
|
Pancreatectomy 48153
|
$7,609.60 |
$7,609.60 |
$7,609.60 |
$7,609.60
|
|
Pancreatectomy dist subtot w/wo splenecto 48140
|
$3,836.00 |
$3,836.00 |
$3,836.00 |
$2,927.40
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$165.60 |
$165.60 |
$165.60 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$78.16 |
$78.16 |
$78.16 |
$28.90
|
|
Parathormone (pth) intact
|
$109.28 |
$109.28 |
$109.28 |
$206.18
|
|
Parathyrdec/expl parathyr medstnl sternal/tthrc 60505
|
$3,424.80 |
$3,424.80 |
$3,424.80 |
$2,681.40
|
|
Parathyrd planar w/spect&ct
|
$1,409.06 |
$1,409.06 |
$1,409.06 |
$1,574.40
|
|
Parathyroid autotransplantation 60512
|
$598.40 |
$598.40 |
$598.40 |
$1,716.15
|
|
Parathyroid planar imaging
|
$681.60 |
$681.60 |
$681.60 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$1,214.71 |
$1,214.71 |
$1,214.71 |
$1,374.75
|
|
Paravaginal defect repair 57284
|
$2,071.20 |
$2,071.20 |
$2,071.20 |
$5,841.60
|
|
Parial mast w/lymph removal 19302
|
$4,406.40 |
$4,406.40 |
$4,406.40 |
$5,763.23
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$245.89 |
$245.89 |
$245.89 |
$245.89
|
|
Parotid duct diversion
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$6,547.81
|
|
Parotid duct diversion
|
$2,048.80 |
$2,048.80 |
$2,048.80 |
$6,839.00
|
|
Parotid duct diversion
|
$1,517.60 |
$1,517.60 |
$1,517.60 |
$3,837.72
|
|
Part exc/post vert comp/sng/thorac 22101
|
$2,093.60 |
$2,093.60 |
$2,093.60 |
$5,855.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$488.80 |
$488.80 |
$488.80 |
$3,762.53
|
|
Partial complicated cystectomy 51555
|
$3,190.40 |
$3,190.40 |
$3,190.40 |
$2,497.20
|
|
Partial exc bone humerus
|
$3,460.80 |
$3,460.80 |
$3,460.80 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$2,982.40 |
$2,982.40 |
$2,982.40 |
$4,914.00
|
|
Partial excision of lip
|
$1,267.20 |
$1,267.20 |
$1,267.20 |
$4,133.59
|
|
Partial hip replacement
|
$5,574.40 |
$5,574.40 |
$5,574.40 |
$3,303.00
|
|
Partial hysterectomy
|
$2,400.00 |
$2,400.00 |
$2,400.00 |
$1,993.68
|
|
Partial proctectomy; perineal 45123
|
$2,772.80 |
$2,772.80 |
$2,772.80 |
$2,772.80
|
|
Partial removal finger bone
|
$1,214.40 |
$1,214.40 |
$1,214.40 |
$2,211.05
|
|
Partial removal finger bone
|
$1,085.60 |
$1,085.60 |
$1,085.60 |
$2,134.33
|
|
Partial removal foot fascia
|
$2,612.80 |
$2,612.80 |
$2,612.80 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$4,315.20 |
$4,315.20 |
$4,315.20 |
$4,315.20
|
|
Partial removal of bladder
|
$2,421.60 |
$2,421.60 |
$2,421.60 |
$1,465.20
|
|
Partial removal of esophagus 43117
|
$7,937.60 |
$7,937.60 |
$7,937.60 |
$7,937.60
|
|
Partial removal of esophagus 43122
|
$6,258.40 |
$6,258.40 |
$6,258.40 |
$6,258.40
|
|
Partial removal of eye fluid
|
$2,340.80 |
$2,340.80 |
$2,340.80 |
$2,698.92
|
|
Partial removal of eye fluid
|
$2,689.60 |
$2,689.60 |
$2,689.60 |
$2,698.92
|
|
Partial removal of fibula
|
$3,283.20 |
$3,283.20 |
$3,283.20 |
$3,821.05
|
|
Partial removal of foot bone
|
$1,521.60 |
$1,521.60 |
$1,521.60 |
$3,839.54
|
|
Partial removal of hand bone
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$3,839.54
|
|
Partial removal of heart sac 33030
|
$4,877.60 |
$4,877.60 |
$4,877.60 |
$3,809.40
|
|
Partial removal of lip
|
$1,344.00 |
$1,344.00 |
$1,344.00 |
$3,276.00
|
|
Partial removal of liver
|
$7,545.60 |
$7,545.60 |
$7,545.60 |
$7,545.60
|
|
Partial removal of liver
|
$8,103.20 |
$8,103.20 |
$8,103.20 |
$8,103.20
|
|
Partial removal of lung 32480
|
$3,603.20 |
$3,603.20 |
$3,603.20 |
$2,868.60
|
|
Partial removal of nose
|
$1,935.20 |
$1,935.20 |
$1,935.20 |
$6,603.11
|
|
Partial removal of pancreas
|
$4,003.20 |
$4,003.20 |
$4,003.20 |
$4,003.20
|
|
Partial removal of pancreas
|
$7,637.60 |
$7,637.60 |
$7,637.60 |
$7,637.60
|
|
Partial removal of penis
|
$1,592.80 |
$1,592.80 |
$1,592.80 |
$4,081.37
|
|
Partial removal of pharynx 42890
|
$3,522.40 |
$3,522.40 |
$3,522.40 |
$6,465.11
|
|
Partial removal of radius
|
$2,875.20 |
$2,875.20 |
$2,875.20 |
$3,986.00
|
|
Partial removal of radius
|
$2,128.00 |
$2,128.00 |
$2,128.00 |
$3,472.00
|
|
Partial removal of rectum
|
$2,684.00 |
$2,684.00 |
$2,684.00 |
$2,414.94
|
|
Partial removal of rectum
|
$3,893.60 |
$3,893.60 |
$3,893.60 |
$3,893.60
|
|
Partial removal of rib
|
$1,351.20 |
$1,351.20 |
$1,351.20 |
$5,376.00
|
|
Partial removal of sternum
|
$1,236.00 |
$1,236.00 |
$1,236.00 |
$1,236.00
|
|
Partial removal of thyroid
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$5,855.00
|
