|
MRI orbit/face/neck without & w/contrast
|
$656.19 |
$656.19 |
$656.19 |
$2,854.80
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$593.63 |
$593.63 |
$593.63 |
$2,020.80
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$656.19 |
$656.19 |
$656.19 |
$2,713.80
|
|
Mr safety determination physician/other qhp
|
$39.10 |
$39.10 |
$39.10 |
$161.40
|
|
Mr safety implant elec prepj
|
$38.87 |
$38.87 |
$38.87 |
$168.60
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$5.52 |
$5.52 |
$5.52 |
$58.08
|
|
Mr safety implt pos&/immoblj
|
$25.30 |
$25.30 |
$25.30 |
$120.80
|
|
Mr sfty implt&/fb asmt stf 1
|
$10.81 |
$10.81 |
$10.81 |
$45.56
|
|
Mr sfty med physics xm cstmz
|
$102.35 |
$102.35 |
$102.35 |
$444.00
|
|
Msh2 gene dup/delete variant
|
$116.84 |
$116.84 |
$116.84 |
$403.20
|
|
Msh2 gene full seq
|
$2,268.72 |
$2,268.72 |
$2,268.72 |
$764.00
|
|
Msh6 gene dup/delete variant
|
$124.89 |
$124.89 |
$124.89 |
$453.60
|
|
Msh6 gene full seq
|
$2,550.93 |
$2,550.93 |
$2,550.93 |
$1,130.35
|
|
Msh6 gene known variants
|
$203.09 |
$203.09 |
$203.09 |
$338.80
|
|
Mthfr gene analy common variants
|
$75.21 |
$75.21 |
$75.21 |
$180.48
|
|
Mucopolysaccharides
|
$34.27 |
$34.27 |
$34.27 |
$178.36
|
|
Mumps antibody igg
|
$22.31 |
$22.31 |
$22.31 |
$78.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$2.33 |
$2.33 |
$2.33 |
$10.79
|
|
Mycoplasma antibody igm
|
$23.00 |
$23.00 |
$23.00 |
$78.40
|
|
Myd88 gene p.leu265pro vrnt
|
$221.03 |
$221.03 |
$221.03 |
$388.40
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$19.55 |
$19.55 |
$19.55 |
$131.07
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$443.48 |
$443.48 |
$443.48 |
$70.87
|
|
Natriuretic peptide
|
$58.42 |
$58.42 |
$58.42 |
$176.15
|
|
Natural killer cells total count
|
$64.63 |
$64.63 |
$64.63 |
$132.60
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$549.24 |
$549.24 |
$549.24 |
$1,732.50
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$521.87 |
$521.87 |
$521.87 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$656.19 |
$656.19 |
$656.19 |
$2,881.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$624.68 |
$624.68 |
$624.68 |
$2,305.71
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$593.63 |
$593.63 |
$593.63 |
$2,054.72
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$656.19 |
$656.19 |
$656.19 |
$2,743.78
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$593.63 |
$593.63 |
$593.63 |
$1,824.90
|
|
Neisseria meningitidis
|
$21.85 |
$21.85 |
$21.85 |
$60.00
|
|
Nerobehav stas exam by psy/md f2f 1st hr
|
$196.88 |
$196.88 |
$196.88 |
$389.50
|
|
Neuromuscular junction testing ea nerve any 1 method
|
$53.59 |
$53.59 |
$53.59 |
$234.00
|
|
New Patient Office Visit (level 2)
|
$27.37 |
$27.37 |
$27.37 |
$151.45
|
|
New Patient Office Visit (level 3)
|
$38.64 |
$38.64 |
$38.64 |
$205.20
|
|
New Patient Office Visit (level 4)
|
$50.14 |
$50.14 |
$50.14 |
$289.60
|
|
New Patient Office Visit (level 5)
|
$64.17 |
$64.17 |
$64.17 |
$349.70
|
|
Nfct ds bv&vaginitis dna alg
|
$156.17 |
$156.17 |
$156.17 |
$435.00
|
|
N.gonorrhoeae dna quant
|
$45.08 |
$45.08 |
$45.08 |
$47.12
|
|
N-invas est c ffr sw aly cta
|
$1,346.88 |
$1,346.88 |
$1,346.88 |
$2,073.00
|
|
Nitrogen n-13 ammonia
|
$604.21 |
$604.21 |
$604.21 |
$914.25
|
|
Njx cath slct p angrph mapca
|
$39.79 |
$39.79 |
$39.79 |
$1,301.25
|
|
Njx cath slct p-art angrp bi
|
$99.59 |
$99.59 |
$99.59 |
$1,300.00
|
|
Njx cath slct pulm vn angrph
|
$66.47 |
$66.47 |
$66.47 |
$927.00
|
|
Njx cth slct p-art angrp uni
|
$66.47 |
$66.47 |
$66.47 |
$1,050.00
|
|
Nm imaging bone/joint 3 phase study
|
$443.90 |
$443.90 |
$443.90 |
$1,708.85
|
|
Nm imaging bone/joint whole body
|
$443.90 |
$443.90 |
$443.90 |
$1,570.65
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$422.74 |
$422.74 |
$422.74 |
$1,397.69
|
|
Nm imaging gastric emptying study
|
$443.90 |
$443.90 |
$443.90 |
$1,340.40
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$443.90 |
$443.90 |
$443.90 |
$1,612.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$443.90 |
$443.90 |
$443.90 |
$1,530.60
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$443.90 |
$443.90 |
$443.90 |
$1,091.00
|
|
Ntrk1 translocation analysis
|
$261.28 |
$261.28 |
$261.28 |
$228.04
|
|
Ntrk2 translocation analysis
|
$261.28 |
$261.28 |
$261.28 |
$261.28
|
|
Ntrk3 translocation analysis
|
$261.28 |
$261.28 |
$261.28 |
$261.28
|
|
Ntrk translocation analysis
|
$652.74 |
$652.74 |
$652.74 |
$873.60
|
|
Nuclear Stress Test (Heart)
|
$443.90 |
$443.90 |
$443.90 |
$3,804.45
|
|
Nudt15 gene common variants
|
$247.71 |
$247.71 |
$247.71 |
$320.50
|
|
Observation per hour
|
$10.81 |
$10.81 |
$10.81 |
$79.95
|
|
Obstetrics panel
|
$70.61 |
$70.61 |
$70.61 |
$214.50
|
|
Obtaining screen pap smear
|
$5.29 |
$5.29 |
$5.29 |
$38.00
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$160.79 |
$160.79 |
$160.79 |
$90.00
|
|
Onc cutan mlnma mrna 31 gene
|
$9,058.78 |
$9,058.78 |
$9,058.78 |
$9,230.85
|
|
Oncology tum unknown origin
|
$2,483.08 |
$2,483.08 |
$2,483.08 |
$4,125.00
|
|
Oncoprotein her-2/neu
|
$67.62 |
$67.62 |
$67.62 |
$161.60
|
|
Onc thyr mrna 10,196 gen alg
|
$4,533.76 |
$4,533.76 |
$4,533.76 |
$4,320.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$8.44 |
$8.44 |
$8.44 |
$22.62
|
|
Opioids & opiate analogs 3/4
|
$29.21 |
$29.21 |
$29.21 |
$24.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$58.50 |
$58.50 |
$58.50 |
$50.63
|
|
Osmolality blood
|
$11.27 |
$11.27 |
$11.27 |
$69.55
|
|
Osmolality urine
|
$11.50 |
$11.50 |
$11.50 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$77.74 |
$77.74 |
$77.74 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$70.38 |
$70.38 |
$70.38 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$74.06 |
$74.06 |
$74.06 |
$263.50
|
|
Oth resp proc, indiv
|
$77.51 |
$77.51 |
$77.51 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$45.31 |
$45.31 |
$45.31 |
$98.62
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$35.65 |
$35.65 |
$35.65 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$28.52 |
$28.52 |
$28.52 |
$105.00
|
|
Ot re-evaluation patient/family
|
$44.85 |
$44.85 |
$44.85 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$33.12 |
$33.12 |
$33.12 |
$98.90
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$30.36 |
$30.36 |
$30.36 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$31.74 |
$31.74 |
$31.74 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$33.12 |
$33.12 |
$33.12 |
$93.60
|
|
Oxytocin 10 unit/ml injection solution
|
$13.50 |
$13.50 |
$13.50 |
$50.40
|
|
Palb2 gene full gene seq
|
$218.04 |
$218.04 |
$218.04 |
$649.44
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$132.18 |
$132.18 |
$132.18 |
$129.80
|
|
Parathormone (pth) intact
|
$71.07 |
$71.07 |
$71.07 |
$201.50
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$38.64 |
$38.64 |
$38.64 |
$242.88
|
|
Partial removal finger bone
|
$679.42 |
$679.42 |
$679.42 |
$1,964.00
|
|
Partial removal foot fascia
|
$1,347.34 |
$1,347.34 |
$1,347.34 |
$3,762.00
|
|
Passy muir valve metal trach
|
$1,046.49 |
$1,046.49 |
$1,046.49 |
$275.75
|
|
Path clin consltj sf 5-20
|
$21.85 |
$21.85 |
$21.85 |
$82.15
|
|
Pcv21 vaccine im
|
$636.35 |
$636.35 |
$636.35 |
$350.40
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$10,895.37 |
$10,895.37 |
$10,895.37 |
$11,216.31
|
|
Pelvic CT scan (with and without contrast)
|
$635.95 |
$635.95 |
$635.95 |
$1,899.75
|
|
Pelvic CT scan (with contrast)
|
$605.36 |
$605.36 |
$605.36 |
$1,635.62
|
|
Pelvic CT scan (without contrast)
|
$576.61 |
$576.61 |
$576.61 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$656.19 |
$656.19 |
$656.19 |
$2,870.36
|
|
Pelvic MRI (without contrast)
|
$593.63 |
$593.63 |
$593.63 |
$1,929.85
|