|
Prolactin
|
$92.80 |
$142.40 |
$238.40 |
|
|
Promethazine hcl injection
|
$61.24 |
$61.24 |
$61.24 |
|
|
Propofol infusion 10 mg/ml
|
$60.00 |
$64.32 |
$331.36 |
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$61.52 |
$61.52 |
$314.80 |
|
|
Pros sock single ply ak
|
$29.60 |
$29.60 |
$29.60 |
|
|
Prosthesis voc advantage 20f 14mm
|
$2,944.00 |
$2,944.00 |
$2,944.00 |
|
|
Prosthesis voc lopres 20f 22mm
|
$612.00 |
$612.00 |
$612.00 |
|
|
Protamine 10 mg/ml intravenous solution
|
$60.98 |
$62.30 |
$190.95 |
|
|
Protein c activity
|
$129.60 |
$266.40 |
$304.00 |
|
|
Protein electrophoretic fractionation & quantitation serum
|
$52.00 |
$84.00 |
$90.40 |
|
|
Protein s total
|
$45.60 |
$176.80 |
$337.60 |
|
|
Protein total 24 hour urine
|
$35.20 |
$62.40 |
$95.20 |
|
|
Protein total body fluid
|
$26.40 |
$61.60 |
$98.40 |
|
|
Protein total serum plasma whole blood
|
$25.60 |
$50.40 |
$70.40 |
|
|
Prothrombin complex kcentra
|
$1,572.80 |
$1,572.80 |
$3,228.00 |
|
|
Prothrombin time substitution plasma fractions each
|
$34.40 |
$34.40 |
$34.40 |
|
|
Provide inr test mater/equip
|
$255.20 |
$259.20 |
$267.20 |
|
|
Prq card revasc mi 1 vsl
|
$19,312.80 |
$19,312.80 |
$25,937.60 |
|
|
Prq card revasc mi 1 vsl drug-eluting
|
$21,836.80 |
$21,836.80 |
$27,753.60 |
|
|
Prq revasc byp graft 1 art and/or branches
|
$21,621.60 |
$21,621.60 |
$25,937.60 |
|
|
Prq tcat plmt ntrac st 1 les
|
$18,580.80 |
$18,580.80 |
$22,156.80 |
|
|
Prq tcat plmt ntrac st 2+les
|
$28,000.00 |
$28,000.00 |
$28,000.00 |
|
|
Prq trlml c athrc st angiop1
|
$22,252.80 |
$22,252.80 |
$24,996.00 |
|
|
Prq trluml c angiop 1art&/br
|
$14,700.00 |
$14,700.00 |
$14,864.80 |
|
|
Prq trluml c athrc 1 art&/br
|
$14,518.40 |
$14,518.40 |
$20,373.60 |
|
|
Prq trluml revsc ch occ ant
|
$25,256.80 |
$25,256.80 |
$27,701.60 |
|
|
Pr removal drug delivery implant
|
$714.40 |
$714.40 |
$1,069.60 |
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$196.00 |
$252.80 |
$311.20 |
|
|
Pr removal intrauterine device
|
$455.20 |
$503.20 |
$562.40 |
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$644.00 |
$683.20 |
$944.00 |
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$334.40 |
$441.60 |
$514.40 |
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$352.80 |
$496.00 |
$514.40 |
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$320.80 |
$444.80 |
$514.40 |
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$339.20 |
$460.00 |
$514.40 |
|
|
Pr split-thickness autograft trunk/arm/leg 1st 100 sq cm/<tbsa infant/child
|
$5,605.60 |
$5,605.60 |
$5,605.60 |
|
|
Pr tube thoracostomy w/connection to drainage open
|
$973.60 |
$1,042.40 |
$1,320.80 |
|
|
PSA (Prostate) Test
|
$89.60 |
$89.60 |
$89.60 |
|
|
Psychoanalysis
|
$467.20 |
$467.20 |
$467.20 |
|
|
Psychotherapy group therapy
|
$212.80 |
$212.80 |
$212.80 |
|
|
Psychotherapy patient individual therapy 30 minutes
|
$44.00 |
$140.80 |
$196.00 |
|
|
Psychotherapy patient individual therapy 45 minutes
|
$148.80 |
$233.60 |
$256.80 |
|
|
Psychotherapy patient individual therapy 60 minutes
|
$144.00 |
$243.20 |
$290.40 |
|
|
Psytx pt w/e&m 16-37 min
|
$135.20 |
$135.20 |
$135.20 |
|
|
Psytx pt w/e&m 38-52 min
|
$190.40 |
$190.40 |
$190.40 |
|
|
Psytx pt w/e&m 53+ min
|
$235.20 |
$235.20 |
$235.20 |
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$94.40 |
$128.00 |
$184.00 |
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$94.40 |
$102.40 |
$129.60 |
|
|
Pt application of modality traction mechanical
|
$100.00 |
$104.80 |
$139.20 |
|
|
Pt repositioning canalith procedure(s) per day
|
$140.80 |
$144.00 |
$238.40 |
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$94.40 |
$97.60 |
$122.40 |
|
|
Pt wheelchair management each 15 minutes
|
$112.80 |
$116.80 |
$126.40 |
|
|
Pul art balloon repr percut
|
$5,341.60 |
$5,341.60 |
$14,953.60 |
|
|
Pul art balloon repr percut
|
$7,529.60 |
$7,529.60 |
$7,529.60 |
|
|
Pulmonary vent imaging
|
$1,181.60 |
$1,181.60 |
$1,262.40 |
|
|
Pulse ox continuous overnight monitoring
|
$340.00 |
$405.60 |
$964.80 |
|
|
Pulse ox multiple
|
$171.20 |
$183.20 |
$571.20 |
|
|
Pulse ox single
|
$80.80 |
$85.60 |
$128.80 |
|
|
Punc of shunt for asp or inj
|
$817.60 |
$817.60 |
$1,092.80 |
|
|
Puncture arterial withdrawal blood for diagnosis
|
$100.00 |
$152.00 |
$163.20 |
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$474.40 |
$492.80 |
$723.20 |
|
|
Puncture spinal lumbar diagnostic
|
$888.00 |
$932.00 |
$1,292.80 |
|
|
Pvb thoracic single inj site
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
|
|
Pyridoxine hcl 100 mg
|
$65.83 |
$65.83 |
$15,777.72 |
|
|
Pyruvate
|
$57.60 |
$57.60 |
$57.60 |
|
|
Quant diff pulm perf and vent w/imaging
|
$2,003.20 |
$2,003.20 |
$2,256.80 |
|
|
Quant diff pulm perf w/imaging
|
$1,459.20 |
$1,459.20 |
$1,495.20 |
|
|
Quest t3 uptake
|
$48.80 |
$48.80 |
$48.80 |
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$817.68 |
$3,688.15 |
$6,469.26 |
|
|
Racepinephrine hcl soln nebu 2.25% (base equivalent)
|
$2.09 |
$4.92 |
$5.92 |
|
|
Radiation handling
|
$587.20 |
$587.20 |
$587.20 |
|
|
Radiation physics consult
|
$987.20 |
$987.20 |
$987.20 |
|
|
Radiation therapy dose plan
|
$778.40 |
$778.40 |
$778.40 |
|
|
Radiation treatment aid(s)
|
$768.00 |
$768.00 |
$768.00 |
|
|
Radiation treatment aid(s)
|
$953.60 |
$953.60 |
$953.60 |
|
|
Radiation treatment aid(s)
|
$1,766.40 |
$1,766.40 |
$1,766.40 |
|
|
Radiation treatment delivery
|
$752.80 |
$752.80 |
$752.80 |
|
|
Radiation treatment delivery
|
$4,083.20 |
$4,083.20 |
$4,083.20 |
|
|
Radiology port images(s)
|
$572.80 |
$572.80 |
$572.80 |
|
|
Radiotherapy dose plan imrt
|
$8,828.80 |
$8,828.80 |
$8,828.80 |
|
|
Radium ra223 dichl ther/uci
|
$188.80 |
$188.80 |
$188.80 |
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$2,806.40 |
$2,806.40 |
$3,667.20 |
|
|
Radphm lcl tmr plnr bdy two day img
|
$3,712.00 |
$3,712.00 |
$4,308.80 |
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$3,880.80 |
$3,880.80 |
$3,880.80 |
|
|
Radphm lcl tomogr sgl area sgl day
|
$2,669.60 |
$2,688.80 |
$3,318.40 |
|
|
Radphm lcl tumor plr sgl day
|
$949.60 |
$1,027.20 |
$1,584.00 |
|
|
Rapid Strep Test
|
$44.00 |
$48.00 |
$84.00 |
|
|
Rasburicase 1.5 mg intravenous solution
|
$2,753.51 |
$2,753.51 |
$2,753.51 |
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$18,051.20 |
$18,051.20 |
$18,051.20 |
|
|
Rb82 rubidium
|
$760.00 |
$760.00 |
$760.00 |
|
|
Rbc count only automated
|
$16.00 |
$31.20 |
$59.20 |
|
|
Rbc irradiated each unit
|
$569.60 |
$584.00 |
$595.20 |
|
|
Realignment of tendons
|
$2,720.00 |
$2,720.00 |
$2,720.00 |
|
|
Reconstruct finger joint
|
$5,562.40 |
$5,562.40 |
$5,562.40 |
|
|
Red blood cells each unit
|
$459.20 |
$478.40 |
$490.40 |
|
|
Red blood cells leukocytes reduced each unit
|
$152.00 |
$499.20 |
$531.20 |
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$711.20 |
$715.20 |
$750.40 |
|
|
Red blood cells washed each unit
|
$656.80 |
$656.80 |
$783.20 |
|
|
Red cell mass multiple
|
$1,215.20 |
$1,215.20 |
$1,360.00 |
|
|
Redo endovas vena cava filtr
|
$6,342.40 |
$6,342.40 |
$6,342.40 |
|
|
Reduction of procidentia 45900
|
$1,826.40 |
$1,826.40 |
$1,826.40 |
|
