|
Obstetrical care 59410
|
$5,365.10 |
$5,365.10 |
$5,365.10 |
$2,112.80
|
|
Obstetrics panel
|
$214.50 |
$214.50 |
$214.50 |
$214.50
|
|
Obtaining screen pap smear
|
$105.95 |
$105.95 |
$105.95 |
$38.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$783.90 |
$783.90 |
$783.90 |
$356.59
|
|
Ob Ultrasound nuchal meas add-on
|
$534.30 |
$534.30 |
$534.30 |
$249.60
|
|
Occlude fallopian tube(s) device 58615
|
$1,024.40 |
$1,024.40 |
$1,024.40 |
$3,744.41
|
|
Occupational Therapy Evaluation (high complexity)
|
$438.10 |
$438.10 |
$438.10 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$438.10 |
$438.10 |
$438.10 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$438.10 |
$438.10 |
$438.10 |
$264.55
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$4,829.99 |
$4,829.99 |
$4,829.99 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$309.04 |
$309.04 |
$309.04 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$16,175.39 |
$16,175.39 |
$16,175.39 |
$12,080.43
|
|
Ocular instrumnt screen bil
|
$46.80 |
$46.80 |
$46.80 |
$13.60
|
|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$376.51 |
$376.51 |
$376.51 |
$2,224.00
|
|
Off/op cnsltj new/est low 30
|
$468.00 |
$468.00 |
$468.00 |
$183.00
|
|
Off/op cnsltj new/est mod 40
|
$699.40 |
$699.40 |
$699.40 |
$273.60
|
|
Off/op consltj new/est hi 55
|
$975.00 |
$975.00 |
$975.00 |
$349.80
|
|
Off/op consltj new/est sf 20
|
$308.75 |
$308.75 |
$308.75 |
$133.80
|
|
Olanzapine 10 mg intramuscular solution
|
$92.41 |
$92.41 |
$92.41 |
$109.62
|
|
Ol dig e/m svc 11-20 min
|
$52.00 |
$52.00 |
$52.00 |
$35.00
|
|
Ol dig e/m svc 21+ min
|
$78.00 |
$78.00 |
$78.00 |
$52.20
|
|
Ol dig e/m svc 5-10 min
|
$42.25 |
$42.25 |
$42.25 |
$21.60
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$4,595.01 |
$4,595.01 |
$4,595.01 |
$4,595.01
|
|
Omental flap intra-abdom 49905
|
$2,355.60 |
$2,355.60 |
$2,355.60 |
$871.20
|
|
Onco (ovar) five proteins
|
$4,022.85 |
$4,022.85 |
$4,022.85 |
$986.70
|
|
Oncoprotein dcp
|
$288.60 |
$288.60 |
$288.60 |
$171.25
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$1.50 |
$1.50 |
$1.50 |
$22.62
|
|
Oophorectomy partial or total 58943
|
$5,075.20 |
$5,075.20 |
$5,075.20 |
$2,901.60
|
|
Open ablate liver tumor rf
|
$6,385.60 |
$6,385.60 |
$6,385.60 |
$2,968.00
|
|
Open aortoiliac prosth repr 34831
|
$9,874.80 |
$9,874.80 |
$9,874.80 |
$3,414.40
|
|
Open bx/exc inguinofem nodes
|
$1,752.40 |
$1,752.40 |
$1,752.40 |
$4,992.00
|
|
Open bx of lung pleura 32098
|
$3,356.60 |
$3,356.60 |
$3,356.60 |
$1,852.00
|
|
Open cor endarterect w cabg/ea ves 33572
|
$1,154.40 |
$1,154.40 |
$1,154.40 |
$1,154.40
|
|
Open periprosthetic breast capsule 19370
|
$2,622.75 |
$2,622.75 |
$2,622.75 |
$4,520.16
|
|
Open skull for drainage 61312
|
$7,844.20 |
$7,844.20 |
$7,844.20 |
$4,872.80
|
|
Open tenotomy tendon flexor foot single or multiple 28230
|
$1,133.60 |
$1,133.60 |
$1,133.60 |
$2,180.80
|
|
Open thrombectomy of av fistula without revision 36831
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$6,311.00
|
|
Open tx compl front sinus fx
|
$5,608.20 |
$5,608.20 |
$5,608.20 |
$6,048.05
|
|
Open tx nose fx w/skele fixj
|
$1,505.40 |
$1,505.40 |
$1,505.40 |
$5,977.18
|
|
Open tx nose & septal fx
|
$2,345.20 |
$2,345.20 |
$2,345.20 |
$3,837.72
|
|
Open tx post pelvic fxcture
|
$5,985.85 |
$5,985.85 |
$5,985.85 |
$4,499.12
|
|
Open tx rib 1-3 fx w/fix 21811
|
$2,805.40 |
$2,805.40 |
$2,805.40 |
$5,855.00
|
|
Open tx rib 4-6 fx w/fix 21812
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$5,112.80
|
|
Open tx rib 7+ fx w/fix 21813
|
$4,578.60 |
$4,578.60 |
$4,578.60 |
$3,986.00
|
|
Open tx/sternum fracture 21825
|
$2,017.60 |
$2,017.60 |
$2,017.60 |
$1,323.20
|
|
Open wedge/bx lung infiltr
|
$3,575.00 |
$3,575.00 |
$3,575.00 |
$3,432.80
|
|
Open wedge bx lung nodule 32097
|
$3,575.00 |
$3,575.00 |
$3,575.00 |
$1,955.20
|
|
Ophthalmic biometry
|
$385.45 |
$385.45 |
$385.45 |
$182.95
|
|
Oph Ultrasound dx quan a-scan only
|
$660.40 |
$660.40 |
$660.40 |
$273.00
|
|
Opn ax/subcla art expos
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,269.60
|
|
Opn exc/dst ntra-abd
|
$11,440.00 |
$11,440.00 |
$11,440.00 |
$3,221.64
|
|
Opn exc/dst ntra-abd 10.1-20
|
$9,724.00 |
$9,724.00 |
$9,724.00 |
$2,774.24
|
|
Opn exc/dstr ntra-abd >30 cm
|
$14,300.00 |
$14,300.00 |
$14,300.00 |
$3,961.69
|
|
Opn exc/dstr ntra-abd 5.1-10
|
$8,193.90 |
$8,193.90 |
$8,193.90 |
$2,317.83
|
|
Opn exc/dstr ntra-abd 5 cm/<
|
$6,292.00 |
$6,292.00 |
$6,292.00 |
$1,491.00
|
|
Opn fem art expos cndt crtj 34714
|
$12,129.00 |
$12,129.00 |
$12,129.00 |
$2,041.65
|
|
Opn ilac art expos cndt crtj
|
$2,121.60 |
$2,121.60 |
$2,121.60 |
$1,169.29
|
|
Opn impltj nea neuromuscular
|
$1,089.40 |
$1,089.40 |
$1,089.40 |
$23,049.60
|
|
Opn impltj nea perph nerve
|
$1,149.20 |
$1,149.20 |
$1,149.20 |
$14,685.79
|
|
Opn impltj nea sacral nerve
|
$11,861.85 |
$11,861.85 |
$11,861.85 |
$7,766.27
|
|
Opn mpltj hpglsl nstm ary pg
|
$3,640.00 |
$3,640.00 |
$3,640.00 |
$36,076.18
|
|
Opn tx complx malar fx
|
$4,360.20 |
$4,360.20 |
$4,360.20 |
$6,605.19
|
|
Opn tx depress front sinus fx 21343
|
$3,723.20 |
$3,723.20 |
$3,723.20 |
$3,723.20
|
|
Opn tx dprsd zygomatic arch
|
$1,255.80 |
$1,255.80 |
$1,255.80 |
$5,110.00
|
|
Opn tx nasomax fx multple
|
$3,517.80 |
$3,517.80 |
$3,517.80 |
$6,547.81
|
|
Opn tx nasomax fx w/fixj
|
$2,977.00 |
$2,977.00 |
$2,977.00 |
$6,465.11
|
|
Opn tx orbit fx combined
|
$2,628.60 |
$2,628.60 |
$2,628.60 |
$6,493.99
|
|
Opn tx orbit fx periorbital
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$6,839.00
|
|
Opn tx orbit fx transantral
|
$2,488.20 |
$2,488.20 |
$2,488.20 |
$6,465.11
|
|
Opn tx orbit fx without impl 21406
|
$1,929.20 |
$1,929.20 |
$1,929.20 |
$6,430.79
|
|
Opn tx orbit periorbtl implt
|
$2,919.80 |
$2,919.80 |
$2,919.80 |
$6,553.49
|
|
Opscpy extnd on/mac draw
|
$74.10 |
$74.10 |
$74.10 |
$70.29
|
|
Opscpy extnd rta draw uni/bi
|
$114.40 |
$114.40 |
$114.40 |
$71.00
|
|
Optx acrclv dslc aq/chrn grf
|
$2,293.20 |
$2,293.20 |
$2,293.20 |
$7,913.97
|
|
Optx acromclv dislc aqt/chrn
|
$1,973.40 |
$1,973.40 |
$1,973.40 |
$6,653.00
|
|
Optx acute shoulder dislc
|
$1,991.60 |
$1,991.60 |
$1,991.60 |
$6,554.95
|
|
Optx carpl scphd fx int fixj
|
$2,514.20 |
$2,514.20 |
$2,514.20 |
$6,653.00
|
|
Optx clavicular fx w/int fix
|
$2,519.40 |
$2,519.40 |
$2,519.40 |
$8,453.60
|
|
Optx complicated mndblr fx
|
$4,560.40 |
$4,560.40 |
$4,560.40 |
$6,553.49
|
|
Optx cranfcl sep comp mlt
|
$6,835.40 |
$6,835.40 |
$6,835.40 |
$6,048.05
|
|
Optx cranfcl sep w/wiring
|
$2,293.20 |
$2,293.20 |
$2,293.20 |
$6,048.05
|
|
Optx crpl fx oth/thn scph ea
|
$1,929.20 |
$1,929.20 |
$1,929.20 |
$4,499.12
|
|
Optx gr hmrl tbrs fx int fix
|
$2,748.20 |
$2,748.20 |
$2,748.20 |
$7,157.53
|
|
Optx lunate dislocation
|
$2,212.60 |
$2,212.60 |
$2,212.60 |
$8,128.38
|
|
Optx medial ankle fx
|
$2,051.40 |
$2,051.40 |
$2,051.40 |
$6,653.00
|
|
Optx mndblr fx wo ntrdntl
|
$2,420.60 |
$2,420.60 |
$2,420.60 |
$6,465.11
|
|
Optx palatal/max fracture
|
$2,269.80 |
$2,269.80 |
$2,269.80 |
$5,855.00
|
|
Optx palatal/max fx comp
|
$2,821.00 |
$2,821.00 |
$2,821.00 |
$4,295.20
|
|
Optx partclr fx&/dslc elbw w
|
$4,105.40 |
$4,105.40 |
$4,105.40 |
$10,629.07
|
|
Optx post ankle fx
|
$2,636.40 |
$2,636.40 |
$2,636.40 |
$5,886.74
|
|
Optx prox humrl fx w/int fix
|
$3,198.00 |
$3,198.00 |
$3,198.00 |
$13,780.53
|
|
Optx prx hmrl fx fix rpr rpl
|
$4,776.20 |
$4,776.20 |
$4,776.20 |
$8,159.00
|
|
Optx radial shaft fracture
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$5,419.00
|
|
Optx rad/uln dislc aqt/chrnc
|
$2,155.40 |
$2,155.40 |
$2,155.40 |
$5,886.74
|
|
Optx rdcrpl/ntrcrpl dislc 1+
|
$2,103.40 |
$2,103.40 |
$2,103.40 |
$6,311.00
|
|
Optx rdl shft fx&cltx rad/ul
|
$2,743.00 |
$2,743.00 |
$2,743.00 |
$7,386.73
|
|
Optx rdl shft fx&dstl rad/ul
|
$3,419.00 |
$3,419.00 |
$3,419.00 |
$7,807.24
|
|
Optx rdl&uln shft fx rds&uln
|
$3,195.40 |
$3,195.40 |
$3,195.40 |
$7,807.24
|
|
Optx rdl&uln shft fx rds/uln
|
$2,288.00 |
$2,288.00 |
$2,288.00 |
$6,665.84
|
|
Optx scapular fx w/int fixj
|
$3,699.80 |
$3,699.80 |
$3,699.80 |
$7,906.00
|
