|
MRI chest without & w/contrast
|
$1,245.62 |
$1,245.62 |
$1,245.62 |
$2,321.61
|
|
MRI loex nonjt w IV cont
|
$1,065.93 |
$1,065.93 |
$1,065.93 |
$1,953.60
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$882.66 |
$882.66 |
$882.66 |
$2,051.28
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$1,356.87 |
$1,356.87 |
$1,356.87 |
$2,614.43
|
|
MRI orbit/face/neck without contrast
|
$1,158.41 |
$1,158.41 |
$1,158.41 |
$1,782.69
|
|
MRI orbit/face/neck without & w/contrast
|
$1,152.21 |
$1,152.21 |
$1,152.21 |
$2,552.60
|
|
MRI orbit fac&nck w IV cont
|
$1,001.88 |
$1,001.88 |
$1,001.88 |
$2,002.00
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$958.56 |
$958.56 |
$958.56 |
$1,902.00
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$1,041.24 |
$1,041.24 |
$1,041.24 |
$2,628.75
|
|
MRI upper extremity w/dye
|
$950.48 |
$950.48 |
$950.48 |
$1,854.07
|
|
Mr safety determination physician/other qhp
|
$75.90 |
$75.90 |
$75.90 |
$156.42
|
|
Mr safety implant elec prepj
|
$78.39 |
$78.39 |
$78.39 |
$167.40
|
|
Mr sfty implt&/fb asmt stf 1
|
$21.11 |
$21.11 |
$21.11 |
$42.00
|
|
Mr sfty med physics xm cstmz
|
$208.35 |
$208.35 |
$208.35 |
$402.40
|
|
Msh6 gene known variants
|
$2,931.66 |
$2,931.66 |
$2,931.66 |
$425.04
|
|
Mthfr gene analy common variants
|
$798.15 |
$798.15 |
$798.15 |
$248.82
|
|
Mumps antibody igg
|
$82.49 |
$82.49 |
$82.49 |
$81.45
|
|
Mycobacteria dna amp probe
|
$161.00 |
$161.00 |
$161.00 |
$216.45
|
|
Mycophenolate mofetil 250 mg capsule
|
$7.11 |
$7.11 |
$7.11 |
$5.76
|
|
Mycoplasma antibody igm
|
$47.07 |
$47.07 |
$47.07 |
$87.50
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$452.69 |
$452.69 |
$452.69 |
$115.05
|
|
Nafcillin 2 gram solution for injection
|
$0.53 |
$0.53 |
$0.53 |
$65.13
|
|
Nalbuphine 10 mg/ml injection solution
|
$9.59 |
$9.59 |
$9.59 |
$22.20
|
|
Natriuretic peptide
|
$113.60 |
$113.60 |
$113.60 |
$161.60
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$904.56 |
$904.56 |
$904.56 |
$1,750.20
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$852.78 |
$852.78 |
$852.78 |
$1,685.58
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$888.18 |
$888.18 |
$888.18 |
$1,435.80
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$1,324.91 |
$1,324.91 |
$1,324.91 |
$2,562.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$1,209.72 |
$1,209.72 |
$1,209.72 |
$2,164.88
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$976.83 |
$976.83 |
$976.83 |
$1,830.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$1,037.03 |
$1,037.03 |
$1,037.03 |
$2,547.30
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$901.76 |
$901.76 |
$901.76 |
$1,890.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$976.59 |
$976.59 |
$976.59 |
$1,741.80
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$0.90 |
$0.90 |
$0.90 |
$34.13
|
|
Nerobehav stas exam by psy/md f2f 1st hr
|
$199.26 |
$199.26 |
$199.26 |
$465.99
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$0.21 |
$0.21 |
$0.21 |
$251.32
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$4.86 |
$4.86 |
$4.86 |
$65.30
|
|
Nm imaging bone/joint 3 phase study
|
$995.72 |
$995.72 |
$995.72 |
$1,572.00
|
|
Nm imaging bone/joint whole body
|
$845.66 |
$845.66 |
$845.66 |
$1,538.86
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$801.99 |
$801.99 |
$801.99 |
$1,347.83
|
|
Nm imaging gastric emptying study
|
$681.51 |
$681.51 |
$681.51 |
$1,331.43
|
|
Nm imaging gastrointestinal acute blood loss
|
$649.56 |
$649.56 |
$649.56 |
$1,125.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$906.38 |
$906.38 |
$906.38 |
$1,586.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$750.63 |
$750.63 |
$750.63 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$783.81 |
$783.81 |
$783.81 |
$1,566.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$801.02 |
$801.02 |
$801.02 |
$1,075.00
|
|
Nm radiopharmaceutical therapy oral administration
|
$584.61 |
$584.61 |
$584.61 |
$1,004.90
|
|
Nuclear Stress Test (Heart)
|
$1,179.32 |
$1,179.32 |
$1,179.32 |
$3,739.20
|
|
Observation per hour
|
$365.67 |
$365.67 |
$365.67 |
$75.15
|
|
Obstetrics panel
|
$97.91 |
$97.91 |
$97.91 |
$214.50
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$5.34 |
$5.34 |
$5.34 |
$59.15
|
|
Olanzapine 10 mg intramuscular solution
|
$3.81 |
$3.81 |
$3.81 |
$120.17
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$0.48 |
$0.48 |
$0.48 |
$12.51
|
|
Organic acids total quant ea spec
|
$259.52 |
$259.52 |
$259.52 |
$152.50
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$33.53 |
$33.53 |
$33.53 |
$40.92
|
|
Oscillation chest wall mechanical per session
|
$229.95 |
$229.95 |
$229.95 |
$204.89
|
|
Osmolality blood
|
$48.57 |
$48.57 |
$48.57 |
$57.00
|
|
Osmolality urine
|
$43.53 |
$43.53 |
$43.53 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$129.60 |
$129.60 |
$129.60 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$129.60 |
$129.60 |
$129.60 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$129.60 |
$129.60 |
$129.60 |
$249.60
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$50.48 |
$50.48 |
$50.48 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$54.56 |
$54.56 |
$54.56 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$54.83 |
$54.83 |
$54.83 |
$105.50
|
|
Ot re-evaluation patient/family
|
$48.26 |
$48.26 |
$48.26 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$58.22 |
$58.22 |
$58.22 |
$96.11
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$28.16 |
$28.16 |
$28.16 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$42.78 |
$42.78 |
$42.78 |
$90.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$53.57 |
$53.57 |
$53.57 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$46.65 |
$46.65 |
$46.65 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$44.01 |
$44.01 |
$44.01 |
$93.60
|
|
Oxytocin 10 unit/ml injection solution
|
$7.20 |
$7.20 |
$7.20 |
$30.78
|
|
Paliperidone 117 mg/0.75 ml inj
|
$32.78 |
$32.78 |
$32.78 |
$4,898.66
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$26.07 |
$26.07 |
$26.07 |
$129.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$10.61 |
$10.61 |
$10.61 |
$18.49
|
|
Parathormone (pth) intact
|
$138.12 |
$138.12 |
$138.12 |
$204.00
|
|
Parathyroid planar imaging
|
$579.72 |
$579.72 |
$579.72 |
$1,041.95
|
|
Pelvic CT scan (with and without contrast)
|
$926.10 |
$926.10 |
$926.10 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$838.05 |
$838.05 |
$838.05 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$817.49 |
$817.49 |
$817.49 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$1,333.79 |
$1,333.79 |
$1,333.79 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$976.83 |
$976.83 |
$976.83 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$882.27 |
$882.27 |
$882.27 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$371.07 |
$371.07 |
$371.07 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$151.50 |
$151.50 |
$151.50 |
$429.66
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$63.08 |
$63.08 |
$63.08 |
$48.74
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$182.99 |
$182.99 |
$182.99 |
$269.36
|
|
Perq dev breast 1st strtctc
|
$1,769.70 |
$1,769.70 |
$1,769.70 |
$1,471.17
|
|
Ph body fluid
|
$56.21 |
$56.21 |
$56.21 |
$35.75
|
|
Phencyclidine (pcp)
|
$96.39 |
$96.39 |
$96.39 |
$74.40
|
|
Phenobarbital therapeutic drug level
|
$82.74 |
$82.74 |
$82.74 |
$97.50
|
|
Phentolaine mesylate inj
|
$958.16 |
$958.16 |
$958.16 |
$881.36
|
|
Phenylephrine 10 mg/ml injection solution
|
$0.21 |
$0.21 |
$0.21 |
$28.92
|
|
Phenytoin total therapeutic drug level
|
$64.71 |
$64.71 |
$64.71 |
$100.75
|
|
Phosphorus
|
$42.81 |
$42.81 |
$42.81 |
$42.37
|
|
Phosphorus 24 hour urine
|
$42.81 |
$42.81 |
$42.81 |
$41.51
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$10.53 |
$10.53 |
$10.53 |
$75.04
|
|
Pinworm exam
|
$78.92 |
$78.92 |
$78.92 |
$38.58
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$7.49 |
$7.49 |
$7.49 |
$51.80
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,461.36 |
$1,461.36 |
$1,461.36 |
$1,679.20
|