|
Obstetric panel inc HIV tstg
|
$206.00 |
$206.00 |
$206.00 |
$264.60
|
|
Obstetrics panel
|
$100.80 |
$100.80 |
$100.80 |
$214.50
|
|
Obtaining screen pap smear
|
$85.20 |
$85.20 |
$85.20 |
$39.00
|
|
Ob Ultrasound nuchal meas 1 gest
|
$202.80 |
$202.80 |
$202.80 |
$359.20
|
|
Ob Ultrasound nuchal meas add-on
|
$202.80 |
$202.80 |
$202.80 |
$249.60
|
|
Open thrombectomy of av fistula without revision 36831
|
$2,222.00 |
$2,222.00 |
$2,222.00 |
$6,366.08
|
|
Ophthalmic biometry
|
$100.80 |
$100.80 |
$100.80 |
$182.95
|
|
Oph Ultrasound dx ant sgm Ultrasound uni/bi
|
$98.80 |
$98.80 |
$98.80 |
$215.90
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$156.24 |
$156.24 |
$156.24 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$270.48 |
$270.48 |
$270.48 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$693.84 |
$693.84 |
$693.84 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$398.16 |
$398.16 |
$398.16 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$144.90 |
$144.90 |
$144.90 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$173.46 |
$173.46 |
$173.46 |
$310.00
|
|
Ortho hnd without jnt w/fit&adj
|
$146.16 |
$146.16 |
$146.16 |
$231.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$201.60 |
$201.60 |
$201.60 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$536.34 |
$536.34 |
$536.34 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$146.40 |
$146.40 |
$146.40 |
$195.00
|
|
Osmolality blood
|
$42.40 |
$42.40 |
$42.40 |
$67.60
|
|
Osmolality urine
|
$42.40 |
$42.40 |
$42.40 |
$65.00
|
|
Osteopath manip tx/5-6 body region 98927
|
$163.20 |
$163.20 |
$163.20 |
$68.25
|
|
Osteopath manip tx/7-8 body region 98928
|
$505.20 |
$505.20 |
$505.20 |
$84.22
|
|
Osteopath manip tx/9-10 body region98929
|
$30.40 |
$30.40 |
$30.40 |
$92.42
|
|
Ot evaluation high complexity patient/family
|
$272.80 |
$272.80 |
$272.80 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$232.40 |
$232.40 |
$232.40 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$241.60 |
$241.60 |
$241.60 |
$263.50
|
|
Oth resp proc, group
|
$230.40 |
$230.40 |
$230.40 |
$123.05
|
|
Oth resp proc, indiv
|
$303.20 |
$303.20 |
$303.20 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$56.40 |
$56.40 |
$56.40 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$70.00 |
$70.00 |
$70.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$107.20 |
$107.20 |
$107.20 |
$105.00
|
|
Ot re-evaluation patient/family
|
$152.80 |
$152.80 |
$152.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$104.00 |
$104.00 |
$104.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$84.40 |
$84.40 |
$84.40 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$155.20 |
$155.20 |
$155.20 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$84.00 |
$84.00 |
$84.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$98.00 |
$98.00 |
$98.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$91.60 |
$91.60 |
$91.60 |
$94.25
|
|
P-32 chromic phos ther per mci
|
$120.54 |
$120.54 |
$120.54 |
$290.64
|
|
P-32 sod phosphate ther per mci
|
$68.44 |
$68.44 |
$68.44 |
$469.34
|
|
Parathormone (pth) intact
|
$193.60 |
$193.60 |
$193.60 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$1,490.40 |
$1,490.40 |
$1,490.40 |
$1,574.40
|
|
Parathyroid planar imaging
|
$707.60 |
$707.60 |
$707.60 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$868.40 |
$868.40 |
$868.40 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$232.80 |
$232.80 |
$232.80 |
$245.00
|
|
Pelvic CT scan (with and without contrast)
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,243.60 |
$1,243.60 |
$1,243.60 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$944.40 |
$944.40 |
$944.40 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,262.80 |
$1,262.80 |
$1,262.80 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$1,061.60 |
$1,061.60 |
$1,061.60 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$520.00 |
$520.00 |
$520.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$368.40 |
$368.40 |
$368.40 |
$430.00
|
|
Penile rear tip xtnd 0.5cm
|
$8,527.68 |
$8,527.68 |
$8,527.68 |
$18,764.94
|
|
Penile vascular study
|
$710.00 |
$710.00 |
$710.00 |
$574.60
|
|
Penis study
|
$468.40 |
$468.40 |
$468.40 |
$368.50
|
|
Perc cryo ablate renal tum
|
$15,700.00 |
$15,700.00 |
$15,700.00 |
$11,458.04
|
|
Perc d-e cor revasc chro add
|
$3,878.40 |
$3,878.40 |
$3,878.40 |
$12,886.61
|
|
Perc d-e cor revasc chro sin
|
$18,270.00 |
$18,270.00 |
$18,270.00 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$3,878.40 |
$3,878.40 |
$3,878.40 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$18,270.00 |
$18,270.00 |
$18,270.00 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$6,436.00 |
$6,436.00 |
$6,436.00 |
$12,191.74
|
|
Perc d-e cor stent ather s
|
$8,212.80 |
$8,212.80 |
$8,212.80 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$3,840.80 |
$3,840.80 |
$3,840.80 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$7,919.60 |
$7,919.60 |
$7,919.60 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$20,273.60 |
$20,273.60 |
$20,273.60 |
$7,243.60
|
|
Percut ablate liver rf
|
$6,440.80 |
$6,440.80 |
$6,440.80 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$2,498.80 |
$2,498.80 |
$2,498.80 |
$2,251.20
|
|
Peripheral vascular rehab
|
$162.80 |
$162.80 |
$162.80 |
$132.50
|
|
Peri-proc device eval icd
|
$2,371.20 |
$2,371.20 |
$2,371.20 |
$192.40
|
|
Peri-proc device eval pm
|
$121.20 |
$121.20 |
$121.20 |
$159.90
|
|
Perit-vens shunt pat tst
|
$603.20 |
$603.20 |
$603.20 |
$758.37
|
|
Permanent tear duct plug
|
$138.60 |
$138.60 |
$138.60 |
$291.00
|
|
Perq art m-thrombect &/nfs
|
$2,834.00 |
$2,834.00 |
$2,834.00 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$6,551.60 |
$6,551.60 |
$6,551.60 |
$9,509.53
|
|
Perq dev breast 1st strtctc
|
$1,678.80 |
$1,678.80 |
$1,678.80 |
$1,456.00
|
|
Perq plmt bile duct stent
|
$4,830.00 |
$4,830.00 |
$4,830.00 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$4,285.60 |
$4,285.60 |
$4,285.60 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$6,478.40 |
$6,478.40 |
$6,478.40 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$600.80 |
$600.80 |
$600.80 |
$625.93
|
|
Perq transcath closure each
|
$11,808.80 |
$11,808.80 |
$11,808.80 |
$9,204.00
|
|
Perq transcath cls aortic
|
$23,617.60 |
$23,617.60 |
$23,617.60 |
$22,633.26
|
|
Perq transcath cls mitral
|
$23,617.60 |
$23,617.60 |
$23,617.60 |
$23,617.60
|
|
Perq transcath septal reduxn
|
$11,498.40 |
$11,498.40 |
$11,498.40 |
$8,605.90
|
|
Pet CT skull-mid thgh initial
|
$3,175.60 |
$3,175.60 |
$3,175.60 |
$4,707.00
|
|
Pet CT whole body initial
|
$3,175.60 |
$3,175.60 |
$3,175.60 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$5,815.60 |
$5,815.60 |
$5,815.60 |
$4,060.00
|
|
Pet image full body
|
$4,010.00 |
$4,010.00 |
$4,010.00 |
$5,070.50
|
|
Pet image skull-thigh
|
$3,175.60 |
$3,175.60 |
$3,175.60 |
$4,256.70
|
|
Pet image w/ct lmtd
|
$3,332.00 |
$3,332.00 |
$3,332.00 |
$4,305.60
|
|
Pet not otherwise specified
|
$1,070.40 |
$1,070.40 |
$1,070.40 |
$1,070.40
|
|
Pfc sigma fem post aug sz3 8mm
|
$12,392.10 |
$12,392.10 |
$12,392.10 |
$38,834.22
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$26.80 |
$26.80 |
$26.80 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$39.60 |
$39.60 |
$39.60 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$39.60 |
$39.60 |
$39.60 |
$33.30
|
|
Ph body fluid
|
$48.30 |
$48.30 |
$48.30 |
$41.28
|
|
Phenobarbital therapeutic drug level
|
$151.20 |
$151.20 |
$151.20 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$105.20 |
$105.20 |
$105.20 |
$110.88
|
|
Phlebotomy therapeutic
|
$133.60 |
$133.60 |
$133.60 |
$231.66
|
|
Phosphorus
|
$35.20 |
$35.20 |
$35.20 |
$48.80
|
