|
Polysom <6 yrs cpap/bilvl
|
$4,802.77 |
$4,802.77 |
$4,802.77 |
$3,514.50
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$5,236.15 |
$5,236.15 |
$7,244.10 |
$3,785.10
|
|
Post 1 srfc resinbased cmpst
|
$72.00 |
$72.00 |
$72.00 |
$142.80
|
|
Post 2 srfc resinbased cmpst
|
$84.00 |
$84.00 |
$84.00 |
$186.48
|
|
Postop app non-wgt bear dsg
|
$881.95 |
$881.95 |
$1,331.36 |
$903.50
|
|
Postop app non-wgt bear dsg
|
$1,449.53 |
$1,449.53 |
$1,449.53 |
$1,389.71
|
|
Postop dress & 1 cast chg bk
|
$3,057.65 |
$3,057.65 |
$3,057.65 |
$2,533.77
|
|
Post-op hip abduct custom fa
|
$2,226.01 |
$2,226.01 |
$2,226.01 |
$1,760.02
|
|
Potassium 24 hour urine
|
$58.91 |
$58.91 |
$121.65 |
$51.10
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$60.00 |
$60.00 |
$97.20 |
$61.80
|
|
Potassium serum/plasma/whole blood
|
$59.87 |
$59.87 |
$142.50 |
$47.85
|
|
Pouch drainable w barrier at
|
$1.35 |
$1.35 |
$1.35 |
$1.35
|
|
Pouch high output 2pc 50mm red
|
$7.35 |
$7.35 |
$7.35 |
$10.83
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$0.87 |
$0.87 |
$0.87 |
$3.25
|
|
Pouch ostmy nb pouchkin ctf
|
$1.55 |
$1.55 |
$1.55 |
$1.55
|
|
Pouch uros new (both sides) 2.75in clr
|
$15.80 |
$15.80 |
$15.80 |
$15.80
|
|
Powder prem protct 1oz
|
$5.43 |
$5.43 |
$5.43 |
$5.43
|
|
Pq biliary strict dil s&i
|
$707.71 |
$707.71 |
$1,323.75 |
$1,102.53
|
|
Pq dr cath chg w cont s&i
|
$633.97 |
$633.97 |
$1,130.85 |
$721.71
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$10,430.78 |
$10,430.78 |
$12,860.55 |
$10,195.00
|
|
Pq thr inj ext pse
|
$1,014.07 |
$1,014.07 |
$1,994.85 |
$786.66
|
|
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl
|
$2,725.56 |
$2,725.56 |
$5,571.60 |
$2,975.00
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$4,236.34 |
$4,236.34 |
$5,623.50 |
$4,664.99
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$4,811.54 |
$4,811.54 |
$8,790.30 |
$4,811.54
|
|
Pralatrexate injection
|
$24,465.07 |
$24,465.07 |
$24,465.07 |
$20,353.38
|
|
Pralidoxime 1 gram solution for injection
|
$187.28 |
$187.28 |
$234.09 |
$292.00
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$3,738.90 |
$3,738.90 |
$3,865.99 |
$3,738.90
|
|
Pr application of long arm splint
|
$356.85 |
$356.85 |
$388.52 |
$334.08
|
|
Pr application splint static short arm
|
$154.05 |
$154.05 |
$370.91 |
$288.51
|
|
Pr biopsy skin punch single lesion
|
$458.25 |
$458.25 |
$505.18 |
$458.25
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$42.30 |
$42.30 |
$48.71 |
$48.00
|
|
Prcrd drg 0-5yr or w/anomly
|
$1,769.84 |
$1,769.84 |
$1,769.84 |
$2,157.55
|
|
Prcrd drg 6+yr without anomly
|
$3,161.89 |
$3,161.89 |
$3,285.15 |
$2,253.00
|
|
Pr cystourethroscopy with insertion indwelling ureteral stent
|
$4,342.83 |
$4,342.83 |
$4,342.83 |
$5,262.80
|
|
Prealbumin
|
$115.26 |
$115.26 |
$193.35 |
$94.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$63.65 |
$63.65 |
$104.12 |
$13.80
|
|
Prednisone 1 mg tablet
|
$0.40 |
$0.40 |
$140.40 |
$2.88
|
|
Pregabalin - sendout
|
$5.00 |
$5.00 |
$5.00 |
$76.70
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$1,641.90 |
$1,641.90 |
$1,641.90 |
$2,298.00
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$381.75 |
$381.75 |
$590.27 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$393.00 |
$393.00 |
$660.98 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$381.75 |
$381.75 |
$459.00 |
$459.00
|
|
Pre-op service lvrs 10-15dos
|
$3,907.86 |
$3,907.86 |
$3,907.86 |
$1,568.00
|
|
Pre-op service lvrs 1-9 dos
|
$2,062.26 |
$2,062.26 |
$2,062.26 |
$1,579.20
|
|
Preparation for bladder xray
|
$1,143.32 |
$1,143.32 |
$1,143.32 |
$1,222.00
|
|
Preparation palate mold
|
$583.82 |
$583.82 |
$583.82 |
$602.63
|
|
Prep skin to 100cm2 other
|
$695.40 |
$695.40 |
$1,198.40 |
$1,193.40
|
|
Prep skin to 100cm2 trk/ext
|
$2,189.70 |
$2,189.70 |
$2,189.70 |
$2,164.64
|
|
Pressure max expiratory/inspiratory
|
$349.83 |
$349.83 |
$349.83 |
$243.75
|
|
Pressure treatment esophagus
|
$2,587.56 |
$2,587.56 |
$2,587.56 |
$2,035.50
|
|
Pressure velocity wire add ves
|
$1,542.30 |
$1,542.30 |
$2,208.05 |
$1,618.20
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$107.65 |
$107.65 |
$152.85 |
$162.00
|
|
Pretreat rbc absorption reference
|
$255.19 |
$255.19 |
$689.10 |
$150.00
|
|
Pretreat rbc density gradient separation reference
|
$47.73 |
$47.73 |
$153.60 |
$182.31
|
|
Pretreat rbc w chem/drugs reference
|
$132.48 |
$132.48 |
$222.75 |
$114.00
|
|
Pretreat rbc w enzyme reference
|
$159.75 |
$159.75 |
$214.33 |
$170.00
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$328.28 |
$328.28 |
$328.28 |
$308.00
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$178.57 |
$178.57 |
$178.57 |
$188.86
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$1,896.60 |
$1,896.60 |
$1,896.60 |
$1,917.33
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$449.25 |
$449.25 |
$1,015.52 |
$780.60
|
|
Prgrmg dev eval impltbl sys
|
$210.00 |
$210.00 |
$210.00 |
$130.00
|
|
Prgrmg dev eval pm/ldls pm
|
$194.40 |
$194.40 |
$194.40 |
$139.10
|
|
Prgrmg dev eval scrms ip
|
$180.33 |
$180.33 |
$180.33 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$202.13 |
$202.13 |
$202.13 |
$157.00
|
|
Prgrmg eval implantable dfb
|
$218.79 |
$218.79 |
$218.79 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$247.66 |
$247.66 |
$247.66 |
$206.05
|
|
Prgr stim/pace a/iv drug
|
$6,468.87 |
$6,468.87 |
$7,396.05 |
$4,540.00
|
|
Prim art mech thrmbc non-intracranial
|
$6,534.20 |
$6,534.20 |
$10,774.05 |
$9,395.50
|
|
Prim art mech thrmbc non-intracranial add-on
|
$3,524.55 |
$3,524.55 |
$5,187.67 |
$3,675.76
|
|
Prin care mgmt staff 1st 30
|
$91.70 |
$91.70 |
$91.70 |
$108.93
|
|
Pr incision & drainage abscess complicated/multiple
|
$782.98 |
$782.98 |
$812.40 |
$705.00
|
|
Pr incision & drainage abscess simple/single
|
$467.85 |
$467.85 |
$596.67 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$306.90 |
$306.90 |
$692.24 |
$543.84
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$484.50 |
$484.50 |
$699.02 |
$605.28
|
|
Pr management transitional care high w/in 7 days of discharge
|
$84.79 |
$84.79 |
$84.79 |
$251.56
|
|
Pr management transitional care moderate w/in 14 days of discharge
|
$64.44 |
$64.44 |
$64.44 |
$195.53
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$228.45 |
$228.45 |
$232.42 |
$255.00
|
|
Probe cryo 1150mm endo flex ster disp
|
$12,003.00 |
$12,003.00 |
$12,640.20 |
$7,350.00
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$170.27 |
$170.27 |
$248.56 |
$674.78
|
|
Procalcitonin
|
$194.93 |
$194.93 |
$488.27 |
$161.11
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$22.86 |
$22.86 |
$24.63 |
$38.32
|
|
Prochlorperazine maleate 5 mg tablet
|
$0.60 |
$0.60 |
$0.97 |
$2.09
|
|
Proctosigmoidoscopy control bleed 45317
|
$748.50 |
$748.50 |
$748.50 |
$1,395.28
|
|
Proctosigmoidoscopy dx 45300
|
$1,094.55 |
$1,094.55 |
$1,650.30 |
$1,078.88
|
|
Proctosigmoidoscopy volvul
|
$1,842.75 |
$1,842.75 |
$1,842.75 |
$3,245.23
|
|
Proctosigmoidoscopy w/bx 45305
|
$748.50 |
$748.50 |
$748.50 |
$1,645.43
|
|
Progesterone
|
$30.75 |
$30.75 |
$146.26 |
$116.00
|
|
Prolactin
|
$25.95 |
$25.95 |
$181.04 |
$123.50
|
|
Prolng svc o/p 1st hour
|
$178.76 |
$178.76 |
$178.76 |
$178.76
|
|
Prolng svc o/p ea addl 30
|
$67.09 |
$67.09 |
$67.09 |
$67.09
|
|
Promethazine hcl injection
|
$6.00 |
$6.00 |
$12.96 |
$12.16
|
|
Propofol infusion 10 mg/ml
|
$75.60 |
$75.60 |
$108.00 |
$73.36
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$21.89 |
$21.89 |
$28.80 |
$33.31
|
|
Prostate biopsy, any mthd
|
$614.11 |
$614.11 |
$614.11 |
$492.88
|
|
Prosthesis voc advantage 20f 14mm
|
$319.80 |
$319.80 |
$2,641.03 |
$1,088.12
|
|
Prosthetic sock multi ply bk
|
$50.95 |
$50.95 |
$57.89 |
$52.00
|
|
Protamine 10 mg/ml intravenous solution
|
$21.18 |
$21.18 |
$159.63 |
$56.70
|
|
Protect body sock ea pre ots
|
$113.63 |
$113.63 |
$113.63 |
$113.63
|
|
Protector nerve neurawrap 4cm
|
$3,326.26 |
$3,326.26 |
$6,280.80 |
$3,842.36
|
|
Protein c activity
|
$216.97 |
$216.97 |
$421.65 |
$119.60
|