|
Ntsty modul rad tx dlvr cplx
|
$2,267.50 |
$2,267.50 |
$2,267.50 |
$2,503.00
|
|
Ntsty modul rad tx dlvr smpl
|
$760.50 |
$760.50 |
$760.50 |
$2,235.00
|
|
Nuclear exam of tear flow
|
$354.50 |
$354.50 |
$354.50 |
$583.70
|
|
Nuclear rx intra-arterial
|
$396.50 |
$396.50 |
$396.50 |
$765.00
|
|
Nuclear rx intracav admin
|
$234.50 |
$234.50 |
$234.50 |
$776.97
|
|
Nuclear rx IV admin
|
$658.50 |
$658.50 |
$658.50 |
$864.50
|
|
Nuclear Stress Test (Heart)
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
$3,804.45
|
|
Nushield 1 square cm
|
$475.00 |
$475.00 |
$475.00 |
$937.50
|
|
Observation direct referral from physician office for admission
|
$354.00 |
$354.00 |
$354.00 |
$384.00
|
|
Observation per hour
|
$31.00 |
$31.00 |
$31.00 |
$81.22
|
|
Ob Ultrasound nuchal meas 1 gest
|
$172.50 |
$172.50 |
$172.50 |
$359.20
|
|
Ob Ultrasound nuchal meas add-on
|
$110.00 |
$110.00 |
$110.00 |
$249.60
|
|
Ocular photodynamic ther
|
$233.50 |
$233.50 |
$233.50 |
$1,050.40
|
|
Oncoprotein dcp
|
$149.00 |
$149.00 |
$149.00 |
$161.60
|
|
Open thrombectomy of av fistula without revision 36831
|
$4,402.50 |
$4,402.50 |
$4,402.50 |
$6,366.08
|
|
Ophthalmic biometry
|
$310.00 |
$310.00 |
$310.00 |
$182.95
|
|
Ophth Ultrasound b & quant a
|
$126.50 |
$126.50 |
$126.50 |
$301.60
|
|
Oph Ultrasound dx ant sgm Ultrasound uni/bi
|
$209.50 |
$209.50 |
$209.50 |
$215.90
|
|
Oph Ultrasound dx quan a-scan only
|
$185.50 |
$185.50 |
$185.50 |
$298.98
|
|
Organic acids total quant ea spec
|
$212.00 |
$212.00 |
$212.00 |
$151.36
|
|
Oropharyngeal biopsy 42800
|
$1,366.00 |
$1,366.00 |
$1,366.00 |
$2,218.86
|
|
Ortho dvc repair per 15 min
|
$53.50 |
$53.50 |
$53.50 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$151.50 |
$151.50 |
$151.50 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$860.50 |
$860.50 |
$860.50 |
$536.90
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$368.00 |
$368.00 |
$368.00 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$254.50 |
$254.50 |
$254.50 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$305.00 |
$305.00 |
$305.00 |
$310.00
|
|
Ortho hnd without jnt w/fit&adj
|
$275.00 |
$275.00 |
$275.00 |
$231.00
|
|
Orthopantogram
|
$83.50 |
$83.50 |
$83.50 |
$241.50
|
|
Orthosis lso rigd frm hyperex
|
$667.50 |
$667.50 |
$667.50 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$701.50 |
$701.50 |
$701.50 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$466.00 |
$466.00 |
$466.00 |
$718.40
|
|
O shoe add instep extension
|
$204.00 |
$204.00 |
$204.00 |
$201.67
|
|
Osmolality blood
|
$47.00 |
$47.00 |
$47.00 |
$67.60
|
|
Osmolality urine
|
$41.50 |
$41.50 |
$41.50 |
$65.00
|
|
Osteopath manip tx/5-6 body region 98927
|
$64.50 |
$64.50 |
$64.50 |
$68.25
|
|
Osteopath manip tx/7-8 body region 98928
|
$64.50 |
$64.50 |
$64.50 |
$84.22
|
|
Osteopath manip tx/9-10 body region98929
|
$64.50 |
$64.50 |
$64.50 |
$92.42
|
|
Ot evaluation high complexity patient/family
|
$142.50 |
$142.50 |
$142.50 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$61.00 |
$61.00 |
$61.00 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$114.00 |
$114.00 |
$114.00 |
$263.50
|
|
Oth resp proc, group
|
$145.00 |
$145.00 |
$145.00 |
$123.05
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$41.00 |
$41.00 |
$41.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$41.00 |
$41.00 |
$41.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$59.50 |
$59.50 |
$59.50 |
$105.00
|
|
Otolaryngo binocular microscopy 92504
|
$11.50 |
$11.50 |
$11.50 |
$60.45
|
|
Ot re-evaluation patient/family
|
$48.50 |
$48.50 |
$48.50 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$59.50 |
$59.50 |
$59.50 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$25.50 |
$25.50 |
$25.50 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$51.50 |
$51.50 |
$51.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$51.50 |
$51.50 |
$51.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$51.50 |
$51.50 |
$51.50 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$51.50 |
$51.50 |
$51.50 |
$94.25
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$18,635.00 |
$18,635.00 |
$18,635.00 |
$47,880.00
|
|
Parathormone (pth) intact
|
$242.00 |
$242.00 |
$242.00 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$1,016.00 |
$1,016.00 |
$1,016.00 |
$1,574.40
|
|
Parathyroid planar imaging
|
$733.00 |
$733.00 |
$733.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$805.00 |
$805.00 |
$805.00 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$118.00 |
$118.00 |
$118.00 |
$245.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$2,421.00 |
$2,421.00 |
$2,421.00 |
$3,762.53
|
|
Partial removal finger bone
|
$1,706.00 |
$1,706.00 |
$1,706.00 |
$2,049.27
|
|
Partial removal foot fascia
|
$2,281.50 |
$2,281.50 |
$2,281.50 |
$3,762.00
|
|
Partial removal of eye fluid
|
$1,554.00 |
$1,554.00 |
$1,554.00 |
$2,698.92
|
|
Partial removal of eye fluid
|
$1,554.00 |
$1,554.00 |
$1,554.00 |
$2,698.92
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$7.00 |
$7.00 |
$7.00 |
$4,921.76
|
|
Passy muir valve metal trach
|
$452.00 |
$452.00 |
$452.00 |
$275.75
|
|
Pdgfra gene
|
$304.50 |
$304.50 |
$304.50 |
$717.23
|
|
Pdt dstr prmlg les phys/qhp
|
$338.50 |
$338.50 |
$338.50 |
$294.77
|
|
Ped home apnea mntr att only
|
$107.50 |
$107.50 |
$107.50 |
$185.15
|
|
Ped home apnea mntr dl&alys
|
$144.50 |
$144.50 |
$144.50 |
$296.92
|
|
Pedicle enel/ntroral 15576
|
$1,036.00 |
$1,036.00 |
$1,036.00 |
$2,501.10
|
|
Pelvic CT scan (with and without contrast)
|
$1,349.00 |
$1,349.00 |
$1,349.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$957.50 |
$957.50 |
$957.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$827.50 |
$827.50 |
$827.50 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,783.00 |
$1,783.00 |
$1,783.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$778.00 |
$778.00 |
$778.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$579.00 |
$579.00 |
$579.00 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$373.00 |
$373.00 |
$373.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$218.00 |
$218.00 |
$218.00 |
$430.00
|
|
Penile injection
|
$230.50 |
$230.50 |
$230.50 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$18,848.00 |
$18,848.00 |
$18,848.00 |
$18,764.94
|
|
Perc cryo ablate renal tum
|
$5,998.50 |
$5,998.50 |
$5,998.50 |
$11,458.04
|
|
Perc rf ablate renal tumor
|
$5,033.50 |
$5,033.50 |
$5,033.50 |
$7,243.60
|
|
Percut ablate liver rf
|
$5,342.00 |
$5,342.00 |
$5,342.00 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$1,796.50 |
$1,796.50 |
$1,796.50 |
$2,251.20
|
|
Pericardiotomy/clot/for bod remove 33020
|
$3,557.50 |
$3,557.50 |
$3,557.50 |
$1,797.00
|
|
Peripheral vascular rehab
|
$34.50 |
$34.50 |
$34.50 |
$132.50
|
|
Peri-proc device eval icd
|
$26.00 |
$26.00 |
$26.00 |
$192.40
|
|
Peri-proc device eval pm
|
$26.00 |
$26.00 |
$26.00 |
$159.90
|
|
Peritoneal cath sub q resv per
|
$3,541.50 |
$3,541.50 |
$3,541.50 |
$5,625.74
|
|
Perit-vens shunt pat tst
|
$613.00 |
$613.00 |
$613.00 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$5,868.50 |
$5,868.50 |
$5,868.50 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$10,309.00 |
$10,309.00 |
$10,309.00 |
$9,509.53
|
|
Perq dev breast 1st mr guide
|
$676.50 |
$676.50 |
$676.50 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$615.50 |
$615.50 |
$615.50 |
$1,456.00
|
|
Perq p-art revsc 1 abnor bi
|
$8,135.50 |
$8,135.50 |
$8,135.50 |
$17,321.20
|
|
Perq p-art revsc 1 abnor uni
|
$13,165.00 |
$13,165.00 |
$13,165.00 |
$21,321.00
|
|
Perq p-art revsc 1 nm nt bi
|
$8,135.50 |
$8,135.50 |
$8,135.50 |
$15,873.70
|
|
Perq p-art revsc 1 nm nt uni
|
$8,135.50 |
$8,135.50 |
$8,135.50 |
$17,321.20
|
|
Perq p-art revsc each addl
|
$5,695.00 |
$5,695.00 |
$5,695.00 |
$8,627.68
|
