|
Pr removal foreign body external auditory canal without anesthesia
|
$78.79 |
$78.79 |
$78.79 |
$252.00
|
|
Pr removal intrauterine device
|
$249.24 |
$249.24 |
$249.24 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$211.72 |
$211.72 |
$211.72 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$63.25 |
$63.25 |
$63.25 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$67.00 |
$67.00 |
$67.00 |
$406.35
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$50.38 |
$50.38 |
$50.38 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$67.00 |
$67.00 |
$67.00 |
$396.00
|
|
Pr tube thoracostomy w/connection to drainage open
|
$264.78 |
$264.78 |
$264.78 |
$1,761.00
|
|
PSA (Prostate) Test
|
$34.44 |
$34.44 |
$34.44 |
$107.50
|
|
Psychotherapy group therapy
|
$300.84 |
$300.84 |
$300.84 |
$225.39
|
|
Psychotherapy patient individual therapy 30 minutes
|
$79.86 |
$79.86 |
$79.86 |
$190.13
|
|
Psychotherapy patient individual therapy 45 minutes
|
$106.67 |
$106.67 |
$106.67 |
$250.95
|
|
Psychotherapy patient individual therapy 60 minutes
|
$158.08 |
$158.08 |
$158.08 |
$287.95
|
|
Psych test eval svc phys/qhp 1st hr
|
$117.52 |
$117.52 |
$117.52 |
$316.50
|
|
Psych test eval svc phys/qhp ea addl hr
|
$90.64 |
$90.64 |
$90.64 |
$221.42
|
|
Psycl/nrpsyc tech 1st
|
$41.11 |
$41.11 |
$41.11 |
$330.00
|
|
Psy/npsy phys/qhp 2> tst 1st 30 min
|
$26.88 |
$26.88 |
$26.88 |
$213.00
|
|
Psy/npsy phys/qhp 2> tst ea l 30 min
|
$21.08 |
$21.08 |
$21.08 |
$156.00
|
|
Psy/npsy tst admin tech 2> ea l 30 min
|
$41.11 |
$41.11 |
$41.11 |
$124.50
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$104.04 |
$104.04 |
$104.04 |
$103.20
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$77.33 |
$77.33 |
$77.33 |
$81.48
|
|
Pt application of modality traction mechanical
|
$108.26 |
$108.26 |
$108.26 |
$91.80
|
|
Pt repositioning canalith procedure(s) per day
|
$158.17 |
$158.17 |
$158.17 |
$118.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$54.13 |
$54.13 |
$54.13 |
$80.30
|
|
Pt wheelchair management each 15 minutes
|
$59.75 |
$59.75 |
$59.75 |
$88.00
|
|
Pulmonary vent imaging
|
$518.16 |
$518.16 |
$518.16 |
$933.75
|
|
Puncture arterial withdrawal blood for diagnosis
|
$52.22 |
$52.22 |
$52.22 |
$129.36
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$377.33 |
$377.33 |
$377.33 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$489.94 |
$489.94 |
$489.94 |
$1,060.47
|
|
Quant diff pulm perf and vent w/imaging
|
$986.79 |
$986.79 |
$986.79 |
$1,547.04
|
|
Quant diff pulm perf w/imaging
|
$603.25 |
$603.25 |
$603.25 |
$1,199.16
|
|
Quest t3 uptake
|
$34.44 |
$34.44 |
$34.44 |
$53.20
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$873.12 |
$873.12 |
$873.12 |
$2,051.70
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,042.04 |
$1,042.04 |
$1,042.04 |
$2,242.80
|
|
Radphm lcl tumor plr sgl day
|
$521.34 |
$521.34 |
$521.34 |
$1,126.32
|
|
Rapid Strep Test
|
$31.45 |
$31.45 |
$31.45 |
$76.00
|
|
Rbc count only automated
|
$40.07 |
$40.07 |
$40.07 |
$20.40
|
|
Rbc serum pretx incubj drugs
|
$556.80 |
$556.80 |
$556.80 |
$231.12
|
|
Red blood cells leukocytes reduced each unit
|
$140.83 |
$140.83 |
$140.83 |
$444.60
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$167.65 |
$167.65 |
$167.65 |
$534.15
|
|
Removal central venous catheter tunneled without port/pump
|
$385.92 |
$385.92 |
$385.92 |
$1,588.50
|
|
Removal cerumen impacted (both sides)
|
$37.52 |
$37.52 |
$37.52 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$139.19 |
$139.19 |
$139.19 |
$255.97
|
|
Removal foreign body foot subcutaneous right
|
$223.51 |
$223.51 |
$223.51 |
$1,260.80
|
|
Removal of foreign body
|
$672.68 |
$672.68 |
$672.68 |
$4,149.00
|
|
Removal sutr and stapl no anes
|
$130.02 |
$130.02 |
$130.02 |
$82.05
|
|
Removal sutr or stapl no anes
|
$97.52 |
$97.52 |
$97.52 |
$93.88
|
|
Renal function panel
|
$95.94 |
$95.94 |
$95.94 |
$114.37
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$290.51 |
$290.51 |
$290.51 |
$1,055.69
|
|
Repair extns tendon finger without grft ea
|
$659.28 |
$659.28 |
$659.28 |
$2,340.00
|
|
Repair finger/hand tendon
|
$805.61 |
$805.61 |
$805.61 |
$4,350.00
|
|
Repair rpr lip full thickness vermilion only
|
$340.36 |
$340.36 |
$340.36 |
$1,244.09
|
|
Reptilase test
|
$19.08 |
$19.08 |
$19.08 |
$72.15
|
|
Resp virus 6-11 targets
|
$412.00 |
$412.00 |
$412.00 |
$479.20
|
|
Resuscitation delivery/birthing room
|
$708.33 |
$708.33 |
$708.33 |
$802.00
|
|
Reticulated platelet assay
|
$68.69 |
$68.69 |
$68.69 |
$75.00
|
|
Reticulocyte direct measurement automated
|
$10.81 |
$10.81 |
$10.81 |
$36.57
|
|
Rheumatoid factor quantitative
|
$38.28 |
$38.28 |
$38.28 |
$57.50
|
|
Rib and Chest X-ray (3 views, left side)
|
$313.98 |
$313.98 |
$313.98 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$394.94 |
$394.94 |
$394.94 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$321.73 |
$321.73 |
$321.73 |
$397.60
|
|
Rmvl fecal impaction/fb spx under anes
|
$257.28 |
$257.28 |
$257.28 |
$2,111.46
|
|
Rsv assay w/optic
|
$25.16 |
$25.16 |
$25.16 |
$76.32
|
|
Rubella antibody igg
|
$38.98 |
$38.98 |
$38.98 |
$77.40
|
|
Rubeola antibody igg
|
$41.76 |
$41.76 |
$41.76 |
$80.00
|
|
Russell viper venom diluted
|
$38.16 |
$38.16 |
$38.16 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$2,955.65 |
$2,955.65 |
$2,955.65 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$370.30 |
$370.30 |
$370.30 |
$314.26
|
|
Salmonella antibody
|
$50.81 |
$50.81 |
$50.81 |
$37.58
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$501.75 |
$501.75 |
$501.75 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$388.69 |
$388.69 |
$388.69 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$525.17 |
$525.17 |
$525.17 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$871.04 |
$871.04 |
$871.04 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$646.25 |
$646.25 |
$646.25 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$719.18 |
$719.18 |
$719.18 |
$597.35
|
|
Screening Mammogram
|
$284.05 |
$284.05 |
$284.05 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$15,588.82 |
$15,588.82 |
$15,588.82 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$805.19 |
$805.19 |
$805.19 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$5.72 |
$5.72 |
$5.72 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$68.19 |
$68.19 |
$68.19 |
$96.00
|
|
Semen analysis presence/motility
|
$28.42 |
$28.42 |
$28.42 |
$70.40
|
|
Semen analysis w/count
|
$19.97 |
$19.97 |
$19.97 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$618.62 |
$618.62 |
$618.62 |
$316.68
|
|
Shot (Injection into Muscle or Under the Skin)
|
$108.15 |
$108.15 |
$108.15 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$265.41 |
$265.41 |
$265.41 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$188.67 |
$188.67 |
$188.67 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$2,207.98 |
$2,207.98 |
$2,207.98 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,839.85 |
$1,839.85 |
$1,839.85 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,471.73 |
$1,471.73 |
$1,471.73 |
$2,096.84
|
|
Shoulder X-ray
|
$312.58 |
$312.58 |
$312.58 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$226.69 |
$226.69 |
$226.69 |
$263.25
|
|
Sickling rbc
|
$35.62 |
$35.62 |
$35.62 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$2,214.08 |
$2,214.08 |
$2,214.08 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,845.07 |
$1,845.07 |
$1,845.07 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,476.06 |
$1,476.06 |
$1,476.06 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$306.24 |
$306.24 |
$306.24 |
$346.45
|
|
Sinus X-ray (limited)
|
$195.01 |
$195.01 |
$195.01 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$94.71 |
$94.71 |
$94.71 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$289.34 |
$289.34 |
$289.34 |
$294.45
|
|
Skull X-ray (complete)
|
$332.29 |
$332.29 |
$332.29 |
$417.50
|