|
Opn tx orbit fx without impl 21406
|
$7,760.34 |
$7,760.34 |
$7,760.34 |
$6,553.49
|
|
Optx clavicular fx w/int fix
|
$8,819.16 |
$8,819.16 |
$8,819.16 |
$8,453.60
|
|
Optx lunate dislocation
|
$8,819.16 |
$8,819.16 |
$8,819.16 |
$7,907.11
|
|
Optx medial ankle fx
|
$8,819.16 |
$8,819.16 |
$8,819.16 |
$7,807.24
|
|
Optx mndblr/max alv ridge fx
|
$7,760.34 |
$7,760.34 |
$7,760.34 |
$6,808.50
|
|
Optx prox humrl fx w/int fix
|
$18,962.58 |
$18,962.58 |
$18,962.58 |
$12,734.70
|
|
Optx ulnar shft fx int fixj
|
$8,819.16 |
$8,819.16 |
$8,819.16 |
$7,913.97
|
|
Oral aprepitant
|
$374.43 |
$374.43 |
$374.43 |
$374.43
|
|
Orchiopexy ingun/scrot appr
|
$5,147.52 |
$5,147.52 |
$5,147.52 |
$4,176.15
|
|
Orthosis lso rigd frm hyperex
|
$1,417.75 |
$1,417.75 |
$1,417.75 |
$920.03
|
|
Oscillation chest wall mechanical per session
|
$83.16 |
$83.16 |
$83.16 |
$221.34
|
|
Osmolality blood
|
$39.06 |
$39.06 |
$39.06 |
$67.60
|
|
Osmolality urine
|
$40.32 |
$40.32 |
$40.32 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$174.72 |
$174.72 |
$174.72 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$174.72 |
$174.72 |
$174.72 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$174.72 |
$174.72 |
$174.72 |
$270.58
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$97.44 |
$97.44 |
$97.44 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$88.62 |
$88.62 |
$88.62 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$49.56 |
$49.56 |
$49.56 |
$107.32
|
|
Ot re-evaluation patient/family
|
$117.60 |
$117.60 |
$117.60 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$69.72 |
$69.72 |
$69.72 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$39.48 |
$39.48 |
$39.48 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$41.16 |
$41.16 |
$41.16 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$53.76 |
$53.76 |
$53.76 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$62.16 |
$62.16 |
$62.16 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$60.06 |
$60.06 |
$60.06 |
$93.75
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$165.13 |
$165.13 |
$165.13 |
$50.50
|
|
Oxytocin 10 unit/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$45.86
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$44,654.40 |
$44,654.40 |
$44,654.40 |
$44,654.40
|
|
Palivizumab 50 mg/0.5 ml inj
|
$231.00 |
$231.00 |
$231.00 |
$5,156.88
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$274.51 |
$274.51 |
$274.51 |
$146.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$56.70 |
$56.70 |
$56.70 |
$44.25
|
|
Parathormone (pth) intact
|
$243.60 |
$243.60 |
$243.60 |
$200.23
|
|
Parathyroid planar imaging
|
$715.26 |
$715.26 |
$715.26 |
$1,166.00
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$240.66 |
$240.66 |
$240.66 |
$270.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$4,109.28 |
$4,109.28 |
$4,109.28 |
$3,762.53
|
|
Partial removal finger bone
|
$1,912.68 |
$1,912.68 |
$1,912.68 |
$2,021.04
|
|
Partial removal finger bone
|
$1,912.68 |
$1,912.68 |
$1,912.68 |
$2,211.05
|
|
Partial removal of toe
|
$3,969.00 |
$3,969.00 |
$3,969.00 |
$3,821.05
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$4,921.76 |
$4,921.76 |
$4,921.76 |
$4,418.62
|
|
Passy muir valve metal trach
|
$478.49 |
$478.49 |
$478.49 |
$241.20
|
|
Pedicle enel/ntroral 15576
|
$2,508.24 |
$2,508.24 |
$2,508.24 |
$2,436.20
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$10,798.46 |
$10,798.46 |
$10,798.46 |
$8,382.81
|
|
Pelvic CT scan (with and without contrast)
|
$1,288.56 |
$1,288.56 |
$1,288.56 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,231.86 |
$1,231.86 |
$1,231.86 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$751.80 |
$751.80 |
$751.80 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$2,559.48 |
$2,559.48 |
$2,559.48 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$2,512.86 |
$2,512.86 |
$2,512.86 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$375.06 |
$375.06 |
$375.06 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$375.06 |
$375.06 |
$375.06 |
$445.00
|
|
Peng benzathine/procaine inj
|
$8.40 |
$8.40 |
$8.40 |
$258.72
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,353.55 |
$1,353.55 |
$1,353.55 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$91.14 |
$91.14 |
$91.14 |
$100.50
|
|
Penile injection
|
$286.44 |
$286.44 |
$286.44 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$19,235.57 |
$19,235.57 |
$19,235.57 |
$19,235.57
|
|
Pericardial drain w/cath pq w/ct guid
|
$124.32 |
$124.32 |
$124.32 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$2,118.90 |
$2,118.90 |
$2,118.90 |
$2,573.60
|
|
Pericardiotomy/clot/for bod remove 33020
|
$124.32 |
$124.32 |
$124.32 |
$2,013.60
|
|
Peripheral vascular rehab
|
$114.24 |
$114.24 |
$114.24 |
$128.69
|
|
Peri-proc device eval pm
|
$73.50 |
$73.50 |
$73.50 |
$195.80
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$226.38 |
$226.38 |
$226.38 |
$625.93
|
|
Perq tx big toe fracture w/manip 28496
|
$3,969.00 |
$3,969.00 |
$3,969.00 |
$3,839.54
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$263.12 |
$263.12 |
$263.12 |
$113.84
|
|
Pfc sigma fem post aug sz3 8mm
|
$47,767.34 |
$47,767.34 |
$47,767.34 |
$34,848.45
|
|
Ph body fluid
|
$21.00 |
$21.00 |
$21.00 |
$39.20
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$174.72 |
$174.72 |
$174.72 |
$123.17
|
|
Phenobarbital therapeutic drug level
|
$34.44 |
$34.44 |
$34.44 |
$104.50
|
|
Phentolaine mesylate inj
|
$3,369.93 |
$3,369.93 |
$3,369.93 |
$1,011.98
|
|
Phenylephrine 10 mg/ml injection solution
|
$56.70 |
$56.70 |
$56.70 |
$58.49
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$56.70 |
$56.70 |
$56.70 |
$23.37
|
|
Phenytoin total therapeutic drug level
|
$29.82 |
$29.82 |
$29.82 |
$111.27
|
|
Phlebotomy therapeutic
|
$155.40 |
$155.40 |
$155.40 |
$249.00
|
|
Phosphorus
|
$28.14 |
$28.14 |
$28.14 |
$47.81
|
|
Phosphorus 24 hour urine
|
$34.44 |
$34.44 |
$34.44 |
$42.81
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$175.11 |
$175.11 |
$175.11 |
$86.36
|
|
Pin caspar distraction 12mm
|
$9,451.68 |
$9,451.68 |
$9,451.68 |
$9,784.88
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$774.90 |
$774.90 |
$774.90 |
$1,016.25
|
|
Pin finger fracture each
|
$3,969.00 |
$3,969.00 |
$3,969.00 |
$3,910.33
|
|
Pinworm exam
|
$30.66 |
$30.66 |
$30.66 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$130.23 |
$130.23 |
$130.23 |
$95.01
|
|
Place gastrostomy tube perc
|
$2,322.18 |
$2,322.18 |
$2,322.18 |
$2,517.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,141.14 |
$1,141.14 |
$1,141.14 |
$1,679.20
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,076.46 |
$1,076.46 |
$1,076.46 |
$800.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,093.68 |
$1,093.68 |
$1,093.68 |
$1,372.15
|
|
Placement of seton
|
$3,425.94 |
$3,425.94 |
$3,425.94 |
$3,375.00
|
|
Plasma cryoprecipitate reduced each unit
|
$27.30 |
$27.30 |
$27.30 |
$156.20
|
|
Platelet aggregation each agent teg
|
$238.14 |
$238.14 |
$238.14 |
$147.96
|
|
Platelet automated
|
$42.84 |
$42.84 |
$42.84 |
$44.00
|
|
Platelets pheresis leukocytes reduced each unit
|
$218.40 |
$218.40 |
$218.40 |
$1,070.30
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$218.40 |
$218.40 |
$218.40 |
$1,180.31
|
|
Platelets pheresis pathogen-reduced each unit
|
$231.00 |
$231.00 |
$231.00 |
$879.36
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$1,031.94 |
$1,031.94 |
$1,031.94 |
$946.80
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$154.14 |
$154.14 |
$154.14 |
$173.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,312.56 |
$4,312.56 |
$4,312.56 |
$4,293.60
|
|
Postpartum Care Only
|
$48.30 |
$48.30 |
$48.30 |
$501.60
|
|
Potassium 24 hour urine
|
$28.14 |
$28.14 |
$28.14 |
$50.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$219.08 |
$219.08 |
$219.08 |
$71.74
|
|
Potassium serum/plasma/whole blood
|
$28.14 |
$28.14 |
$28.14 |
$44.64
|
|
Pq thr inj ext pse
|
$792.96 |
$792.96 |
$792.96 |
$872.61
|