|
Mopath procedure level 9
|
$1,535.52 |
$1,535.52 |
$1,535.52 |
$2,250.00
|
|
Morphometric analysis in situ hybridization computer-assisted per specimen each multiplex stain
|
$151.20 |
$151.20 |
$151.20 |
$428.00
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain computer-assisted
|
$148.96 |
$148.96 |
$148.96 |
$322.24
|
|
Morphometric analysis tumor ihc qn/sq per specimen each single antibody stain manual
|
$128.80 |
$128.80 |
$128.80 |
$309.50
|
|
M/phmtrc alys ishquant/semiq
|
$235.20 |
$235.20 |
$235.20 |
$540.15
|
|
M/phmtrc alysishquant/semiq
|
$86.80 |
$86.80 |
$86.80 |
$292.13
|
|
MRI breast c- unilateral
|
$1,020.32 |
$1,020.32 |
$1,020.32 |
$1,020.32
|
|
MRI breast without cont bi
|
$1,043.28 |
$1,043.28 |
$1,043.28 |
$1,541.80
|
|
MRI chest without contrast
|
$757.12 |
$757.12 |
$757.12 |
$1,661.55
|
|
MRI chest without & w/contrast
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$2,321.61
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$665.28 |
$665.28 |
$665.28 |
$2,051.28
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$931.84 |
$931.84 |
$931.84 |
$2,614.43
|
|
MRI orbit/face/neck without contrast
|
$653.52 |
$653.52 |
$653.52 |
$1,782.69
|
|
MRI orbit/face/neck without & w/contrast
|
$909.44 |
$909.44 |
$909.44 |
$2,552.60
|
|
MRI tmj
|
$523.60 |
$523.60 |
$523.60 |
$1,658.77
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$673.68 |
$673.68 |
$673.68 |
$1,902.00
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$861.28 |
$861.28 |
$861.28 |
$2,628.75
|
|
MRI without fol w/cont, breast
|
$1,303.12 |
$1,303.12 |
$1,303.12 |
$1,312.08
|
|
MRI without fol w/cont, brst, un
|
$1,275.68 |
$1,275.68 |
$1,275.68 |
$1,225.98
|
|
Msh2 gene dup/delete variant
|
$44.80 |
$44.80 |
$44.80 |
$427.20
|
|
Msh2 gene full seq
|
$82.88 |
$82.88 |
$82.88 |
$504.56
|
|
Msh6 gene dup/delete variant
|
$50.40 |
$50.40 |
$50.40 |
$476.00
|
|
Msh6 gene full seq
|
$136.08 |
$136.08 |
$136.08 |
$641.85
|
|
Mthfr gene analy common variants
|
$138.88 |
$138.88 |
$138.88 |
$248.82
|
|
Mucopolysaccharides
|
$57.12 |
$57.12 |
$57.12 |
$255.20
|
|
Mumps antibody igg
|
$23.03 |
$23.03 |
$23.03 |
$81.45
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$101.62 |
$101.62 |
$101.62 |
$115.05
|
|
Natriuretic peptide
|
$53.74 |
$53.74 |
$53.74 |
$161.60
|
|
Natural killer cells total count
|
$97.43 |
$97.43 |
$97.43 |
$121.70
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$490.56 |
$490.56 |
$490.56 |
$1,685.58
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$421.68 |
$421.68 |
$421.68 |
$1,435.80
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$869.68 |
$869.68 |
$869.68 |
$2,562.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$798.56 |
$798.56 |
$798.56 |
$2,164.88
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$838.32 |
$838.32 |
$838.32 |
$1,830.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$1,159.20 |
$1,159.20 |
$1,159.20 |
$2,547.30
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$697.20 |
$697.20 |
$697.20 |
$1,741.80
|
|
Nitroblue tetrazolium dye
|
$48.42 |
$48.42 |
$48.42 |
$33.60
|
|
Njx aa&/strd lmbr plex nfs
|
$1,795.92 |
$1,795.92 |
$1,795.92 |
$1,555.85
|
|
Njx aa&/strd sc nrv nfs img
|
$1,795.92 |
$1,795.92 |
$1,795.92 |
$1,644.28
|
|
Nm imaging bone/joint 3 phase study
|
$537.04 |
$537.04 |
$537.04 |
$1,572.00
|
|
Nm imaging bone/joint whole body
|
$474.88 |
$474.88 |
$474.88 |
$1,538.86
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$412.72 |
$412.72 |
$412.72 |
$1,347.83
|
|
Nm imaging gastric emptying study
|
$297.36 |
$297.36 |
$297.36 |
$1,331.43
|
|
Nm imaging gastrointestinal acute blood loss
|
$360.08 |
$360.08 |
$360.08 |
$1,125.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$412.16 |
$412.16 |
$412.16 |
$1,586.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$531.44 |
$531.44 |
$531.44 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$334.88 |
$334.88 |
$334.88 |
$1,075.00
|
|
Noonan spectrum disorders
|
$1,645.84 |
$1,645.84 |
$1,645.84 |
$2,412.00
|
|
Nuclear Stress Test (Heart)
|
$1,632.40 |
$1,632.40 |
$1,632.40 |
$3,739.20
|
|
Observation per hour
|
$69.44 |
$69.44 |
$69.44 |
$75.15
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$4.03 |
$4.03 |
$4.03 |
$59.15
|
|
Onco (ovar) two proteins
|
$291.76 |
$291.76 |
$291.76 |
$260.50
|
|
Organic acids total quant ea spec
|
$42.84 |
$42.84 |
$42.84 |
$152.50
|
|
Osmolality blood
|
$23.62 |
$23.62 |
$23.62 |
$57.00
|
|
Osmolality urine
|
$23.62 |
$23.62 |
$23.62 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$159.04 |
$159.04 |
$159.04 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$159.04 |
$159.04 |
$159.04 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$159.04 |
$159.04 |
$159.04 |
$249.60
|
|
Other immunoelectrophoresis
|
$46.65 |
$46.65 |
$46.65 |
$92.70
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$34.72 |
$34.72 |
$34.72 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$53.20 |
$53.20 |
$53.20 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$53.20 |
$53.20 |
$53.20 |
$105.50
|
|
Ot re-evaluation patient/family
|
$98.56 |
$98.56 |
$98.56 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$53.20 |
$53.20 |
$53.20 |
$96.11
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$53.20 |
$53.20 |
$53.20 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$53.20 |
$53.20 |
$53.20 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$64.40 |
$64.40 |
$64.40 |
$93.60
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$14.47 |
$14.47 |
$14.47 |
$129.80
|
|
Parathormone (pth) intact
|
$118.16 |
$118.16 |
$118.16 |
$204.00
|
|
Parathyroid planar imaging
|
$257.60 |
$257.60 |
$257.60 |
$1,041.95
|
|
Parathyroid planar img w/tomo spect
|
$463.12 |
$463.12 |
$463.12 |
$1,317.94
|
|
Pelvic CT scan (with and without contrast)
|
$557.20 |
$557.20 |
$557.20 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$490.56 |
$490.56 |
$490.56 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$421.68 |
$421.68 |
$421.68 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$924.00 |
$924.00 |
$924.00 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$635.04 |
$635.04 |
$635.04 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$670.88 |
$670.88 |
$670.88 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$306.88 |
$306.88 |
$306.88 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$120.96 |
$120.96 |
$120.96 |
$429.66
|
|
Penile rear tip xtnd 0.5cm
|
$10,917.76 |
$10,917.76 |
$10,917.76 |
$26,765.44
|
|
Pertussis ag if
|
$10.76 |
$10.76 |
$10.76 |
$53.95
|
|
Pet CT skull-mid thgh initial
|
$2,176.72 |
$2,176.72 |
$2,176.72 |
$4,850.00
|
|
Pet CT whole body initial
|
$2,352.00 |
$2,352.00 |
$2,352.00 |
$4,915.50
|
|
Pfc sigma fem post aug sz3 8mm
|
$20,503.84 |
$20,503.84 |
$20,503.84 |
$22,916.00
|
|
Ph body fluid
|
$10.63 |
$10.63 |
$10.63 |
$35.75
|
|
Phencyclidine (pcp)
|
$73.92 |
$73.92 |
$73.92 |
$74.40
|
|
Phenobarbital therapeutic drug level
|
$42.52 |
$42.52 |
$42.52 |
$97.50
|
|
Phenytoin total therapeutic drug level
|
$41.34 |
$41.34 |
$41.34 |
$100.75
|
|
Phlebotomy therapeutic
|
$35.28 |
$35.28 |
$35.28 |
$240.24
|
|
Phosphorus
|
$11.22 |
$11.22 |
$11.22 |
$42.37
|
|
Phosphorus 24 hour urine
|
$14.76 |
$14.76 |
$14.76 |
$41.51
|
|
Pin caspar distraction 12mm
|
$6,048.00 |
$6,048.00 |
$6,048.00 |
$29,164.20
|
|
Pinworm exam
|
$24.21 |
$24.21 |
$24.21 |
$38.58
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,660.96 |
$1,660.96 |
$1,660.96 |
$1,679.20
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,509.76 |
$1,509.76 |
$1,509.76 |
$1,094.83
|
|
Placental lactogen
|
$60.48 |
$60.48 |
$60.48 |
$133.00
|
|
Plasma cryoprecipitate reduced each unit
|
$56.56 |
$56.56 |
$56.56 |
$160.55
|
|
Platelet aggregation each agent teg
|
$122.64 |
$122.64 |
$122.64 |
$145.60
|
|
Platelet automated
|
$10.63 |
$10.63 |
$10.63 |
$33.60
|
|
Platelet pheresis each unit
|
$490.56 |
$490.56 |
$490.56 |
$943.15
|