|
Ortho hnd without jnt w/fit&adj
|
$299.50 |
$310.50 |
$310.50 |
|
|
Orthopantogram
|
$143.50 |
$143.50 |
$194.50 |
|
|
Ortho shoe add full sole
|
$116.50 |
$120.00 |
$123.50 |
|
|
Orthosis lso rigd frm hyperex
|
$645.00 |
$659.00 |
$728.50 |
|
|
Orthovisc inj per dose
|
$180.00 |
$269.50 |
$1,672.20 |
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$204.00 |
$232.50 |
$421.00 |
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$541.50 |
$1,168.50 |
$1,168.50 |
|
|
Oscillation chest wall mechanical per session
|
$37.50 |
$251.50 |
$755.50 |
|
|
Osmolality blood
|
$12.50 |
$40.00 |
$233.05 |
|
|
Osmolality urine
|
$13.00 |
$41.50 |
$207.00 |
|
|
Ostectomy complete 1st metatarsal head 28111
|
$332.00 |
$337.50 |
$540.00 |
|
|
Osteochondral knee allograft
|
$1,684.80 |
$3,997.50 |
$14,838.50 |
|
|
Osteopath manip tx/5-6 body region 98927
|
$6.50 |
$46.00 |
$122.00 |
|
|
Osteopath manip tx/7-8 body region 98928
|
$24.00 |
$30.50 |
$150.00 |
|
|
Osteopath manip tx/9-10 body region98929
|
$28.00 |
$40.50 |
$179.50 |
|
|
Osteot mlt relignmt imed rod
|
$11,492.33 |
$11,492.33 |
$11,492.33 |
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$2,825.50 |
$2,825.50 |
$2,825.50 |
|
|
Ost skn barr extnd >4 sq
|
$12.00 |
$12.00 |
$12.00 |
|
|
Ot evaluation high complexity patient/family
|
$86.50 |
$185.00 |
$544.50 |
|
|
Ot evaluation low complexity patient/family
|
$86.50 |
$185.00 |
$337.80 |
|
|
Ot evaluation moderate complexity patient/family
|
$86.50 |
$204.80 |
$351.00 |
|
|
Other immunoelectrophoresis
|
$146.50 |
$146.50 |
$182.83 |
|
|
Oth resp proc, group
|
$50.00 |
$83.50 |
$311.50 |
|
|
Oth resp proc, indiv
|
$32.00 |
$39.50 |
$258.00 |
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$50.50 |
$79.00 |
$179.40 |
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$61.50 |
$94.50 |
$276.00 |
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$30.00 |
$147.00 |
$340.00 |
|
|
Otolaryngo binocular microscopy 92504
|
$6.00 |
$9.50 |
$169.50 |
|
|
Ot re-evaluation patient/family
|
$52.00 |
$105.50 |
$280.00 |
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$37.50 |
$145.00 |
$382.50 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$13.00 |
$30.40 |
$193.50 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$13.00 |
$20.00 |
$97.50 |
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$29.50 |
$248.00 |
$364.00 |
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$46.00 |
$163.00 |
$372.00 |
|
|
Ot training self care/home management direct contact each 15 minutes
|
$60.00 |
$104.50 |
$387.00 |
|
|
Ovarian cystectomy 58925
|
$5,428.83 |
$5,428.83 |
$5,428.83 |
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$1.50 |
$2.00 |
$334.13 |
|
|
Oxaliplatin 5 mg/ml desensitization
|
$27.68 |
$74.41 |
$667.20 |
|
|
Oxytocin 10 unit/ml injection solution
|
$2.15 |
$9.60 |
$14.18 |
|
|
P-32 chromic phos ther per mci
|
$5,274.00 |
$5,274.00 |
$5,274.00 |
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$12,141.00 |
$12,141.00 |
$12,141.00 |
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$53.99 |
$171.08 |
$334.20 |
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$5,308.54 |
$6,613.86 |
$9,810.55 |
|
|
Palb2 gene full gene seq
|
$126.00 |
$126.00 |
$126.00 |
|
|
Paliperidone 117 mg/0.75 ml inj
|
$21.50 |
$32.00 |
$8,341.20 |
|
|
Palivizumab 50 mg/0.5 ml inj
|
$2,731.00 |
$4,096.50 |
$4,369.60 |
|
|
Palonosetron hcl
|
$3.86 |
$112.50 |
$1,510.80 |
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$18.30 |
$36.70 |
$120.60 |
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$13,318.60 |
$15,835.80 |
$31,964.64 |
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$3.68 |
$7.45 |
$48.00 |
|
|
Papaverin hcl injection
|
$5.22 |
$104.40 |
$165.30 |
|
|
Parathormone (pth) intact
|
$33.60 |
$213.00 |
$583.20 |
|
|
Parathyrd planar w/spect&ct
|
$80.00 |
$816.00 |
$2,305.50 |
|
|
Parathyroid autotransplantation 60512
|
$4,818.50 |
$5,413.50 |
$5,659.67 |
|
|
Parathyroid planar imaging
|
$383.00 |
$787.00 |
$1,559.00 |
|
|
Parathyroid planar img w/tomo spect
|
$57.00 |
$97.60 |
$1,651.50 |
|
|
Parial mast w/lymph removal 19302
|
$972.50 |
$1,007.00 |
$27,828.34 |
|
|
Paricalcitol
|
$15.33 |
$15.33 |
$15.33 |
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$43.20 |
$296.00 |
$2,993.50 |
|
|
Part hymenectomy/revi hymenal ring 56700
|
$205.00 |
$328.00 |
$5,344.50 |
|
|
Partial exc bone humerus
|
$5,494.00 |
$5,494.00 |
$5,494.00 |
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$457.00 |
$3,976.00 |
$14,281.00 |
|
|
Partial hip replacement
|
$1,185.00 |
$1,185.00 |
$1,896.00 |
|
|
Partial hysterectomy
|
$1,008.50 |
$1,016.50 |
$8,840.00 |
|
|
Partial proctectomy; perineal 45123
|
$1,169.00 |
$1,190.00 |
$1,904.00 |
|
|
Partial removal finger bone
|
$519.00 |
$519.00 |
$5,926.00 |
|
|
Partial removal finger bone
|
$469.00 |
$2,340.00 |
$6,990.50 |
|
|
Partial removal foot fascia
|
$374.50 |
$390.50 |
$6,769.50 |
|
|
Partial removal leg bone(s)
|
$943.00 |
$959.50 |
$41,053.00 |
|
|
Partial removal of eye fluid
|
$450.00 |
$476.00 |
$8,232.00 |
|
|
Partial removal of eye fluid
|
$512.00 |
$544.00 |
$6,265.34 |
|
|
Partial removal of fibula
|
$688.00 |
$691.00 |
$21,401.51 |
|
|
Partial removal of foot bone
|
$449.50 |
$733.60 |
$3,912.50 |
|
|
Partial removal of hand bone
|
$3,050.33 |
$3,050.33 |
$6,977.00 |
|
|
Partial removal of heart sac 33030
|
$2,133.00 |
$2,231.50 |
$3,570.40 |
|
|
Partial removal of lip
|
$882.00 |
$1,557.34 |
$5,763.00 |
|
|
Partial removal of lung 32480
|
$1,577.50 |
$1,656.50 |
$2,650.40 |
|
|
Partial removal of nose
|
$13,468.50 |
$13,468.50 |
$13,468.50 |
|
|
Partial removal of penis
|
$4,019.38 |
$4,019.38 |
$4,019.38 |
|
|
Partial removal of pharynx 42890
|
$78,795.50 |
$78,795.50 |
$78,795.50 |
|
|
Partial removal of radius
|
$2,884.25 |
$2,884.25 |
$2,884.25 |
|
|
Partial removal of sternum
|
$5,691.50 |
$5,691.50 |
$5,691.50 |
|
|
Partial removal of thyroid
|
$737.50 |
$1,673.40 |
$18,649.50 |
|
|
Partial removal of thyroid
|
$978.50 |
$994.50 |
$16,979.00 |
|
|
Partial removal of tibia
|
$6,155.67 |
$6,155.67 |
$6,155.67 |
|
|
Partial removal of toe
|
$277.00 |
$281.50 |
$2,058.83 |
|
|
Partial removal of tongue
|
$15,635.00 |
$15,635.00 |
$15,635.00 |
|
|
Partial removal of tongue
|
$16,667.50 |
$16,667.50 |
$16,667.50 |
|
|
Partial removal of ulna
|
$4,102.34 |
$4,102.34 |
$4,102.34 |
|
|
Partial removal of ulna
|
$8,051.00 |
$8,051.00 |
$8,369.50 |
|
|
Partial removal of vaginal wall 57106
|
$4,598.50 |
$4,598.50 |
$7,231.50 |
|
|
Partial removal tear gland
|
$6,061.78 |
$6,061.78 |
$6,061.78 |
|
|
Partial thyroid excision
|
$748.00 |
$753.00 |
$13,083.50 |
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$8.00 |
$8.00 |
$4,432.80 |
|
|
Part removal of metatarsal
|
$307.00 |
$498.40 |
$13,708.00 |
|
|
Part removal of metatarsal
|
$2,675.50 |
$3,371.50 |
$6,544.50 |
|
|
Part removal of metatarsal 28112
|
$326.00 |
$1,144.01 |
$12,096.00 |
|
|
Passy muir valve metal trach
|
$186.50 |
$186.50 |
$564.21 |
|
|
Pca3/klk3 antigen
|
$330.00 |
$330.00 |
$552.00 |
|
|
Pcv21 vaccine im
|
$222.50 |
$222.50 |
$533.60 |
|
