|
Orthopantogram
|
$319.00 |
$319.00 |
$319.00 |
$241.50
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$605.00 |
$605.00 |
$605.00 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$1,750.50 |
$1,750.50 |
$1,750.50 |
$718.40
|
|
Osmolality blood
|
$208.50 |
$208.50 |
$208.50 |
$67.60
|
|
Osmolality urine
|
$164.00 |
$164.00 |
$164.00 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$490.50 |
$490.50 |
$490.50 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$357.50 |
$357.50 |
$357.50 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$400.00 |
$400.00 |
$400.00 |
$263.50
|
|
Oth resp proc, group
|
$231.00 |
$231.00 |
$231.00 |
$123.05
|
|
Oth resp proc, indiv
|
$214.50 |
$214.50 |
$214.50 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$188.00 |
$188.00 |
$188.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$216.50 |
$216.50 |
$216.50 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$178.00 |
$178.00 |
$178.00 |
$105.00
|
|
Ot re-evaluation patient/family
|
$184.00 |
$184.00 |
$184.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$163.00 |
$163.00 |
$163.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$133.50 |
$133.50 |
$133.50 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$267.00 |
$267.00 |
$267.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$158.50 |
$158.50 |
$158.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$189.00 |
$189.00 |
$189.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$141.50 |
$141.50 |
$141.50 |
$94.25
|
|
Parathormone (pth) intact
|
$501.50 |
$501.50 |
$501.50 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$5,156.50 |
$5,156.50 |
$5,156.50 |
$1,574.40
|
|
Parathyroid planar imaging
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$4,556.00 |
$4,556.00 |
$4,556.00 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$557.00 |
$557.00 |
$557.00 |
$245.00
|
|
Partial removal finger bone
|
$5,200.50 |
$5,200.50 |
$5,200.50 |
$2,049.27
|
|
Passy muir valve metal trach
|
$372.50 |
$372.50 |
$372.50 |
$275.75
|
|
Pdgfra gene
|
$919.00 |
$919.00 |
$919.00 |
$717.23
|
|
Pelvic CT scan (with and without contrast)
|
$1,236.50 |
$1,236.50 |
$1,236.50 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,124.00 |
$1,124.00 |
$1,124.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,022.00 |
$1,022.00 |
$1,022.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,509.00 |
$1,509.00 |
$1,509.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$1,372.50 |
$1,372.50 |
$1,372.50 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$967.50 |
$967.50 |
$967.50 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$2,034.00 |
$2,034.00 |
$2,034.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$981.50 |
$981.50 |
$981.50 |
$430.00
|
|
Penile injection
|
$715.50 |
$715.50 |
$715.50 |
$418.00
|
|
Penile vascular study
|
$1,683.00 |
$1,683.00 |
$1,683.00 |
$576.40
|
|
Perc cryo ablate renal tum
|
$9,097.50 |
$9,097.50 |
$9,097.50 |
$11,458.04
|
|
Perc d-e cor revasc chro add
|
$15,361.50 |
$15,361.50 |
$15,361.50 |
$12,886.61
|
|
Perc d-e cor revasc chro sin
|
$13,404.50 |
$13,404.50 |
$13,404.50 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$14,271.00 |
$14,271.00 |
$14,271.00 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$13,915.50 |
$13,915.50 |
$13,915.50 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$11,115.50 |
$11,115.50 |
$11,115.50 |
$12,191.74
|
|
Perc d-e cor stent ather s
|
$12,870.00 |
$12,870.00 |
$12,870.00 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$11,974.50 |
$11,974.50 |
$11,974.50 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$14,546.50 |
$14,546.50 |
$14,546.50 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$11,426.50 |
$11,426.50 |
$11,426.50 |
$7,243.60
|
|
Percut ablate liver rf
|
$19,813.00 |
$19,813.00 |
$19,813.00 |
$6,904.15
|
|
Pericardiocentesis wwo imaging
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$2,251.20
|
|
Peripheral vascular rehab
|
$376.00 |
$376.00 |
$376.00 |
$132.50
|
|
Peri-proc device eval icd
|
$527.50 |
$527.50 |
$527.50 |
$192.40
|
|
Peri-proc device eval pm
|
$440.50 |
$440.50 |
$440.50 |
$159.90
|
|
Peritoneal cath sub q resv per
|
$4,753.50 |
$4,753.50 |
$4,753.50 |
$5,625.74
|
|
Peritoneogram rs&i
|
$698.50 |
$698.50 |
$698.50 |
$695.89
|
|
Perit-vens shunt pat tst
|
$1,579.50 |
$1,579.50 |
$1,579.50 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$11,854.00 |
$11,854.00 |
$11,854.00 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$17,513.00 |
$17,513.00 |
$17,513.00 |
$9,509.53
|
|
Perq dev breast 1st mr guide
|
$5,928.00 |
$5,928.00 |
$5,928.00 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$5,149.00 |
$5,149.00 |
$5,149.00 |
$1,456.00
|
|
Perq p-art revsc 1 abnor bi
|
$12,830.00 |
$12,830.00 |
$12,830.00 |
$17,321.20
|
|
Perq p-art revsc 1 abnor uni
|
$21,321.00 |
$21,321.00 |
$21,321.00 |
$21,321.00
|
|
Perq p-art revsc 1 nm nt bi
|
$12,830.00 |
$12,830.00 |
$12,830.00 |
$15,873.70
|
|
Perq p-art revsc 1 nm nt uni
|
$12,830.00 |
$12,830.00 |
$12,830.00 |
$17,321.20
|
|
Perq p-art revsc each addl
|
$9,354.00 |
$9,354.00 |
$9,354.00 |
$8,627.68
|
|
Perq plmt bile duct stent
|
$3,124.00 |
$3,124.00 |
$3,124.00 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$6,857.50 |
$6,857.50 |
$6,857.50 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$4,792.00 |
$4,792.00 |
$4,792.00 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$517.50 |
$517.50 |
$517.50 |
$625.93
|
|
Perq transcath cls mitral
|
$21,791.50 |
$21,791.50 |
$21,791.50 |
$23,617.60
|
|
Pet CT skull-mid thgh initial
|
$4,707.00 |
$4,707.00 |
$4,707.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$6,407.50 |
$6,407.50 |
$6,407.50 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$7,919.50 |
$7,919.50 |
$7,919.50 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$7,144.50 |
$7,144.50 |
$7,144.50 |
$4,305.60
|
|
Ph body fluid
|
$141.00 |
$141.00 |
$141.00 |
$41.28
|
|
Phenobarbital therapeutic drug level
|
$295.00 |
$295.00 |
$295.00 |
$104.50
|
|
Phenytoin total therapeutic drug level
|
$343.50 |
$343.50 |
$343.50 |
$110.88
|
|
Phlebotomy therapeutic
|
$363.50 |
$363.50 |
$363.50 |
$231.66
|
|
Phosphorus
|
$202.50 |
$202.50 |
$202.50 |
$48.80
|
|
Phosphorus 24 hour urine
|
$82.00 |
$82.00 |
$82.00 |
$41.51
|
|
Pik3ca gene trgt seq alys
|
$616.00 |
$616.00 |
$616.00 |
$463.20
|
|
Pinworm exam
|
$83.50 |
$83.50 |
$83.50 |
$39.75
|
|
Place cath intracranial art
|
$5,234.00 |
$5,234.00 |
$5,234.00 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$7,692.50 |
$7,692.50 |
$7,692.50 |
$4,202.90
|
|
Place cecostomy tube perc
|
$2,104.00 |
$2,104.00 |
$2,104.00 |
$2,580.90
|
|
Place device/marker, non pro
|
$1,564.00 |
$1,564.00 |
$1,564.00 |
$1,969.20
|
|
Place duod/jej tube perc
|
$2,365.00 |
$2,365.00 |
$2,365.00 |
$2,473.10
|
|
Place gastrostomy tube perc
|
$2,680.00 |
$2,680.00 |
$2,680.00 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$5,871.00 |
$5,871.00 |
$5,871.00 |
$1,517.21
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$867.00 |
$867.00 |
$867.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$3,727.50 |
$3,727.50 |
$3,727.50 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$3,542.00 |
$3,542.00 |
$3,542.00 |
$3,873.65
|
|
Placement occlusive device venous/arterial access site post procedure
|
$825.50 |
$825.50 |
$825.50 |
$571.45
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$12,099.50 |
$12,099.50 |
$12,099.50 |
$13,964.50
|
|
Place needles pelvic for right
|
$11,874.00 |
$11,874.00 |
$11,874.00 |
$6,624.80
|
|
Place non-slctv cath thoracic arta
|
$4,396.00 |
$4,396.00 |
$4,396.00 |
$5,053.33
|
|
Place slctv cath carotd art uni
|
$9,271.50 |
$9,271.50 |
$9,271.50 |
$10,014.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$4,696.00 |
$4,696.00 |
$4,696.00 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$9,089.00 |
$9,089.00 |
$9,089.00 |
$8,538.00
|
|
Place slctv cath subclavian art
|
$6,325.00 |
$6,325.00 |
$6,325.00 |
$6,325.00
|
