|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$177.50 |
$177.50 |
$177.50 |
$213.39
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$210.00 |
$210.00 |
$210.00 |
$310.00
|
|
Ortho hnd without jnt w/fit&adj
|
$177.50 |
$177.50 |
$177.50 |
$225.00
|
|
Orthopantogram
|
$280.00 |
$280.00 |
$280.00 |
$237.43
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$232.50 |
$232.50 |
$232.50 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$645.00 |
$645.00 |
$645.00 |
$645.00
|
|
Oscillation chest wall mechanical per session
|
$92.50 |
$92.50 |
$92.50 |
$195.00
|
|
Osmolality blood
|
$50.00 |
$50.00 |
$50.00 |
$69.55
|
|
Osmolality urine
|
$50.00 |
$50.00 |
$50.00 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$310.00 |
$310.00 |
$310.00 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$177.50 |
$177.50 |
$177.50 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$240.00 |
$240.00 |
$240.00 |
$263.50
|
|
Oth resp proc, group
|
$162.50 |
$162.50 |
$162.50 |
$127.40
|
|
Oth resp proc, indiv
|
$65.00 |
$65.00 |
$65.00 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$70.00 |
$70.00 |
$70.00 |
$98.62
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$92.50 |
$92.50 |
$92.50 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$105.00
|
|
Ot re-evaluation patient/family
|
$125.00 |
$125.00 |
$125.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$98.90
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$82.50 |
$82.50 |
$82.50 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$82.50 |
$82.50 |
$82.50 |
$91.20
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$93.60
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$6.69 |
$6.69 |
$6.69 |
$79.80
|
|
Oxytocin 10 unit/ml injection solution
|
$34.24 |
$34.24 |
$34.24 |
$50.40
|
|
Palonosetron hcl
|
$12.90 |
$12.90 |
$12.90 |
$154.78
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$41.22 |
$41.22 |
$41.22 |
$27.16
|
|
Parathormone (pth) intact
|
$120.00 |
$120.00 |
$120.00 |
$201.50
|
|
Parathyrd planar w/spect&ct
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,555.00
|
|
Parathyroid planar imaging
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$1,073.82
|
|
Parathyroid planar img w/tomo spect
|
$1,345.00 |
$1,345.00 |
$1,345.00 |
$1,345.00
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$100.00 |
$100.00 |
$100.00 |
$242.88
|
|
Passy muir valve metal trach
|
$223.96 |
$223.96 |
$223.96 |
$275.75
|
|
Patient recorded spirometry
|
$135.00 |
$135.00 |
$135.00 |
$338.52
|
|
Pdgfra gene
|
$960.00 |
$960.00 |
$960.00 |
$717.23
|
|
Pelvic CT scan (with and without contrast)
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,899.75
|
|
Pelvic CT scan (with contrast)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,635.62
|
|
Pelvic CT scan (without contrast)
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,366.50
|
|
Pelvic MRI (with and without contrast)
|
$3,265.00 |
$3,265.00 |
$3,265.00 |
$2,870.36
|
|
Pelvic MRI (with contrast)
|
$2,210.00 |
$2,210.00 |
$2,210.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,110.00 |
$2,110.00 |
$2,110.00 |
$1,929.85
|
|
Pelvic Ultrasound (complete)
|
$770.00 |
$770.00 |
$770.00 |
$650.40
|
|
Pelvic Ultrasound (limited)
|
$497.50 |
$497.50 |
$497.50 |
$430.00
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$87.70 |
$87.70 |
$87.70 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$11.03 |
$11.03 |
$11.03 |
$97.85
|
|
Penile injection
|
$305.00 |
$305.00 |
$305.00 |
$418.00
|
|
Perc cryo ablate renal tum
|
$10,485.00 |
$10,485.00 |
$10,485.00 |
$11,458.04
|
|
Percut ablate liver rf
|
$4,650.00 |
$4,650.00 |
$4,650.00 |
$6,904.15
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$177.50 |
$177.50 |
$177.50 |
$335.79
|
|
Pericardiocentesis wwo imaging
|
$2,230.00 |
$2,230.00 |
$2,230.00 |
$2,341.50
|
|
Peripheral vascular rehab
|
$132.50 |
$132.50 |
$132.50 |
$129.60
|
|
Peritoneogram rs&i
|
$845.00 |
$845.00 |
$845.00 |
$689.15
|
|
Perq art m-thrombect &/nfs
|
$9,600.00 |
$9,600.00 |
$9,600.00 |
$7,559.55
|
|
Perq dev breast 1st mr guide
|
$1,575.00 |
$1,575.00 |
$1,575.00 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$1,360.00 |
$1,360.00 |
$1,360.00 |
$1,456.00
|
|
Perq p-art revsc 1 abnor bi
|
$25,825.00 |
$25,825.00 |
$25,825.00 |
$17,321.20
|
|
Perq p-art revsc 1 abnor uni
|
$20,660.00 |
$20,660.00 |
$20,660.00 |
$21,249.26
|
|
Perq p-art revsc 1 nm nt bi
|
$15,655.00 |
$15,655.00 |
$15,655.00 |
$15,916.29
|
|
Perq p-art revsc 1 nm nt uni
|
$12,520.00 |
$12,520.00 |
$12,520.00 |
$17,321.20
|
|
Perq p-art revsc each addl
|
$5,010.00 |
$5,010.00 |
$5,010.00 |
$7,958.34
|
|
Perq plmt bile duct stent
|
$6,520.00 |
$6,520.00 |
$6,520.00 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$6,435.00 |
$6,435.00 |
$6,435.00 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$6,620.00 |
$6,620.00 |
$6,620.00 |
$7,085.70
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$457.50 |
$457.50 |
$457.50 |
$625.93
|
|
Pet CT skull-mid thgh initial
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,711.20
|
|
Pet CT whole body initial
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$3,789.00
|
|
Pet image w/ct lmtd
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,366.50
|
|
Pfc sigma fem post aug sz3 8mm
|
$24,829.20 |
$24,829.20 |
$24,829.20 |
$34,920.00
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$82.50 |
$82.50 |
$82.50 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$105.00 |
$105.00 |
$105.00 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$50.00 |
$50.00 |
$50.00 |
$31.20
|
|
Ph body fluid
|
$35.00 |
$35.00 |
$35.00 |
$40.04
|
|
Phencyclidine (pcp)
|
$90.00 |
$90.00 |
$90.00 |
$90.00
|
|
Phenobarbital therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$104.50
|
|
Phenylephrine 10 mg/ml injection solution
|
$1.94 |
$1.94 |
$1.94 |
$62.98
|
|
Phenytoin total therapeutic drug level
|
$97.50 |
$97.50 |
$97.50 |
$112.50
|
|
Phlebotomy therapeutic
|
$125.00 |
$125.00 |
$125.00 |
$231.66
|
|
Phleb veins 1 extrm 10-20 stab
|
$3,420.00 |
$3,420.00 |
$3,420.00 |
$4,599.65
|
|
Phleb veins 1 extrm >20 stab
|
$3,960.00 |
$3,960.00 |
$3,960.00 |
$4,453.46
|
|
Phosphorus
|
$47.50 |
$47.50 |
$47.50 |
$49.60
|
|
Phosphorus 24 hour urine
|
$47.50 |
$47.50 |
$47.50 |
$41.58
|
|
Phys blood bank serv reactj
|
$207.50 |
$207.50 |
$207.50 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$111.10 |
$111.10 |
$111.10 |
$85.79
|
|
Piflu f-18, dia 1 millicurie
|
$890.00 |
$890.00 |
$890.00 |
$880.00
|
|
Pinworm exam
|
$52.50 |
$52.50 |
$52.50 |
$40.00
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$16.70 |
$16.70 |
$16.70 |
$83.57
|
|
Place duod/jej tube perc
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$2,577.56
|
|
Place gastrostomy tube perc
|
$990.00 |
$990.00 |
$990.00 |
$2,244.82
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,542.40
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$795.00 |
$795.00 |
$795.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,165.00 |
$1,165.00 |
$1,165.00 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$5,190.00 |
$5,190.00 |
$5,190.00 |
$4,094.00
|
|
Placement occlusive device venous/arterial access site post procedure
|
$765.00 |
$765.00 |
$765.00 |
$585.00
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$16,005.00 |
$16,005.00 |
$16,005.00 |
$13,964.50
|
|
Place non-slctv cath thoracic arta
|
$5,085.00 |
$5,085.00 |
$5,085.00 |
$5,274.33
|
|
Place right device/marker pros
|
$965.00 |
$965.00 |
$965.00 |
$1,905.00
|
|
Place slctv cath carotd art uni
|
$10,420.00 |
$10,420.00 |
$10,420.00 |
$10,150.40
|
|
Plasma cryoprecipitate reduced each unit
|
$95.00 |
$95.00 |
$95.00 |
$157.95
|
