|
Protein electrophoretic fractionation & quantitation serum
|
$37.91 |
$37.91 |
$37.91 |
$84.00
|
|
Protein s total
|
$39.85 |
$39.85 |
$39.85 |
$85.10
|
|
Protein total 24 hour urine
|
$37.24 |
$37.24 |
$37.24 |
$52.50
|
|
Protein total body fluid
|
$37.24 |
$37.24 |
$37.24 |
$49.80
|
|
Protein total serum plasma whole blood
|
$37.24 |
$37.24 |
$37.24 |
$43.00
|
|
Prothrombin time substitution plasma fractions each
|
$39.85 |
$39.85 |
$39.85 |
$42.00
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$90.11 |
$90.11 |
$90.11 |
$252.00
|
|
Pr removal intrauterine device
|
$290.62 |
$290.62 |
$290.62 |
$367.80
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$242.14 |
$242.14 |
$242.14 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$72.33 |
$72.33 |
$72.33 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$76.62 |
$76.62 |
$76.62 |
$406.35
|
|
Pr repair sprfcl wounds simple scalp/neck/axillae/gent/trunk/ext <= 2.5 cm
|
$57.62 |
$57.62 |
$57.62 |
$374.23
|
|
Pr repair superficial wd simple scalp/neck/ax/gent/trunk/ext 2.6-7.5 cm
|
$76.62 |
$76.62 |
$76.62 |
$396.00
|
|
Pr subsequent hospital care e/m normal newborn per day
|
$63.98 |
$63.98 |
$63.98 |
$71.40
|
|
Pr tube thoracostomy w/connection to drainage open
|
$302.82 |
$302.82 |
$302.82 |
$1,761.00
|
|
PSA (Prostate) Test
|
$46.55 |
$46.55 |
$46.55 |
$107.50
|
|
Pt application of modality >=1 area hot/cold packs
|
$42.48 |
$42.48 |
$42.48 |
$35.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$106.56 |
$106.56 |
$106.56 |
$103.20
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$79.20 |
$79.20 |
$79.20 |
$81.48
|
|
Pt application of modality traction mechanical
|
$110.88 |
$110.88 |
$110.88 |
$91.80
|
|
Pt repositioning canalith procedure(s) per day
|
$162.00 |
$162.00 |
$162.00 |
$118.20
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$55.44 |
$55.44 |
$55.44 |
$80.30
|
|
Pt wheelchair management each 15 minutes
|
$61.20 |
$61.20 |
$61.20 |
$88.00
|
|
Pulmonary vent imaging
|
$590.78 |
$590.78 |
$590.78 |
$933.75
|
|
Puncture arterial withdrawal blood for diagnosis
|
$44.40 |
$44.40 |
$44.40 |
$129.36
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$120.15 |
$120.15 |
$120.15 |
$520.80
|
|
Puncture spinal lumbar diagnostic
|
$575.33 |
$575.33 |
$575.33 |
$1,060.47
|
|
Quant diff pulm perf and vent w/imaging
|
$1,125.10 |
$1,125.10 |
$1,125.10 |
$1,547.04
|
|
Quant diff pulm perf w/imaging
|
$687.80 |
$687.80 |
$687.80 |
$1,199.16
|
|
Quest t3 uptake
|
$37.24 |
$37.24 |
$37.24 |
$53.20
|
|
Radphm lcl tomogr sgl area sgl day
|
$1,188.08 |
$1,188.08 |
$1,188.08 |
$2,242.80
|
|
Rapid Strep Test
|
$35.10 |
$35.10 |
$35.10 |
$76.00
|
|
Rbc count only automated
|
$43.28 |
$43.28 |
$43.28 |
$20.40
|
|
Rbc serum pretx incubj drugs
|
$604.80 |
$604.80 |
$604.80 |
$231.12
|
|
Reconstruction of nail bed
|
$242.75 |
$242.75 |
$242.75 |
$2,204.43
|
|
Red blood cells leukocytes reduced each unit
|
$186.40 |
$186.40 |
$186.40 |
$444.60
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$221.90 |
$221.90 |
$221.90 |
$534.15
|
|
Removal central venous catheter tunneled without port/pump
|
$427.72 |
$427.72 |
$427.72 |
$1,588.50
|
|
Removal cerumen impacted (both sides)
|
$42.91 |
$42.91 |
$42.91 |
$163.20
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$142.56 |
$142.56 |
$142.56 |
$255.97
|
|
Removal foreign body foot subcutaneous right
|
$255.62 |
$255.62 |
$255.62 |
$1,260.80
|
|
Removal skin tags fibrocutaneous any area <= 15 lesions
|
$93.18 |
$93.18 |
$93.18 |
$292.50
|
|
Removal sutr and stapl no anes
|
$144.10 |
$144.10 |
$144.10 |
$82.05
|
|
Removal sutr or stapl no anes
|
$108.08 |
$108.08 |
$108.08 |
$93.88
|
|
Renal function panel
|
$103.74 |
$103.74 |
$103.74 |
$114.37
|
|
Repair complex wound scalp/arms/legs 2.6 - 7.5 cm
|
$332.25 |
$332.25 |
$332.25 |
$1,055.69
|
|
Repair extns tendon finger without grft ea
|
$753.99 |
$753.99 |
$753.99 |
$2,340.00
|
|
Repair of toe dislocation
|
$514.31 |
$514.31 |
$514.31 |
$3,986.00
|
|
Repair rpr lac tongue floor mouth > 2.6 cm/cmplx
|
$266.04 |
$266.04 |
$266.04 |
$954.20
|
|
Reptilase test
|
$20.61 |
$20.61 |
$20.61 |
$72.15
|
|
Resp virus 6-11 targets
|
$459.81 |
$459.81 |
$459.81 |
$479.20
|
|
Reticulated platelet assay
|
$74.20 |
$74.20 |
$74.20 |
$75.00
|
|
Reticulocyte direct measurement automated
|
$11.68 |
$11.68 |
$11.68 |
$36.57
|
|
Rheumatoid factor quantitative
|
$41.58 |
$41.58 |
$41.58 |
$57.50
|
|
Rib and Chest X-ray (3 views, left side)
|
$337.62 |
$337.62 |
$337.62 |
$359.47
|
|
Rib and Chest X-ray (4 or more views, both sides)
|
$424.68 |
$424.68 |
$424.68 |
$491.70
|
|
Rib X-ray (3 views, both sides)
|
$345.95 |
$345.95 |
$345.95 |
$397.60
|
|
Rsv assay w/optic
|
$28.08 |
$28.08 |
$28.08 |
$76.32
|
|
Rubella antibody igg
|
$42.34 |
$42.34 |
$42.34 |
$77.40
|
|
Rubeola antibody igg
|
$45.36 |
$45.36 |
$45.36 |
$80.00
|
|
Russell viper venom diluted
|
$41.22 |
$41.22 |
$41.22 |
$73.03
|
|
Rx metab gen seq alys pnl 6
|
$1,659.46 |
$1,659.46 |
$1,659.46 |
$1,008.79
|
|
Sacroiliac Joint X-ray (3 or more views)
|
$398.18 |
$398.18 |
$398.18 |
$314.26
|
|
Salmonella antibody
|
$55.19 |
$55.19 |
$55.19 |
$37.58
|
|
Same day nb discharge 99463
|
$168.14 |
$168.14 |
$168.14 |
$183.07
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$543.75 |
$543.75 |
$543.75 |
$761.15
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$421.22 |
$421.22 |
$421.22 |
$497.68
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$569.12 |
$569.12 |
$569.12 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$943.95 |
$943.95 |
$943.95 |
$726.18
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$700.35 |
$700.35 |
$700.35 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$779.38 |
$779.38 |
$779.38 |
$597.35
|
|
Screening Mammogram
|
$272.46 |
$272.46 |
$272.46 |
$310.20
|
|
Screw cortex 2.0 x 10mm
|
$130,746.98 |
$130,746.98 |
$130,746.98 |
$29,785.18
|
|
Scrotal (Testicle) Ultrasound
|
$829.24 |
$829.24 |
$829.24 |
$611.91
|
|
Sedimentation rate erythrocyte automated
|
$6.18 |
$6.18 |
$6.18 |
$42.00
|
|
Self-Care and Home Skills Training (each 15 minutes)
|
$69.84 |
$69.84 |
$69.84 |
$96.00
|
|
Semen analysis presence/motility
|
$24.16 |
$24.16 |
$24.16 |
$70.40
|
|
Semen analysis w/count
|
$16.98 |
$16.98 |
$16.98 |
$56.44
|
|
Sept9 promoter methylation analysis
|
$347.33 |
$347.33 |
$347.33 |
$316.68
|
|
Sheath gldlight lasr 12fx50cm
|
$10,171.14 |
$10,171.14 |
$10,171.14 |
$6,570.70
|
|
Shot (Injection into Muscle or Under the Skin)
|
$119.12 |
$119.12 |
$119.12 |
$136.20
|
|
Shoulder AC Joint X-ray (both sides)
|
$285.39 |
$285.39 |
$285.39 |
$270.20
|
|
Shoulder Blade (Scapula) X-ray (both sides)
|
$202.88 |
$202.88 |
$202.88 |
$286.89
|
|
Shoulder MRI (with and without contrast)
|
$2,168.09 |
$2,168.09 |
$2,168.09 |
$2,743.02
|
|
Shoulder MRI (with contrast)
|
$1,806.61 |
$1,806.61 |
$1,806.61 |
$2,476.20
|
|
Shoulder MRI (without contrast)
|
$1,445.14 |
$1,445.14 |
$1,445.14 |
$2,096.84
|
|
Shoulder X-ray
|
$336.11 |
$336.11 |
$336.11 |
$340.10
|
|
Shoulder X-ray (single view, both shoulders)
|
$243.75 |
$243.75 |
$243.75 |
$263.25
|
|
Sickling rbc
|
$38.47 |
$38.47 |
$38.47 |
$59.40
|
|
Sinus CT scan (with and without contrast)
|
$2,376.18 |
$2,376.18 |
$2,376.18 |
$1,796.30
|
|
Sinus CT scan (with contrast)
|
$1,980.15 |
$1,980.15 |
$1,980.15 |
$1,527.60
|
|
Sinus CT scan (without contrast)
|
$1,584.12 |
$1,584.12 |
$1,584.12 |
$1,289.00
|
|
Sinus X-ray (complete)
|
$329.30 |
$329.30 |
$329.30 |
$346.45
|
|
Sinus X-ray (limited)
|
$209.69 |
$209.69 |
$209.69 |
$215.40
|
|
Skeletal muscle relaxant 1/2
|
$102.41 |
$102.41 |
$102.41 |
$83.85
|
|
Skull X-ray (1 to 3 views)
|
$311.13 |
$311.13 |
$311.13 |
$294.45
|
|
Skull X-ray (complete)
|
$357.30 |
$357.30 |
$357.30 |
$417.50
|
|
Slco1b1 gene com variants
|
$316.58 |
$316.58 |
$316.58 |
$241.24
|
|
Sleep Study (Polysomnography)
|
$4,178.81 |
$4,178.81 |
$4,178.81 |
$3,734.50
|
|
Sleep study unattended
|
$531.03 |
$531.03 |
$531.03 |
$594.00
|