|
Part exc/post vert comp/sng/thorac 22101
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$5,855.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$3,474.84 |
$3,474.84 |
$3,474.84 |
$3,762.53
|
|
Partial exc bone humerus
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$4,914.00
|
|
Partial excision of lip
|
$3,544.29 |
$3,544.29 |
$3,544.29 |
$4,133.59
|
|
Partial removal finger bone
|
$1,749.06 |
$1,749.06 |
$1,749.06 |
$2,211.05
|
|
Partial removal finger bone
|
$1,749.06 |
$1,749.06 |
$1,749.06 |
$2,134.33
|
|
Partial removal foot fascia
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$4,315.20
|
|
Partial removal of eye fluid
|
$2,492.56 |
$2,492.56 |
$2,492.56 |
$2,698.92
|
|
Partial removal of eye fluid
|
$2,492.56 |
$2,492.56 |
$2,492.56 |
$2,698.92
|
|
Partial removal of fibula
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,821.05
|
|
Partial removal of foot bone
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,839.54
|
|
Partial removal of hand bone
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,839.54
|
|
Partial removal of lip
|
$3,544.29 |
$3,544.29 |
$3,544.29 |
$3,276.00
|
|
Partial removal of nose
|
$6,465.11 |
$6,465.11 |
$6,465.11 |
$6,603.11
|
|
Partial removal of penis
|
$3,769.31 |
$3,769.31 |
$3,769.31 |
$4,081.37
|
|
Partial removal of pharynx 42890
|
$6,465.11 |
$6,465.11 |
$6,465.11 |
$6,465.11
|
|
Partial removal of radius
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,986.00
|
|
Partial removal of radius
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,472.00
|
|
Partial removal of rib
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$5,376.00
|
|
Partial removal of thyroid
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$5,855.00
|
|
Partial removal of thyroid
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$5,741.00
|
|
Partial removal of tibia
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$4,108.80
|
|
Partial removal of toe
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,674.58
|
|
Partial removal of tongue
|
$6,465.11 |
$6,465.11 |
$6,465.11 |
$6,084.97
|
|
Partial removal of ulna
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,986.00
|
|
Partial removal of ulna
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,803.90
|
|
Partial removal of ulna
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$3,474.84 |
$3,474.84 |
$3,474.84 |
$3,762.53
|
|
Partial removal tear gland
|
$4,121.25 |
$4,121.25 |
$4,121.25 |
$5,006.40
|
|
Partial thyroid excision
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$6,463.42
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$6,213.84
|
|
Part removal of metatarsal
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,821.05
|
|
Part removal of metatarsal
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$3,545.97 |
$3,545.97 |
$3,545.97 |
$3,839.54
|
|
Path clin consltj high 41-60
|
$187.28 |
$187.28 |
$187.28 |
$202.78
|
|
Path clin consltj mod 21-40
|
$187.28 |
$187.28 |
$187.28 |
$202.78
|
|
Path clin consltj sf 5-20
|
$58.39 |
$58.39 |
$58.39 |
$97.14
|
|
Pathogen reduced plasma pool
|
$61.32 |
$61.32 |
$61.32 |
$66.40
|
|
Pathogen reduced plasma sing
|
$319.70 |
$319.70 |
$319.70 |
$344.50
|
|
Patient recorded spirometry
|
$436.10 |
$436.10 |
$436.10 |
$456.56
|
|
Patient recorded spirometry
|
$340.32 |
$340.32 |
$340.32 |
$338.52
|
|
Pca3/klk3 antigen
|
$255.05 |
$255.05 |
$255.05 |
$510.40
|
|
Pdgfra gene
|
$329.51 |
$329.51 |
$329.51 |
$717.23
|
|
Pdt dstr prmlg les phys/qhp
|
$217.16 |
$217.16 |
$217.16 |
$294.77
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$1,999.13 |
$1,999.13 |
$1,999.13 |
$2,837.09
|
|
Ped home apnea mntr att only
|
$170.99 |
$170.99 |
$170.99 |
$185.15
|
|
Ped home apnea mntr dl&alys
|
$170.99 |
$170.99 |
$170.99 |
$296.92
|
|
Pedicle enel/ntroral 15576
|
$1,999.13 |
$1,999.13 |
$1,999.13 |
$2,508.24
|
|
Pegaspargase injection
|
$28,424.06 |
$28,424.06 |
$28,424.06 |
$41,065.49
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$58.40 |
$58.40 |
$58.40 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$132.04 |
$132.04 |
$132.04 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$136.04 |
$136.04 |
$136.04 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$229.11 |
$229.11 |
$229.11 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$103.71 |
$103.71 |
$103.71 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$149.21 |
$149.21 |
$149.21 |
$4,120.37
|
|
Pegloticase 8 mg/ml intravenous solution
|
$3,638.86 |
$3,638.86 |
$3,638.86 |
$49,135.11
|
|
Pegunigalsidase alfa-iwxj
|
$230.28 |
$230.28 |
$230.28 |
$2,146.13
|
|
Pelvic CT scan (with and without contrast)
|
$194.55 |
$194.55 |
$194.55 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$194.55 |
$194.55 |
$194.55 |
$1,610.00
|
|
Pelvic CT scan (without contrast)
|
$116.22 |
$116.22 |
$116.22 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$390.30 |
$390.30 |
$390.30 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$390.30 |
$390.30 |
$390.30 |
$2,224.75
|
|
Pelvic MRI (without contrast)
|
$264.17 |
$264.17 |
$264.17 |
$1,902.00
|
|
Pelvic ring fracture uni/bil
|
$7,807.24 |
$7,807.24 |
$7,807.24 |
$4,599.00
|
|
Pelvic Ultrasound (complete)
|
$116.22 |
$116.22 |
$116.22 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$116.22 |
$116.22 |
$116.22 |
$435.09
|
|
Pelvis X-ray (1 to 2 views)
|
$116.22 |
$116.22 |
$116.22 |
$282.00
|
|
Pelvis X-ray (complete, 4 or more views)
|
$116.22 |
$116.22 |
$116.22 |
$355.50
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$58.56 |
$58.56 |
$58.56 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$3.73 |
$3.73 |
$3.73 |
$7,089.13
|
|
Pemivibart infusion
|
$492.34 |
$492.34 |
$492.34 |
$533.10
|
|
Peng benzathine/procaine inj
|
$17.37 |
$17.37 |
$17.37 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$29.30 |
$29.30 |
$29.30 |
$824.70
|
|
Penicillin g procaine inj
|
$47.19 |
$47.19 |
$47.19 |
$149.20
|
|
Penile injection
|
$265.80 |
$265.80 |
$265.80 |
$418.86
|
|
Penile vascular study
|
$116.22 |
$116.22 |
$116.22 |
$561.00
|
|
Penile vascular study
|
$116.22 |
$116.22 |
$116.22 |
$574.60
|
|
Penile venous occlusion
|
$3,769.31 |
$3,769.31 |
$3,769.31 |
$4,081.37
|
|
Penis plastic surgery
|
$3,769.31 |
$3,769.31 |
$3,769.31 |
$4,081.37
|
|
Penis study
|
$340.32 |
$340.32 |
$340.32 |
$368.50
|
|
Pentostatin 10 mg intravenous solution
|
$2,543.89 |
$2,543.89 |
$2,543.89 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$11,378.21 |
$11,378.21 |
$11,378.21 |
$11,533.76
|
|
Perc d-e cor revasc chro sin
|
$19,624.54 |
$19,624.54 |
$19,624.54 |
$18,435.36
|
|
Perc d-e cor revasc t cabg s
|
$12,393.88 |
$12,393.88 |
$12,393.88 |
$16,047.20
|
|
Perc d-e cor stent ather s
|
$19,624.54 |
$19,624.54 |
$19,624.54 |
$18,545.83
|
|
Perc drug-el cor stent sing
|
$12,393.88 |
$12,393.88 |
$12,393.88 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$7,243.60
|
|
Percut ablate liver rf
|
$6,376.26 |
$6,376.26 |
$6,376.26 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$1,697.72 |
$1,697.72 |
$1,697.72 |
$2,418.99
|
|
Peri-implt capslc brst compl
|
$4,184.94 |
$4,184.94 |
$4,184.94 |
$4,184.94
|
|
Perineoplasty rpr per nonob
|
$3,474.84 |
$3,474.84 |
$3,474.84 |
$3,720.50
|
|
Peripheral vascular rehab
|
$64.92 |
$64.92 |
$64.92 |
$132.50
|
|
Peritoneal cath sub q resv per
|
$5,907.78 |
$5,907.78 |
$5,907.78 |
$5,625.74
|
|
Peritoneogram rs&i
|
$599.23 |
$599.23 |
$599.23 |
$698.50
|
|
Perit-vens shunt pat tst
|
$439.15 |
$439.15 |
$439.15 |
$787.20
|
|
Perq dev breast 1st mr guide
|
$768.94 |
$768.94 |
$768.94 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$768.94 |
$768.94 |
$768.94 |
$1,456.00
|
|
Perq nl/pl lithotrp cplx>2cm
|
$10,106.03 |
$10,106.03 |
$10,106.03 |
$10,114.58
|
