|
Parotid duct diversion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,339.00
|
|
Parotid duct diversion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,465.11
|
|
Parotid duct diversion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Part exc/post vert comp/sng/thorac 22101
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$7,553.59
|
|
Part hymenectomy/revi hymenal ring 56700
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,762.53
|
|
Partial exc bone humerus
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,881.50
|
|
Partial excision of lip
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Partial removal finger bone
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,021.04
|
|
Partial removal finger bone
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,211.05
|
|
Partial removal foot fascia
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial removal leg bone(s)
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,315.20
|
|
Partial removal of eye fluid
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,698.92
|
|
Partial removal of eye fluid
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,698.92
|
|
Partial removal of fibula
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,714.10
|
|
Partial removal of foot bone
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial removal of hand bone
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,668.02
|
|
Partial removal of lip
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Partial removal of nose
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,547.81
|
|
Partial removal of penis
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,081.37
|
|
Partial removal of pharynx 42890
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,416.89
|
|
Partial removal of radius
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial removal of radius
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,594.44
|
|
Partial removal of rib
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,855.00
|
|
Partial removal of thyroid
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,311.00
|
|
Partial removal of thyroid
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,741.00
|
|
Partial removal of tibia
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,108.80
|
|
Partial removal of toe
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,821.05
|
|
Partial removal of tongue
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,978.70
|
|
Partial removal of ulna
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial removal of ulna
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,803.90
|
|
Partial removal of ulna
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,744.41
|
|
Partial removal tear gland
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,627.00
|
|
Partial thyroid excision
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,038.00
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,855.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$588.90 |
$588.90 |
$588.90 |
$4,418.35
|
|
Part removal of metatarsal
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,795.71
|
|
Part removal of metatarsal
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,942.23
|
|
Part removal of metatarsal 28112
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,591.33
|
|
Passy muir valve metal trach
|
$29.14 |
$29.14 |
$29.14 |
$242.47
|
|
Pdgfra gene
|
$362.46 |
$362.46 |
$362.46 |
$659.20
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,216.80
|
|
Pedicle enel/ntroral 15576
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,436.20
|
|
Pelvic CT scan (with and without contrast)
|
$365.84 |
$365.84 |
$365.84 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$330.62 |
$330.62 |
$330.62 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$260.58 |
$260.58 |
$260.58 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$677.63 |
$677.63 |
$677.63 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$580.88 |
$580.88 |
$580.88 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$493.81 |
$493.81 |
$493.81 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$171.69 |
$171.69 |
$171.69 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$84.23 |
$84.23 |
$84.23 |
$445.00
|
|
Pemivibart infusion
|
$116.10 |
$116.10 |
$116.10 |
$603.65
|
|
Penile injection
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$418.00
|
|
Penile vascular study
|
$178.02 |
$178.02 |
$178.02 |
$460.20
|
|
Penile venous occlusion
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,081.37
|
|
Penis plastic surgery
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,081.37
|
|
Penis study
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$308.10
|
|
Perc cryo ablate renal tum
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$12,320.22
|
|
Perc rf ablate renal tumor
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,949.48
|
|
Percut ablate liver rf
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$7,024.12
|
|
Pericardiocentesis wwo imaging
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,573.60
|
|
Peri-implt capslc brst compl
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,184.94
|
|
Perineoplasty rpr per nonob
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,474.84
|
|
Peritoneal cath sub q resv per
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,625.74
|
|
Perq dev breast 1st mr guide
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$2,032.24
|
|
Perq dev breast 1st strtctc
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,548.60
|
|
Perq nl/pl lithotrp cplx>2cm
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$10,114.58
|
|
Perq nl/pl lithotrp smpl<2cm
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$8,748.48
|
|
Perq p-art revsc 1 abnor bi
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$15,916.29
|
|
Perq p-art revsc 1 abnor uni
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$20,544.05
|
|
Perq p-art revsc 1 nm nt bi
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$15,217.89
|
|
Perq p-art revsc 1 nm nt uni
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$15,145.00
|
|
Perq plmt bile duct stent
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$6,457.82
|
|
Perq plmt bile duct stent
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$7,082.99
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$625.93
|
|
Perq skel fix rad/uln dislc
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,603.83
|
|
Perq skel fix ulnar styld fx
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,591.33
|
|
Perq tx big toe fracture w/manip 28496
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,839.54
|
|
Perq tx malar fracture
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Perq tx mndblr fx xtrnl fixj
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,110.00
|
|
Perq tx nasoethmoid fx
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,837.72
|
|
Pertussis ag if
|
$13.18 |
$13.18 |
$13.18 |
$49.00
|
|
Pet fdg brain metoblic eval sb
|
$564.37 |
$564.37 |
$564.37 |
$3,559.05
|
|
Phalangectomy ea toe 28150
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,591.33
|
|
Ph body fluid
|
$3.94 |
$3.94 |
$3.94 |
$39.20
|
|
Phencyclidine (pcp)
|
$14.96 |
$14.96 |
$14.96 |
$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
|
$68.62 |
$68.62 |
$68.62 |
$249.00
|
|
Phleb veins 1 extrm 10-20 stab
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$4,341.66
|
|
Phleb veins 1 extrm >20 stab
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$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
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$5,988.98
|
|
Pik3ca gene trgt seq alys
|
$302.31 |
$302.31 |
$302.31 |
$400.95
|
|
Pillow shldr abduc inflat univ
|
$203.92 |
$203.92 |
$203.92 |
$537.66
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$1,016.25
|
|
Pin finger dislocation
|
$4,627.00 |
$4,627.00 |
$4,627.00 |
$3,821.05
|
