|
Partial removal of ulna
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,744.41
|
|
Partial removal tear gland
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,627.00
|
|
Partial thyroid excision
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,038.00
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,855.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$856.88 |
$856.88 |
$856.88 |
$4,418.35
|
|
Part removal of metatarsal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,795.71
|
|
Part removal of metatarsal
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,942.23
|
|
Part removal of metatarsal 28112
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,591.33
|
|
Passy muir valve metal trach
|
$42.40 |
$42.40 |
$42.40 |
$242.47
|
|
Path clin consltj sf 5-20
|
$26.84 |
$26.84 |
$26.84 |
$82.15
|
|
Pca3/klk3 antigen
|
$280.56 |
$280.56 |
$280.56 |
$510.40
|
|
Pdgfra gene
|
$362.46 |
$362.46 |
$362.46 |
$659.20
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,216.80
|
|
Pedicle enel/ntroral 15576
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,436.20
|
|
Pelvic CT scan (with and without contrast)
|
$532.31 |
$532.31 |
$532.31 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$481.07 |
$481.07 |
$481.07 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$379.15 |
$379.15 |
$379.15 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$954.07 |
$954.07 |
$954.07 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$933.80 |
$933.80 |
$933.80 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$599.32 |
$599.32 |
$599.32 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$213.60 |
$213.60 |
$213.60 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$74.70 |
$74.70 |
$74.70 |
$445.00
|
|
Penile injection
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$418.00
|
|
Penile venous occlusion
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,081.37
|
|
Penis plastic surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,081.37
|
|
Penis study
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$308.10
|
|
Perc cryo ablate renal tum
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$12,320.22
|
|
Perc rf ablate renal tumor
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,949.48
|
|
Percut ablate liver rf
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,024.12
|
|
Pericardiocentesis wwo imaging
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,573.60
|
|
Peri-implt capslc brst compl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,184.94
|
|
Perineoplasty rpr per nonob
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,474.84
|
|
Peritoneal cath sub q resv per
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,625.74
|
|
Peritoneogram rs&i
|
$446.72 |
$446.72 |
$446.72 |
$648.84
|
|
Perq dev breast 1st mr guide
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,032.24
|
|
Perq dev breast 1st strtctc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,548.60
|
|
Perq nl/pl lithotrp cplx>2cm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$10,114.58
|
|
Perq nl/pl lithotrp smpl<2cm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$8,748.48
|
|
Perq p-art revsc 1 abnor bi
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$15,916.29
|
|
Perq p-art revsc 1 abnor uni
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$20,544.05
|
|
Perq p-art revsc 1 nm nt bi
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$15,217.89
|
|
Perq p-art revsc 1 nm nt uni
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$15,145.00
|
|
Perq plmt bile duct stent
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,457.82
|
|
Perq plmt bile duct stent
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$7,082.99
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$625.93
|
|
Perq skel fix rad/uln dislc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,603.83
|
|
Perq skel fix ulnar styld fx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,591.33
|
|
Perq tx big toe fracture w/manip 28496
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Perq tx malar fracture
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,837.72
|
|
Perq tx mndblr fx xtrnl fixj
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,110.00
|
|
Perq tx nasoethmoid fx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,837.72
|
|
Pertussis ag if
|
$13.18 |
$13.18 |
$13.18 |
$49.00
|
|
Pet fdg brain metoblic eval sb
|
$839.76 |
$839.76 |
$839.76 |
$3,559.05
|
|
Phalangectomy ea toe 28150
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,591.33
|
|
Ph body fluid
|
$3.94 |
$3.94 |
$3.94 |
$39.20
|
|
Phencyclidine (pcp)
|
$19.89 |
$19.89 |
$19.89 |
$88.00
|
|
Phenobarbital therapeutic drug level
|
$16.83 |
$16.83 |
$16.83 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$14.58 |
$14.58 |
$14.58 |
$111.27
|
|
Phlebotomy therapeutic
|
$130.45 |
$130.45 |
$130.45 |
$249.00
|
|
Phleb veins 1 extrm 10-20 stab
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,341.66
|
|
Phleb veins 1 extrm >20 stab
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,341.66
|
|
Phosphorus
|
$5.21 |
$5.21 |
$5.21 |
$47.81
|
|
Phosphorus 24 hour urine
|
$6.36 |
$6.36 |
$6.36 |
$42.81
|
|
Photopheresis
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,988.98
|
|
Pik3ca gene trgt seq alys
|
$302.31 |
$302.31 |
$302.31 |
$400.95
|
|
Pillow shldr abduc inflat univ
|
$296.72 |
$296.72 |
$296.72 |
$537.66
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,016.25
|
|
Pin finger dislocation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,821.05
|
|
Pin finger fracture each
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,910.33
|
|
Pin hand dislocation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Pin knuckle dislocation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,594.44
|
|
Pin service 60m per month
|
$38.47 |
$38.47 |
$38.47 |
$151.20
|
|
Pinworm exam
|
$4.70 |
$4.70 |
$4.70 |
$39.75
|
|
Pinworm examinations
|
$4.70 |
$4.70 |
$4.70 |
$5.89
|
|
Pituitary evaluation panel
|
$637.43 |
$637.43 |
$637.43 |
$799.68
|
|
Place breast rad tube/caths
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,215.93
|
|
Place cecostomy tube perc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,576.20
|
|
Place device/marker, non pro
|
$619.41 |
$619.41 |
$619.41 |
$1,868.78
|
|
Place duod/jej tube perc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,588.00
|
|
Place gastrostomy tube perc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,517.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,679.20
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$800.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,372.15
|
|
Placement nephrostomy catheter (both sides)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,450.11
|
|
Placement occlusive device venous/arterial access site post procedure
|
$198.96 |
$198.96 |
$198.96 |
$656.63
|
|
Placement of seton
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,375.00
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$14,934.35
|
|
Place ndl musc/tis for right
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,512.89
|
|
Place needles h&n for right
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,547.81
|
|
Place needles pelvic for right
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,855.00
|
|
Place non-slctv cath thoracic arta
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,110.00
|
|
Placental lactogen
|
$22.24 |
$22.24 |
$22.24 |
$143.67
|
|
Place po breast cath for rad
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$11,238.72
|
|
Place right device/marker pros
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,903.23
|
|
Place slctv cath carotd art uni
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$10,549.80
|
|
Place slctv cath carotid/inom art excrn uni
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,726.70
|
|
Place slctv cath carotid/inom art intcrn uni
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$9,181.35
|
|
Place slctv cath subclavian art
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,732.48
|
