|
Protein electrophoretic fractionation & quantitation serum
|
$48.00 |
$48.00 |
$48.00 |
$84.00
|
|
Protein s total
|
$51.20 |
$51.20 |
$51.20 |
$83.52
|
|
Protein total 24 hour urine
|
$16.00 |
$16.00 |
$16.00 |
$52.50
|
|
Protein total body fluid
|
$16.00 |
$16.00 |
$16.00 |
$49.80
|
|
Protein total serum plasma whole blood
|
$16.00 |
$16.00 |
$16.00 |
$42.81
|
|
Prothrombin complex kcentra
|
$3.39 |
$3.39 |
$3.39 |
$7.40
|
|
Prothrombin time substitution plasma fractions each
|
$17.60 |
$17.60 |
$17.60 |
$41.50
|
|
Provide inr test mater/equip
|
$164.80 |
$164.80 |
$164.80 |
$253.47
|
|
Prq av fstl crtj uxtr 1 acs
|
$35,015.20 |
$35,015.20 |
$35,015.20 |
$21,249.26
|
|
Prq av fstl crt uxtr sep acs
|
$35,015.20 |
$35,015.20 |
$35,015.20 |
$20,978.32
|
|
Prq card revasc mi 1 vsl
|
$8,564.80 |
$8,564.80 |
$8,564.80 |
$15,190.50
|
|
Prq card revasc mi 1 vsl drug-eluting
|
$27,621.60 |
$27,621.60 |
$27,621.60 |
$18,150.00
|
|
Prq revasc byp graft 1 art and/or branches
|
$18,282.00 |
$18,282.00 |
$18,282.00 |
$13,398.65
|
|
Prq tcat plmt ntrac st 1 les
|
$18,840.80 |
$18,840.80 |
$18,840.80 |
$13,239.59
|
|
Prq tcat plmt ntrac st 2+les
|
$11,936.80 |
$11,936.80 |
$11,936.80 |
$22,098.20
|
|
Prq trlml c athrc st angiop1
|
$23,247.60 |
$23,247.60 |
$23,247.60 |
$15,296.00
|
|
Prq trl rvs ch occ ant&rtrgr
|
$9,573.20 |
$9,573.20 |
$9,573.20 |
$23,158.66
|
|
Prq trluml c angiop 1art&/br
|
$10,840.80 |
$10,840.80 |
$10,840.80 |
$9,131.70
|
|
Prq trluml c athrc 1 art&/br
|
$18,778.80 |
$18,778.80 |
$18,778.80 |
$13,419.98
|
|
Prq trluml revsc ch occ ant
|
$18,282.00 |
$18,282.00 |
$18,282.00 |
$15,349.60
|
|
Pr removal drug delivery implant
|
$591.20 |
$591.20 |
$591.20 |
$533.00
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$200.00 |
$200.00 |
$200.00 |
$251.43
|
|
Pr removal intrauterine device
|
$305.20 |
$305.20 |
$305.20 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$567.60 |
$567.60 |
$567.60 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$320.80 |
$320.80 |
$320.80 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$320.80 |
$320.80 |
$320.80 |
$414.00
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$317.60 |
$317.60 |
$317.60 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$320.80 |
$320.80 |
$320.80 |
$396.00
|
|
Pr tube thoracostomy w/connection to drainage open
|
$1,867.20 |
$1,867.20 |
$1,867.20 |
$1,720.93
|
|
PSA (Prostate) Test
|
$81.60 |
$81.60 |
$81.60 |
$107.50
|
|
Pt application of modality >=1 area hot/cold packs
|
$20.00 |
$20.00 |
$20.00 |
$35.00
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$59.60 |
$59.60 |
$59.60 |
$81.00
|
|
Pt evaluation high complexity patient/family
|
$190.00 |
$190.00 |
$190.00 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$190.00 |
$190.00 |
$190.00 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$190.00 |
$190.00 |
$190.00 |
$254.88
|
|
Pt re-evaluation patient/family
|
$114.40 |
$114.40 |
$114.40 |
$152.80
|
|
Pt repositioning canalith procedure(s) per day
|
$59.60 |
$59.60 |
$59.60 |
$118.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$34.00 |
$34.00 |
$34.00 |
$81.48
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$66.80 |
$66.80 |
$66.80 |
$87.50
|
|
Pt wheelchair management each 15 minutes
|
$114.80 |
$114.80 |
$114.80 |
$87.50
|
|
Pul art balloon repr percut
|
$16,235.60 |
$16,235.60 |
$16,235.60 |
$9,760.40
|
|
Pul art balloon repr percut
|
$3,909.20 |
$3,909.20 |
$3,909.20 |
$3,965.20
|
|
Pulmonary vent imaging
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$908.00
|
|
Pulse ox multiple
|
$98.40 |
$98.40 |
$98.40 |
$156.40
|
|
Pulse ox single
|
$24.40 |
$24.40 |
$24.40 |
$81.70
|
|
Punc of shunt for asp or inj
|
$991.60 |
$991.60 |
$991.60 |
$957.50
|
|
Puncture arterial withdrawal blood for diagnosis
|
$186.40 |
$186.40 |
$186.40 |
$127.50
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$567.60 |
$567.60 |
$567.60 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$991.60 |
$991.60 |
$991.60 |
$1,051.80
|
|
Puraply 1 sq cm
|
$4,976.00 |
$4,976.00 |
$4,976.00 |
$304.50
|
|
Pvb thoracic single inj site
|
$1,038.40 |
$1,038.40 |
$1,038.40 |
$1,320.80
|
|
Pyridoxine hcl 100 mg
|
$62.90 |
$62.90 |
$62.90 |
$48.70
|
|
Pyruvate
|
$52.00 |
$52.00 |
$52.00 |
$66.00
|
|
Pyruvate kinase
|
$24.00 |
$24.00 |
$24.00 |
$80.64
|
|
Quadrilateral brim
|
$190.00 |
$190.00 |
$190.00 |
$316.40
|
|
Quan puplmtry phy/qhp uni/bi
|
$280.80 |
$280.80 |
$280.80 |
$182.95
|
|
Quant diff pulm perf and vent w/imaging
|
$1,622.00 |
$1,622.00 |
$1,622.00 |
$1,542.40
|
|
Quest t3 uptake
|
$28.80 |
$28.80 |
$28.80 |
$52.25
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$891.42 |
$891.42 |
$891.42 |
$4,262.90
|
|
Radiation physics consult
|
$244.40 |
$244.40 |
$244.40 |
$606.50
|
|
Radiation therapy dose plan
|
$193.60 |
$193.60 |
$193.60 |
$514.05
|
|
Radiation treatment aid(s)
|
$244.40 |
$244.40 |
$244.40 |
$520.00
|
|
Radiation treatment aid(s)
|
$324.40 |
$324.40 |
$324.40 |
$644.16
|
|
Radiation treatment aid(s)
|
$786.80 |
$786.80 |
$786.80 |
$1,076.78
|
|
Radiation treatment delivery
|
$359.60 |
$359.60 |
$359.60 |
$552.40
|
|
Radiation treatment delivery
|
$1,131.20 |
$1,131.20 |
$1,131.20 |
$920.00
|
|
Radiofq trsmtr for implt neu
|
$6,040.00 |
$6,040.00 |
$6,040.00 |
$6,081.60
|
|
Radiology port images(s)
|
$96.40 |
$96.40 |
$96.40 |
$251.50
|
|
Radiotherapy dose plan imrt
|
$4,566.80 |
$4,566.80 |
$4,566.80 |
$5,744.60
|
|
Radium ra223 dichl ther/uci
|
$213.20 |
$213.20 |
$213.20 |
$215.00
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$4,303.60 |
$4,303.60 |
$4,303.60 |
$2,048.87
|
|
Radphm lcl tmr plnr bdy two day img
|
$4,698.40 |
$4,698.40 |
$4,698.40 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$2,684.40 |
$2,684.40 |
$2,684.40 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$1,120.50
|
|
Rapid Strep Test
|
$58.80 |
$58.80 |
$58.80 |
$75.24
|
|
Rbc count only automated
|
$5.20 |
$5.20 |
$5.20 |
$20.40
|
|
Rbc deglycerolized each unit
|
$1,172.80 |
$1,172.80 |
$1,172.80 |
$841.75
|
|
Rbc irradiated each unit
|
$516.00 |
$516.00 |
$516.00 |
$560.00
|
|
Rechanneling w/wo patch graft deep profunda fem art 35372
|
$7,669.20 |
$7,669.20 |
$7,669.20 |
$9,706.55
|
|
Red blood cells each unit
|
$293.20 |
$293.20 |
$293.20 |
$387.36
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$518.80 |
$518.80 |
$518.80 |
$577.71
|
|
Red blood cells leukocytes reduced each unit
|
$401.20 |
$401.20 |
$401.20 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$567.20 |
$567.20 |
$567.20 |
$528.45
|
|
Red blood cells washed each unit
|
$789.60 |
$789.60 |
$789.60 |
$572.46
|
|
Redo endovas vena cava filtr
|
$5,101.20 |
$5,101.20 |
$5,101.20 |
$4,435.43
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$59.48 |
$59.48 |
$59.48 |
$364.47
|
|
Relocation skin pocket aicd
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$2,761.55
|
|
Relocation skin pocket pm
|
$3,037.20 |
$3,037.20 |
$3,037.20 |
$2,585.00
|
|
Rem/biv cast full arm/leg
|
$429.20 |
$429.20 |
$429.20 |
$320.79
|
|
Remdesivir 100 mg intravenous powder for solution
|
$14.30 |
$14.30 |
$14.30 |
$1,524.70
|
|
Rem endovas vena cava filter
|
$5,101.20 |
$5,101.20 |
$5,101.20 |
$5,509.05
|
|
Removable insert each
|
$247.60 |
$247.60 |
$247.60 |
$518.00
|
|
Removal biliary drg cath
|
$1,446.40 |
$1,446.40 |
$1,446.40 |
$1,380.82
|
|
Removal central venous catheter tunneled without port/pump
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$1,552.93
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$2,356.71
|
|
Removal cerclage without anes
|
$251.60 |
$251.60 |
$251.60 |
$361.50
|
|
Removal cerumen impacted (both sides)
|
$106.80 |
$106.80 |
$106.80 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$245.20 |
$245.20 |
$245.20 |
$249.60
|
|
Removal duct glbldr calculi
|
$1,740.80 |
$1,740.80 |
$1,740.80 |
$2,771.60
|
|
Removal embedded foreign body vestibule mouth smpl
|
$1,331.20 |
$1,331.20 |
$1,331.20 |
$783.75
|
