|
New Patient Office Visit (level 2)
|
$141.60 |
$141.60 |
$141.60 |
$163.30
|
|
New Patient Office Visit (level 3)
|
$203.20 |
$203.20 |
$203.20 |
$211.00
|
|
New Patient Office Visit (level 4)
|
$268.80 |
$268.80 |
$268.80 |
$291.06
|
|
New Patient Office Visit (level 5)
|
$328.00 |
$328.00 |
$328.00 |
$355.80
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$88.60 |
$88.60 |
$88.60 |
$251.32
|
|
Nintedanib 150 mg capsule
|
$5.01 |
$5.01 |
$5.01 |
$262.93
|
|
Nm imaging pulmonary ventilation/perfusion
|
$2,065.60 |
$2,065.60 |
$2,065.60 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,316.80 |
$1,316.80 |
$1,316.80 |
$1,091.00
|
|
No pt prsnt train add 15
|
$70.40 |
$70.40 |
$70.40 |
$47.60
|
|
No pt prsnt train initial 30
|
$140.80 |
$140.80 |
$140.80 |
$61.33
|
|
Nose (Nasal Bone) X-ray (complete)
|
$404.80 |
$404.80 |
$404.80 |
$274.65
|
|
Nuclear Stress Test (Heart)
|
$3,842.40 |
$3,842.40 |
$3,842.40 |
$3,859.98
|
|
Observation direct referral from physician office for admission
|
$200.00 |
$200.00 |
$200.00 |
$384.00
|
|
Observation per hour
|
$76.80 |
$76.80 |
$76.80 |
$82.50
|
|
Occupational Therapy Evaluation (high complexity)
|
$303.20 |
$303.20 |
$303.20 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$268.80 |
$268.80 |
$268.80 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$289.60 |
$289.60 |
$289.60 |
$263.90
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$49.52 |
$49.52 |
$49.52 |
$90.00
|
|
Olanzapine 10 mg intramuscular solution
|
$69.65 |
$69.65 |
$69.65 |
$109.62
|
|
Ondansetron 4 mg s0119
|
$5.80 |
$5.80 |
$5.80 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$49.56 |
$49.56 |
$49.56 |
$22.62
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$59.33 |
$59.33 |
$59.33 |
$50.63
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$310.73 |
$310.73 |
$310.73 |
$279.81
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$526.45 |
$526.45 |
$526.45 |
$231.66
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$167.30 |
$167.30 |
$167.30 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$423.72 |
$423.72 |
$423.72 |
$229.45
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$534.64 |
$534.64 |
$534.64 |
$421.00
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$1,211.11 |
$1,211.11 |
$1,211.11 |
$686.79
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$134.40 |
$134.40 |
$134.40 |
$97.80
|
|
Ot re-evaluation patient/family
|
$154.40 |
$154.40 |
$154.40 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$124.00 |
$124.00 |
$124.00 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$138.40 |
$138.40 |
$138.40 |
$93.12
|
|
Oxytocin 10 unit/ml injection solution
|
$49.12 |
$49.12 |
$49.12 |
$50.40
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$51.17 |
$51.17 |
$51.17 |
$28.90
|
|
Parathyroid planar imaging
|
$1,509.60 |
$1,509.60 |
$1,509.60 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$1,752.80 |
$1,752.80 |
$1,752.80 |
$1,374.75
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$5,000.86 |
$5,000.86 |
$5,000.86 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$3,092.26 |
$3,092.26 |
$3,092.26 |
$7,297.36
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$826.05 |
$826.05 |
$826.05 |
$4,120.37
|
|
Pelvic CT scan (with contrast)
|
$2,002.40 |
$2,002.40 |
$2,002.40 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,715.20 |
$1,715.20 |
$1,715.20 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,837.60 |
$3,837.60 |
$3,837.60 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$2,744.00 |
$2,744.00 |
$2,744.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$772.00 |
$772.00 |
$772.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$410.40 |
$410.40 |
$410.40 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$351.20 |
$351.20 |
$351.20 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$456.80 |
$456.80 |
$456.80 |
$351.75
|
|
Pemivibart infusion
|
$798.40 |
$798.40 |
$798.40 |
$533.10
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$214.52 |
$214.52 |
$214.52 |
$824.70
|
|
Pentamidine non-comp unit
|
$111.81 |
$111.81 |
$111.81 |
$294.39
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$95.96 |
$95.96 |
$95.96 |
$114.56
|
|
Phenylephrine 10 mg/ml injection solution
|
$51.41 |
$51.41 |
$51.41 |
$62.98
|
|
Phlebotomy therapeutic
|
$261.60 |
$261.60 |
$261.60 |
$231.40
|
|
Physical Therapy Evaluation (high complexity)
|
$340.80 |
$340.80 |
$340.80 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$268.80 |
$268.80 |
$268.80 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$304.00 |
$304.00 |
$304.00 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$154.40 |
$154.40 |
$154.40 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$86.71 |
$86.71 |
$86.71 |
$90.25
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$54.54 |
$54.54 |
$54.54 |
$81.36
|
|
Platelets each unit
|
$570.40 |
$570.40 |
$570.40 |
$169.29
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,139.20 |
$1,139.20 |
$1,139.20 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,396.00 |
$1,396.00 |
$1,396.00 |
$1,284.80
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$49.28 |
$49.28 |
$49.28 |
$62.79
|
|
Pr application of long arm splint
|
$408.00 |
$408.00 |
$408.00 |
$332.75
|
|
Pr application splint static short arm
|
$352.00 |
$352.00 |
$352.00 |
$288.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$48.00 |
$48.00 |
$48.00 |
$48.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$13.11 |
$13.11 |
$13.11 |
$13.87
|
|
Pregnancy Ultrasound (first trimester)
|
$426.40 |
$426.40 |
$426.40 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$344.00 |
$344.00 |
$344.00 |
$459.00
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$1,176.80 |
$1,176.80 |
$1,176.80 |
$779.35
|
|
Pr incision & drainage abscess complicated/multiple
|
$852.00 |
$852.00 |
$852.00 |
$705.00
|
|
Pr incision & drainage abscess simple/single
|
$556.00 |
$556.00 |
$556.00 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$603.20 |
$603.20 |
$603.20 |
$543.84
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$858.40 |
$858.40 |
$858.40 |
$592.62
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$225.60 |
$225.60 |
$225.60 |
$253.55
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$54.92 |
$54.92 |
$54.92 |
$38.48
|
|
Propofol infusion 10 mg/ml
|
$57.51 |
$57.51 |
$57.51 |
$73.36
|
|
Protamine 10 mg/ml intravenous solution
|
$50.88 |
$50.88 |
$50.88 |
$56.70
|
|
Prothrombin complex kcentra
|
$1,620.00 |
$1,620.00 |
$1,620.00 |
$6.98
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$260.80 |
$260.80 |
$260.80 |
$252.00
|
|
Pr removal intrauterine device
|
$434.40 |
$434.40 |
$434.40 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$919.20 |
$919.20 |
$919.20 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$489.60 |
$489.60 |
$489.60 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$509.60 |
$509.60 |
$509.60 |
$406.35
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$469.60 |
$469.60 |
$469.60 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$492.80 |
$492.80 |
$492.80 |
$396.00
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,410.40 |
$1,410.40 |
$1,410.40 |
$1,761.00
|
|
Psychotherapy group therapy
|
$1,400.00 |
$1,400.00 |
$1,400.00 |
$225.39
|
|
Psychotherapy patient individual therapy 30 minutes
|
$480.00 |
$480.00 |
$480.00 |
$190.13
|
|
Psychotherapy patient individual therapy 45 minutes
|
$520.00 |
$520.00 |
$520.00 |
$250.95
|
|
Psychotherapy patient individual therapy 60 minutes
|
$528.00 |
$528.00 |
$528.00 |
$287.95
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$144.00 |
$144.00 |
$144.00 |
$103.20
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$98.40 |
$98.40 |
$98.40 |
$81.48
|
|
Pt application of modality traction mechanical
|
$119.20 |
$119.20 |
$119.20 |
$91.80
|
|
Pt repositioning canalith procedure(s) per day
|
$146.40 |
$146.40 |
$146.40 |
$118.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$98.40 |
$98.40 |
$98.40 |
$80.30
|
|
Pt wheelchair management each 15 minutes
|
$134.40 |
$134.40 |
$134.40 |
$88.00
|
|
Pulse ox continuous overnight monitoring
|
$341.60 |
$341.60 |
$341.60 |
$347.11
|
|
Pulse ox multiple
|
$213.60 |
$213.60 |
$213.60 |
$157.30
|
|
Pulse ox single
|
$85.60 |
$85.60 |
$85.60 |
$84.00
|