|
MRI lower extremity other than joint without contrast (both sides)
|
$2,393.00 |
$2,393.00 |
$2,393.00 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$3,344.55 |
$3,344.55 |
$3,344.55 |
$2,753.50
|
|
MRI orbit fac&nck w IV cont
|
$2,838.35 |
$2,838.35 |
$2,838.35 |
$2,203.50
|
|
MRI tmj
|
$2,468.60 |
$2,468.60 |
$2,468.60 |
$1,741.07
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,378.10 |
$2,378.10 |
$2,378.10 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$3,355.25 |
$3,355.25 |
$3,355.25 |
$2,655.25
|
|
MRI upper extremity w/dye
|
$2,827.60 |
$2,827.60 |
$2,827.60 |
$2,061.15
|
|
MRI w/cont, breast, bi
|
$4,817.00 |
$4,817.00 |
$4,817.00 |
$2,119.87
|
|
Mr safety determination physician/other qhp
|
$135.50 |
$135.50 |
$135.50 |
$160.20
|
|
Mr safety implant elec prepj
|
$141.25 |
$141.25 |
$141.25 |
$170.13
|
|
Mr safety implt pos&/immoblj
|
$91.40 |
$91.40 |
$91.40 |
$122.85
|
|
Mr sfty implt&/fb asmt stf 1
|
$37.70 |
$37.70 |
$37.70 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$371.95 |
$371.95 |
$371.95 |
$439.80
|
|
Multiple sleep latency test
|
$3,459.30 |
$3,459.30 |
$3,459.30 |
$2,466.00
|
|
Mumps antibody igg
|
$86.35 |
$86.35 |
$86.35 |
$78.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$0.92 |
$0.92 |
$0.92 |
$10.79
|
|
Mycoplasma antibody igm
|
$109.35 |
$109.35 |
$109.35 |
$77.35
|
|
Myd88 gene p.leu265pro vrnt
|
$803.85 |
$803.85 |
$803.85 |
$416.00
|
|
Myelogphy 2/> spine regions
|
$169.00 |
$169.00 |
$169.00 |
$1,494.22
|
|
Myelography l-s spine
|
$1,961.10 |
$1,961.10 |
$1,961.10 |
$1,334.09
|
|
Myelography neck spine
|
$116.00 |
$116.00 |
$116.00 |
$1,241.50
|
|
Myelography thoracic spine
|
$1,322.70 |
$1,322.70 |
$1,322.70 |
$1,255.00
|
|
Myelography via inj w/s&i lumbosacral
|
$1,961.10 |
$1,961.10 |
$1,961.10 |
$1,850.00
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$76.15 |
$76.15 |
$76.15 |
$130.80
|
|
Nalbuphine 10 mg/ml injection solution
|
$117.29 |
$117.29 |
$117.29 |
$38.00
|
|
Naltrexone, depot form
|
$7,361.27 |
$7,361.27 |
$7,361.27 |
$3,249.40
|
|
Nasal endoscopy dx uni/bi separate proc
|
$453.50 |
$453.50 |
$453.50 |
$353.62
|
|
Nasal endoscopy with removal of nasal foreign body
|
$226.05 |
$226.05 |
$226.05 |
$406.00
|
|
Nasopharyngoscopy w/endoscope
|
$238.85 |
$238.85 |
$238.85 |
$293.58
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$22,308.20 |
$22,308.20 |
$22,308.20 |
$16,254.52
|
|
Natriuretic peptide
|
$353.65 |
$353.65 |
$353.65 |
$176.15
|
|
Natural killer cells total count
|
$108.30 |
$108.30 |
$108.30 |
$135.00
|
|
Nebulizer Breathing Treatment
|
$116.85 |
$116.85 |
$116.85 |
$203.49
|
|
Neck Airway (Soft Tissue) X-ray
|
$326.65 |
$326.65 |
$326.65 |
$237.43
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,109.70 |
$3,109.70 |
$3,109.70 |
$2,032.54
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,113.65 |
$2,113.65 |
$2,113.65 |
$1,717.80
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,755.90 |
$1,755.90 |
$1,755.90 |
$1,470.00
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,669.70 |
$2,669.70 |
$2,669.70 |
$2,869.75
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,301.25 |
$2,301.25 |
$2,301.25 |
$2,042.95
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$384.65 |
$384.65 |
$384.65 |
$333.83
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$472.40 |
$472.40 |
$472.40 |
$463.80
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$626.25 |
$626.25 |
$626.25 |
$508.50
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$5,211.25 |
$5,211.25 |
$5,211.25 |
$2,659.98
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,931.50 |
$2,931.50 |
$2,931.50 |
$2,109.10
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,282.40 |
$2,282.40 |
$2,282.40 |
$1,806.75
|
|
Neck Soft Tissue CT Scan (with and without contrast)
|
$2,862.65 |
$2,862.65 |
$2,862.65 |
$1,940.00
|
|
Neck Soft Tissue CT Scan (with contrast)
|
$2,205.35 |
$2,205.35 |
$2,205.35 |
$1,603.55
|
|
Neck Soft Tissue CT Scan (without contrast)
|
$1,839.65 |
$1,839.65 |
$1,839.65 |
$1,312.00
|
|
Neurolysis celiac plexus
|
$686.20 |
$686.20 |
$686.20 |
$1,780.24
|
|
New Patient Office Visit (level 2)
|
$307.70 |
$307.70 |
$307.70 |
$163.30
|
|
New Patient Office Visit (level 3)
|
$441.30 |
$441.30 |
$441.30 |
$211.00
|
|
New Patient Office Visit (level 4)
|
$680.20 |
$680.20 |
$680.20 |
$291.06
|
|
New Patient Office Visit (level 5)
|
$857.05 |
$857.05 |
$857.05 |
$355.80
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$234.59 |
$234.59 |
$234.59 |
$74.56
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$20,347.51 |
$20,347.51 |
$20,347.51 |
$14,820.18
|
|
Njx aa&/strd vagus nrv
|
$201.10 |
$201.10 |
$201.10 |
$408.64
|
|
Njx interlaminar crv/thrc
|
$239.20 |
$239.20 |
$239.20 |
$1,622.32
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$3,663.10 |
$3,663.10 |
$3,663.10 |
$1,397.69
|
|
Nm imaging gastrointestinal acute blood loss
|
$2,093.35 |
$2,093.35 |
$2,093.35 |
$1,207.59
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$3,287.85 |
$3,287.85 |
$3,287.85 |
$1,541.32
|
|
Nm imaging pulmonary ventilation/perfusion
|
$3,005.80 |
$3,005.80 |
$3,005.80 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$2,326.85 |
$2,326.85 |
$2,326.85 |
$1,091.00
|
|
Non-ophthalmic fva
|
$567.85 |
$567.85 |
$567.85 |
$609.12
|
|
Nose (Nasal Bone) X-ray (complete)
|
$380.60 |
$380.60 |
$380.60 |
$274.65
|
|
Nras gene variants exon 2&3
|
$743.70 |
$743.70 |
$743.70 |
$593.45
|
|
Nuclear exam of tear flow
|
$1,319.95 |
$1,319.95 |
$1,319.95 |
$648.04
|
|
Nuclear matrix protein 22
|
$76.00 |
$76.00 |
$76.00 |
$44.00
|
|
Nuclear rx intra-arterial
|
$297.00 |
$297.00 |
$297.00 |
$765.00
|
|
Nuclear Stress Test (Heart)
|
$3,228.40 |
$3,228.40 |
$3,228.40 |
$3,859.98
|
|
Nursing facility discharge management > 30 min 99316
|
$237.55 |
$237.55 |
$237.55 |
$166.25
|
|
Nursing facility discharge management 30 min/less than 99315
|
$179.50 |
$179.50 |
$179.50 |
$119.60
|
|
Nushield 1 square cm
|
$255.48 |
$255.48 |
$255.48 |
$931.43
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$22,504.18 |
$22,504.18 |
$22,504.18 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$113.65 |
$113.65 |
$113.65 |
$384.00
|
|
Observation/inpatient hospital care hi severity 99236
|
$611.40 |
$611.40 |
$611.40 |
$390.40
|
|
Observation/inpatient hospital care low severity 99234
|
$337.40 |
$337.40 |
$337.40 |
$239.20
|
|
Observation/inpatient hospital care mod severity 99235
|
$516.95 |
$516.95 |
$516.95 |
$303.20
|
|
Observation per hour
|
$106.20 |
$106.20 |
$106.20 |
$82.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$491.35 |
$491.35 |
$491.35 |
$357.00
|
|
Ob Ultrasound nuchal meas add-on
|
$278.05 |
$278.05 |
$278.05 |
$249.60
|
|
Occupational Therapy Evaluation (high complexity)
|
$357.65 |
$357.65 |
$357.65 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$329.30 |
$329.30 |
$329.30 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$344.15 |
$344.15 |
$344.15 |
$263.90
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$53,932.77 |
$53,932.77 |
$53,932.77 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$98.51 |
$98.51 |
$98.51 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$18,061.83 |
$18,061.83 |
$18,061.83 |
$12,080.43
|
|
Off/op cnsltj new/est low 30
|
$225.40 |
$225.40 |
$225.40 |
$183.00
|
|
Off/op cnsltj new/est mod 40
|
$336.00 |
$336.00 |
$336.00 |
$273.60
|
|
Off/op consltj new/est hi 55
|
$410.25 |
$410.25 |
$410.25 |
$352.50
|
|
Off/op consltj new/est sf 20
|
$207.90 |
$207.90 |
$207.90 |
$137.80
|
|
Olanzapine 10 mg intramuscular solution
|
$319.33 |
$319.33 |
$319.33 |
$109.62
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$11,511.93 |
$11,511.93 |
$11,511.93 |
$4,595.01
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$38.33 |
$38.33 |
$38.33 |
$22.62
|
|
Oral aprepitant
|
$306.41 |
$306.41 |
$306.41 |
$410.20
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$288.80 |
$288.80 |
$288.80 |
$279.81
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$415.75 |
$415.75 |
$415.75 |
$702.80
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$356.30 |
$356.30 |
$356.30 |
$231.66
|
|
Ortho hnd without jnt w/fit&adj
|
$126.85 |
$126.85 |
$126.85 |
$229.45
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$288.80 |
$288.80 |
$288.80 |
$421.00
|