|
Ot evaluation low complexity patient/family
|
$71.70 |
$71.70 |
$71.70 |
$228.58
|
|
Ot evaluation moderate complexity patient/family
|
$75.45 |
$75.45 |
$75.45 |
$257.50
|
|
Oth resp proc, group
|
$79.05 |
$79.05 |
$79.05 |
$122.84
|
|
Oth resp proc, indiv
|
$79.05 |
$79.05 |
$79.05 |
$81.73
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$46.20 |
$46.20 |
$46.20 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$36.60 |
$36.60 |
$36.60 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$28.95 |
$28.95 |
$28.95 |
$104.80
|
|
Ot re-evaluation patient/family
|
$45.90 |
$45.90 |
$45.90 |
$158.40
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$33.60 |
$33.60 |
$33.60 |
$98.90
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$22.65 |
$22.65 |
$22.65 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$23.70 |
$23.70 |
$23.70 |
$91.20
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$30.90 |
$30.90 |
$30.90 |
$97.44
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$32.25 |
$32.25 |
$32.25 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$33.60 |
$33.60 |
$33.60 |
$93.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$196.95 |
$196.95 |
$196.95 |
$347.26
|
|
Oxytocin 10 unit/ml injection solution
|
$8.80 |
$8.80 |
$8.80 |
$49.12
|
|
P-32 sod phosphate ther per mci
|
$14.70 |
$14.70 |
$14.70 |
$521.62
|
|
Palb2 gene full gene seq
|
$222.30 |
$222.30 |
$222.30 |
$649.44
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$66.03 |
$66.03 |
$66.03 |
$128.31
|
|
Parathormone (pth) intact
|
$72.30 |
$72.30 |
$72.30 |
$200.80
|
|
Parathyrd planar w/spect&ct
|
$452.25 |
$452.25 |
$452.25 |
$1,591.94
|
|
Parathyroid planar imaging
|
$452.25 |
$452.25 |
$452.25 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$452.25 |
$452.25 |
$452.25 |
$1,345.00
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$39.15 |
$39.15 |
$39.15 |
$249.00
|
|
Partial removal finger bone
|
$692.25 |
$692.25 |
$692.25 |
$2,021.04
|
|
Partial removal foot fascia
|
$1,372.80 |
$1,372.80 |
$1,372.80 |
$3,786.00
|
|
Partial removal of vaginal wall 57106
|
$3,139.50 |
$3,139.50 |
$3,139.50 |
$3,762.53
|
|
Passy muir valve metal trach
|
$682.50 |
$682.50 |
$682.50 |
$275.75
|
|
Path clin consltj sf 5-20
|
$22.20 |
$22.20 |
$22.20 |
$88.35
|
|
Pca3/klk3 antigen
|
$334.05 |
$334.05 |
$334.05 |
$510.40
|
|
Pcv21 vaccine im
|
$415.01 |
$415.01 |
$415.01 |
$384.24
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$7,105.68 |
$7,105.68 |
$7,105.68 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,622.35 |
$4,622.35 |
$4,622.35 |
$7,265.37
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,622.35 |
$4,622.35 |
$4,622.35 |
$4,112.40
|
|
Pelvic CT scan (with and without contrast)
|
$648.00 |
$648.00 |
$648.00 |
$1,881.00
|
|
Pelvic CT scan (with contrast)
|
$617.10 |
$617.10 |
$617.10 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$587.70 |
$587.70 |
$587.70 |
$1,350.25
|
|
Pelvic MRI (with and without contrast)
|
$668.55 |
$668.55 |
$668.55 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$636.75 |
$636.75 |
$636.75 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$604.95 |
$604.95 |
$604.95 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$101.55 |
$101.55 |
$101.55 |
$649.35
|
|
Pelvic Ultrasound (limited)
|
$101.55 |
$101.55 |
$101.55 |
$430.80
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$4,481.22 |
$4,481.22 |
$4,481.22 |
$6,582.76
|
|
Peng benzathine/procaine inj
|
$294.81 |
$294.81 |
$294.81 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$184.92 |
$184.92 |
$184.92 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$31.11 |
$31.11 |
$31.11 |
$97.85
|
|
Penile injection
|
$1,412.85 |
$1,412.85 |
$1,412.85 |
$418.86
|
|
Penile vascular study
|
$273.75 |
$273.75 |
$273.75 |
$566.79
|
|
Perc cryo ablate renal tum
|
$1,502.85 |
$1,502.85 |
$1,502.85 |
$11,425.00
|
|
Perc d-e cor revasc chro add
|
$4,235.40 |
$4,235.40 |
$4,235.40 |
$13,103.00
|
|
Perc d-e cor revasc chro sin
|
$4,926.60 |
$4,926.60 |
$4,926.60 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$4,307.40 |
$4,307.40 |
$4,307.40 |
$11,976.00
|
|
Perc d-e cor revasc t cabg s
|
$4,926.60 |
$4,926.60 |
$4,926.60 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$4,235.40 |
$4,235.40 |
$4,235.40 |
$12,449.00
|
|
Perc d-e cor stent ather s
|
$4,926.60 |
$4,926.60 |
$4,926.60 |
$18,808.65
|
|
Perc drug-el cor stent bran
|
$4,243.35 |
$4,243.35 |
$4,243.35 |
$11,974.50
|
|
Perc drug-el cor stent sing
|
$4,926.60 |
$4,926.60 |
$4,926.60 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$1,772.70 |
$1,772.70 |
$1,772.70 |
$7,021.90
|
|
Percut ablate liver rf
|
$1,791.15 |
$1,791.15 |
$1,791.15 |
$6,904.15
|
|
Pericardial drain w/cath pq w/ct guid
|
$913.65 |
$913.65 |
$913.65 |
$2,455.70
|
|
Pericardiocentesis wwo imaging
|
$774.15 |
$774.15 |
$774.15 |
$2,300.48
|
|
Perineoplasty rpr per nonob
|
$1,346.40 |
$1,346.40 |
$1,346.40 |
$3,519.29
|
|
Peripheral vascular rehab
|
$513.90 |
$513.90 |
$513.90 |
$132.50
|
|
Peritoneogram rs&i
|
$153.90 |
$153.90 |
$153.90 |
$698.50
|
|
Perit-vens shunt pat tst
|
$452.25 |
$452.25 |
$452.25 |
$861.25
|
|
Perq clsr tcat l atr apndge
|
$2,262.75 |
$2,262.75 |
$2,262.75 |
$9,316.30
|
|
Perq dev breast 1st mr guide
|
$280.35 |
$280.35 |
$280.35 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$280.35 |
$280.35 |
$280.35 |
$1,456.00
|
|
Perq plmt bile duct stent
|
$1,975.50 |
$1,975.50 |
$1,975.50 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$2,173.20 |
$2,173.20 |
$2,173.20 |
$6,857.50
|
|
Perq plmt bile duct stent
|
$2,173.20 |
$2,173.20 |
$2,173.20 |
$7,082.99
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$1,167.75 |
$1,167.75 |
$1,167.75 |
$625.93
|
|
Perq transcath closure each
|
$1,818.15 |
$1,818.15 |
$1,818.15 |
$9,204.00
|
|
Perq transcath closure pda
|
$3,018.15 |
$3,018.15 |
$3,018.15 |
$18,408.00
|
|
Perq transcath cls aortic
|
$3,392.70 |
$3,392.70 |
$3,392.70 |
$22,633.26
|
|
Perq transcath cls mitral
|
$3,392.70 |
$3,392.70 |
$3,392.70 |
$25,206.69
|
|
Pertussis ag if
|
$11.10 |
$11.10 |
$11.10 |
$69.05
|
|
Pet CT skull-mid thgh initial
|
$1,537.20 |
$1,537.20 |
$1,537.20 |
$4,707.00
|
|
Pet CT whole body initial
|
$1,614.00 |
$1,614.00 |
$1,614.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$1,529.85 |
$1,529.85 |
$1,529.85 |
$3,861.90
|
|
Pet image full body
|
$1,937.55 |
$1,937.55 |
$1,937.55 |
$5,148.14
|
|
Pet image ltd area
|
$1,601.25 |
$1,601.25 |
$1,601.25 |
$3,677.40
|
|
Pet image skull-thigh
|
$1,761.45 |
$1,761.45 |
$1,761.45 |
$4,658.45
|
|
Pet image w/ct lmtd
|
$1,405.50 |
$1,405.50 |
$1,405.50 |
$4,398.30
|
|
Pet scan brain perf study
|
$1,742.70 |
$1,742.70 |
$1,742.70 |
$3,832.80
|
|
Pfc sigma fem post aug sz3 8mm
|
$81.45 |
$81.45 |
$81.45 |
$37,573.99
|
|
Ph body fluid
|
$5.25 |
$5.25 |
$5.25 |
$40.04
|
|
Phencyclidine (pcp)
|
$13.35 |
$13.35 |
$13.35 |
$90.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$121.44 |
$121.44 |
$121.44 |
$112.16
|
|
Phenobarbital therapeutic drug level
|
$19.95 |
$19.95 |
$19.95 |
$104.25
|
|
Phentolaine mesylate inj
|
$706.65 |
$706.65 |
$706.65 |
$1,021.73
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$7.34 |
$7.34 |
$7.34 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$23.10 |
$23.10 |
$23.10 |
$111.27
|
|
Phlebotomy therapeutic
|
$65.10 |
$65.10 |
$65.10 |
$238.04
|
|
Phosphorus
|
$7.95 |
$7.95 |
$7.95 |
$48.80
|
|
Phosphorus 24 hour urine
|
$9.15 |
$9.15 |
$9.15 |
$41.30
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$103.34 |
$103.34 |
$103.34 |
$85.79
|
|
Piflu f-18, dia 1 millicurie
|
$174.80 |
$174.80 |
$174.80 |
$923.20
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$234.30 |
$234.30 |
$234.30 |
$1,116.00
|
|
Pinworm exam
|
$7.20 |
$7.20 |
$7.20 |
$40.00
|