|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted
|
$188.80 |
$188.80 |
$188.80 |
$322.24
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual
|
$76.40 |
$76.40 |
$76.40 |
$309.50
|
|
M/phmtrc alys ishquant/semiq
|
$184.40 |
$184.40 |
$184.40 |
$540.15
|
|
MRA abdomen post contrast
|
$724.00 |
$724.00 |
$724.00 |
$2,144.35
|
|
MRI chest without contrast
|
$1,360.40 |
$1,360.40 |
$1,360.40 |
$1,661.55
|
|
MRI chest without & w/contrast
|
$2,250.00 |
$2,250.00 |
$2,250.00 |
$2,321.61
|
|
MRI loex nonjt w IV cont
|
$1,513.60 |
$1,513.60 |
$1,513.60 |
$1,953.60
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$1,610.80 |
$1,610.80 |
$1,610.80 |
$2,051.28
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$2,403.20 |
$2,403.20 |
$2,403.20 |
$2,614.43
|
|
MRI orbit/face/neck without & w/contrast
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$2,552.60
|
|
MRI tmj
|
$968.80 |
$968.80 |
$968.80 |
$1,658.77
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$1,402.00 |
$1,402.00 |
$1,402.00 |
$1,902.00
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$2,628.75
|
|
MRI upper extremity w/dye
|
$1,469.20 |
$1,469.20 |
$1,469.20 |
$1,854.07
|
|
Msh2 gene full seq
|
$252.00 |
$252.00 |
$252.00 |
$504.56
|
|
Msh6 gene full seq
|
$423.60 |
$423.60 |
$423.60 |
$641.85
|
|
Mthfr gene analy common variants
|
$171.60 |
$171.60 |
$171.60 |
$248.82
|
|
Multiple sleep latency test
|
$824.00 |
$824.00 |
$824.00 |
$2,672.68
|
|
Mumps antibody igg
|
$74.80 |
$74.80 |
$74.80 |
$81.45
|
|
Mycoplasma antibody igm
|
$44.00 |
$44.00 |
$44.00 |
$87.50
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$146.40 |
$146.40 |
$146.40 |
$115.05
|
|
Natriuretic peptide
|
$109.60 |
$109.60 |
$109.60 |
$161.60
|
|
Natural killer cells total count
|
$122.00 |
$122.00 |
$122.00 |
$121.70
|
|
N block inj hypogas plxs
|
$1,004.00 |
$1,004.00 |
$1,004.00 |
$2,031.75
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$1,307.20 |
$1,307.20 |
$1,307.20 |
$1,685.58
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,264.00 |
$1,264.00 |
$1,264.00 |
$1,435.80
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,849.20 |
$2,849.20 |
$2,849.20 |
$2,562.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$1,549.60 |
$1,549.60 |
$1,549.60 |
$2,164.88
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$1,402.00 |
$1,402.00 |
$1,402.00 |
$1,830.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$1,791.60 |
$1,791.60 |
$1,791.60 |
$2,547.30
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$1,595.60 |
$1,595.60 |
$1,595.60 |
$1,890.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$1,342.40 |
$1,342.40 |
$1,342.40 |
$1,741.80
|
|
New Patient Office Visit (level 3)
|
$221.20 |
$221.20 |
$221.20 |
$205.40
|
|
Nuclear Stress Test (Heart)
|
$1,341.20 |
$1,341.20 |
$1,341.20 |
$3,739.20
|
|
Obstetrics panel
|
$86.80 |
$86.80 |
$86.80 |
$214.50
|
|
Osmolality blood
|
$68.40 |
$68.40 |
$68.40 |
$57.00
|
|
Osmolality urine
|
$86.80 |
$86.80 |
$86.80 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$145.20 |
$145.20 |
$145.20 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$97.60 |
$97.60 |
$97.60 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$121.20 |
$121.20 |
$121.20 |
$249.60
|
|
Other immunoelectrophoresis
|
$68.40 |
$68.40 |
$68.40 |
$92.70
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$70.40 |
$70.40 |
$70.40 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$131.60 |
$131.60 |
$131.60 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$105.50
|
|
Ot re-evaluation patient/family
|
$93.60 |
$93.60 |
$93.60 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$53.60 |
$53.60 |
$53.60 |
$96.11
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$77.60 |
$77.60 |
$77.60 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$85.20 |
$85.20 |
$85.20 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$75.60 |
$75.60 |
$75.60 |
$93.60
|
|
Parathormone (pth) intact
|
$216.40 |
$216.40 |
$216.40 |
$204.00
|
|
Pelvic CT scan (with and without contrast)
|
$1,338.80 |
$1,338.80 |
$1,338.80 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$1,230.80 |
$1,230.80 |
$1,230.80 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$1,145.60 |
$1,145.60 |
$1,145.60 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$2,475.20 |
$2,475.20 |
$2,475.20 |
$2,603.25
|
|
Pelvic MRI (without contrast)
|
$1,694.40 |
$1,694.40 |
$1,694.40 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$564.40 |
$564.40 |
$564.40 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$396.00 |
$396.00 |
$396.00 |
$429.66
|
|
Ph body fluid
|
$16.40 |
$16.40 |
$16.40 |
$35.75
|
|
Phenobarbital therapeutic drug level
|
$80.00 |
$80.00 |
$80.00 |
$97.50
|
|
Phenytoin total therapeutic drug level
|
$82.80 |
$82.80 |
$82.80 |
$100.75
|
|
Phlebotomy therapeutic
|
$94.00 |
$94.00 |
$94.00 |
$240.24
|
|
Phosphorus
|
$44.00 |
$44.00 |
$44.00 |
$42.37
|
|
Phosphorus 24 hour urine
|
$26.80 |
$26.80 |
$26.80 |
$41.51
|
|
Phys blood bank serv reactj
|
$69.20 |
$69.20 |
$69.20 |
$219.94
|
|
Pinworm exam
|
$24.40 |
$24.40 |
$24.40 |
$38.58
|
|
Platelet automated
|
$29.60 |
$29.60 |
$29.60 |
$33.60
|
|
Pms2 gene dup/delet variants
|
$136.00 |
$136.00 |
$136.00 |
$407.20
|
|
Pms2 gene full seq analysis
|
$446.80 |
$446.80 |
$446.80 |
$860.68
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$105.60 |
$105.60 |
$105.60 |
$146.15
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$1,277.20 |
$1,277.20 |
$1,277.20 |
$4,313.58
|
|
Potassium 24 hour urine
|
$18.00 |
$18.00 |
$18.00 |
$45.00
|
|
Potassium serum/plasma/whole blood
|
$50.80 |
$50.80 |
$50.80 |
$40.00
|
|
Pr application of long arm splint
|
$114.40 |
$114.40 |
$114.40 |
$320.00
|
|
Pr application splint static short arm
|
$159.60 |
$159.60 |
$159.60 |
$277.60
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$287.60 |
$287.60 |
$287.60 |
$350.98
|
|
Prealbumin
|
$93.20 |
$93.20 |
$93.20 |
$80.40
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$504.00 |
$504.00 |
$504.00 |
$573.21
|
|
Pregnancy Ultrasound (first trimester)
|
$462.40 |
$462.40 |
$462.40 |
$539.37
|
|
Pretreat rbc absorption reference
|
$78.00 |
$78.00 |
$78.00 |
$139.00
|
|
Pretreat rbc w chem/drugs reference
|
$41.20 |
$41.20 |
$41.20 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$98.40 |
$98.40 |
$98.40 |
$170.31
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$176.80 |
$176.80 |
$176.80 |
$328.28
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$458.40 |
$458.40 |
$458.40 |
$779.35
|
|
Pr incision & drainage abscess complicated/multiple
|
$738.40 |
$738.40 |
$738.40 |
$605.00
|
|
Pr incision & drainage abscess simple/single
|
$122.40 |
$122.40 |
$122.40 |
$437.53
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$535.20 |
$535.20 |
$535.20 |
$606.60
|
|
Procalcitonin
|
$95.60 |
$95.60 |
$95.60 |
$133.20
|
|
Progesterone
|
$90.40 |
$90.40 |
$90.40 |
$100.24
|
|
Prolactin
|
$102.40 |
$102.40 |
$102.40 |
$123.20
|
|
Protein c activity
|
$70.40 |
$70.40 |
$70.40 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$44.00 |
$44.00 |
$44.00 |
$84.00
|
|
Protein s total
|
$116.80 |
$116.80 |
$116.80 |
$85.10
|
|
Protein total 24 hour urine
|
$32.40 |
$32.40 |
$32.40 |
$45.00
|
|
Protein total body fluid
|
$29.20 |
$29.20 |
$29.20 |
$49.20
|
|
Protein total serum plasma whole blood
|
$32.40 |
$32.40 |
$32.40 |
$40.70
|
|
Prothrombin time substitution plasma fractions each
|
$37.60 |
$37.60 |
$37.60 |
$37.05
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$135.60 |
$135.60 |
$135.60 |
$278.20
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$224.80 |
$224.80 |
$224.80 |
$742.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$236.40 |
$236.40 |
$236.40 |
$365.60
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$236.40 |
$236.40 |
$236.40 |
$387.40
|