|
Protein total serum plasma whole blood
|
$42.81 |
$42.81 |
$42.81 |
$40.70
|
|
Prothrombin complex kcentra
|
$5.63 |
$5.63 |
$5.63 |
$3.84
|
|
Prothrombin time substitution plasma fractions each
|
$72.89 |
$72.89 |
$72.89 |
$37.05
|
|
Pr tube thoracostomy w/connection to drainage open
|
$843.44 |
$843.44 |
$843.44 |
$1,653.31
|
|
PSA (Prostate) Test
|
$65.19 |
$65.19 |
$65.19 |
$103.85
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$60.20 |
$60.20 |
$60.20 |
$87.49
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$61.77 |
$61.77 |
$61.77 |
$105.95
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$46.82 |
$46.82 |
$46.82 |
$82.55
|
|
Pt application of modality traction mechanical
|
$65.00 |
$65.00 |
$65.00 |
$87.19
|
|
Pt evaluation high complexity patient/family
|
$123.42 |
$123.42 |
$123.42 |
$274.20
|
|
Pt evaluation low complexity patient/family
|
$123.42 |
$123.42 |
$123.42 |
$218.03
|
|
Pt evaluation moderate complexity patient/family
|
$123.42 |
$123.42 |
$123.42 |
$247.20
|
|
Pt re-evaluation patient/family
|
$45.95 |
$45.95 |
$45.95 |
$141.93
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$45.41 |
$45.41 |
$45.41 |
$43.92
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$46.82 |
$46.82 |
$46.82 |
$83.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$47.09 |
$47.09 |
$47.09 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$46.82 |
$46.82 |
$46.82 |
$84.90
|
|
Pulse ox continuous overnight monitoring
|
$207.80 |
$207.80 |
$207.80 |
$351.20
|
|
Pulse ox single
|
$78.99 |
$78.99 |
$78.99 |
$78.99
|
|
Puncture arterial withdrawal blood for diagnosis
|
$72.66 |
$72.66 |
$72.66 |
$113.75
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$458.54 |
$458.54 |
$458.54 |
$478.80
|
|
Puncture/clear windpipe 31612
|
$4,473.50 |
$4,473.50 |
$4,473.50 |
$3,592.74
|
|
Puncture spinal lumbar diagnostic
|
$696.02 |
$696.02 |
$696.02 |
$1,087.80
|
|
Quant diff pulm perf w/imaging
|
$657.60 |
$657.60 |
$657.60 |
$1,228.80
|
|
Quest t3 uptake
|
$60.08 |
$60.08 |
$60.08 |
$55.00
|
|
Rabies ig ht&sol human im/sc
|
$801.24 |
$801.24 |
$801.24 |
$5,401.91
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$801.24 |
$801.24 |
$801.24 |
$1,624.21
|
|
Rasburicase 1.5 mg intravenous solution
|
$769.79 |
$769.79 |
$769.79 |
$568.06
|
|
Rbc count only automated
|
$37.20 |
$37.20 |
$37.20 |
$20.00
|
|
Rbc deglycerolized each unit
|
$740.15 |
$740.15 |
$740.15 |
$785.20
|
|
Red blood cells each unit
|
$416.07 |
$416.07 |
$416.07 |
$380.25
|
|
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit
|
$422.13 |
$422.13 |
$422.13 |
$537.70
|
|
Red blood cells leukocytes reduced each unit
|
$315.69 |
$315.69 |
$315.69 |
$519.35
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$359.34 |
$359.34 |
$359.34 |
$645.45
|
|
Red blood cells washed each unit
|
$455.57 |
$455.57 |
$455.57 |
$561.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$10.76 |
$10.76 |
$10.76 |
$115.07
|
|
Remdesivir 100 mg intravenous powder for solution
|
$12.87 |
$12.87 |
$12.87 |
$1,888.50
|
|
Removal central venous catheter tunneled without port/pump
|
$804.26 |
$804.26 |
$804.26 |
$1,538.15
|
|
Removal cerclage w/anes
|
$2,146.38 |
$2,146.38 |
$2,146.38 |
$3,522.35
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$115.89 |
$115.89 |
$115.89 |
$236.64
|
|
Removal of anal tags
|
$2,659.16 |
$2,659.16 |
$2,659.16 |
$3,229.60
|
|
Removal tunnled intprtnl cath
|
$2,194.44 |
$2,194.44 |
$2,194.44 |
$4,200.00
|
|
Renal cyst study s&i
|
$283.65 |
$283.65 |
$283.65 |
$599.23
|
|
Renal function panel
|
$72.72 |
$72.72 |
$72.72 |
$95.76
|
|
Reptilase test
|
$40.82 |
$40.82 |
$40.82 |
$65.72
|
|
Resuscitation cardiopulmonary
|
$923.46 |
$923.46 |
$923.46 |
$895.44
|
|
Resuscitation delivery/birthing room
|
$388.95 |
$388.95 |
$388.95 |
$726.60
|
|
Reticulocyte automated
|
$81.84 |
$81.84 |
$81.84 |
$54.27
|
|
Reticulocyte direct measurement automated
|
$54.54 |
$54.54 |
$54.54 |
$32.50
|
|
Rheumatoid factor quantitative
|
$44.87 |
$44.87 |
$44.87 |
$59.80
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$104.46 |
$104.46 |
$104.46 |
$345.07
|
|
Rho d immune globulin inj
|
$111.15 |
$111.15 |
$111.15 |
$232.72
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$26.42 |
$26.42 |
$26.42 |
$1,771.44
|
|
Romiplostim 125 mcg subcutaneous solution
|
$22.55 |
$22.55 |
$22.55 |
$25.95
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$95.70 |
$95.70 |
$95.70 |
$60.40
|
|
Rp loclzj tum 2+area 1+d img
|
$721.88 |
$721.88 |
$721.88 |
$1,283.66
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$1,496.51 |
$1,496.51 |
$1,496.51 |
$2,182.05
|
|
Rubella antibody igg
|
$73.10 |
$73.10 |
$73.10 |
$73.05
|
|
Rubeola antibody igg
|
$74.43 |
$74.43 |
$74.43 |
$80.00
|
|
Russell viper venom diluted
|
$71.88 |
$71.88 |
$71.88 |
$73.03
|
|
Salmonella antibody
|
$37.58 |
$37.58 |
$37.58 |
$37.58
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$523.35 |
$523.35 |
$523.35 |
$976.95
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$440.78 |
$440.78 |
$440.78 |
$662.40
|
|
Scan duplex extremity veins unilateral/limited study
|
$523.35 |
$523.35 |
$523.35 |
$691.07
|
|
Scan duplex lower extremity arteries complete bilateral
|
$389.69 |
$389.69 |
$389.69 |
$957.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$369.29 |
$369.29 |
$369.29 |
$612.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$418.61 |
$418.61 |
$418.61 |
$527.80
|
|
Screening Colonoscopy (average risk)
|
$1,253.13 |
$1,253.13 |
$1,253.13 |
$1,093.16
|
|
Screening Colonoscopy (high risk)
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,575.00
|
|
Screening Mammogram
|
$189.54 |
$189.54 |
$189.54 |
$287.12
|
|
Screen pap by tech w md supv
|
$27.65 |
$27.65 |
$27.65 |
$27.65
|
|
Semen analysis presence/motility
|
$51.29 |
$51.29 |
$51.29 |
$79.92
|
|
Sgmdsc w/band ligation
|
$1,133.61 |
$1,133.61 |
$1,133.61 |
$1,523.20
|
|
Shoulder MRI (with and without contrast)
|
$1,138.83 |
$1,138.83 |
$1,138.83 |
$2,628.75
|
|
Shoulder MRI (with contrast)
|
$926.37 |
$926.37 |
$926.37 |
$2,353.60
|
|
Shoulder MRI (without contrast)
|
$891.57 |
$891.57 |
$891.57 |
$1,938.28
|
|
Shoulder X-ray
|
$143.13 |
$143.13 |
$143.13 |
$307.20
|
|
Shuntogram nonvascular supervision & interpretation
|
$135.69 |
$135.69 |
$135.69 |
$342.54
|
|
Sickling rbc
|
$156.71 |
$156.71 |
$156.71 |
$53.40
|
|
Sigmoidoscopy and biopsy
|
$672.71 |
$672.71 |
$672.71 |
$1,351.63
|
|
Sigmoidoscopy flex decompression 45337
|
$672.71 |
$672.71 |
$672.71 |
$1,009.14
|
|
Sigmoidoscopy for bleeding
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,594.50
|
|
Sigmoidoscopy/submucosal injection 45335
|
$672.71 |
$672.71 |
$672.71 |
$1,278.72
|
|
Sigmoidoscopy w/ablation
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$2,604.00
|
|
Sigmoidoscopy w/fb removal 45332
|
$672.71 |
$672.71 |
$672.71 |
$1,370.25
|
|
Sigmoidoscopy w/tumr remove
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,350.83
|
|
Sigmoid/rmv tumor/polyp/hot bx for 45333
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,183.20
|
|
Sig w/tndsc balloon dilation
|
$1,093.16 |
$1,093.16 |
$1,093.16 |
$1,364.66
|
|
Sincalide 5 mcg solution for injection
|
$280.40 |
$280.40 |
$280.40 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$658.53 |
$658.53 |
$658.53 |
$1,610.70
|
|
Sinus CT scan (with contrast)
|
$622.91 |
$622.91 |
$622.91 |
$1,419.18
|
|
Sinus CT scan (without contrast)
|
$554.03 |
$554.03 |
$554.03 |
$1,151.00
|
|
Sleep Study (Polysomnography)
|
$1,237.68 |
$1,237.68 |
$1,237.68 |
$4,043.20
|
|
Small bowel endoscopy
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$1,104.13
|
|
Small bowel endoscopy br/wa
|
$1,261.31 |
$1,261.31 |
$1,261.31 |
$1,247.13
|
|
Small bowel endoscopy br/wa
|
$1,201.23 |
$1,201.23 |
$1,201.23 |
$2,218.50
|
|
Smear fluorescent and/or acid fast stain
|
$46.43 |
$46.43 |
$46.43 |
$50.70
|
|
Smear gram stain
|
$41.24 |
$41.24 |
$41.24 |
$48.00
|
|
Smear special stain inclusion bodies/parasites
|
$58.32 |
$58.32 |
$58.32 |
$60.00
|
|
Smear wet mount
|
$42.57 |
$42.57 |
$42.57 |
$56.13
|