|
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
|
$209.30 |
$209.30 |
$209.30 |
$221.34
|
|
Osmolality blood
|
$202.30 |
$202.30 |
$202.30 |
$67.60
|
|
Osmolality urine
|
$202.30 |
$202.30 |
$202.30 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$220.50 |
$220.50 |
$220.50 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$214.20 |
$214.20 |
$214.20 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$217.70 |
$217.70 |
$217.70 |
$270.58
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$90.65 |
$90.65 |
$90.65 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$107.32
|
|
Ot re-evaluation patient/family
|
$214.20 |
$214.20 |
$214.20 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$89.95 |
$89.95 |
$89.95 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$81.90 |
$81.90 |
$81.90 |
$93.75
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$83.08 |
$83.08 |
$83.08 |
$67.80
|
|
Oxaliplatin 5 mg/ml desensitization
|
$373.39 |
$373.39 |
$373.39 |
$342.84
|
|
Oxytocin 10 unit/ml injection solution
|
$33.79 |
$33.79 |
$33.79 |
$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
|
$627.33 |
$627.33 |
$627.33 |
$231.63
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$5,256.98 |
$5,256.98 |
$5,256.98 |
$3,656.90
|
|
Palivizumab 50 mg/0.5 ml inj
|
$7,101.31 |
$7,101.31 |
$7,101.31 |
$5,156.88
|
|
Palonosetron hcl
|
$730.45 |
$730.45 |
$730.45 |
$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
|
$34.27 |
$34.27 |
$34.27 |
$35.43
|
|
Papaverin hcl injection
|
$35.36 |
$35.36 |
$35.36 |
$83.77
|
|
Parathormone (pth) intact
|
$175.70 |
$175.70 |
$175.70 |
$200.23
|
|
Parathyroid planar imaging
|
$402.85 |
$402.85 |
$402.85 |
$1,166.00
|
|
Paricalcitol
|
$32.87 |
$32.87 |
$32.87 |
$47.38
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$233.80 |
$233.80 |
$233.80 |
$270.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$2,422.70 |
$2,422.70 |
$2,422.70 |
$3,762.53
|
|
Partial removal finger bone
|
$1,346.45 |
$1,346.45 |
$1,346.45 |
$2,021.04
|
|
Partial removal finger bone
|
$1,346.45 |
$1,346.45 |
$1,346.45 |
$2,211.05
|
|
Partial removal of toe
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$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
|
$1,581.30 |
$1,581.30 |
$1,581.30 |
$2,436.20
|
|
Pegaspargase injection
|
$23,567.55 |
$23,567.55 |
$23,567.55 |
$33,512.48
|
|
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
|
$5,655.15 |
$5,655.15 |
$5,655.15 |
$7,531.80
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,842.40 |
$4,842.40 |
$4,842.40 |
$4,749.07
|
|
Pegloticase 8 mg/ml intravenous solution
|
$72,846.22 |
$72,846.22 |
$72,846.22 |
$49,707.63
|
|
Pelvic CT scan (with and without contrast)
|
$2,015.65 |
$2,015.65 |
$2,015.65 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,174.25 |
$1,174.25 |
$1,174.25 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$1,064.70 |
$1,064.70 |
$1,064.70 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$4,561.20 |
$4,561.20 |
$4,561.20 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$3,480.05 |
$3,480.05 |
$3,480.05 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$3,023.30 |
$3,023.30 |
$3,023.30 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$502.60 |
$502.60 |
$502.60 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$321.30 |
$321.30 |
$321.30 |
$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
|
$873.45 |
$873.45 |
$873.45 |
$284.45
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$765.75 |
$765.75 |
$765.75 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$182.71 |
$182.71 |
$182.71 |
$90.35
|
|
Penile injection
|
$296.10 |
$296.10 |
$296.10 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$14,758.57 |
$14,758.57 |
$14,758.57 |
$19,815.11
|
|
Penile vascular study
|
$200.55 |
$200.55 |
$200.55 |
$561.00
|
|
Pentobarbital sodium inj
|
$344.35 |
$344.35 |
$344.35 |
$185.00
|
|
Pentostatin 10 mg intravenous solution
|
$8,440.05 |
$8,440.05 |
$8,440.05 |
$6,659.13
|
|
Perc cryo ablate renal tum
|
$5,121.90 |
$5,121.90 |
$5,121.90 |
$12,320.22
|
|
Perc d-e cor revasc chro add
|
$4,833.85 |
$4,833.85 |
$4,833.85 |
$14,712.96
|
|
Perc d-e cor revasc chro sin
|
$7,149.10 |
$7,149.10 |
$7,149.10 |
$21,249.26
|
|
Perc d-e cor revasc t cabg b
|
$4,833.85 |
$4,833.85 |
$4,833.85 |
$12,091.30
|
|
Perc d-e cor revasc t cabg s
|
$7,149.10 |
$7,149.10 |
$7,149.10 |
$17,162.50
|
|
Perc d-e cor stent ather br
|
$4,604.60 |
$4,604.60 |
$4,604.60 |
$12,467.24
|
|
Perc d-e cor stent ather s
|
$6,809.95 |
$6,809.95 |
$6,809.95 |
$21,249.26
|
|
Perc drug-el cor stent bran
|
$4,604.60 |
$4,604.60 |
$4,604.60 |
$12,091.30
|
|
Perc drug-el cor stent sing
|
$6,809.95 |
$6,809.95 |
$6,809.95 |
$16,846.20
|
|
Perc rf ablate renal tumor
|
$5,735.10 |
$5,735.10 |
$5,735.10 |
$6,949.48
|
|
Percut ablate liver rf
|
$9,027.55 |
$9,027.55 |
$9,027.55 |
$7,024.12
|
|
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
|
$1,274.70 |
$1,274.70 |
$1,274.70 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$2,758.00 |
$2,758.00 |
$2,758.00 |
$2,573.60
|
|
Pericardiotomy/clot/for bod remove 33020
|
$1,274.70 |
$1,274.70 |
$1,274.70 |
$2,013.60
|
|
Peri-proc device eval icd
|
$121.10 |
$121.10 |
$121.10 |
$220.35
|
|
Peri-proc device eval pm
|
$121.10 |
$121.10 |
$121.10 |
$195.80
|
|
Peritoneogram rs&i
|
$710.50 |
$710.50 |
$710.50 |
$648.84
|
|
Perit-vens shunt pat tst
|
$709.45 |
$709.45 |
$709.45 |
$695.40
|
|
Perq art m-thrombect &/nfs
|
$5,241.60 |
$5,241.60 |
$5,241.60 |
$7,796.10
|
|
Perq clsr tcat l atr apndge
|
$711.90 |
$711.90 |
$711.90 |
$12,032.67
|
|
Perq plmt bile duct stent
|
$2,578.80 |
$2,578.80 |
$2,578.80 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$3,677.80 |
$3,677.80 |
$3,677.80 |
$6,457.82
|
|
Perq plmt bile duct stent
|
$3,677.80 |
$3,677.80 |
$3,677.80 |
$7,082.99
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$285.60 |
$285.60 |
$285.60 |
$625.93
|
|
Perq tx big toe fracture w/manip 28496
|
$2,738.05 |
$2,738.05 |
$2,738.05 |
$3,839.54
|
|
Pertuzumab 30 mg/ml desensitization
|
$11,876.18 |
$11,876.18 |
$11,876.18 |
$15,007.91
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$85.17 |
$85.17 |
$85.17 |
$113.84
|
|
Pet CT skull-mid thgh initial
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$4,854.75
|
|
Pet CT whole body initial
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$5,017.50
|
|
Pet fdg brain metoblic eval sb
|
$1,490.65 |
$1,490.65 |
$1,490.65 |
$3,559.05
|
|
Pet image ltd area
|
$1,801.80 |
$1,801.80 |
$1,801.80 |
$2,519.20
|
|
Pfc sigma fem post aug sz3 8mm
|
$46,021.89 |
$46,021.89 |
$46,021.89 |
$33,990.40
|
|
Ph body fluid
|
$166.25 |
$166.25 |
$166.25 |
$39.20
|