|
Pelvic CT scan (with and without contrast)
|
$1,067.04 |
$1,067.04 |
$1,067.04 |
$1,891.05
|
|
Pelvic CT scan (with contrast)
|
$1,024.92 |
$1,024.92 |
$1,024.92 |
$1,631.40
|
|
Pelvic CT scan (without contrast)
|
$1,518.92 |
$1,518.92 |
$1,518.92 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,423.24 |
$1,423.24 |
$1,423.24 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$992.68 |
$992.68 |
$992.68 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$273.00 |
$273.00 |
$273.00 |
$676.20
|
|
Pelvic Ultrasound (limited)
|
$331.76 |
$331.76 |
$331.76 |
$435.09
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$6,177.83 |
$6,177.83 |
$6,177.83 |
$6,582.76
|
|
Pemivibart infusion
|
$365.04 |
$365.04 |
$365.04 |
$533.10
|
|
Peritoneal cath sub q resv per
|
$7,755.80 |
$7,755.80 |
$7,755.80 |
$5,983.35
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$677.04 |
$677.04 |
$677.04 |
$625.93
|
|
Ph body fluid
|
$5.20 |
$5.20 |
$5.20 |
$40.04
|
|
Phencyclidine (pcp)
|
$166.92 |
$166.92 |
$166.92 |
$90.00
|
|
Phenobarbital therapeutic drug level
|
$49.92 |
$49.92 |
$49.92 |
$106.40
|
|
Phentolaine mesylate inj
|
$1,679.38 |
$1,679.38 |
$1,679.38 |
$1,028.40
|
|
Phenytoin total therapeutic drug level
|
$56.68 |
$56.68 |
$56.68 |
$113.00
|
|
Phlebotomy therapeutic
|
$19.24 |
$19.24 |
$19.24 |
$237.00
|
|
Phosphorus
|
$34.84 |
$34.84 |
$34.84 |
$50.76
|
|
Pik3ca gene trgt seq alys
|
$482.04 |
$482.04 |
$482.04 |
$453.18
|
|
Platelet automated
|
$12.48 |
$12.48 |
$12.48 |
$45.76
|
|
Platelet pheresis each unit
|
$1,637.48 |
$1,637.48 |
$1,637.48 |
$947.00
|
|
Platelets each unit
|
$67.60 |
$67.60 |
$67.60 |
$163.35
|
|
Platelets pheresis leukocytes reduced each unit
|
$598.00 |
$598.00 |
$598.00 |
$1,108.08
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$598.00 |
$598.00 |
$598.00 |
$1,231.75
|
|
Plerixafor injection
|
$1,731.79 |
$1,731.79 |
$1,731.79 |
$16,079.30
|
|
Pml/raralpha 1 breakpoint
|
$364.00 |
$364.00 |
$364.00 |
$307.13
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$114.40 |
$114.40 |
$114.40 |
$189.60
|
|
Potassium 24 hour urine
|
$11.44 |
$11.44 |
$11.44 |
$52.20
|
|
Potassium serum/plasma/whole blood
|
$34.84 |
$34.84 |
$34.84 |
$47.40
|
|
Pralatrexate injection
|
$14,379.50 |
$14,379.50 |
$14,379.50 |
$20,786.08
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$1,063.92 |
$1,063.92 |
$1,063.92 |
$3,738.90
|
|
Pr application of long arm splint
|
$136.24 |
$136.24 |
$136.24 |
$329.00
|
|
Pr application splint static short arm
|
$136.24 |
$136.24 |
$136.24 |
$288.75
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$30.68 |
$30.68 |
$30.68 |
$48.50
|
|
Prealbumin
|
$64.48 |
$64.48 |
$64.48 |
$96.00
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$278.20 |
$278.20 |
$278.20 |
$596.40
|
|
Pregnancy Ultrasound (first trimester)
|
$278.20 |
$278.20 |
$278.20 |
$539.37
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$1,317.68 |
$1,317.68 |
$1,317.68 |
$779.35
|
|
Pr incision & drainage abscess complicated/multiple
|
$191.36 |
$191.36 |
$191.36 |
$704.90
|
|
Pr incision & drainage abscess simple/single
|
$119.08 |
$119.08 |
$119.08 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$257.40 |
$257.40 |
$257.40 |
$539.80
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$207.48 |
$207.48 |
$207.48 |
$572.00
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$2,056.51 |
$2,056.51 |
$2,056.51 |
$674.78
|
|
Procalcitonin
|
$70.72 |
$70.72 |
$70.72 |
$159.25
|
|
Proctosigmoidoscopy w/fb remove 45307
|
$3,973.84 |
$3,973.84 |
$3,973.84 |
$3,237.36
|
|
Progesterone
|
$48.88 |
$48.88 |
$48.88 |
$117.48
|
|
Prolactin
|
$43.68 |
$43.68 |
$43.68 |
$126.00
|
|
Protein c activity
|
$22.88 |
$22.88 |
$22.88 |
$122.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$39.00 |
$39.00 |
$39.00 |
$83.85
|
|
Protein total 24 hour urine
|
$19.24 |
$19.24 |
$19.24 |
$52.50
|
|
Protein total body fluid
|
$52.00 |
$52.00 |
$52.00 |
$52.00
|
|
Protein total serum plasma whole blood
|
$39.00 |
$39.00 |
$39.00 |
$44.40
|
|
Prothrombin time substitution plasma fractions each
|
$5.72 |
$5.72 |
$5.72 |
$41.50
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$96.72 |
$96.72 |
$96.72 |
$252.60
|
|
Pr removal intrauterine device
|
$165.36 |
$165.36 |
$165.36 |
$373.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$234.52 |
$234.52 |
$234.52 |
$736.90
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$335.92 |
$335.92 |
$335.92 |
$380.00
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$335.92 |
$335.92 |
$335.92 |
$406.35
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$335.92 |
$335.92 |
$335.92 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$335.92 |
$335.92 |
$335.92 |
$393.25
|
|
Pr tube thoracostomy w/connection to drainage open
|
$575.12 |
$575.12 |
$575.12 |
$1,738.08
|
|
PSA (Prostate) Test
|
$49.92 |
$49.92 |
$49.92 |
$109.45
|
|
Psychotherapy group therapy
|
$116.48 |
$116.48 |
$116.48 |
$223.60
|
|
Psychotherapy patient individual therapy 30 minutes
|
$171.08 |
$171.08 |
$171.08 |
$190.13
|
|
Psychotherapy patient individual therapy 45 minutes
|
$204.88 |
$204.88 |
$204.88 |
$251.00
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$85.80 |
$85.80 |
$85.80 |
$87.49
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$31.72 |
$31.72 |
$31.72 |
$103.35
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$21.84 |
$21.84 |
$21.84 |
$80.40
|
|
Pt application of modality traction mechanical
|
$30.68 |
$30.68 |
$30.68 |
$88.93
|
|
Pten gene dup/delet variant
|
$526.24 |
$526.24 |
$526.24 |
$330.00
|
|
Pten gene full sequence
|
$1,053.00 |
$1,053.00 |
$1,053.00 |
$816.31
|
|
Pten gene known fam variant
|
$82.16 |
$82.16 |
$82.16 |
$127.86
|
|
Pt evaluation high complexity patient/family
|
$108.68 |
$108.68 |
$108.68 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$108.68 |
$108.68 |
$108.68 |
$222.56
|
|
Pt evaluation moderate complexity patient/family
|
$108.68 |
$108.68 |
$108.68 |
$254.88
|
|
Pt re-evaluation patient/family
|
$54.08 |
$54.08 |
$54.08 |
$154.40
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$24.96 |
$24.96 |
$24.96 |
$82.20
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$104.00 |
$104.00 |
$104.00 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$34.84 |
$34.84 |
$34.84 |
$79.00
|
|
Pt wheelchair management each 15 minutes
|
$44.20 |
$44.20 |
$44.20 |
$87.50
|
|
Pulse ox continuous overnight monitoring
|
$190.84 |
$190.84 |
$190.84 |
$350.40
|
|
Puncture arterial withdrawal blood for diagnosis
|
$52.00 |
$52.00 |
$52.00 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$207.48 |
$207.48 |
$207.48 |
$505.20
|
|
Puncture spinal lumbar diagnostic
|
$488.80 |
$488.80 |
$488.80 |
$1,087.80
|
|
Quest t3 uptake
|
$13.52 |
$13.52 |
$13.52 |
$55.00
|
|
Rapid Strep Test
|
$24.96 |
$24.96 |
$24.96 |
$76.00
|
|
Rbc count only automated
|
$5.72 |
$5.72 |
$5.72 |
$20.03
|
|
Rbc irradiated each unit
|
$1,867.84 |
$1,867.84 |
$1,867.84 |
$517.86
|
|
Red blood cells each unit
|
$1,245.92 |
$1,245.92 |
$1,245.92 |
$382.50
|
|
Red blood cells leukocytes reduced each unit
|
$284.44 |
$284.44 |
$284.44 |
$422.84
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$824.20 |
$824.20 |
$824.20 |
$523.83
|
|
Red blood cells washed each unit
|
$171.08 |
$171.08 |
$171.08 |
$559.00
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$526.76 |
$526.76 |
$526.76 |
$2,449.20
|
|
Removal cerumen impacted (both sides)
|
$42.12 |
$42.12 |
$42.12 |
$169.20
|
|
Removal foreign body foot cmplx
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$2,659.20
|
|
Removal foreign body foot subcutaneous right
|
$605.28 |
$605.28 |
$605.28 |
$1,256.00
|
|
Removal foreign body gum 41805
|
$2,199.08 |
$2,199.08 |
$2,199.08 |
$2,199.08
|
|
Removal foreign body mouth
|
$735.28 |
$735.28 |
$735.28 |
$1,424.80
|
|
Removal of foreign body
|
$3,708.12 |
$3,708.12 |
$3,708.12 |
$4,149.00
|
|
Removal of hip foreign body 27087
|
$4,606.16 |
$4,606.16 |
$4,606.16 |
$4,313.40
|
