|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$190.40 |
$190.40 |
$190.40 |
$365.00
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$227.20 |
$227.20 |
$227.20 |
$370.93
|
|
Pr tube thoracostomy w/connection to drainage open
|
$478.80 |
$478.80 |
$478.80 |
$1,653.31
|
|
PSA (Prostate) Test
|
$96.00 |
$96.00 |
$96.00 |
$103.85
|
|
Psychotherapy group therapy
|
$126.40 |
$126.40 |
$126.40 |
$268.80
|
|
Psychotherapy patient individual therapy 30 minutes
|
$116.00 |
$116.00 |
$116.00 |
$196.80
|
|
Psychotherapy patient individual therapy 45 minutes
|
$158.40 |
$158.40 |
$158.40 |
$267.00
|
|
Psychotherapy patient individual therapy 60 minutes
|
$176.80 |
$176.80 |
$176.80 |
$294.00
|
|
Psytx complex interactive
|
$10.80 |
$10.80 |
$10.80 |
$54.00
|
|
Psytx pt w/e&m 16-37 min
|
$116.00 |
$116.00 |
$116.00 |
$126.14
|
|
Psytx pt w/e&m 38-52 min
|
$158.40 |
$158.40 |
$158.40 |
$194.90
|
|
Psytx pt w/e&m 53+ min
|
$176.80 |
$176.80 |
$176.80 |
$242.25
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$18.40 |
$18.40 |
$18.40 |
$87.49
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$82.00 |
$82.00 |
$82.00 |
$105.95
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$66.80 |
$66.80 |
$66.80 |
$82.55
|
|
Pt application of modality traction mechanical
|
$64.80 |
$64.80 |
$64.80 |
$87.19
|
|
Pt evaluation high complexity patient/family
|
$131.60 |
$131.60 |
$131.60 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$88.40 |
$88.40 |
$88.40 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$110.00 |
$110.00 |
$110.00 |
$247.20
|
|
Pt re-evaluation patient/family
|
$80.80 |
$80.80 |
$80.80 |
$141.93
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$50.40 |
$50.40 |
$50.40 |
$83.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$65.20 |
$65.20 |
$65.20 |
$84.90
|
|
Pulse ox multiple
|
$86.00 |
$86.00 |
$86.00 |
$190.25
|
|
Puncture arterial withdrawal blood for diagnosis
|
$74.00 |
$74.00 |
$74.00 |
$113.75
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$471.60 |
$471.60 |
$471.60 |
$478.80
|
|
Quest t3 uptake
|
$68.40 |
$68.40 |
$68.40 |
$55.00
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$556.30 |
$556.30 |
$556.30 |
$1,624.21
|
|
Rapid Strep Test
|
$60.00 |
$60.00 |
$60.00 |
$67.80
|
|
Red blood cells leukocytes reduced each unit
|
$232.80 |
$232.80 |
$232.80 |
$519.35
|
|
Removal cerumen impacted (both sides)
|
$310.80 |
$310.80 |
$310.80 |
$161.25
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$113.60 |
$113.60 |
$113.60 |
$236.64
|
|
Renal function panel
|
$105.60 |
$105.60 |
$105.60 |
$95.76
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$280.40 |
$280.40 |
$280.40 |
$1,156.00
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$145.20 |
$145.20 |
$145.20 |
$504.12
|
|
Reptilase test
|
$44.40 |
$44.40 |
$44.40 |
$65.72
|
|
Resuscitation cardiopulmonary
|
$663.20 |
$663.20 |
$663.20 |
$895.44
|
|
Reticulocyte automated
|
$138.00 |
$138.00 |
$138.00 |
$54.27
|
|
Rheumatoid factor qualitative
|
$56.80 |
$56.80 |
$56.80 |
$54.60
|
|
Rheumatoid factor quantitative
|
$20.80 |
$20.80 |
$20.80 |
$59.80
|
|
Rho(d) immune globulin (rhig) human full dose im
|
$172.80 |
$172.80 |
$172.80 |
$159.25
|
|
Rubella antibody igg
|
$95.20 |
$95.20 |
$95.20 |
$73.05
|
|
Rubeola antibody igg
|
$43.20 |
$43.20 |
$43.20 |
$80.00
|
|
Russell viper venom diluted
|
$61.60 |
$61.60 |
$61.60 |
$73.03
|
|
Scan duplex extremity veins unilateral/limited study
|
$274.00 |
$274.00 |
$274.00 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$502.80 |
$502.80 |
$502.80 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$266.00 |
$266.00 |
$266.00 |
$612.00
|
|
Screening Mammogram
|
$188.80 |
$188.80 |
$188.80 |
$287.12
|
|
Screening prostate cancer PSA
|
$58.40 |
$58.40 |
$58.40 |
$96.00
|
|
Semen analysis presence/motility
|
$44.00 |
$44.00 |
$44.00 |
$79.92
|
|
Serial casting application 97139app
|
$55.20 |
$55.20 |
$55.20 |
$67.42
|
|
Serpina1 gene
|
$80.00 |
$80.00 |
$80.00 |
$195.65
|
|
Shoulder MRI (with and without contrast)
|
$2,403.20 |
$2,403.20 |
$2,403.20 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$1,732.00 |
$1,732.00 |
$1,732.00 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$1,402.00 |
$1,402.00 |
$1,402.00 |
$1,938.28
|
|
Shoulder X-ray
|
$228.00 |
$228.00 |
$228.00 |
$307.20
|
|
Sickling rbc
|
$19.20 |
$19.20 |
$19.20 |
$53.40
|
|
Sinus CT scan (with and without contrast)
|
$972.40 |
$972.40 |
$972.40 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$644.80 |
$644.80 |
$644.80 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$740.40 |
$740.40 |
$740.40 |
$1,151.00
|
|
Sleep Study (Polysomnography)
|
$1,174.40 |
$1,174.40 |
$1,174.40 |
$4,043.20
|
|
Sleep study unattended
|
$185.60 |
$185.60 |
$185.60 |
$631.55
|
|
Smear fluorescent and/or acid fast stain
|
$38.80 |
$38.80 |
$38.80 |
$50.70
|
|
Smear gram stain
|
$39.60 |
$39.60 |
$39.60 |
$48.00
|
|
Smear nasal eosinophil
|
$43.20 |
$43.20 |
$43.20 |
$50.00
|
|
Smear special stain inclusion bodies/parasites
|
$28.80 |
$28.80 |
$28.80 |
$60.00
|
|
Smear wet mount
|
$60.00 |
$60.00 |
$60.00 |
$56.13
|
|
Sodium 24 hour urine
|
$32.40 |
$32.40 |
$32.40 |
$47.25
|
|
Sodium serum/plasma/whole blood
|
$44.00 |
$44.00 |
$44.00 |
$42.43
|
|
Specific gravity body fluid
|
$17.60 |
$17.60 |
$17.60 |
$21.55
|
|
St analysis behavior qualitative voice/resonance
|
$155.60 |
$155.60 |
$155.60 |
$295.10
|
|
Staph a dna amp probe
|
$39.60 |
$39.60 |
$39.60 |
$116.39
|
|
St evaluate speech sound production
|
$250.80 |
$250.80 |
$250.80 |
$298.41
|
|
St evaluate speech sound production comprehensive/expressive
|
$162.40 |
$162.40 |
$162.40 |
$387.00
|
|
St evaluation motion fluoroscopic swallow function cine/video
|
$228.80 |
$228.80 |
$228.80 |
$336.00
|
|
St evaluation swallow function
|
$236.40 |
$236.40 |
$236.40 |
$323.72
|
|
Strep b dna amp probe
|
$36.00 |
$36.00 |
$36.00 |
$124.20
|
|
St treatment speech individual
|
$189.60 |
$189.60 |
$189.60 |
$246.87
|
|
St treatment swallow dysfunction/oral
|
$189.60 |
$189.60 |
$189.60 |
$221.00
|
|
Surgical pathology level 1 gross examination only
|
$18.80 |
$18.80 |
$18.80 |
$81.00
|
|
Surgical pathology level 3 gross & microscopic examination
|
$71.20 |
$71.20 |
$71.20 |
$181.00
|
|
Surgical pathology level 4 gross & microscopic examination
|
$120.00 |
$120.00 |
$120.00 |
$239.85
|
|
Surgical pathology level 5 gross & microscopic examination
|
$188.80 |
$188.80 |
$188.80 |
$489.00
|
|
Susceptibility agar dilution per agent
|
$25.60 |
$25.60 |
$25.60 |
$38.58
|
|
Susceptibility enzyme detection per enzyme
|
$28.80 |
$28.80 |
$28.80 |
$31.85
|
|
Susceptibility mic per plate
|
$70.40 |
$70.40 |
$70.40 |
$89.70
|
|
Syphilis test non-treponemal antibody quantitative rpr
|
$40.80 |
$40.80 |
$40.80 |
$45.70
|
|
T3 (triiodothyronine) free
|
$128.40 |
$128.40 |
$128.40 |
$91.20
|
|
T3 (triiodothyronine) total
|
$124.80 |
$124.80 |
$124.80 |
$88.00
|
|
T4 (thyroxine) free
|
$36.40 |
$36.40 |
$36.40 |
$65.00
|
|
T4 (thyroxine) total
|
$50.80 |
$50.80 |
$50.80 |
$62.40
|
|
Tacrolimus therapeutic drug level
|
$58.80 |
$58.80 |
$58.80 |
$137.15
|
|
Tbs techl calculation only
|
$64.80 |
$64.80 |
$64.80 |
$119.66
|
|
Tbs techl prep&transmis data
|
$64.80 |
$64.80 |
$64.80 |
$105.08
|
|
Tb test cell mediated immunity antigen response gamma interferon
|
$214.40 |
$214.40 |
$214.40 |
$178.40
|
|
T cells absolute cd4/cd8 including ratio
|
$68.40 |
$68.40 |
$68.40 |
$189.60
|
|
T cells absolute cd 4 count
|
$68.40 |
$68.40 |
$68.40 |
$120.25
|
|
T cells total count
|
$45.20 |
$45.20 |
$45.20 |
$126.90
|
|
Test stress cardiovascular tracing only
|
$338.40 |
$338.40 |
$338.40 |
$1,016.00
|
|
Theophylline therapeutic drug level
|
$72.80 |
$72.80 |
$72.80 |
$101.40
|
