|
New Patient Office Visit (level 3)
|
$128.77 |
$128.77 |
$128.77 |
$221.20
|
|
New Patient Office Visit (level 4)
|
$219.90 |
$219.90 |
$219.90 |
$300.00
|
|
New Patient Office Visit (level 5)
|
$285.16 |
$285.16 |
$285.16 |
$367.20
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$46.62 |
$46.62 |
$46.62 |
$65.30
|
|
Nm imaging bone/joint 3 phase study
|
$1,447.10 |
$1,447.10 |
$1,447.10 |
$1,798.90
|
|
Nm imaging bone/joint whole body
|
$1,224.47 |
$1,224.47 |
$1,224.47 |
$1,736.40
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$1,393.73 |
$1,393.73 |
$1,393.73 |
$1,428.50
|
|
Nm imaging gastric emptying study
|
$445.38 |
$445.38 |
$445.38 |
$1,431.75
|
|
Nm imaging gastrointestinal acute blood loss
|
$445.38 |
$445.38 |
$445.38 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$1,224.47 |
$1,224.47 |
$1,224.47 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,780.94 |
$1,780.94 |
$1,780.94 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$2,226.25 |
$2,226.25 |
$2,226.25 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,335.88 |
$1,335.88 |
$1,335.88 |
$1,186.03
|
|
Nuclear Stress Test (Heart)
|
$2,003.63 |
$2,003.63 |
$2,003.63 |
$3,921.45
|
|
Observation direct referral from physician office for admission
|
$860.73 |
$860.73 |
$860.73 |
$411.10
|
|
Observation per hour
|
$79.69 |
$79.69 |
$79.69 |
$79.30
|
|
Obstetrics panel
|
$586.63 |
$586.63 |
$586.63 |
$204.80
|
|
Obtaining screen pap smear
|
$40.95 |
$40.95 |
$40.95 |
$29.55
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$10.92 |
$10.92 |
$10.92 |
$73.13
|
|
Olanzapine 10 mg intramuscular solution
|
$96.76 |
$96.76 |
$96.76 |
$122.78
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$1.37 |
$1.37 |
$1.37 |
$34.32
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$27.30 |
$27.30 |
$27.30 |
$65.07
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$490.56 |
$490.56 |
$490.56 |
$284.85
|
|
Ortho ewhf rigd without jnt cstm w
|
$592.48 |
$592.48 |
$592.48 |
$782.70
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$584.22 |
$584.22 |
$584.22 |
$801.60
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$414.83 |
$414.83 |
$414.83 |
$213.39
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$563.68 |
$563.68 |
$563.68 |
$269.58
|
|
Oscillation chest wall mechanical per session
|
$78.00 |
$78.00 |
$78.00 |
$221.34
|
|
Osmolality blood
|
$62.27 |
$62.27 |
$62.27 |
$67.60
|
|
Osmolality urine
|
$64.22 |
$64.22 |
$64.22 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$186.29 |
$186.29 |
$186.29 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$155.22 |
$155.22 |
$155.22 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$170.69 |
$170.69 |
$170.69 |
$270.58
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$88.21 |
$88.21 |
$88.21 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$105.50 |
$105.50 |
$105.50 |
$107.32
|
|
Ot re-evaluation patient/family
|
$87.82 |
$87.82 |
$87.82 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$80.54 |
$80.54 |
$80.54 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$236.54 |
$236.54 |
$236.54 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$106.99 |
$106.99 |
$106.99 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$65.33 |
$65.33 |
$65.33 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$67.54 |
$67.54 |
$67.54 |
$93.75
|
|
Oxytocin 10 unit/ml injection solution
|
$3.41 |
$3.41 |
$3.41 |
$45.86
|
|
Parathormone (pth) intact
|
$216.91 |
$216.91 |
$216.91 |
$200.23
|
|
Parathyroid planar imaging
|
$556.73 |
$556.73 |
$556.73 |
$1,166.00
|
|
Pelvic CT scan (with and without contrast)
|
$1,706.77 |
$1,706.77 |
$1,706.77 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,511.71 |
$1,511.71 |
$1,511.71 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$1,316.71 |
$1,316.71 |
$1,316.71 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$2,486.90 |
$2,486.90 |
$2,486.90 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$2,291.84 |
$2,291.84 |
$2,291.84 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$1,789.65 |
$1,789.65 |
$1,789.65 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$442.91 |
$442.91 |
$442.91 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$319.74 |
$319.74 |
$319.74 |
$445.00
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$693.86 |
$693.86 |
$693.86 |
$643.59
|
|
Perit-vens shunt pat tst
|
$612.43 |
$612.43 |
$612.43 |
$695.40
|
|
Pet CT skull-mid thgh initial
|
$8,021.39 |
$8,021.39 |
$8,021.39 |
$4,854.75
|
|
Pet CT whole body initial
|
$8,021.39 |
$8,021.39 |
$8,021.39 |
$5,017.50
|
|
Pet fdg brain metoblic eval sb
|
$5,986.18 |
$5,986.18 |
$5,986.18 |
$3,559.05
|
|
Pet image w/ct lmtd
|
$8,021.39 |
$8,021.39 |
$8,021.39 |
$4,422.60
|
|
Pet not otherwise specified
|
$5,986.18 |
$5,986.18 |
$5,986.18 |
$475.51
|
|
Pfc sigma fem post aug sz3 8mm
|
$16,248.51 |
$16,248.51 |
$16,248.51 |
$34,848.45
|
|
Ph body fluid
|
$33.80 |
$33.80 |
$33.80 |
$39.20
|
|
Phencyclidine (pcp)
|
$107.84 |
$107.84 |
$107.84 |
$88.00
|
|
Phenobarbital therapeutic drug level
|
$88.34 |
$88.34 |
$88.34 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,114.69 |
$1,114.69 |
$1,114.69 |
$1,011.98
|
|
Phenylephrine 10 mg/ml injection solution
|
$16.50 |
$16.50 |
$16.50 |
$58.49
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$4.53 |
$4.53 |
$4.53 |
$23.37
|
|
Phenytoin total therapeutic drug level
|
$124.87 |
$124.87 |
$124.87 |
$111.27
|
|
Phlebotomy therapeutic
|
$232.25 |
$232.25 |
$232.25 |
$249.00
|
|
Phosphorus
|
$44.72 |
$44.72 |
$44.72 |
$47.81
|
|
Phosphorus 24 hour urine
|
$48.82 |
$48.82 |
$48.82 |
$42.81
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$111.41 |
$111.41 |
$111.41 |
$86.36
|
|
Pinworm exam
|
$50.70 |
$50.70 |
$50.70 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$42.00 |
$42.00 |
$42.00 |
$95.01
|
|
Platelet aggregation each agent teg
|
$128.83 |
$128.83 |
$128.83 |
$147.96
|
|
Platelet automated
|
$26.00 |
$26.00 |
$26.00 |
$44.00
|
|
Platelet pheresis each unit
|
$995.22 |
$995.22 |
$995.22 |
$864.00
|
|
Platelet pheresis irr ea
|
$1,062.49 |
$1,062.49 |
$1,062.49 |
$970.54
|
|
Platelets leukocytes reduced each unit
|
$125.78 |
$125.78 |
$125.78 |
$273.70
|
|
Platelets pheresis pathogen-reduced each unit
|
$992.49 |
$992.49 |
$992.49 |
$879.36
|
|
#pnh-flow cytometry interp
|
$60.78 |
$60.78 |
$60.78 |
$154.14
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$169.20 |
$169.20 |
$169.20 |
$173.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$3,483.42 |
$3,483.42 |
$3,483.42 |
$4,293.60
|
|
Potassium 24 hour urine
|
$40.50 |
$40.50 |
$40.50 |
$50.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$8.99 |
$8.99 |
$8.99 |
$71.74
|
|
Potassium serum/plasma/whole blood
|
$19.37 |
$19.37 |
$19.37 |
$44.64
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$48.43 |
$48.43 |
$48.43 |
$48.71
|
|
Prealbumin
|
$135.01 |
$135.01 |
$135.01 |
$87.20
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$2,830.04 |
$2,830.04 |
$2,830.04 |
$2,363.79
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$662.94 |
$662.94 |
$662.94 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$662.94 |
$662.94 |
$662.94 |
$541.45
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$86.84 |
$86.84 |
$86.84 |
$141.00
|
|
Pretreat rbc absorption reference
|
$124.02 |
$124.02 |
$124.02 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$222.56 |
$222.56 |
$222.56 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$85.93 |
$85.93 |
$85.93 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$18.59 |
$18.59 |
$18.59 |
$166.10
|
|
Pr incision & drainage abscess vulva/perineal
|
$539.44 |
$539.44 |
$539.44 |
$638.55
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$193.38 |
$193.38 |
$193.38 |
$666.10
|
|
Procalcitonin
|
$240.83 |
$240.83 |
$240.83 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$12.06 |
$12.06 |
$12.06 |
$46.50
|
|
Progesterone
|
$180.51 |
$180.51 |
$180.51 |
$105.00
|