|
Part hymenectomy/revi hymenal ring 56700
|
$6,641.00 |
$6,641.00 |
$6,641.00 |
$3,762.53
|
|
Partial removal finger bone
|
$4,257.00 |
$4,257.00 |
$4,257.00 |
$2,134.33
|
|
Ped home apnea mntr dl&alys
|
$137.00 |
$137.00 |
$137.00 |
$296.92
|
|
Pelvic CT scan (with and without contrast)
|
$1,992.00 |
$1,992.00 |
$1,992.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,669.00 |
$1,669.00 |
$1,669.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,076.00 |
$1,076.00 |
$1,076.00 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,387.00 |
$3,387.00 |
$3,387.00 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$1,830.00 |
$1,830.00 |
$1,830.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$992.00 |
$992.00 |
$992.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$674.00 |
$674.00 |
$674.00 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$485.00 |
$485.00 |
$485.00 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$499.00 |
$499.00 |
$499.00 |
$351.75
|
|
Penile injection
|
$370.00 |
$370.00 |
$370.00 |
$424.60
|
|
Penile vascular study
|
$370.00 |
$370.00 |
$370.00 |
$561.00
|
|
Perc cryo ablate renal tum
|
$25,224.00 |
$25,224.00 |
$25,224.00 |
$11,523.76
|
|
Perc rf ablate renal tumor
|
$14,904.00 |
$14,904.00 |
$14,904.00 |
$7,243.60
|
|
Percut ablate liver rf
|
$10,455.00 |
$10,455.00 |
$10,455.00 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$9,306.00 |
$9,306.00 |
$9,306.00 |
$2,375.00
|
|
Peripheral vascular rehab
|
$169.00 |
$169.00 |
$169.00 |
$132.50
|
|
Perq art m-thrombect &/nfs
|
$9,758.00 |
$9,758.00 |
$9,758.00 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$7,847.00 |
$7,847.00 |
$7,847.00 |
$9,309.08
|
|
Perq dev breast 1st mr guide
|
$2,471.00 |
$2,471.00 |
$2,471.00 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$710.00 |
$710.00 |
$710.00 |
$1,456.00
|
|
Perq p-art revsc 1 abnor uni
|
$27,532.00 |
$27,532.00 |
$27,532.00 |
$22,559.00
|
|
Perq p-art revsc 1 nm nt uni
|
$27,532.00 |
$27,532.00 |
$27,532.00 |
$17,321.20
|
|
Perq plmt bile duct stent
|
$16,456.00 |
$16,456.00 |
$16,456.00 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$625.93
|
|
Perq transcath closure pda
|
$12,931.00 |
$12,931.00 |
$12,931.00 |
$18,408.00
|
|
Perq transcath septal reduxn
|
$10,571.00 |
$10,571.00 |
$10,571.00 |
$8,999.20
|
|
Perq trluml angp nt/recr coa
|
$6,658.00 |
$6,658.00 |
$6,658.00 |
$7,398.00
|
|
Pet CT skull-mid thgh initial
|
$7,712.00 |
$7,712.00 |
$7,712.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$8,569.00 |
$8,569.00 |
$8,569.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$8,705.00 |
$8,705.00 |
$8,705.00 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$6,941.00 |
$6,941.00 |
$6,941.00 |
$4,349.76
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$80.00 |
$80.00 |
$80.00 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$119.00 |
$119.00 |
$119.00 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$39.00 |
$39.00 |
$39.00 |
$31.20
|
|
Ph body fluid
|
$14.00 |
$14.00 |
$14.00 |
$42.00
|
|
Phencyclidine (pcp)
|
$69.00 |
$69.00 |
$69.00 |
$96.39
|
|
Phenobarbital therapeutic drug level
|
$97.00 |
$97.00 |
$97.00 |
$105.00
|
|
Phenytoin total therapeutic drug level
|
$113.00 |
$113.00 |
$113.00 |
$111.27
|
|
Phlebotomy therapeutic
|
$367.00 |
$367.00 |
$367.00 |
$231.40
|
|
Phosphorus
|
$19.00 |
$19.00 |
$19.00 |
$49.20
|
|
Phosphorus 24 hour urine
|
$20.00 |
$20.00 |
$20.00 |
$42.25
|
|
Photopheresis
|
$8,010.00 |
$8,010.00 |
$8,010.00 |
$7,967.00
|
|
Physical Therapy Evaluation (high complexity)
|
$241.00 |
$241.00 |
$241.00 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$226.00 |
$226.00 |
$226.00 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$237.00 |
$237.00 |
$237.00 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$142.00 |
$142.00 |
$142.00 |
$154.80
|
|
Pinworm exam
|
$40.00 |
$40.00 |
$40.00 |
$39.62
|
|
Place cath intracranial art
|
$5,799.00 |
$5,799.00 |
$5,799.00 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$17,182.00 |
$17,182.00 |
$17,182.00 |
$4,202.90
|
|
Place cecostomy tube perc
|
$2,974.00 |
$2,974.00 |
$2,974.00 |
$2,580.90
|
|
Place duod/jej tube perc
|
$4,111.00 |
$4,111.00 |
$4,111.00 |
$2,562.75
|
|
Place gastrostomy tube perc
|
$4,977.00 |
$4,977.00 |
$4,977.00 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$822.00 |
$822.00 |
$822.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$822.00 |
$822.00 |
$822.00 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$4,116.00 |
$4,116.00 |
$4,116.00 |
$3,933.00
|
|
Placement occlusive device venous/arterial access site post procedure
|
$1,358.00 |
$1,358.00 |
$1,358.00 |
$572.00
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$17,973.00 |
$17,973.00 |
$17,973.00 |
$13,879.25
|
|
Place non-slctv cath thoracic arta
|
$4,307.00 |
$4,307.00 |
$4,307.00 |
$5,271.46
|
|
Place slctv cath carotd art uni
|
$23,575.00 |
$23,575.00 |
$23,575.00 |
$10,150.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$6,336.00 |
$6,336.00 |
$6,336.00 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$16,490.00 |
$16,490.00 |
$16,490.00 |
$9,074.00
|
|
Place slctv cath subclavian art
|
$28,463.00 |
$28,463.00 |
$28,463.00 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$26,973.00 |
$26,973.00 |
$26,973.00 |
$9,090.00
|
|
Plasma cryoprecipitate reduced each unit
|
$288.00 |
$288.00 |
$288.00 |
$163.04
|
|
Platelet aggregation each agent teg
|
$168.00 |
$168.00 |
$168.00 |
$148.98
|
|
Platelet automated
|
$30.00 |
$30.00 |
$30.00 |
$46.00
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$3,526.88 |
$3,526.88 |
$3,526.88 |
$1,532.70
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,030.63 |
$2,030.63 |
$2,030.63 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$1,284.80
|
|
Platelets pheresis pathogen-reduced each unit
|
$2,137.50 |
$2,137.50 |
$2,137.50 |
$1,005.65
|
|
Plcmnt biliary drainage cath w/img ext
|
$8,700.00 |
$8,700.00 |
$8,700.00 |
$4,642.20
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$20,599.00 |
$20,599.00 |
$20,599.00 |
$5,087.15
|
|
Plcmnt ureteral stent pq w/img new w/cath
|
$4,738.00 |
$4,738.00 |
$4,738.00 |
$5,589.75
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$2,622.00 |
$2,622.00 |
$2,622.00 |
$1,230.00
|
|
Plc pq device breast ea addl lesion stereo guide
|
$498.00 |
$498.00 |
$498.00 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$822.00 |
$822.00 |
$822.00 |
$754.00
|
|
Plethysmography lung volumes/airway resistance
|
$636.00 |
$636.00 |
$636.00 |
$408.05
|
|
Plmt biliary drainage cath
|
$3,273.00 |
$3,273.00 |
$3,273.00 |
$4,762.80
|
|
Plmt nephroureteral catheter
|
$4,620.00 |
$4,620.00 |
$4,620.00 |
$4,128.81
|
|
Plmt ureteral stent prq
|
$4,738.00 |
$4,738.00 |
$4,738.00 |
$5,128.50
|
|
Pm device progr eval dual
|
$139.00 |
$139.00 |
$139.00 |
$149.15
|
|
Pm device progr eval multi
|
$139.00 |
$139.00 |
$139.00 |
$139.10
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$97.00 |
$97.00 |
$97.00 |
$187.32
|
|
Polysom <6 yrs cpap/bilvl
|
$9,575.00 |
$9,575.00 |
$9,575.00 |
$3,514.50
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$6,258.00 |
$6,258.00 |
$6,258.00 |
$3,790.61
|
|
Positional nystagmus test
|
$39.00 |
$39.00 |
$39.00 |
$73.50
|
|
Potassium 24 hour urine
|
$18.00 |
$18.00 |
$18.00 |
$51.17
|
|
Potassium serum/plasma/whole blood
|
$37.00 |
$37.00 |
$37.00 |
$47.85
|
|
Pq dr cath chg w cont s&i
|
$327.00 |
$327.00 |
$327.00 |
$720.00
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$14,726.00 |
$14,726.00 |
$14,726.00 |
$10,173.15
|
|
Pq thr inj ext pse
|
$436.00 |
$436.00 |
$436.00 |
$781.62
|
|
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl
|
$1,759.00 |
$1,759.00 |
$1,759.00 |
$2,957.56
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$3,254.00 |
$3,254.00 |
$3,254.00 |
$4,627.00
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$3,254.00 |
$3,254.00 |
$3,254.00 |
$4,811.54
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$3,235.00 |
$3,235.00 |
$3,235.00 |
$3,738.90
|
|
Pr application of long arm splint
|
$347.00 |
$347.00 |
$347.00 |
$332.75
|
