|
Nushield 1 square cm
|
$4,076.38 |
$4,076.38 |
$4,076.38 |
$937.50
|
|
Observation direct referral from physician office for admission
|
$789.48 |
$789.48 |
$789.48 |
$420.00
|
|
Observation per hour
|
$122.91 |
$122.91 |
$122.91 |
$83.52
|
|
Obtaining screen pap smear
|
$39.78 |
$39.78 |
$39.78 |
$32.04
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$70.66
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$1,642.02 |
$1,642.02 |
$1,642.02 |
$1,091.15
|
|
Olanzapine 10 mg intramuscular solution
|
$84.15 |
$84.15 |
$84.15 |
$120.17
|
|
Oncoprotein dcp
|
$99.45 |
$99.45 |
$99.45 |
$167.75
|
|
Ondansetron 8 mg disintegrating tablet
|
$5.61 |
$5.61 |
$5.61 |
$10.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$30.15
|
|
Opn tx orbit fx without impl 21406
|
$6,808.50 |
$6,808.50 |
$6,808.50 |
$6,553.49
|
|
Optx clavicular fx w/int fix
|
$8,846.46 |
$8,846.46 |
$8,846.46 |
$8,453.60
|
|
Optx lunate dislocation
|
$8,846.46 |
$8,846.46 |
$8,846.46 |
$7,907.11
|
|
Optx medial ankle fx
|
$8,846.46 |
$8,846.46 |
$8,846.46 |
$7,807.24
|
|
Optx mndblr/max alv ridge fx
|
$6,808.50 |
$6,808.50 |
$6,808.50 |
$6,808.50
|
|
Optx prox humrl fx w/int fix
|
$16,636.71 |
$16,636.71 |
$16,636.71 |
$12,734.70
|
|
Optx ulnar shft fx int fixj
|
$8,846.46 |
$8,846.46 |
$8,846.46 |
$7,913.97
|
|
Orchiopexy ingun/scrot appr
|
$4,516.05 |
$4,516.05 |
$4,516.05 |
$4,176.15
|
|
Orthosis lso rigd frm hyperex
|
$1,552.95 |
$1,552.95 |
$1,552.95 |
$813.61
|
|
Osmolality blood
|
$197.88 |
$197.88 |
$197.88 |
$67.60
|
|
Osmolality urine
|
$172.38 |
$172.38 |
$172.38 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$477.36 |
$477.36 |
$477.36 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$239.19 |
$239.19 |
$239.19 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$358.53 |
$358.53 |
$358.53 |
$270.58
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$74.46 |
$74.46 |
$74.46 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$113.73 |
$113.73 |
$113.73 |
$107.32
|
|
Ot re-evaluation patient/family
|
$181.05 |
$181.05 |
$181.05 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$103.02 |
$103.02 |
$103.02 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$65.79 |
$65.79 |
$65.79 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$65.79 |
$65.79 |
$65.79 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$105.06 |
$105.06 |
$105.06 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$100.98 |
$100.98 |
$100.98 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$101.49 |
$101.49 |
$101.49 |
$93.75
|
|
Oxytocin 10 unit/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$48.29
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$28,029.60 |
$28,029.60 |
$28,029.60 |
$44,654.40
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$84.15 |
$84.15 |
$84.15 |
$131.62
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$84.15 |
$84.15 |
$84.15 |
$35.43
|
|
Papaverin hcl injection
|
$102.05 |
$102.05 |
$102.05 |
$83.77
|
|
Parathormone (pth) intact
|
$326.40 |
$326.40 |
$326.40 |
$200.23
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$241.74 |
$241.74 |
$241.74 |
$270.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$3,605.19 |
$3,605.19 |
$3,605.19 |
$3,762.53
|
|
Partial removal finger bone
|
$1,919.13 |
$1,919.13 |
$1,919.13 |
$2,021.04
|
|
Partial removal finger bone
|
$1,919.13 |
$1,919.13 |
$1,919.13 |
$2,211.05
|
|
Partial removal of toe
|
$3,981.06 |
$3,981.06 |
$3,981.06 |
$3,821.05
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$3,827.10 |
$3,827.10 |
$3,827.10 |
$4,418.35
|
|
Passy muir valve metal trach
|
$442.08 |
$442.08 |
$442.08 |
$242.47
|
|
Pedicle enel/ntroral 15576
|
$2,200.65 |
$2,200.65 |
$2,200.65 |
$2,436.20
|
|
Pelvic CT scan (with and without contrast)
|
$3,267.06 |
$3,267.06 |
$3,267.06 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$2,430.15 |
$2,430.15 |
$2,430.15 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$2,146.59 |
$2,146.59 |
$2,146.59 |
$1,332.80
|
|
Pelvic MRI (without contrast)
|
$1,816.62 |
$1,816.62 |
$1,816.62 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$1,605.48 |
$1,605.48 |
$1,605.48 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$986.34 |
$986.34 |
$986.34 |
$445.00
|
|
Peng benzathine/procaine inj
|
$752.05 |
$752.05 |
$752.05 |
$284.45
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$581.06 |
$581.06 |
$581.06 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$145.35 |
$145.35 |
$145.35 |
$90.35
|
|
Penile injection
|
$585.99 |
$585.99 |
$585.99 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$12,244.67 |
$12,244.67 |
$12,244.67 |
$19,815.11
|
|
Perc drug-el cor stent bran
|
$10,171.44 |
$10,171.44 |
$10,171.44 |
$12,091.30
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$162.95 |
$162.95 |
$162.95 |
$321.71
|
|
Pericardial drain w/cath pq w/ct guid
|
$6,560.64 |
$6,560.64 |
$6,560.64 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$2,276.64 |
$2,276.64 |
$2,276.64 |
$2,573.60
|
|
Pericardiotomy/clot/for bod remove 33020
|
$15,595.80 |
$15,595.80 |
$15,595.80 |
$2,013.60
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$287.64 |
$287.64 |
$287.64 |
$625.93
|
|
Perq tx big toe fracture w/manip 28496
|
$3,981.06 |
$3,981.06 |
$3,981.06 |
$3,839.54
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$208.90 |
$208.90 |
$208.90 |
$113.84
|
|
Pfc sigma fem post aug sz3 8mm
|
$30,356.81 |
$30,356.81 |
$30,356.81 |
$33,990.40
|
|
Ph body fluid
|
$47.43 |
$47.43 |
$47.43 |
$39.20
|
|
Phencyclidine (pcp)
|
$51.00 |
$51.00 |
$51.00 |
$88.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$129.01 |
$129.01 |
$129.01 |
$115.32
|
|
Phenobarbital therapeutic drug level
|
$122.91 |
$122.91 |
$122.91 |
$104.50
|
|
Phenylephrine 10 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$57.09
|
|
Phenytoin total therapeutic drug level
|
$181.05 |
$181.05 |
$181.05 |
$111.27
|
|
Phlebotomy therapeutic
|
$155.55 |
$155.55 |
$155.55 |
$249.00
|
|
Phosphorus
|
$72.93 |
$72.93 |
$72.93 |
$47.81
|
|
Phosphorus 24 hour urine
|
$17.85 |
$17.85 |
$17.85 |
$42.81
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$128.32 |
$128.32 |
$128.32 |
$92.07
|
|
Pin caspar distraction 12mm
|
$6,455.84 |
$6,455.84 |
$6,455.84 |
$10,255.29
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$777.24 |
$777.24 |
$777.24 |
$1,016.25
|
|
Pin finger fracture each
|
$3,981.06 |
$3,981.06 |
$3,981.06 |
$3,910.33
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$145.35 |
$145.35 |
$145.35 |
$101.60
|
|
Place cath xtrnl carotid
|
$287.13 |
$287.13 |
$287.13 |
$4,202.65
|
|
Place gastrostomy tube perc
|
$2,329.17 |
$2,329.17 |
$2,329.17 |
$2,517.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,900.26 |
$1,900.26 |
$1,900.26 |
$1,679.20
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$264.69 |
$264.69 |
$264.69 |
$800.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,900.26 |
$1,900.26 |
$1,900.26 |
$1,372.15
|
|
Placement of seton
|
$3,436.38 |
$3,436.38 |
$3,436.38 |
$3,375.00
|
|
Place slctv cath carotd art uni
|
$7,380.21 |
$7,380.21 |
$7,380.21 |
$10,549.80
|
|
Place slctv cath carotid/inom art intcrn uni
|
$8,652.66 |
$8,652.66 |
$8,652.66 |
$9,181.35
|
|
Platelet aggregation each agent teg
|
$303.96 |
$303.96 |
$303.96 |
$147.96
|
|
Platelet automated
|
$183.09 |
$183.09 |
$183.09 |
$44.00
|
|
Platelets pheresis leukocytes reduced each unit
|
$265.20 |
$265.20 |
$265.20 |
$1,235.83
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$476.34 |
$476.34 |
$476.34 |
$1,363.70
|
|
Platelets pheresis pathogen-reduced each unit
|
$406.47 |
$406.47 |
$406.47 |
$992.49
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$683.91 |
$683.91 |
$683.91 |
$1,292.45
|
|
#pnh-flow cytometry interp
|
$35.86 |
$35.86 |
$35.86 |
$154.14
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$541.11 |
$541.11 |
$541.11 |
$173.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$2,580.60 |
$2,580.60 |
$2,580.60 |
$4,293.60
|
|
Potassium 24 hour urine
|
$65.28 |
$65.28 |
$65.28 |
$50.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$176.87 |
$176.87 |
$176.87 |
$76.40
|
