|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$24,596.98 |
$24,596.98 |
$24,596.98 |
$12,749.16
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$867.27 |
$867.27 |
$867.27 |
$1,091.15
|
|
Olanzapine 10 mg intramuscular solution
|
$141.86 |
$141.86 |
$141.86 |
$120.17
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$5,523.43 |
$5,523.43 |
$5,523.43 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$0.61 |
$0.61 |
$0.61 |
$10.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$32.88 |
$32.88 |
$32.88 |
$30.15
|
|
Opn tx orbit fx without impl 21406
|
$2,725.45 |
$2,725.45 |
$2,725.45 |
$6,553.49
|
|
Optx clavicular fx w/int fix
|
$4,544.05 |
$4,544.05 |
$4,544.05 |
$8,453.60
|
|
Optx lunate dislocation
|
$4,544.05 |
$4,544.05 |
$4,544.05 |
$7,907.11
|
|
Optx medial ankle fx
|
$4,544.05 |
$4,544.05 |
$4,544.05 |
$7,807.24
|
|
Optx mndblr/max alv ridge fx
|
$2,725.45 |
$2,725.45 |
$2,725.45 |
$6,808.50
|
|
Optx prox humrl fx w/int fix
|
$6,659.10 |
$6,659.10 |
$6,659.10 |
$12,734.70
|
|
Optx ulnar shft fx int fixj
|
$4,544.05 |
$4,544.05 |
$4,544.05 |
$7,913.97
|
|
Oral aprepitant
|
$103.45 |
$103.45 |
$103.45 |
$413.91
|
|
Oral methotrexate (xatmep)
|
$632.05 |
$632.05 |
$632.05 |
$20.83
|
|
Orchiopexy ingun/scrot appr
|
$1,807.40 |
$1,807.40 |
$1,807.40 |
$4,176.15
|
|
Oritavancin 400 mg intravenous solution
|
$4,170.88 |
$4,170.88 |
$4,170.88 |
$3,745.44
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$43.05 |
$43.05 |
$43.05 |
$279.81
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$24.50 |
$24.50 |
$24.50 |
$231.00
|
|
Ortho hnd without jnt w/fit&adj
|
$24.50 |
$24.50 |
$24.50 |
$225.00
|
|
Orthosis lso rigd frm hyperex
|
$746.03 |
$746.03 |
$746.03 |
$813.61
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$43.05 |
$43.05 |
$43.05 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$134.75 |
$134.75 |
$134.75 |
$410.92
|
|
Oscillation chest wall mechanical per session
|
$333.20 |
$333.20 |
$333.20 |
$221.34
|
|
Osmolality blood
|
$133.35 |
$133.35 |
$133.35 |
$67.60
|
|
Osmolality urine
|
$133.35 |
$133.35 |
$133.35 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$308.35 |
$308.35 |
$308.35 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$279.65 |
$279.65 |
$279.65 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$293.65 |
$293.65 |
$293.65 |
$270.58
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$60.20 |
$60.20 |
$60.20 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$80.85 |
$80.85 |
$80.85 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$80.85 |
$80.85 |
$80.85 |
$107.32
|
|
Ot re-evaluation patient/family
|
$279.65 |
$279.65 |
$279.65 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$80.85 |
$80.85 |
$80.85 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$66.85 |
$66.85 |
$66.85 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$66.85 |
$66.85 |
$66.85 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$80.85 |
$80.85 |
$80.85 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$80.85 |
$80.85 |
$80.85 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$60.20 |
$60.20 |
$60.20 |
$93.75
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$80.90 |
$80.90 |
$80.90 |
$67.80
|
|
Oxaliplatin 5 mg/ml desensitization
|
$372.78 |
$372.78 |
$372.78 |
$342.84
|
|
Oxytocin 10 unit/ml injection solution
|
$32.96 |
$32.96 |
$32.96 |
$48.29
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$34,860.00 |
$34,860.00 |
$34,860.00 |
$44,654.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$463.12 |
$463.12 |
$463.12 |
$231.63
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$5,256.98 |
$5,256.98 |
$5,256.98 |
$3,656.90
|
|
Paliperidone 117 mg/0.75 ml inj
|
$12,567.75 |
$12,567.75 |
$12,567.75 |
$6,272.41
|
|
Palivizumab 50 mg/0.5 ml inj
|
$11,992.38 |
$11,992.38 |
$11,992.38 |
$5,156.88
|
|
Palonosetron hcl
|
$35.53 |
$35.53 |
$35.53 |
$306.70
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$134.49 |
$134.49 |
$134.49 |
$131.62
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$11,622.77 |
$11,622.77 |
$11,622.77 |
$14,082.00
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$33.62 |
$33.62 |
$33.62 |
$35.43
|
|
Papaverin hcl injection
|
$59.73 |
$59.73 |
$59.73 |
$83.77
|
|
Parathormone (pth) intact
|
$109.20 |
$109.20 |
$109.20 |
$200.23
|
|
Parathyroid planar imaging
|
$1,292.90 |
$1,292.90 |
$1,292.90 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$1,292.90 |
$1,292.90 |
$1,292.90 |
$1,398.75
|
|
Paricalcitol
|
$33.92 |
$33.92 |
$33.92 |
$47.38
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$523.25 |
$523.25 |
$523.25 |
$270.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$2,345.35 |
$2,345.35 |
$2,345.35 |
$3,762.53
|
|
Partial removal finger bone
|
$1,543.15 |
$1,543.15 |
$1,543.15 |
$2,021.04
|
|
Partial removal finger bone
|
$1,543.15 |
$1,543.15 |
$1,543.15 |
$2,211.05
|
|
Partial removal of toe
|
$3,137.40 |
$3,137.40 |
$3,137.40 |
$3,821.05
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$3,311.28 |
$3,311.28 |
$3,311.28 |
$4,418.35
|
|
Passy muir valve metal trach
|
$188.44 |
$188.44 |
$188.44 |
$242.47
|
|
Pedicle enel/ntroral 15576
|
$1,530.90 |
$1,530.90 |
$1,530.90 |
$2,436.20
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$14,249.25 |
$14,249.25 |
$14,249.25 |
$11,569.18
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$5,653.31 |
$5,653.31 |
$5,653.31 |
$7,531.80
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,842.40 |
$4,842.40 |
$4,842.40 |
$4,749.07
|
|
Pelvic CT scan (with and without contrast)
|
$1,685.60 |
$1,685.60 |
$1,685.60 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,331.40 |
$1,331.40 |
$1,331.40 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$917.00 |
$917.00 |
$917.00 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$3,700.20 |
$3,700.20 |
$3,700.20 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$3,199.70 |
$3,199.70 |
$3,199.70 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$3,084.90 |
$3,084.90 |
$3,084.90 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$757.40 |
$757.40 |
$757.40 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$340.90 |
$340.90 |
$340.90 |
$445.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$10,474.80 |
$10,474.80 |
$10,474.80 |
$13,809.00
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$13,399.77 |
$13,399.77 |
$13,399.77 |
$4,181.29
|
|
Peng benzathine/procaine inj
|
$498.54 |
$498.54 |
$498.54 |
$284.45
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$765.51 |
$765.51 |
$765.51 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$87.68 |
$87.68 |
$87.68 |
$90.35
|
|
Penile injection
|
$602.00 |
$602.00 |
$602.00 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$14,758.57 |
$14,758.57 |
$14,758.57 |
$19,815.11
|
|
Penis study
|
$721.00 |
$721.00 |
$721.00 |
$308.10
|
|
Pentobarbital sodium inj
|
$260.36 |
$260.36 |
$260.36 |
$185.00
|
|
Pentostatin 10 mg intravenous solution
|
$8,440.05 |
$8,440.05 |
$8,440.05 |
$6,659.13
|
|
Perc d-e cor revasc chro add
|
$3,959.55 |
$3,959.55 |
$3,959.55 |
$14,712.96
|
|
Perc d-e cor revasc chro sin
|
$5,335.75 |
$5,335.75 |
$5,335.75 |
$21,249.26
|
|
Perc d-e cor revasc t cabg b
|
$3,959.55 |
$3,959.55 |
$3,959.55 |
$12,091.30
|
|
Perc d-e cor revasc t cabg s
|
$8,034.60 |
$8,034.60 |
$8,034.60 |
$17,162.50
|
|
Perc d-e cor stent ather br
|
$3,771.95 |
$3,771.95 |
$3,771.95 |
$12,467.24
|
|
Perc d-e cor stent ather s
|
$7,652.05 |
$7,652.05 |
$7,652.05 |
$21,249.26
|
|
Perc drug-el cor stent bran
|
$3,771.95 |
$3,771.95 |
$3,771.95 |
$12,091.30
|
|
Perc drug-el cor stent sing
|
$8,053.50 |
$8,053.50 |
$8,053.50 |
$16,846.20
|
|
Perc rf ablate renal tumor
|
$11,686.15 |
$11,686.15 |
$11,686.15 |
$6,949.48
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$111.83 |
$111.83 |
$111.83 |
$321.71
|
|
Pericardial drain w/cath pq w/ct guid
|
$2,341.50 |
$2,341.50 |
$2,341.50 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$2,341.50 |
$2,341.50 |
$2,341.50 |
$2,573.60
|
|
Pericardiotomy/clot/for bod remove 33020
|
$2,341.50 |
$2,341.50 |
$2,341.50 |
$2,013.60
|
|
Peri-proc device eval icd
|
$106.40 |
$106.40 |
$106.40 |
$220.35
|
|
Peri-proc device eval pm
|
$106.40 |
$106.40 |
$106.40 |
$195.80
|