|
Observation/inpatient hospital care mod severity 99235
|
$184.80 |
$184.80 |
$184.80 |
$303.20
|
|
Observation per hour
|
$91.80 |
$91.80 |
$91.80 |
$79.95
|
|
Obstetrics panel
|
$205.80 |
$205.80 |
$205.80 |
$214.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$930.60 |
$930.60 |
$930.60 |
$338.17
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$801.00 |
$801.00 |
$801.00 |
$90.00
|
|
Off/op cnsltj new/est low 30
|
$75.00 |
$75.00 |
$75.00 |
$183.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$17.40 |
$17.40 |
$17.40 |
$22.62
|
|
Optx clavicular fx w/int fix
|
$1,103.40 |
$1,103.40 |
$1,103.40 |
$8,819.16
|
|
Optx gr hmrl tbrs fx int fix
|
$1,126.20 |
$1,126.20 |
$1,126.20 |
$7,157.53
|
|
Optx rdl&uln shft fx rds&uln
|
$1,672.20 |
$1,672.20 |
$1,672.20 |
$6,839.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$53.40 |
$53.40 |
$53.40 |
$50.63
|
|
Osmolality blood
|
$157.80 |
$157.80 |
$157.80 |
$69.55
|
|
Osmolality urine
|
$100.80 |
$100.80 |
$100.80 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$276.00 |
$276.00 |
$276.00 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$276.00 |
$276.00 |
$276.00 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$276.00 |
$276.00 |
$276.00 |
$263.50
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$150.00 |
$150.00 |
$150.00 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$223.20 |
$223.20 |
$223.20 |
$105.00
|
|
Ot re-evaluation patient/family
|
$219.00 |
$219.00 |
$219.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$175.20 |
$175.20 |
$175.20 |
$98.90
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$189.00 |
$189.00 |
$189.00 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$164.40 |
$164.40 |
$164.40 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$171.60 |
$171.60 |
$171.60 |
$93.60
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$120.60 |
$120.60 |
$120.60 |
$129.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$11.40 |
$11.40 |
$11.40 |
$27.16
|
|
Parathormone (pth) intact
|
$440.40 |
$440.40 |
$440.40 |
$201.50
|
|
Parathyroid planar imaging
|
$928.20 |
$928.20 |
$928.20 |
$1,073.82
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$306.60 |
$306.60 |
$306.60 |
$242.88
|
|
Pelvic CT scan (with and without contrast)
|
$3,442.80 |
$3,442.80 |
$3,442.80 |
$1,899.75
|
|
Pelvic CT scan (with contrast)
|
$2,767.80 |
$2,767.80 |
$2,767.80 |
$1,635.62
|
|
Pelvic CT scan (without contrast)
|
$1,997.40 |
$1,997.40 |
$1,997.40 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$3,763.20 |
$3,763.20 |
$3,763.20 |
$2,870.36
|
|
Pelvic MRI (without contrast)
|
$3,517.20 |
$3,517.20 |
$3,517.20 |
$1,929.85
|
|
Pelvic Ultrasound (complete)
|
$844.80 |
$844.80 |
$844.80 |
$650.40
|
|
Pelvic Ultrasound (limited)
|
$400.20 |
$400.20 |
$400.20 |
$430.00
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$525.60 |
$525.60 |
$525.60 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$43.20 |
$43.20 |
$43.20 |
$97.85
|
|
Perq skel fix ulnar styld fx
|
$4,828.20 |
$4,828.20 |
$4,828.20 |
$3,839.54
|
|
Pfc sigma fem post aug sz3 8mm
|
$19,072.21 |
$19,072.21 |
$19,072.21 |
$34,920.00
|
|
Ph body fluid
|
$136.20 |
$136.20 |
$136.20 |
$40.04
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$70.20 |
$70.20 |
$70.20 |
$114.60
|
|
Phenobarbital therapeutic drug level
|
$189.60 |
$189.60 |
$189.60 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,675.20 |
$1,675.20 |
$1,675.20 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$80.40 |
$80.40 |
$80.40 |
$62.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$6.60 |
$6.60 |
$6.60 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$184.20 |
$184.20 |
$184.20 |
$112.50
|
|
Phlebotomy therapeutic
|
$156.00 |
$156.00 |
$156.00 |
$231.66
|
|
Phosphorus
|
$72.00 |
$72.00 |
$72.00 |
$49.60
|
|
Phosphorus 24 hour urine
|
$70.80 |
$70.80 |
$70.80 |
$41.58
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$16.80 |
$16.80 |
$16.80 |
$85.79
|
|
Pin finger dislocation
|
$4,828.20 |
$4,828.20 |
$4,828.20 |
$3,839.54
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$20.40 |
$20.40 |
$20.40 |
$83.57
|
|
Platelet automated
|
$57.00 |
$57.00 |
$57.00 |
$45.00
|
|
Platelets leukocytes reduced irradiated each unit
|
$90.60 |
$90.60 |
$90.60 |
$413.25
|
|
Platelets pheresis leukocytes reduced each unit
|
$504.00 |
$504.00 |
$504.00 |
$1,108.08
|
|
Plethysmography lung volumes/airway resistance
|
$88.80 |
$88.80 |
$88.80 |
$399.50
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$175.20 |
$175.20 |
$175.20 |
$187.04
|
|
Potassium 24 hour urine
|
$98.40 |
$98.40 |
$98.40 |
$50.70
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$48.00 |
$48.00 |
$48.00 |
$64.09
|
|
Potassium serum/plasma/whole blood
|
$77.40 |
$77.40 |
$77.40 |
$46.00
|
|
Pr application of long arm splint
|
$203.40 |
$203.40 |
$203.40 |
$328.78
|
|
Pr application splint static short arm
|
$203.40 |
$203.40 |
$203.40 |
$287.70
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$54.00 |
$54.00 |
$54.00 |
$48.43
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$249.60 |
$249.60 |
$249.60 |
$350.98
|
|
Pr discharge day management hospital ip/obs <=30 min on ecounter date
|
$91.20 |
$91.20 |
$91.20 |
$133.25
|
|
Pr discharge day management hospital ip/obs > 30 min on encounter date
|
$118.80 |
$118.80 |
$118.80 |
$189.80
|
|
Prealbumin
|
$118.80 |
$118.80 |
$118.80 |
$93.60
|
|
Pr ecg 12 lead report only
|
$43.20 |
$43.20 |
$43.20 |
$21.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$11.40 |
$11.40 |
$11.40 |
$13.80
|
|
Pregnancy Ultrasound (first trimester)
|
$879.00 |
$879.00 |
$879.00 |
$537.00
|
|
Pr e&m preventive medicine initial comprehensive new patient 12-17 years
|
$99.60 |
$99.60 |
$99.60 |
$126.50
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$127.80 |
$127.80 |
$127.80 |
$313.30
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$175.80 |
$175.80 |
$175.80 |
$188.86
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$144.00 |
$144.00 |
$144.00 |
$1,908.09
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$551.40 |
$551.40 |
$551.40 |
$753.64
|
|
Pr hospital ip/obs care initial high level per day
|
$192.60 |
$192.60 |
$192.60 |
$362.40
|
|
Pr hospital ip/obs care initial moderate level per day
|
$133.20 |
$133.20 |
$133.20 |
$246.40
|
|
Pr hospital ip/obs care initial straightforward or low level per day
|
$97.20 |
$97.20 |
$97.20 |
$180.05
|
|
Pr hospital ip/obs care subsequent high level per day
|
$109.20 |
$109.20 |
$109.20 |
$193.70
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$74.40 |
$74.40 |
$74.40 |
$120.90
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$57.00 |
$57.00 |
$57.00 |
$73.80
|
|
Pr incision & drainage abscess complicated/multiple
|
$524.40 |
$524.40 |
$524.40 |
$689.01
|
|
Pr incision & drainage abscess simple/single
|
$321.60 |
$321.60 |
$321.60 |
$460.00
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$480.60 |
$480.60 |
$480.60 |
$570.00
|
|
Pr management transitional care high w/in 7 days of discharge
|
$405.00 |
$405.00 |
$405.00 |
$240.00
|
|
Pr management transitional care moderate w/in 14 days of discharge
|
$305.40 |
$305.40 |
$305.40 |
$195.53
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$294.00 |
$294.00 |
$294.00 |
$252.00
|
|
Pr neuroplasty and/or transposition ulnar nerve at elbow
|
$1,549.80 |
$1,549.80 |
$1,549.80 |
$3,786.00
|
|
Procalcitonin
|
$327.60 |
$327.60 |
$327.60 |
$157.56
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$62.40 |
$62.40 |
$62.40 |
$36.33
|
|
Progesterone
|
$199.20 |
$199.20 |
$199.20 |
$113.24
|
|
Prolactin
|
$208.80 |
$208.80 |
$208.80 |
$123.50
|
|
Propofol infusion 10 mg/ml
|
$86.40 |
$86.40 |
$86.40 |
$73.36
|
|
Protein c activity
|
$108.60 |
$108.60 |
$108.60 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$139.80 |
$139.80 |
$139.80 |
$84.00
|
|
Protein s total
|
$60.60 |
$60.60 |
$60.60 |
$77.60
|
|
Protein total 24 hour urine
|
$102.00 |
$102.00 |
$102.00 |
$52.47
|
|
Protein total body fluid
|
$9.00 |
$9.00 |
$9.00 |
$52.00
|
|
Protein total serum plasma whole blood
|
$102.00 |
$102.00 |
$102.00 |
$42.81
|
|
Prothrombin complex kcentra
|
$6.60 |
$6.60 |
$6.60 |
$7.55
|
