|
Optx mndblr/max alv ridge fx
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$7,000.36
|
|
Optx palatal/max fracture
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$5,855.00
|
|
Optx partclr fx&/dslc elbw w
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,629.07
|
|
Optx post ankle fx
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,886.74
|
|
Optx prox humrl fx w/int fix
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$13,780.53
|
|
Optx prx hmrl fx fix rpr rpl
|
$21,762.05 |
$21,762.05 |
$21,762.05 |
$8,159.00
|
|
Optx radial shaft fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,419.00
|
|
Optx rad/uln dislc aqt/chrnc
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,886.74
|
|
Optx rdcrpl/ntrcrpl dislc 1+
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,311.00
|
|
Optx rdl shft fx&cltx rad/ul
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,386.73
|
|
Optx rdl shft fx&dstl rad/ul
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Optx rdl&uln shft fx rds&uln
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Optx rdl&uln shft fx rds/uln
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,665.84
|
|
Optx scapular fx w/int fixj
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,906.00
|
|
Optx sho dislc fx
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,110.00
|
|
Optx sho dislc neck fx fixj
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$6,411.60
|
|
Optx strclv dslc aq/chrn grf
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Optx strnclav dislc aqt/chrn
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,807.24
|
|
Optx tmprmand dislocation
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,179.20
|
|
Optx trns-scphprlnr fx dislc
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,741.00
|
|
Optx ulnar shft fx int fixj
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$8,453.60
|
|
Optx ulnar styloid fracture
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,295.25
|
|
Oral busulfan
|
$84.21 |
$84.21 |
$84.21 |
$176.80
|
|
Oral hiv-1/hiv-2 screen
|
$11.98 |
$11.98 |
$11.98 |
$38.58
|
|
Oral methotrexate (jylamvo)
|
$19.36 |
$19.36 |
$19.36 |
$19.36
|
|
Oral methotrexate (xatmep)
|
$20.71 |
$20.71 |
$20.71 |
$4,371.50
|
|
Oral netupitant, palonosetro
|
$400.24 |
$400.24 |
$400.24 |
$1,120.66
|
|
Orchiectomy partial
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,061.71
|
|
Orchiopexy (fowler-stephens)
|
$4,176.15 |
$4,176.15 |
$4,176.15 |
$3,909.56
|
|
Orchiopexy ingun/scrot appr
|
$4,176.15 |
$4,176.15 |
$4,176.15 |
$4,176.15
|
|
Organic acids total quant ea spec
|
$23.60 |
$23.60 |
$23.60 |
$152.50
|
|
Oritavancin 1,200 mg intravenous solution
|
$42.50 |
$42.50 |
$42.50 |
$11,017.26
|
|
Oritavancin 400 mg intravenous solution
|
$28.46 |
$28.46 |
$28.46 |
$3,311.06
|
|
Oropharyngeal biopsy 42800
|
$1,752.89 |
$1,752.89 |
$1,752.89 |
$2,443.00
|
|
Orthopantogram
|
$104.19 |
$104.19 |
$104.19 |
$248.04
|
|
Orthop traing supvj phys/qhp
|
$70.29 |
$70.29 |
$70.29 |
$112.32
|
|
Orthovisc inj per dose
|
$122.91 |
$122.91 |
$122.91 |
$537.58
|
|
Oscillation chest wall mechanical per session
|
$240.68 |
$240.68 |
$240.68 |
$196.70
|
|
Osmolality blood
|
$6.61 |
$6.61 |
$6.61 |
$68.80
|
|
Osmolality urine
|
$6.82 |
$6.82 |
$6.82 |
$65.00
|
|
Ostectomy complete 1st metatarsal head 28111
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,266.96
|
|
Ostectomy scapula partial
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,821.05
|
|
Osteochondral knee allograft
|
$15,226.08 |
$15,226.08 |
$15,226.08 |
$10,629.07
|
|
Osteochondral knee autograft
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,952.51
|
|
Osteochondral talus autogrft
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$6,982.66
|
|
Osteopath manip tx/5-6 body region 98927
|
$29.94 |
$29.94 |
$29.94 |
$67.84
|
|
Osteopath manip tx/7-8 body region 98928
|
$29.94 |
$29.94 |
$29.94 |
$83.27
|
|
Osteopath manip tx/9-10 body region98929
|
$29.94 |
$29.94 |
$29.94 |
$89.00
|
|
Osteoplasty humerus
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,913.97
|
|
Osteot humerus w/wo int fixj
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,907.11
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$7,906.00
|
|
Other immunoelectrophoresis
|
$23.13 |
$23.13 |
$23.13 |
$107.52
|
|
Oth resp proc, group
|
$46.45 |
$46.45 |
$46.45 |
$126.26
|
|
Oth resp proc, indiv
|
$28.98 |
$28.98 |
$28.98 |
$84.00
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$58.30 |
$58.30 |
$58.30 |
$98.40
|
|
Otoplasty 69300
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,592.74
|
|
Ot re-evaluation patient/family
|
$79.95 |
$79.95 |
$79.95 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$22.98 |
$22.98 |
$22.98 |
$88.50
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$23.67 |
$23.67 |
$23.67 |
$91.91
|
|
Ovarian cystectomy 58925
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,841.60
|
|
Ovulation tests
|
$12.70 |
$12.70 |
$12.70 |
$29.60
|
|
P-32 sod phosphate ther per mci
|
$179.12 |
$179.12 |
$179.12 |
$469.34
|
|
Pabpn1 gene detc abnor allel
|
$137.00 |
$137.00 |
$137.00 |
$225.42
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$13.34 |
$13.34 |
$13.34 |
$3,435.42
|
|
Palb2 gene full gene seq
|
$676.50 |
$676.50 |
$676.50 |
$672.50
|
|
Palb2 gene known famil vrnt
|
$301.35 |
$301.35 |
$301.35 |
$496.86
|
|
Palifermin injection
|
$33.99 |
$33.99 |
$33.99 |
$5,464.63
|
|
Paliperidone 117 mg/0.75 ml inj
|
$14.76 |
$14.76 |
$14.76 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$719.87 |
$719.87 |
$719.87 |
$5,569.20
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$159.33 |
$159.33 |
$159.33 |
$13,051.61
|
|
Parathormone (pth) intact
|
$41.28 |
$41.28 |
$41.28 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$636.97 |
$636.97 |
$636.97 |
$1,574.40
|
|
Parathyroid planar imaging
|
$475.51 |
$475.51 |
$475.51 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$475.51 |
$475.51 |
$475.51 |
$1,374.75
|
|
Paravaginal defect repair 57284
|
$5,841.60 |
$5,841.60 |
$5,841.60 |
$5,841.60
|
|
Parial mast w/lymph removal 19302
|
$7,717.23 |
$7,717.23 |
$7,717.23 |
$5,763.23
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$235.13 |
$235.13 |
$235.13 |
$245.89
|
|
Parotid duct diversion
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,547.81
|
|
Parotid duct diversion
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,839.00
|
|
Parotid duct diversion
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,837.72
|
|
Part exc/post vert comp/sng/thorac 22101
|
$8,453.60 |
$8,453.60 |
$8,453.60 |
$5,855.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$3,762.53 |
$3,762.53 |
$3,762.53 |
$3,762.53
|
|
Partial exc bone humerus
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,914.00
|
|
Partial excision of lip
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$4,133.59
|
|
Partial removal finger bone
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,211.05
|
|
Partial removal finger bone
|
$1,893.86 |
$1,893.86 |
$1,893.86 |
$2,134.33
|
|
Partial removal foot fascia
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$4,315.20
|
|
Partial removal of eye fluid
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,698.92
|
|
Partial removal of eye fluid
|
$2,698.92 |
$2,698.92 |
$2,698.92 |
$2,698.92
|
|
Partial removal of fibula
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,821.05
|
|
Partial removal of foot bone
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Partial removal of hand bone
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,839.54
|
|
Partial removal of lip
|
$3,837.72 |
$3,837.72 |
$3,837.72 |
$3,276.00
|
|
Partial removal of nose
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,603.11
|
|
Partial removal of penis
|
$4,081.37 |
$4,081.37 |
$4,081.37 |
$4,081.37
|
|
Partial removal of pharynx 42890
|
$7,000.36 |
$7,000.36 |
$7,000.36 |
$6,465.11
|
|
Partial removal of radius
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,986.00
|
|
Partial removal of radius
|
$3,839.54 |
$3,839.54 |
$3,839.54 |
$3,472.00
|
