|
Oph Ultrasound dx quan a-scan only
|
$143.75 |
$143.75 |
$143.75 |
$273.00
|
|
Opn abltj 1/> rnl mas crysrg
|
$1,576.48 |
$1,576.48 |
$1,576.48 |
$2,111.20
|
|
Opn ax/subcla art expos
|
$417.57 |
$417.57 |
$417.57 |
$1,269.60
|
|
Opn exc/dst ntra-abd
|
$3,221.64 |
$3,221.64 |
$3,221.64 |
$3,221.64
|
|
Opn exc/dst ntra-abd 10.1-20
|
$2,774.24 |
$2,774.24 |
$2,774.24 |
$2,774.24
|
|
Opn exc/dstr ntra-abd >30 cm
|
$3,961.69 |
$3,961.69 |
$3,961.69 |
$3,961.69
|
|
Opn exc/dstr ntra-abd 5.1-10
|
$2,317.83 |
$2,317.83 |
$2,317.83 |
$2,317.83
|
|
Opn exc/dstr ntra-abd 5 cm/<
|
$1,822.08 |
$1,822.08 |
$1,822.08 |
$1,491.00
|
|
Opn fem art expos cndt crtj 34714
|
$377.28 |
$377.28 |
$377.28 |
$2,041.65
|
|
Opn ilac art expos cndt crtj
|
$553.46 |
$553.46 |
$553.46 |
$1,169.29
|
|
Opn impltj crnl nrv nea&pg
|
$60,565.56 |
$60,565.56 |
$60,565.56 |
$35,498.40
|
|
Opn impltj nea neuromuscular
|
$26,675.88 |
$26,675.88 |
$26,675.88 |
$23,049.60
|
|
Opn impltj nea perph nerve
|
$15,321.63 |
$15,321.63 |
$15,321.63 |
$14,685.79
|
|
Opn impltj nea sacral nerve
|
$8,763.11 |
$8,763.11 |
$8,763.11 |
$7,766.27
|
|
Opn mpltj hpglsl nstm ary pg
|
$42,430.50 |
$42,430.50 |
$42,430.50 |
$36,076.18
|
|
Opn tx complx malar fx
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,605.19
|
|
Opn tx complx malar w/grft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Opn tx depress front sinus fx 21343
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$3,723.20
|
|
Opn tx dprsd zygomatic arch
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$5,110.00
|
|
Opn tx nasomax fx multple
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Opn tx nasomax fx w/fixj
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,465.11
|
|
Opn tx nasomax fx w/graft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$2,694.40
|
|
Opn tx orbit fx combined
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,493.99
|
|
Opn tx orbit fx periorbital
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,839.00
|
|
Opn tx orbit fx transantral
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,465.11
|
|
Opn tx orbit fx w/bone grft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Opn tx orbit fx w/implant
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,966.64
|
|
Opn tx orbit fx without impl 21406
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,430.79
|
|
Opn tx orbit periorbtl implt
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,553.49
|
|
Opn tx orbit periorbt w/grft
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Opps service,sched team conf
|
$573.75 |
$573.75 |
$573.75 |
$503.90
|
|
Opscpy extnd on/mac draw
|
$81.12 |
$81.12 |
$81.12 |
$70.29
|
|
Opscpy extnd rta draw uni/bi
|
$81.12 |
$81.12 |
$81.12 |
$70.29
|
|
Optical endomicroscpy interp
|
$63.15 |
$63.15 |
$63.15 |
$86.40
|
|
Optx acrclv dslc aq/chrn grf
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,913.97
|
|
Optx acromclv dislc aqt/chrn
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,653.00
|
|
Optx acute shoulder dislc
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,554.95
|
|
Optx carpl scphd fx int fixj
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,653.00
|
|
Optx clavicular fx w/int fix
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$8,453.60
|
|
Optx complicated mndblr fx
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,553.49
|
|
Optx cranfcl sep comp mlt
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,048.05
|
|
Optx cranfcl sep w/wiring
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,048.05
|
|
Optx crnfcl sep comp mlt int
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,048.05
|
|
Optx crnfc sep comp int&/xtr
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,048.05
|
|
Optx crpl fx oth/thn scph ea
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$4,499.12
|
|
Optx gr hmrl tbrs fx int fix
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,157.53
|
|
Optx lunate dislocation
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$8,128.38
|
|
Optx medial ankle fx
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,653.00
|
|
Optx mndblr cndylr fx
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$7,000.36
|
|
Optx mndblr fx wo ntrdntl
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,465.11
|
|
Optx mndblr fx xtrnl fixj
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,547.81
|
|
Optx mndblr/max alv ridge fx
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$7,000.36
|
|
Optx palatal/max fracture
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$5,855.00
|
|
Optx palatal/max fx comp
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$4,295.20
|
|
Optx partclr fx&/dslc elbw w
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$10,629.07
|
|
Optx post ankle fx
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,886.74
|
|
Optx prox humrl fx w/int fix
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$13,780.53
|
|
Optx prx hmrl fx fix rpr rpl
|
$24,109.66 |
$24,109.66 |
$24,109.66 |
$8,159.00
|
|
Optx radial shaft fracture
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,419.00
|
|
Optx rad/uln dislc aqt/chrnc
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,886.74
|
|
Optx rdcrpl/ntrcrpl dislc 1+
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,311.00
|
|
Optx rdl shft fx&cltx rad/ul
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,386.73
|
|
Optx rdl shft fx&dstl rad/ul
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,807.24
|
|
Optx rdl&uln shft fx rds&uln
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,807.24
|
|
Optx rdl&uln shft fx rds/uln
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,665.84
|
|
Optx scapular fx w/int fixj
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,906.00
|
|
Optx sho dislc fx
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,110.00
|
|
Optx sho dislc neck fx fixj
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$6,411.60
|
|
Optx strclv dslc aq/chrn grf
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,807.24
|
|
Optx strnclav dislc aqt/chrn
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,807.24
|
|
Optx thigh fx
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$1,362.00
|
|
Optx tmprmand dislocation
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$4,179.20
|
|
Optx trns-scphprlnr fx dislc
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,741.00
|
|
Optx ulnar shft fx int fixj
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$8,453.60
|
|
Optx ulnar styloid fracture
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$5,295.25
|
|
Oral aprepitant
|
$3.82 |
$3.82 |
$3.82 |
$410.20
|
|
Oral busulfan
|
$13.97 |
$13.97 |
$13.97 |
$176.80
|
|
Oral everolimus
|
$1.62 |
$1.62 |
$1.62 |
$30.30
|
|
Oral hiv-1/hiv-2 screen
|
$16.53 |
$16.53 |
$16.53 |
$38.58
|
|
Oral methotrexate (jylamvo)
|
$25.72 |
$25.72 |
$25.72 |
$19.36
|
|
Oral methotrexate (xatmep)
|
$30.96 |
$30.96 |
$30.96 |
$4,371.50
|
|
Oral netupitant, palonosetro
|
$524.66 |
$524.66 |
$524.66 |
$1,120.66
|
|
Orbitocranial approach/skull
|
$4,306.44 |
$4,306.44 |
$4,306.44 |
$4,306.44
|
|
Orbitocranial approach/skull
|
$4,984.23 |
$4,984.23 |
$4,984.23 |
$4,984.23
|
|
Orbitocranial approach/skull
|
$4,643.15 |
$4,643.15 |
$4,643.15 |
$4,643.15
|
|
Orchiectomy partial
|
$4,846.99 |
$4,846.99 |
$4,846.99 |
$4,061.71
|
|
Orchiopexy (fowler-stephens)
|
$4,923.19 |
$4,923.19 |
$4,923.19 |
$3,909.56
|
|
Orchiopexy ingun/scrot appr
|
$4,923.19 |
$4,923.19 |
$4,923.19 |
$4,176.15
|
|
Organic acids total quant ea spec
|
$32.57 |
$32.57 |
$32.57 |
$152.50
|
|
Oritavancin 1,200 mg intravenous solution
|
$59.42 |
$59.42 |
$59.42 |
$11,017.26
|
|
Oritavancin 400 mg intravenous solution
|
$39.29 |
$39.29 |
$39.29 |
$3,311.06
|
|
Oropharyngeal biopsy 42800
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$2,443.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$8.82 |
$8.82 |
$8.82 |
$50.63
|
|
Ortho dvc repair per 15 min
|
$41.29 |
$41.29 |
$41.29 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$445.70 |
$445.70 |
$445.70 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$771.92 |
$771.92 |
$771.92 |
$550.50
|
|
Ortho ewhf rigd without jnt cstm w
|
$1,979.13 |
$1,979.13 |
$1,979.13 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$1,155.05 |
$1,155.05 |
$1,155.05 |
$750.36
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$418.00 |
$418.00 |
$418.00 |
$247.80
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$495.81 |
$495.81 |
$495.81 |
$315.01
|
