|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$177.50 |
$177.50 |
$177.50 |
$238.34
|
|
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 |
$231.00
|
|
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 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$92.50 |
$92.50 |
$92.50 |
$195.00
|
|
Osmolality blood
|
$50.00 |
$50.00 |
$50.00 |
$67.60
|
|
Osmolality urine
|
$50.00 |
$50.00 |
$50.00 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$310.00 |
$310.00 |
$310.00 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$177.50 |
$177.50 |
$177.50 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$240.00 |
$240.00 |
$240.00 |
$263.50
|
|
Oth resp proc, group
|
$162.50 |
$162.50 |
$162.50 |
$123.05
|
|
Oth resp proc, indiv
|
$65.00 |
$65.00 |
$65.00 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$70.00 |
$70.00 |
$70.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$92.50 |
$92.50 |
$92.50 |
$105.00
|
|
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 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$82.50 |
$82.50 |
$82.50 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$82.50 |
$82.50 |
$82.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$87.50 |
$87.50 |
$87.50 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$4.44 |
$4.44 |
$4.44 |
$83.08
|
|
Oxytocin 10 unit/ml injection solution
|
$33.45 |
$33.45 |
$33.45 |
$50.40
|
|
Palonosetron hcl
|
$12.32 |
$12.32 |
$12.32 |
$170.48
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$25.35 |
$25.35 |
$25.35 |
$29.31
|
|
Parathormone (pth) intact
|
$120.00 |
$120.00 |
$120.00 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,345.00 |
$1,345.00 |
$1,345.00 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$100.00 |
$100.00 |
$100.00 |
$245.00
|
|
Passy muir valve metal trach
|
$200.00 |
$200.00 |
$200.00 |
$275.75
|
|
Pdgfra gene
|
$960.00 |
$960.00 |
$960.00 |
$717.23
|
|
Pegloticase 8 mg/ml intravenous solution
|
$9,065.50 |
$9,065.50 |
$9,065.50 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$2,305.00 |
$2,305.00 |
$2,305.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,570.00 |
$1,570.00 |
$1,570.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$3,265.00 |
$3,265.00 |
$3,265.00 |
$2,860.00
|
|
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 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$850.00 |
$850.00 |
$850.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$635.00 |
$635.00 |
$635.00 |
$430.00
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$84.85 |
$84.85 |
$84.85 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$7.44 |
$7.44 |
$7.44 |
$101.34
|
|
Penile injection
|
$305.00 |
$305.00 |
$305.00 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$28,916.60 |
$28,916.60 |
$28,916.60 |
$18,764.94
|
|
Penile vascular study
|
$510.00 |
$510.00 |
$510.00 |
$576.40
|
|
Perc cryo ablate renal tum
|
$10,485.00 |
$10,485.00 |
$10,485.00 |
$11,458.04
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$177.50 |
$177.50 |
$177.50 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$2,230.00 |
$2,230.00 |
$2,230.00 |
$2,251.20
|
|
Peripheral vascular rehab
|
$132.50 |
$132.50 |
$132.50 |
$132.50
|
|
Peritoneogram rs&i
|
$845.00 |
$845.00 |
$845.00 |
$695.89
|
|
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 |
$1,837.20
|
|
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 |
$21,321.00
|
|
Perq p-art revsc 1 nm nt bi
|
$15,655.00 |
$15,655.00 |
$15,655.00 |
$15,873.70
|
|
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 |
$8,627.68
|
|
Perq plmt bile duct stent
|
$9,820.00 |
$9,820.00 |
$9,820.00 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$9,465.00 |
$9,465.00 |
$9,465.00 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$10,740.00 |
$10,740.00 |
$10,740.00 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$457.50 |
$457.50 |
$457.50 |
$625.93
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$135.00 |
$135.00 |
$135.00 |
$141.60
|
|
Pet CT skull-mid thgh initial
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,850.00
|
|
Pet image skull-thigh
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,256.70
|
|
Pet image w/ct lmtd
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$4,305.60
|
|
Pet not otherwise specified
|
$4,060.00 |
$4,060.00 |
$4,060.00 |
$1,070.40
|
|
Pfc sigma fem post aug sz3 8mm
|
$22,499.94 |
$22,499.94 |
$22,499.94 |
$38,834.22
|
|
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 |
$33.30
|
|
Ph body fluid
|
$35.00 |
$35.00 |
$35.00 |
$41.28
|
|
Phencyclidine (pcp)
|
$90.00 |
$90.00 |
$90.00 |
$96.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$78.76 |
$78.76 |
$78.76 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$104.50
|
|
Phenylephrine 10 mg/ml injection solution
|
$1.68 |
$1.68 |
$1.68 |
$67.89
|
|
Phenytoin total therapeutic drug level
|
$97.50 |
$97.50 |
$97.50 |
$110.88
|
|
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 |
$48.80
|
|
Phosphorus 24 hour urine
|
$47.50 |
$47.50 |
$47.50 |
$41.51
|
|
Phys blood bank serv reactj
|
$207.50 |
$207.50 |
$207.50 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$95.07 |
$95.07 |
$95.07 |
$87.50
|
|
Piflu f-18, dia 1 millicurie
|
$890.00 |
$890.00 |
$890.00 |
$1,035.81
|
|
Pinworm exam
|
$52.50 |
$52.50 |
$52.50 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$11.58 |
$11.58 |
$11.58 |
$83.03
|
|
Place cath intracranial art
|
$1,940.00 |
$1,940.00 |
$1,940.00 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$3,880.00 |
$3,880.00 |
$3,880.00 |
$4,202.90
|
|
Place duod/jej tube perc
|
$1,125.00 |
$1,125.00 |
$1,125.00 |
$2,473.10
|
|
Place gastrostomy tube perc
|
$990.00 |
$990.00 |
$990.00 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,060.00 |
$1,060.00 |
$1,060.00 |
$1,517.21
|
|
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)
|
$7,140.00 |
$7,140.00 |
$7,140.00 |
$3,873.65
|
|
Placement occlusive device venous/arterial access site post procedure
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$571.45
|
