|
Platelet pheresis irr ea
|
$650.45 |
$650.45 |
$650.45 |
$976.30
|
|
Platelets each unit
|
$84.08 |
$84.08 |
$84.08 |
$300.60
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$860.57 |
$860.57 |
$860.57 |
$1,484.60
|
|
Platelets irradiated ea unit
|
$150.29 |
$150.29 |
$150.29 |
$215.80
|
|
Platelets leukocytes reduced each unit
|
$139.21 |
$139.21 |
$139.21 |
$274.95
|
|
Platelets leukocytes reduced irradiated each unit
|
$227.34 |
$227.34 |
$227.34 |
$348.48
|
|
Platelets leukoreduced cmv negative apheresis/phresis each unit
|
$251.53 |
$251.53 |
$251.53 |
$1,146.60
|
|
Platelets pheresis leukocytes reduced cmv negative irradiated each unit
|
$508.30 |
$508.30 |
$508.30 |
$1,424.80
|
|
Platelets pheresis leukocytes reduced each unit
|
$539.15 |
$539.15 |
$539.15 |
$1,554.42
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$747.86 |
$747.86 |
$747.86 |
$1,509.95
|
|
Platelets pheresis pathogen-reduced each unit
|
$650.04 |
$650.04 |
$650.04 |
$992.49
|
|
Platelet survival
|
$444.77 |
$444.77 |
$444.77 |
$473.22
|
|
Plcmnt biliary drainage cath w/img ext
|
$3,906.18 |
$3,906.18 |
$3,906.18 |
$4,406.61
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$3,817.53 |
$3,817.53 |
$3,817.53 |
$5,110.00
|
|
Plcmnt ureteral stent pq w/img new w/cath
|
$3,817.53 |
$3,817.53 |
$3,817.53 |
$6,328.92
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$778.78 |
$778.78 |
$778.78 |
$1,372.15
|
|
Plerixafor injection
|
$119.47 |
$119.47 |
$119.47 |
$36,856.95
|
|
Plethysmography lung volumes/airway resistance
|
$344.68 |
$344.68 |
$344.68 |
$403.80
|
|
Plmt access bil tree sm bwl
|
$6,906.53 |
$6,906.53 |
$6,906.53 |
$4,126.58
|
|
Plmt biliary drainage cath
|
$3,906.18 |
$3,906.18 |
$3,906.18 |
$4,923.19
|
|
Plmt nephroureteral catheter
|
$3,817.53 |
$3,817.53 |
$3,817.53 |
$4,846.99
|
|
Plmt ureteral stent prq
|
$3,817.53 |
$3,817.53 |
$3,817.53 |
$5,668.80
|
|
Pm device progr eval dual
|
$41.27 |
$41.27 |
$41.27 |
$154.40
|
|
Pm device progr eval multi
|
$41.27 |
$41.27 |
$41.27 |
$180.80
|
|
Pml/raralpha 1 breakpoint
|
$207.31 |
$207.31 |
$207.31 |
$307.13
|
|
Pmp22 gene dup/delet
|
$758.36 |
$758.36 |
$758.36 |
$1,029.75
|
|
Pmp22 gene full sequence
|
$769.58 |
$769.58 |
$769.58 |
$1,062.02
|
|
Pmp22 gene known fam variant
|
$46.60 |
$46.60 |
$46.60 |
$51.26
|
|
Pm phone r-strip device eval
|
$41.27 |
$41.27 |
$41.27 |
$139.10
|
|
Pms2 gene dup/delet variants
|
$203.50 |
$203.50 |
$203.50 |
$407.20
|
|
Pms2 gene full seq analysis
|
$676.50 |
$676.50 |
$676.50 |
$860.68
|
|
Pms2 known familial variants
|
$331.00 |
$331.00 |
$331.00 |
$364.10
|
|
Pneumothrx tx-intraplrl inj ai
|
$684.33 |
$684.33 |
$684.33 |
$785.00
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$26.07 |
$26.07 |
$26.07 |
$146.15
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$136.23 |
$136.23 |
$136.23 |
$136.23
|
|
Polysom <6 yrs cpap/bilvl
|
$1,126.11 |
$1,126.11 |
$1,126.11 |
$4,023.12
|
|
Polysom any age 1-3> param
|
$1,126.11 |
$1,126.11 |
$1,126.11 |
$1,424.80
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$1,126.11 |
$1,126.11 |
$1,126.11 |
$4,306.90
|
|
Porfimer sodium injection
|
$24,228.42 |
$24,228.42 |
$24,228.42 |
$60,070.25
|
|
Positional change of finger
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$5,339.00
|
|
Post 1 srfc resinbased cmpst
|
$1,840.30 |
$1,840.30 |
$1,840.30 |
$1,840.30
|
|
Post 2 srfc resinbased cmpst
|
$1,840.30 |
$1,840.30 |
$1,840.30 |
$1,840.30
|
|
Post >=4srfc resinbase cmpst
|
$1,840.30 |
$1,840.30 |
$1,840.30 |
$1,840.30
|
|
Post op service lvrs min 6
|
$587.30 |
$587.30 |
$587.30 |
$587.81
|
|
Potassium 24 hour urine
|
$4.73 |
$4.73 |
$4.73 |
$44.85
|
|
Potassium hydroxide preps
|
$5.83 |
$5.83 |
$5.83 |
$6.41
|
|
Potassium serum/plasma/whole blood
|
$4.76 |
$4.76 |
$4.76 |
$39.60
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$7,907.11 |
$7,907.11 |
$7,907.11 |
$10,430.78
|
|
Pq thr inj ext pse
|
$684.33 |
$684.33 |
$684.33 |
$843.97
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$4,452.80
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$4,432.24
|
|
Pralatrexate injection
|
$388.83 |
$388.83 |
$388.83 |
$388.83
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$3,630.00
|
|
Pr application of long arm splint
|
$174.65 |
$174.65 |
$174.65 |
$328.78
|
|
Pr application splint static short arm
|
$142.67 |
$142.67 |
$142.67 |
$288.75
|
|
Pr assessment emotional/behavioral per instrument brief
|
$43.44 |
$43.44 |
$43.44 |
$43.29
|
|
Pr biopsy skin punch single lesion
|
$442.22 |
$442.22 |
$442.22 |
$461.12
|
|
Pr correction hallux valgus (bunionectomy) with sesamoidectomy when performed with first metatarsal and cuneiform joint arthrodesis any method
|
$14,241.77 |
$14,241.77 |
$14,241.77 |
$5,741.00
|
|
Pr correction hammertoe
|
$3,591.33 |
$3,591.33 |
$3,591.33 |
$3,786.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$32.97 |
$32.97 |
$32.97 |
$48.71
|
|
Pr cystourethroscopy with insertion indwelling ureteral stent
|
$3,817.53 |
$3,817.53 |
$3,817.53 |
$4,555.88
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$219.93 |
$219.93 |
$219.93 |
$350.98
|
|
Prealbumin
|
$14.59 |
$14.59 |
$14.59 |
$80.00
|
|
Prefab stnlss steel crown pe
|
$1,840.30 |
$1,840.30 |
$1,840.30 |
$1,840.30
|
|
Prefab stnlss steel crwn pri
|
$1,840.30 |
$1,840.30 |
$1,840.30 |
$1,840.30
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$2,099.70 |
$2,099.70 |
$2,099.70 |
$2,636.00
|
|
Pregnancy associated plasma protein-a
|
$15.05 |
$15.05 |
$15.05 |
$64.47
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$117.70 |
$117.70 |
$117.70 |
$572.13
|
|
Pregnancy Ultrasound (first trimester)
|
$117.70 |
$117.70 |
$117.70 |
$517.12
|
|
Pre-op service lvrs 10-15dos
|
$344.68 |
$344.68 |
$344.68 |
$344.68
|
|
Pre-op service lvrs 1-9 dos
|
$587.30 |
$587.30 |
$587.30 |
$587.30
|
|
Pre-op service lvrs complete
|
$587.30 |
$587.30 |
$587.30 |
$587.30
|
|
Preparation palate mold
|
$563.67 |
$563.67 |
$563.67 |
$583.82
|
|
Prepare embryo for transfer
|
$59.14 |
$59.14 |
$59.14 |
$503.57
|
|
Pre-plan 3d model w/ccta
|
$1,126.11 |
$1,126.11 |
$1,126.11 |
$1,126.11
|
|
Prep skin to 100cm2 other
|
$677.54 |
$677.54 |
$677.54 |
$1,193.40
|
|
Prep skin to 100cm2 trk/ext
|
$2,024.70 |
$2,024.70 |
$2,024.70 |
$1,882.12
|
|
Pressure max expiratory/inspiratory
|
$173.18 |
$173.18 |
$173.18 |
$260.25
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$189.67 |
$189.67 |
$189.67 |
$139.80
|
|
Pretreat rbc absorption reference
|
$65.75 |
$65.75 |
$65.75 |
$139.00
|
|
Pretreat rbc density gradient separation reference
|
$189.67 |
$189.67 |
$189.67 |
$168.00
|
|
Pretreat rbc w chem/drugs reference
|
$65.75 |
$65.75 |
$65.75 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$189.67 |
$189.67 |
$189.67 |
$167.48
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$177.84 |
$177.84 |
$177.84 |
$313.30
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$142.64 |
$142.64 |
$142.64 |
$133.90
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$1,793.38 |
$1,793.38 |
$1,793.38 |
$1,874.89
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$1,793.38 |
$1,793.38 |
$1,793.38 |
$2,184.60
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$442.22 |
$442.22 |
$442.22 |
$780.60
|
|
Prgrmg dev eval impltbl sys
|
$41.27 |
$41.27 |
$41.27 |
$162.40
|
|
Prgrmg dev eval pm/ldls pm
|
$41.27 |
$41.27 |
$41.27 |
$140.80
|
|
Prgrmg dev eval scrms ip
|
$41.27 |
$41.27 |
$41.27 |
$150.61
|
|
Prgrmg eval implantable dfb
|
$41.27 |
$41.27 |
$41.27 |
$168.80
|
|
Prgrmg eval implantable dfb
|
$41.27 |
$41.27 |
$41.27 |
$209.60
|
|
Prgrmg eval implantable dfb
|
$41.27 |
$41.27 |
$41.27 |
$215.59
|
|
Prim art mech thrmbc non-intracranial
|
$19,875.58 |
$19,875.58 |
$19,875.58 |
$9,298.32
|
|
Pr incision & drainage abscess complicated/multiple
|
$442.22 |
$442.22 |
$442.22 |
$605.00
|
|
Pr incision & drainage abscess simple/single
|
$219.93 |
$219.93 |
$219.93 |
$437.53
|
|
Pr incision & drainage abscess vulva/perineal
|
$336.70 |
$336.70 |
$336.70 |
$539.80
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$442.22 |
$442.22 |
$442.22 |
$619.20
|
|
Pr management transitional care high w/in 7 days of discharge
|
$142.64 |
$142.64 |
$142.64 |
$255.50
|