|
Open thrombectomy of av fistula without revision 36831
|
$657.50 |
$657.50 |
$657.50 |
$6,366.08
|
|
Ophthalmic biometry
|
$137.50 |
$137.50 |
$137.50 |
$182.95
|
|
Ophthalmic mitomycin
|
$566.00 |
$566.00 |
$566.00 |
$775.44
|
|
Oph Ultrasound dx ant sgm Ultrasound uni/bi
|
$118.50 |
$118.50 |
$118.50 |
$215.90
|
|
Opn ax/subcla art expos
|
$320.00 |
$320.00 |
$320.00 |
$1,269.60
|
|
Opn exc/dst ntra-abd 10.1-20
|
$2,142.50 |
$2,142.50 |
$2,142.50 |
$2,774.24
|
|
Opn exc/dstr ntra-abd 5 cm/<
|
$1,393.50 |
$1,393.50 |
$1,393.50 |
$1,822.08
|
|
Opn fem art expos cndt crtj 34714
|
$288.00 |
$288.00 |
$288.00 |
$2,041.65
|
|
Opn ilac art expos cndt crtj
|
$424.00 |
$424.00 |
$424.00 |
$1,169.29
|
|
Opn impltj crnl nrv nea&pg
|
$640.50 |
$640.50 |
$640.50 |
$35,498.40
|
|
Optx acrclv dslc aq/chrn grf
|
$682.00 |
$682.00 |
$682.00 |
$7,907.11
|
|
Optx acromclv dislc aqt/chrn
|
$5,850.00 |
$5,850.00 |
$5,850.00 |
$6,721.67
|
|
Optx acute shoulder dislc
|
$619.00 |
$619.00 |
$619.00 |
$6,554.95
|
|
Optx carpl scphd fx int fixj
|
$760.50 |
$760.50 |
$760.50 |
$7,807.24
|
|
Optx clavicular fx w/int fix
|
$16,095.00 |
$16,095.00 |
$16,095.00 |
$9,013.88
|
|
Optx gr hmrl tbrs fx int fix
|
$17,163.50 |
$17,163.50 |
$17,163.50 |
$7,157.53
|
|
Optx medial ankle fx
|
$14,511.50 |
$14,511.50 |
$14,511.50 |
$7,807.24
|
|
Optx post ankle fx
|
$799.00 |
$799.00 |
$799.00 |
$5,886.74
|
|
Optx prox humrl fx w/int fix
|
$21,605.00 |
$21,605.00 |
$21,605.00 |
$13,938.00
|
|
Optx radial shaft fracture
|
$709.50 |
$709.50 |
$709.50 |
$5,301.66
|
|
Optx rad/uln dislc aqt/chrnc
|
$666.00 |
$666.00 |
$666.00 |
$5,883.95
|
|
Optx rdl&uln shft fx rds&uln
|
$994.00 |
$994.00 |
$994.00 |
$6,915.75
|
|
Optx rdl&uln shft fx rds/uln
|
$718.50 |
$718.50 |
$718.50 |
$6,665.84
|
|
Optx scapular fx w/int fixj
|
$1,075.00 |
$1,075.00 |
$1,075.00 |
$7,907.11
|
|
Optx sho dislc fx
|
$962.00 |
$962.00 |
$962.00 |
$5,339.00
|
|
Optx thigh fx
|
$1,291.50 |
$1,291.50 |
$1,291.50 |
$1,767.20
|
|
Optx ulnar shft fx int fixj
|
$21,605.00 |
$21,605.00 |
$21,605.00 |
$8,453.60
|
|
Optx ulnar styloid fracture
|
$661.00 |
$661.00 |
$661.00 |
$4,627.00
|
|
Oral aprepitant
|
$43.08 |
$43.08 |
$43.08 |
$410.20
|
|
Orchiectomy partial
|
$614.00 |
$614.00 |
$614.00 |
$4,081.37
|
|
Orchiopexy ingun/scrot appr
|
$454.50 |
$454.50 |
$454.50 |
$4,176.15
|
|
Organic acids total quant ea spec
|
$279.00 |
$279.00 |
$279.00 |
$151.36
|
|
Oritavancin 1,200 mg intravenous solution
|
$61.50 |
$61.50 |
$61.50 |
$10,393.98
|
|
Oritavancin 400 mg intravenous solution
|
$40.00 |
$40.00 |
$40.00 |
$3,082.73
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$6.50 |
$6.50 |
$6.50 |
$50.63
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$100.50 |
$100.50 |
$100.50 |
$238.34
|
|
Orthovisc inj per dose
|
$293.79 |
$293.79 |
$293.79 |
$537.58
|
|
Osmolality blood
|
$55.00 |
$55.00 |
$55.00 |
$67.60
|
|
Osmolality urine
|
$43.00 |
$43.00 |
$43.00 |
$65.00
|
|
Ostectomy complete 1st metatarsal head 28111
|
$332.00 |
$332.00 |
$332.00 |
$3,542.56
|
|
Osteopath manip tx/5-6 body region 98927
|
$47.50 |
$47.50 |
$47.50 |
$68.25
|
|
Ot evaluation high complexity patient/family
|
$86.50 |
$86.50 |
$86.50 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$86.50 |
$86.50 |
$86.50 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$86.50 |
$86.50 |
$86.50 |
$263.50
|
|
Oth resp proc, group
|
$50.00 |
$50.00 |
$50.00 |
$123.05
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$49.50 |
$49.50 |
$49.50 |
$105.00
|
|
Otolaryngo binocular microscopy 92504
|
$9.50 |
$9.50 |
$9.50 |
$60.45
|
|
Ot re-evaluation patient/family
|
$70.50 |
$70.50 |
$70.50 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$98.00 |
$98.00 |
$98.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$17.00 |
$17.00 |
$17.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$15.50 |
$15.50 |
$15.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$147.00 |
$147.00 |
$147.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$86.00 |
$86.00 |
$86.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$134.00 |
$134.00 |
$134.00 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$1.50 |
$1.50 |
$1.50 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$34.55 |
$34.55 |
$34.55 |
$370.75
|
|
Palb2 gene full gene seq
|
$126.00 |
$126.00 |
$126.00 |
$672.50
|
|
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
|
|
Palonosetron hcl
|
$3.86 |
$3.86 |
$3.86 |
$170.48
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$4.97 |
$4.97 |
$4.97 |
$29.31
|
|
Parathormone (pth) intact
|
$136.00 |
$136.00 |
$136.00 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$755.00 |
$755.00 |
$755.00 |
$1,574.40
|
|
Parathyroid planar imaging
|
$416.50 |
$416.50 |
$416.50 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$57.00 |
$57.00 |
$57.00 |
$1,350.60
|
|
Parial mast w/lymph removal 19302
|
$972.50 |
$972.50 |
$972.50 |
$5,509.55
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$235.50 |
$235.50 |
$235.50 |
$245.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$211.00 |
$211.00 |
$211.00 |
$3,762.53
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$457.00 |
$457.00 |
$457.00 |
$4,914.00
|
|
Partial hip replacement
|
$1,248.00 |
$1,248.00 |
$1,248.00 |
$3,874.00
|
|
Partial hysterectomy
|
$1,016.50 |
$1,016.50 |
$1,016.50 |
$2,400.00
|
|
Partial proctectomy; perineal 45123
|
$1,169.00 |
$1,169.00 |
$1,169.00 |
$2,772.80
|
|
Partial removal finger bone
|
$519.00 |
$519.00 |
$519.00 |
$2,021.04
|
|
Partial removal finger bone
|
$1,961.50 |
$1,961.50 |
$1,961.50 |
$2,049.27
|
|
Partial removal foot fascia
|
$374.50 |
$374.50 |
$374.50 |
$3,762.00
|
|
Partial removal leg bone(s)
|
$943.00 |
$943.00 |
$943.00 |
$4,315.20
|
|
Partial removal of eye fluid
|
$476.00 |
$476.00 |
$476.00 |
$2,698.92
|
|
Partial removal of eye fluid
|
$544.00 |
$544.00 |
$544.00 |
$2,698.92
|
|
Partial removal of fibula
|
$691.00 |
$691.00 |
$691.00 |
$3,786.00
|
|
Partial removal of foot bone
|
$449.50 |
$449.50 |
$449.50 |
$3,839.54
|
|
Partial removal of heart sac 33030
|
$2,133.00 |
$2,133.00 |
$2,133.00 |
$4,877.60
|
|
Partial removal of lung 32480
|
$1,577.50 |
$1,577.50 |
$1,577.50 |
$2,868.60
|
|
Partial removal of thyroid
|
$748.00 |
$748.00 |
$748.00 |
$6,457.82
|
|
Partial removal of thyroid
|
$994.50 |
$994.50 |
$994.50 |
$5,855.00
|
|
Partial removal of toe
|
$277.00 |
$277.00 |
$277.00 |
$3,674.58
|
|
Partial thyroid excision
|
$753.00 |
$753.00 |
$753.00 |
$6,457.82
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$8.00 |
$8.00 |
$8.00 |
$4,921.76
|
|
Part removal of metatarsal
|
$307.00 |
$307.00 |
$307.00 |
$3,795.71
|
|
Part removal of metatarsal
|
$3,134.00 |
$3,134.00 |
$3,134.00 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$326.00 |
$326.00 |
$326.00 |
$3,839.54
|
|
Pcv21 vaccine im
|
$333.50 |
$333.50 |
$333.50 |
$410.26
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$6,348.40 |
$6,348.40 |
$6,348.40 |
$11,216.31
|
|
Pegloticase 8 mg/ml intravenous solution
|
$30,634.44 |
$30,634.44 |
$30,634.44 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$1,423.50 |
$1,423.50 |
$1,423.50 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,182.00 |
$1,182.00 |
$1,182.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,037.00 |
$1,037.00 |
$1,037.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,690.50 |
$1,690.50 |
$1,690.50 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$1,040.50 |
$1,040.50 |
$1,040.50 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$393.00 |
$393.00 |
$393.00 |
$643.80
|
