|
Nm imaging bone/joint whole body
|
$10,565.13 |
$10,565.13 |
$10,565.13 |
$1,736.40
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$9,541.68 |
$9,541.68 |
$9,541.68 |
$1,428.50
|
|
Nm imaging gastric emptying study
|
$11,043.17 |
$11,043.17 |
$11,043.17 |
$1,431.75
|
|
Nm imaging gastrointestinal acute blood loss
|
$9,118.31 |
$9,118.31 |
$9,118.31 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$12,163.25 |
$12,163.25 |
$12,163.25 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$9,959.95 |
$9,959.95 |
$9,959.95 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$19,904.66 |
$19,904.66 |
$19,904.66 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$10,532.07 |
$10,532.07 |
$10,532.07 |
$1,186.03
|
|
Nm radiopharmaceutical therapy oral administration
|
$8,575.43 |
$8,575.43 |
$8,575.43 |
$1,020.34
|
|
Non-card vasc flow imaging
|
$8,171.13 |
$8,171.13 |
$8,171.13 |
$608.56
|
|
Npm1 gene
|
$424.61 |
$424.61 |
$424.61 |
$430.95
|
|
Nras gene variants exon 2&3
|
$424.61 |
$424.61 |
$424.61 |
$554.45
|
|
Nuclear rx intra-arterial
|
$1,427.76 |
$1,427.76 |
$1,427.76 |
$761.95
|
|
Nuclear rx IV admin
|
$1,167.12 |
$1,167.12 |
$1,167.12 |
$866.71
|
|
Nuclear Stress Test (Heart)
|
$22,348.25 |
$22,348.25 |
$22,348.25 |
$3,921.45
|
|
Ob Ultrasound nuchal meas 1 gest
|
$8,261.82 |
$8,261.82 |
$8,261.82 |
$331.29
|
|
Ob Ultrasound nuchal meas add-on
|
$428.91 |
$428.91 |
$428.91 |
$243.29
|
|
Olanzapine 10 mg intramuscular solution
|
$74.25 |
$74.25 |
$74.25 |
$122.78
|
|
Ondansetron 4 mg s0119
|
$4.59 |
$4.59 |
$4.59 |
$136.80
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$29.48 |
$29.48 |
$29.48 |
$34.32
|
|
Open thrombectomy of av fistula without revision 36831
|
$33,278.15 |
$33,278.15 |
$33,278.15 |
$6,182.35
|
|
Oral aprepitant
|
$1,160.08 |
$1,160.08 |
$1,160.08 |
$374.43
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$150.82 |
$150.82 |
$150.82 |
$65.07
|
|
Osmolality blood
|
$1,009.38 |
$1,009.38 |
$1,009.38 |
$67.60
|
|
Osmolality urine
|
$1,009.38 |
$1,009.38 |
$1,009.38 |
$65.65
|
|
Other immunoelectrophoresis
|
$1,849.70 |
$1,849.70 |
$1,849.70 |
$46.40
|
|
Oth resp proc, group
|
$487.56 |
$487.56 |
$487.56 |
$154.00
|
|
Oth resp proc, indiv
|
$487.56 |
$487.56 |
$487.56 |
$87.45
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$14.74 |
$14.74 |
$14.74 |
$50.50
|
|
Oxaliplatin 5 mg/ml desensitization
|
$9,514.26 |
$9,514.26 |
$9,514.26 |
$364.29
|
|
Oxytocin 10 unit/ml injection solution
|
$125.87 |
$125.87 |
$125.87 |
$45.86
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$61.67 |
$61.67 |
$61.67 |
$231.46
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$5,503.30 |
$5,503.30 |
$5,503.30 |
$146.80
|
|
Parathyroid planar imaging
|
$9,578.54 |
$9,578.54 |
$9,578.54 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$9,541.68 |
$9,541.68 |
$9,541.68 |
$1,398.75
|
|
Paricalcitol
|
$437.72 |
$437.72 |
$437.72 |
$47.38
|
|
Paste skin barrier .5oz adapt
|
$30.50 |
$30.50 |
$30.50 |
$7.00
|
|
Pelvic CT scan (with and without contrast)
|
$12,627.75 |
$12,627.75 |
$12,627.75 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$10,619.64 |
$10,619.64 |
$10,619.64 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$9,010.91 |
$9,010.91 |
$9,010.91 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$20,488.72 |
$20,488.72 |
$20,488.72 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$10,418.18 |
$10,418.18 |
$10,418.18 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$14,792.79 |
$14,792.79 |
$14,792.79 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$6,350.87 |
$6,350.87 |
$6,350.87 |
$643.80
|
|
Pentamidine non-comp unit
|
$352.30 |
$352.30 |
$352.30 |
$299.25
|
|
Pentobarbital sodium inj
|
$130.41 |
$130.41 |
$130.41 |
$167.64
|
|
Pericardial drain w/cath pq w/ct guid
|
$9,829.95 |
$9,829.95 |
$9,829.95 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$8,601.18 |
$8,601.18 |
$8,601.18 |
$2,573.60
|
|
Peri-proc device eval icd
|
$825.00 |
$825.00 |
$825.00 |
$220.35
|
|
Peri-proc device eval pm
|
$825.00 |
$825.00 |
$825.00 |
$195.80
|
|
Perit-vens shunt pat tst
|
$8,258.86 |
$8,258.86 |
$8,258.86 |
$695.40
|
|
Perphenazine 4mg oral
|
$29.48 |
$29.48 |
$29.48 |
$9.93
|
|
Perq clsr tcat l atr apndge
|
$193,430.23 |
$193,430.23 |
$193,430.23 |
$12,032.67
|
|
Pet CT skull-mid thgh initial
|
$37,515.66 |
$37,515.66 |
$37,515.66 |
$4,854.75
|
|
Pet CT whole body initial
|
$37,515.66 |
$37,515.66 |
$37,515.66 |
$5,017.50
|
|
Pet image w/ct lmtd
|
$37,515.66 |
$37,515.66 |
$37,515.66 |
$4,422.60
|
|
Ph body fluid
|
$537.75 |
$537.75 |
$537.75 |
$39.20
|
|
Phenobarbital therapeutic drug level
|
$1,933.60 |
$1,933.60 |
$1,933.60 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,204.31 |
$1,204.31 |
$1,204.31 |
$1,011.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$105.46 |
$105.46 |
$105.46 |
$23.37
|
|
Phenytoin total therapeutic drug level
|
$1,975.55 |
$1,975.55 |
$1,975.55 |
$111.27
|
|
Phosphorus
|
$991.59 |
$991.59 |
$991.59 |
$47.81
|
|
Phosphorus 24 hour urine
|
$972.52 |
$972.52 |
$972.52 |
$42.81
|
|
Pinworm exam
|
$569.53 |
$569.53 |
$569.53 |
$39.75
|
|
Place gastrostomy tube perc
|
$10,786.86 |
$10,786.86 |
$10,786.86 |
$2,517.60
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$57,968.24 |
$57,968.24 |
$57,968.24 |
$14,934.35
|
|
Place non-slctv cath thoracic arta
|
$25,840.56 |
$25,840.56 |
$25,840.56 |
$5,110.00
|
|
Platelet automated
|
$586.05 |
$586.05 |
$586.05 |
$44.00
|
|
Platelet pheresis each unit
|
$3,257.27 |
$3,257.27 |
$3,257.27 |
$864.00
|
|
Platelets each unit
|
$350.90 |
$350.90 |
$350.90 |
$169.29
|
|
Platelets pheresis leukocytes reduced each unit
|
$860.72 |
$860.72 |
$860.72 |
$1,070.30
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,182.95 |
$2,182.95 |
$2,182.95 |
$1,180.31
|
|
Platelets pheresis pathogen-reduced each unit
|
$860.72 |
$860.72 |
$860.72 |
$879.36
|
|
Plcmnt biliary drainage cath w/img ext
|
$17,879.18 |
$17,879.18 |
$17,879.18 |
$4,650.08
|
|
Plcmt dlyd xtn pros 1st vsl
|
$71,213.26 |
$71,213.26 |
$71,213.26 |
$4,002.00
|
|
Plcmt xtn pros evasc rpr per vsl
|
$71,213.26 |
$71,213.26 |
$71,213.26 |
$3,969.00
|
|
Plmt biliary drainage cath
|
$17,879.18 |
$17,879.18 |
$17,879.18 |
$4,942.53
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$32,754.74 |
$32,754.74 |
$32,754.74 |
$4,293.60
|
|
Potassium 24 hour urine
|
$910.23 |
$910.23 |
$910.23 |
$50.00
|
|
Powder prem protct 1oz
|
$184.00 |
$184.00 |
$184.00 |
$5.20
|
|
Pq biliary strict dil s&i
|
$336.31 |
$336.31 |
$336.31 |
$1,006.00
|
|
Pq dr cath chg w cont s&i
|
$5,834.49 |
$5,834.49 |
$5,834.49 |
$711.36
|
|
Prcrd drg 0-5yr or w/anomly
|
$9,829.95 |
$9,829.95 |
$9,829.95 |
$2,253.00
|
|
Prcrd drg 6+yr without anomly
|
$9,829.95 |
$9,829.95 |
$9,829.95 |
$2,708.85
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$996.95 |
$996.95 |
$996.95 |
$356.40
|
|
Prealbumin
|
$1,058.97 |
$1,058.97 |
$1,058.97 |
$87.20
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$112.27 |
$112.27 |
$112.27 |
$16.30
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$8,261.82 |
$8,261.82 |
$8,261.82 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$6,889.80 |
$6,889.80 |
$6,889.80 |
$541.45
|
|
Pressure velocity wire add ves
|
$3,766.92 |
$3,766.92 |
$3,766.92 |
$1,595.78
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$912.77 |
$912.77 |
$912.77 |
$141.00
|
|
Pretreat rbc absorption reference
|
$912.77 |
$912.77 |
$912.77 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$912.77 |
$912.77 |
$912.77 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$122.04 |
$122.04 |
$122.04 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$912.77 |
$912.77 |
$912.77 |
$166.10
|
|
Pr exam init preventive phys new visit during 1st 12 mo of mcare enrollment
|
$554.81 |
$554.81 |
$554.81 |
$142.76
|
|
Prgrmg eval implantable dfb
|
$5,118.82 |
$5,118.82 |
$5,118.82 |
$143.55
|
|
Prgrmg eval implantable dfb
|
$5,118.82 |
$5,118.82 |
$5,118.82 |
$172.33
|
|
Prgr stim/pace a/iv drug
|
$9,335.07 |
$9,335.07 |
$9,335.07 |
$4,889.30
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$484.22 |
$484.22 |
$484.22 |
$277.60
|