|
Pregnancy associated plasma protein-a
|
$68.75 |
$68.75 |
$68.75 |
$67.60
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$601.70 |
$601.70 |
$601.70 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$440.55 |
$440.55 |
$440.55 |
$542.33
|
|
Pressure max expiratory/inspiratory
|
$314.05 |
$314.05 |
$314.05 |
$253.00
|
|
Pressure velocity wire add ves
|
$1,997.60 |
$1,997.60 |
$1,997.60 |
$1,596.10
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$245.30 |
$245.30 |
$245.30 |
$141.00
|
|
Pretreat rbc absorption reference
|
$156.20 |
$156.20 |
$156.20 |
$139.00
|
|
Pretreat rbc w chem/drugs reference
|
$123.75 |
$123.75 |
$123.75 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$176.55 |
$176.55 |
$176.55 |
$167.05
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$136.22 |
$136.22 |
$136.22 |
$142.64
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$100.98 |
$100.98 |
$100.98 |
$1,793.38
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$178.99 |
$178.99 |
$178.99 |
$2,211.50
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$897.60 |
$897.60 |
$897.60 |
$779.35
|
|
Prgrmg dev eval pm/ldls pm
|
$41.58 |
$41.58 |
$41.58 |
$140.80
|
|
Prgrmg eval implantable dfb
|
$44.22 |
$44.22 |
$44.22 |
$152.10
|
|
Prgrmg eval implantable dfb
|
$48.84 |
$48.84 |
$48.84 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$52.14 |
$52.14 |
$52.14 |
$205.40
|
|
Pr incision & drainage abscess complicated/multiple
|
$380.05 |
$380.05 |
$380.05 |
$625.95
|
|
Pr incision & drainage abscess simple/single
|
$353.10 |
$353.10 |
$353.10 |
$437.53
|
|
Pr incision & drainage abscess vulva/perineal
|
$717.20 |
$717.20 |
$717.20 |
$586.40
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$772.20 |
$772.20 |
$772.20 |
$589.80
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$246.40 |
$246.40 |
$246.40 |
$273.38
|
|
Procalcitonin
|
$220.00 |
$220.00 |
$220.00 |
$142.50
|
|
Progesterone
|
$95.70 |
$95.70 |
$95.70 |
$99.00
|
|
Prolactin
|
$143.55 |
$143.55 |
$143.55 |
$127.40
|
|
_propoxygc/msur
|
$117.70 |
$117.70 |
$117.70 |
$104.65
|
|
Protein c activity
|
$60.50 |
$60.50 |
$60.50 |
$118.80
|
|
Protein electrophoretic fractionation & quantitation serum
|
$110.00 |
$110.00 |
$110.00 |
$84.00
|
|
Protein s total
|
$249.70 |
$249.70 |
$249.70 |
$77.91
|
|
Protein total 24 hour urine
|
$49.50 |
$49.50 |
$49.50 |
$52.50
|
|
Protein total body fluid
|
$55.55 |
$55.55 |
$55.55 |
$52.50
|
|
Protein total serum plasma whole blood
|
$53.35 |
$53.35 |
$53.35 |
$42.00
|
|
Prothrombin time substitution plasma fractions each
|
$47.85 |
$47.85 |
$47.85 |
$38.40
|
|
Prq cardiac angio addl art
|
$5,949.35 |
$5,949.35 |
$5,949.35 |
$5,574.15
|
|
Prq card revasc chronic addl
|
$4,215.75 |
$4,215.75 |
$4,215.75 |
$12,141.09
|
|
Prq card revasc mi 1 vsl
|
$8,793.95 |
$8,793.95 |
$8,793.95 |
$16,508.80
|
|
Prq card revasc mi 1 vsl drug-eluting
|
$12,264.45 |
$12,264.45 |
$12,264.45 |
$16,299.40
|
|
Prq card stent w/angio addl
|
$4,215.75 |
$4,215.75 |
$4,215.75 |
$8,568.26
|
|
Prq revasc byp graft 1 art and/or branches
|
$11,628.10 |
$11,628.10 |
$11,628.10 |
$13,054.80
|
|
Prq revasc byp graft addl
|
$4,215.75 |
$4,215.75 |
$4,215.75 |
$10,108.80
|
|
Prq tcat plmt ntrac st 1 les
|
$8,793.95 |
$8,793.95 |
$8,793.95 |
$13,355.34
|
|
Prq trlml c athrc st angiop1
|
$12,264.45 |
$12,264.45 |
$12,264.45 |
$17,662.80
|
|
Prq trluml c angiop 1art&/br
|
$7,816.05 |
$7,816.05 |
$7,816.05 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$8,941.90 |
$8,941.90 |
$8,941.90 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$8,793.95 |
$8,793.95 |
$8,793.95 |
$16,678.62
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$168.30 |
$168.30 |
$168.30 |
$280.79
|
|
Pr removal intrauterine device
|
$347.05 |
$347.05 |
$347.05 |
$419.01
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$452.10 |
$452.10 |
$452.10 |
$746.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$391.60 |
$391.60 |
$391.60 |
$382.85
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$391.60 |
$391.60 |
$391.60 |
$410.80
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$391.60 |
$391.60 |
$391.60 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$391.60 |
$391.60 |
$391.60 |
$391.60
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,646.15 |
$1,646.15 |
$1,646.15 |
$1,783.00
|
|
PSA (Prostate) Test
|
$95.15 |
$95.15 |
$95.15 |
$107.50
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$71.50 |
$71.50 |
$71.50 |
$92.43
|
|
Pt application of modality >=1 area hot/cold packs
|
$36.85 |
$36.85 |
$36.85 |
$32.21
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$74.80 |
$74.80 |
$74.80 |
$108.80
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$68.75 |
$68.75 |
$68.75 |
$85.93
|
|
Pt application of modality traction mechanical
|
$74.80 |
$74.80 |
$74.80 |
$91.20
|
|
Pt evaluation high complexity patient/family
|
$265.10 |
$265.10 |
$265.10 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$73.70 |
$73.70 |
$73.70 |
$226.80
|
|
Pt evaluation moderate complexity patient/family
|
$147.40 |
$147.40 |
$147.40 |
$264.00
|
|
Pt re-evaluation patient/family
|
$157.30 |
$157.30 |
$157.30 |
$157.50
|
|
Pt repositioning canalith procedure(s) per day
|
$154.00 |
$154.00 |
$154.00 |
$127.60
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$91.30 |
$91.30 |
$91.30 |
$69.42
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$78.10 |
$78.10 |
$78.10 |
$86.35
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$62.70 |
$62.70 |
$62.70 |
$80.30
|
|
Pulse ox multiple
|
$202.95 |
$202.95 |
$202.95 |
$194.33
|
|
Pulse ox single
|
$129.80 |
$129.80 |
$129.80 |
$88.80
|
|
Punc of shunt for asp or inj
|
$1,483.90 |
$1,483.90 |
$1,483.90 |
$960.40
|
|
Puncture arterial withdrawal blood for diagnosis
|
$227.15 |
$227.15 |
$227.15 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$343.75 |
$343.75 |
$343.75 |
$516.45
|
|
Puncture spinal lumbar diagnostic
|
$1,131.35 |
$1,131.35 |
$1,131.35 |
$1,088.25
|
|
Pyruvate
|
$105.60 |
$105.60 |
$105.60 |
$65.00
|
|
Pyruvate kinase
|
$100.10 |
$100.10 |
$100.10 |
$65.00
|
|
Quest t3 uptake
|
$43.45 |
$43.45 |
$43.45 |
$58.60
|
|
Radiation physics consult
|
$349.25 |
$349.25 |
$349.25 |
$595.40
|
|
Radiation therapy dose plan
|
$275.55 |
$275.55 |
$275.55 |
$521.30
|
|
Radiation treatment aid(s)
|
$234.85 |
$234.85 |
$234.85 |
$526.80
|
|
Radiation treatment aid(s)
|
$624.25 |
$624.25 |
$624.25 |
$1,075.03
|
|
Radiation treatment delivery
|
$253.55 |
$253.55 |
$253.55 |
$552.40
|
|
Radiation treatment delivery
|
$436.70 |
$436.70 |
$436.70 |
$919.00
|
|
Radiology port images(s)
|
$86.90 |
$86.90 |
$86.90 |
$259.70
|
|
Radiotherapy dose plan imrt
|
$3,084.40 |
$3,084.40 |
$3,084.40 |
$5,996.21
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$1,172.05 |
$1,172.05 |
$1,172.05 |
$2,014.64
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,739.10 |
$1,739.10 |
$1,739.10 |
$2,290.77
|
|
Rapid Strep Test
|
$78.10 |
$78.10 |
$78.10 |
$74.10
|
|
Rbc serum pretx incubj drugs
|
$245.30 |
$245.30 |
$245.30 |
$231.12
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$525.80 |
$525.80 |
$525.80 |
$624.65
|
|
Red blood cells leukocytes reduced each unit
|
$398.20 |
$398.20 |
$398.20 |
$439.45
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$398.20 |
$398.20 |
$398.20 |
$570.99
|
|
Reduction of procidentia 45900
|
$1,625.80 |
$1,625.80 |
$1,625.80 |
$1,075.80
|
|
Refill/maint pump/resvr syst
|
$181.50 |
$181.50 |
$181.50 |
$369.63
|
|
Relocation skin pocket aicd
|
$1,843.05 |
$1,843.05 |
$1,843.05 |
$3,128.16
|
|
Relocation skin pocket pm
|
$1,724.80 |
$1,724.80 |
$1,724.80 |
$2,939.25
|
|
Rem interrog dev eval icpms
|
$36.82 |
$36.82 |
$36.82 |
$109.50
|
|
Rem interrog dev eval scrms
|
$60.44 |
$60.44 |
$60.44 |
$139.10
|
|
Rem interrog evl pm/ids
|
$33.66 |
$33.66 |
$33.66 |
$139.10
|
|
Removal central venous catheter tunneled without port/pump
|
$1,127.50 |
$1,127.50 |
$1,127.50 |
$1,671.00
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$3,389.10 |
$3,389.10 |
$3,389.10 |
$2,599.13
|
