|
Protein total 24 hour urine
|
$32.10 |
$32.10 |
$32.10 |
$45.00
|
|
Protein total body fluid
|
$27.94 |
$27.94 |
$27.94 |
$49.20
|
|
Protein total serum plasma whole blood
|
$40.70 |
$40.70 |
$40.70 |
$40.70
|
|
Prothrombin time substitution plasma fractions each
|
$17.48 |
$17.48 |
$17.48 |
$37.05
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$113.04 |
$113.04 |
$113.04 |
$278.20
|
|
Pr removal intrauterine device
|
$113.31 |
$113.31 |
$113.31 |
$411.00
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$215.62 |
$215.62 |
$215.62 |
$742.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$107.30 |
$107.30 |
$107.30 |
$365.60
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$125.34 |
$125.34 |
$125.34 |
$387.40
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$129.50 |
$129.50 |
$129.50 |
$365.00
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$146.43 |
$146.43 |
$146.43 |
$370.93
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,074.85 |
$1,074.85 |
$1,074.85 |
$1,653.31
|
|
PSA (Prostate) Test
|
$76.96 |
$76.96 |
$76.96 |
$103.85
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$25.07 |
$25.07 |
$25.07 |
$87.49
|
|
Pt application of modality >=1 area hot/cold packs
|
$7.59 |
$7.59 |
$7.59 |
$25.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$32.38 |
$32.38 |
$32.38 |
$105.95
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$29.05 |
$29.05 |
$29.05 |
$82.55
|
|
Pt application of modality traction mechanical
|
$23.87 |
$23.87 |
$23.87 |
$87.19
|
|
Pt evaluation high complexity patient/family
|
$74.56 |
$74.56 |
$74.56 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$74.56 |
$74.56 |
$74.56 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$74.56 |
$74.56 |
$74.56 |
$247.20
|
|
Pt re-evaluation patient/family
|
$40.89 |
$40.89 |
$40.89 |
$141.93
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$32.38 |
$32.38 |
$32.38 |
$43.92
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$30.43 |
$30.43 |
$30.43 |
$83.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$19.61 |
$19.61 |
$19.61 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$29.60 |
$29.60 |
$29.60 |
$84.90
|
|
Pulse ox continuous overnight monitoring
|
$78.07 |
$78.07 |
$78.07 |
$351.20
|
|
Pulse ox multiple
|
$52.91 |
$52.91 |
$52.91 |
$190.25
|
|
Pulse ox single
|
$24.88 |
$24.88 |
$24.88 |
$78.99
|
|
Punc of shunt for asp or inj
|
$668.13 |
$668.13 |
$668.13 |
$877.00
|
|
Puncture arterial withdrawal blood for diagnosis
|
$69.01 |
$69.01 |
$69.01 |
$113.75
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$191.94 |
$191.94 |
$191.94 |
$478.80
|
|
Puncture/clear windpipe 31612
|
$2,427.76 |
$2,427.76 |
$2,427.76 |
$3,592.74
|
|
Puncture spinal lumbar diagnostic
|
$507.55 |
$507.55 |
$507.55 |
$1,087.80
|
|
Pvb thoracic single inj site
|
$514.58 |
$514.58 |
$514.58 |
$1,021.03
|
|
Pyridoxine hcl 100 mg
|
$9.79 |
$9.79 |
$9.79 |
$29.11
|
|
Pyruvate
|
$81.03 |
$81.03 |
$81.03 |
$65.00
|
|
Pyruvate kinase
|
$46.16 |
$46.16 |
$46.16 |
$84.50
|
|
Quest t3 uptake
|
$37.28 |
$37.28 |
$37.28 |
$55.00
|
|
Quinupristin/dalfopristin
|
$358.62 |
$358.62 |
$358.62 |
$358.62
|
|
Rabies ig heat-treated human im/subq 90376
|
$815.67 |
$815.67 |
$815.67 |
$1,059.01
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$4,350.89 |
$4,350.89 |
$4,350.89 |
$1,624.21
|
|
Radiation treatment aid(s)
|
$298.50 |
$298.50 |
$298.50 |
$644.36
|
|
Radiation treatment aid(s)
|
$447.24 |
$447.24 |
$447.24 |
$1,075.03
|
|
Radiesse injection
|
$1,171.09 |
$1,171.09 |
$1,171.09 |
$1,112.56
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$188.33 |
$188.33 |
$188.33 |
$115.89
|
|
Rapid desensitization
|
$412.09 |
$412.09 |
$412.09 |
$442.06
|
|
Rapid Strep Test
|
$48.56 |
$48.56 |
$48.56 |
$67.80
|
|
Rasburicase 1.5 mg intravenous solution
|
$294.71 |
$294.71 |
$294.71 |
$568.06
|
|
Rbc count only automated
|
$13.41 |
$13.41 |
$13.41 |
$20.00
|
|
Reconstruct extra finger
|
$1,848.61 |
$1,848.61 |
$1,848.61 |
$2,558.40
|
|
Reconstruction of nail bed
|
$1,694.60 |
$1,694.60 |
$1,694.60 |
$2,066.10
|
|
Reduction of procidentia 45900
|
$657.12 |
$657.12 |
$657.12 |
$1,056.92
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$82.61 |
$82.61 |
$82.61 |
$115.07
|
|
Rem/biv cast full arm/leg
|
$471.57 |
$471.57 |
$471.57 |
$320.25
|
|
Removal central venous catheter tunneled without port/pump
|
$871.17 |
$871.17 |
$871.17 |
$1,538.15
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,296.20 |
$1,296.20 |
$1,296.20 |
$2,164.52
|
|
Removal cerclage w/anes
|
$1,394.81 |
$1,394.81 |
$1,394.81 |
$3,522.35
|
|
Removal cerumen impacted (both sides)
|
$113.96 |
$113.96 |
$113.96 |
$161.25
|
|
Removal embedded foreign body vestibule mouth smpl
|
$838.33 |
$838.33 |
$838.33 |
$838.33
|
|
Removal foreign body extrn auditory canal with anes
|
$1,036.83 |
$1,036.83 |
$1,036.83 |
$1,793.38
|
|
Removal foreign body foot subcutaneous right
|
$1,433.57 |
$1,433.57 |
$1,433.57 |
$1,256.00
|
|
Removal foreign body gum 41805
|
$1,079.48 |
$1,079.48 |
$1,079.48 |
$1,735.00
|
|
Removal implant from finger/hand 26320
|
$1,510.80 |
$1,510.80 |
$1,510.80 |
$1,794.93
|
|
Removal implant superficial separate procedure
|
$1,108.06 |
$1,108.06 |
$1,108.06 |
$2,880.30
|
|
Removal of intranasal lesion
|
$1,733.17 |
$1,733.17 |
$1,733.17 |
$2,265.60
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$155.49 |
$155.49 |
$155.49 |
$313.53
|
|
Removal tunnled intprtnl cath
|
$2,103.36 |
$2,103.36 |
$2,103.36 |
$4,200.00
|
|
Remove ext hem groups 2+
|
$2,503.42 |
$2,503.42 |
$2,503.42 |
$3,038.07
|
|
Remove eyelid lesion
|
$286.29 |
$286.29 |
$286.29 |
$436.44
|
|
Remove foreign body from eye
|
$1,206.57 |
$1,206.57 |
$1,206.57 |
$3,173.34
|
|
Remove nasal foreign body
|
$2,232.95 |
$2,232.95 |
$2,232.95 |
$2,309.02
|
|
Remove shoulder foreign body subq 23330
|
$1,234.14 |
$1,234.14 |
$1,234.14 |
$1,794.93
|
|
Remove vaginal foreign body 57415
|
$1,159.40 |
$1,159.40 |
$1,159.40 |
$3,577.50
|
|
Renal function panel
|
$26.55 |
$26.55 |
$26.55 |
$95.76
|
|
Repair av fistula ext 35190
|
$1,880.62 |
$1,880.62 |
$1,880.62 |
$3,489.20
|
|
Repair blood vessel direct hand finger
|
$2,453.56 |
$2,453.56 |
$2,453.56 |
$3,780.66
|
|
Repair blood vessel dir lower extr
|
$1,377.70 |
$1,377.70 |
$1,377.70 |
$2,000.88
|
|
Repair blood vessel dir upper extr
|
$4,596.33 |
$4,596.33 |
$4,596.33 |
$4,341.66
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$250.03 |
$250.03 |
$250.03 |
$1,156.00
|
|
Repair extns tendon finger without grft ea
|
$1,922.98 |
$1,922.98 |
$1,922.98 |
$2,479.03
|
|
Repair eyelid wound
|
$1,154.86 |
$1,154.86 |
$1,154.86 |
$2,675.25
|
|
Repair eyelid wound
|
$3,254.34 |
$3,254.34 |
$3,254.34 |
$2,947.20
|
|
Repair finger/hand tendon
|
$1,492.40 |
$1,492.40 |
$1,492.40 |
$3,591.33
|
|
Repair finger/hand tendon
|
$3,022.72 |
$3,022.72 |
$3,022.72 |
$3,545.97
|
|
Repair finger/hand tendon
|
$1,627.63 |
$1,627.63 |
$1,627.63 |
$3,545.97
|
|
Repair/graft finger tendon
|
$1,492.40 |
$1,492.40 |
$1,492.40 |
$3,591.33
|
|
Repair/graft hand tendon
|
$1,561.12 |
$1,561.12 |
$1,561.12 |
$5,560.25
|
|
Repair/graft hand tendon
|
$5,703.55 |
$5,703.55 |
$5,703.55 |
$5,703.55
|
|
Repair lip full thkns =<one-half vert height
|
$605.41 |
$605.41 |
$605.41 |
$1,245.60
|
|
Repair lip full thkns >one-half vert height/cmplx
|
$890.87 |
$890.87 |
$890.87 |
$1,810.85
|
|
Repair of eye socket wound
|
$2,963.70 |
$2,963.70 |
$2,963.70 |
$3,423.42
|
|
Repair of toe dislocation
|
$1,633.64 |
$1,633.64 |
$1,633.64 |
$3,318.59
|
|
Repair of urethra injury 53502
|
$2,738.46 |
$2,738.46 |
$2,738.46 |
$3,817.53
|
|
Repair of windpipe
|
$2,894.60 |
$2,894.60 |
$2,894.60 |
$5,269.27
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$821.03 |
$821.03 |
$821.03 |
$1,026.40
|
|
Repair rpr lip full thickness vermilion only
|
$890.87 |
$890.87 |
$890.87 |
$1,255.30
|
|
Repair tendon/muscle forearm/wrist prime sngl ea
|
$3,279.59 |
$3,279.59 |
$3,279.59 |
$4,410.60
|
|
Repair testis injury
|
$1,709.40 |
$1,709.40 |
$1,709.40 |
$3,498.74
|
|
Repair tongue lac <2.5cm past 1/3 tongue 41251
|
$365.47 |
$365.47 |
$365.47 |
$504.12
|