|
Observation/inpatient hospital care mod severity 99235
|
$164.00 |
$164.00 |
$164.00 |
$303.20
|
|
Observation per hour
|
$44.00 |
$44.00 |
$44.00 |
$80.73
|
|
Obtaining screen pap smear
|
$28.00 |
$28.00 |
$28.00 |
$37.54
|
|
Ob Ultrasound nuchal meas 1 gest
|
$63.00 |
$63.00 |
$63.00 |
$359.20
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$10.50 |
$10.50 |
$10.50 |
$90.00
|
|
Ocular function screen
|
$49.00 |
$49.00 |
$49.00 |
$41.60
|
|
Ocular instrumnt screen bil
|
$42.00 |
$42.00 |
$42.00 |
$37.50
|
|
Ocular reconst transplant
|
$559.50 |
$559.50 |
$559.50 |
$4,462.45
|
|
Off/op cnsltj new/est low 30
|
$98.50 |
$98.50 |
$98.50 |
$180.00
|
|
Off/op cnsltj new/est mod 40
|
$150.00 |
$150.00 |
$150.00 |
$269.60
|
|
Off/op consltj new/est hi 55
|
$201.50 |
$201.50 |
$201.50 |
$339.30
|
|
Off/op consltj new/est sf 20
|
$92.50 |
$92.50 |
$92.50 |
$133.80
|
|
Ol dig e/m svc 11-20 min
|
$25.50 |
$25.50 |
$25.50 |
$37.92
|
|
Ol dig e/m svc 21+ min
|
$40.00 |
$40.00 |
$40.00 |
$60.00
|
|
Ol dig e/m svc 5-10 min
|
$12.50 |
$12.50 |
$12.50 |
$22.26
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$74.00 |
$74.00 |
$74.00 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$0.50 |
$0.50 |
$0.50 |
$9.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$0.50 |
$0.50 |
$0.50 |
$22.75
|
|
Open tenotomy tendon flexor foot single or multiple 28230
|
$299.00 |
$299.00 |
$299.00 |
$2,180.80
|
|
Ophthalmic biometry
|
$33.00 |
$33.00 |
$33.00 |
$182.95
|
|
Ophthalmic mitomycin
|
$566.00 |
$566.00 |
$566.00 |
$775.44
|
|
Oph Ultrasound dx ant sgm Ultrasound uni/bi
|
$35.50 |
$35.50 |
$35.50 |
$251.94
|
|
Organic acids total quant ea spec
|
$279.00 |
$279.00 |
$279.00 |
$149.40
|
|
Oritavancin 1,200 mg intravenous solution
|
$61.50 |
$61.50 |
$61.50 |
$11,017.26
|
|
Oritavancin 400 mg intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$3,354.72
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$6.50 |
$6.50 |
$6.50 |
$50.63
|
|
Orthovisc inj per dose
|
$180.00 |
$180.00 |
$180.00 |
$537.58
|
|
Oscillation chest wall mechanical per session
|
$200.50 |
$200.50 |
$200.50 |
$196.70
|
|
Osmolality blood
|
$40.00 |
$40.00 |
$40.00 |
$67.60
|
|
Osmolality urine
|
$207.00 |
$207.00 |
$207.00 |
$65.50
|
|
Osteopath manip tx/5-6 body region 98927
|
$46.00 |
$46.00 |
$46.00 |
$67.84
|
|
Ot evaluation high complexity patient/family
|
$175.00 |
$175.00 |
$175.00 |
$292.00
|
|
Ot evaluation low complexity patient/family
|
$175.00 |
$175.00 |
$175.00 |
$228.58
|
|
Ot evaluation moderate complexity patient/family
|
$175.00 |
$175.00 |
$175.00 |
$257.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$30.00 |
$30.00 |
$30.00 |
$104.80
|
|
Otolaryngo binocular microscopy 92504
|
$9.00 |
$9.00 |
$9.00 |
$60.80
|
|
Ot re-evaluation patient/family
|
$89.50 |
$89.50 |
$89.50 |
$158.40
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$61.00 |
$61.00 |
$61.00 |
$98.90
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$67.50 |
$67.50 |
$67.50 |
$97.44
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$69.00 |
$69.00 |
$69.00 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$70.00 |
$70.00 |
$70.00 |
$93.60
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$1.50 |
$1.50 |
$1.50 |
$80.90
|
|
Paliperidone 117 mg/0.75 ml inj
|
$21.50 |
$21.50 |
$21.50 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$2,731.00 |
$2,731.00 |
$2,731.00 |
$5,569.20
|
|
Parathormone (pth) intact
|
$113.50 |
$113.50 |
$113.50 |
$200.80
|
|
Parathyrd planar w/spect&ct
|
$784.50 |
$784.50 |
$784.50 |
$1,591.94
|
|
Parathyroid planar imaging
|
$594.00 |
$594.00 |
$594.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$61.00 |
$61.00 |
$61.00 |
$1,345.00
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$192.50 |
$192.50 |
$192.50 |
$249.00
|
|
Partial removal finger bone
|
$519.00 |
$519.00 |
$519.00 |
$2,021.04
|
|
Partial removal foot fascia
|
$381.50 |
$381.50 |
$381.50 |
$3,786.00
|
|
Partial removal of eye fluid
|
$512.00 |
$512.00 |
$512.00 |
$2,698.92
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$8.00 |
$8.00 |
$8.00 |
$4,921.76
|
|
Part removal of metatarsal
|
$3,134.00 |
$3,134.00 |
$3,134.00 |
$3,134.00
|
|
Pcv21 vaccine im
|
$333.50 |
$333.50 |
$333.50 |
$384.24
|
|
Pelvic CT scan (with and without contrast)
|
$1,139.00 |
$1,139.00 |
$1,139.00 |
$1,881.00
|
|
Pelvic CT scan (with contrast)
|
$850.50 |
$850.50 |
$850.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$725.50 |
$725.50 |
$725.50 |
$1,350.25
|
|
Pelvic MRI (with and without contrast)
|
$1,854.00 |
$1,854.00 |
$1,854.00 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$1,166.00 |
$1,166.00 |
$1,166.00 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$440.50 |
$440.50 |
$440.50 |
$649.35
|
|
Pelvic Ultrasound (limited)
|
$273.50 |
$273.50 |
$273.50 |
$430.80
|
|
Peng benzathine/procaine inj
|
$28.00 |
$28.00 |
$28.00 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$42.50 |
$42.50 |
$42.50 |
$826.47
|
|
Penile injection
|
$77.00 |
$77.00 |
$77.00 |
$418.86
|
|
Peri-proc device eval icd
|
$24.00 |
$24.00 |
$24.00 |
$192.40
|
|
Peri-proc device eval pm
|
$91.00 |
$91.00 |
$91.00 |
$159.90
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$95.50 |
$95.50 |
$95.50 |
$625.93
|
|
Perq skel fix ulnar styld fx
|
$524.00 |
$524.00 |
$524.00 |
$3,839.54
|
|
Pet CT skull-mid thgh initial
|
$1,983.00 |
$1,983.00 |
$1,983.00 |
$4,707.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$4,039.00 |
$4,039.00 |
$4,039.00 |
$37,573.99
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$23.00 |
$23.00 |
$23.00 |
$64.00
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$33.00 |
$33.00 |
$33.00 |
$92.30
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$12.00 |
$12.00 |
$12.00 |
$31.20
|
|
Ph body fluid
|
$43.00 |
$43.00 |
$43.00 |
$40.04
|
|
Phencyclidine (pcp)
|
$77.00 |
$77.00 |
$77.00 |
$90.00
|
|
Phenobarbital therapeutic drug level
|
$74.50 |
$74.50 |
$74.50 |
$104.25
|
|
Phenytoin total therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$111.27
|
|
Phlebotomy therapeutic
|
$99.00 |
$99.00 |
$99.00 |
$238.04
|
|
Phosphorus
|
$40.00 |
$40.00 |
$40.00 |
$48.80
|
|
Phosphorus 24 hour urine
|
$32.00 |
$32.00 |
$32.00 |
$41.30
|
|
Photopheresis
|
$89.50 |
$89.50 |
$89.50 |
$7,921.50
|
|
Phys blood bank serv reactj
|
$45.00 |
$45.00 |
$45.00 |
$208.73
|
|
Physician standby services
|
$58.50 |
$58.50 |
$58.50 |
$145.60
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$3.00 |
$3.00 |
$3.00 |
$85.79
|
|
Piflu f-18, dia 1 millicurie
|
$577.00 |
$577.00 |
$577.00 |
$923.20
|
|
Pillow shldr abduc inflat univ
|
$274.00 |
$274.00 |
$274.00 |
$537.66
|
|
Pinworm exam
|
$26.00 |
$26.00 |
$26.00 |
$40.00
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$3.00 |
$3.00 |
$3.00 |
$83.41
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,519.00 |
$1,519.00 |
$1,519.00 |
$1,528.80
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$767.50 |
$767.50 |
$767.50 |
$1,332.43
|
|
Platelet aggregation each agent teg
|
$66.50 |
$66.50 |
$66.50 |
$141.27
|
|
Platelet automated
|
$49.00 |
$49.00 |
$49.00 |
$45.00
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,268.50 |
$1,268.50 |
$1,268.50 |
$1,004.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$42.00 |
$42.00 |
$42.00 |
$758.52
|
|
Plethysmography lung volumes/airway resistance
|
$303.00 |
$303.00 |
$303.00 |
$405.00
|
|
Pm device progr eval dual
|
$41.00 |
$41.00 |
$41.00 |
$148.00
|
|
Pm device progr eval multi
|
$45.50 |
$45.50 |
$45.50 |
$139.10
|
|
Pmp22 gene dup/delet
|
$995.00 |
$995.00 |
$995.00 |
$1,029.75
|
|
#pnh-flow cytometry interp
|
$39.00 |
$39.00 |
$39.00 |
$132.00
|
