|
Nushield 1 square cm
|
$6,167.23 |
$6,167.23 |
$6,167.23 |
$937.50
|
|
Observation direct referral from physician office for admission
|
$619.68 |
$619.68 |
$619.68 |
$420.00
|
|
Observation per hour
|
$71.04 |
$71.04 |
$71.04 |
$83.52
|
|
Ob Ultrasound nuchal meas 1 gest
|
$547.68 |
$547.68 |
$547.68 |
$331.29
|
|
Ob Ultrasound nuchal meas add-on
|
$378.24 |
$378.24 |
$378.24 |
$243.29
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$44.76 |
$44.76 |
$44.76 |
$70.66
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$1,773.06 |
$1,773.06 |
$1,773.06 |
$1,091.15
|
|
Olanzapine 10 mg intramuscular solution
|
$188.01 |
$188.01 |
$188.01 |
$120.17
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$2,029.02 |
$2,029.02 |
$2,029.02 |
$4,595.01
|
|
Oncoprotein dcp
|
$93.60 |
$93.60 |
$93.60 |
$167.75
|
|
Ondansetron 8 mg disintegrating tablet
|
$24.72 |
$24.72 |
$24.72 |
$10.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$44.76 |
$44.76 |
$44.76 |
$30.15
|
|
Opn fem art expos cndt crtj 34714
|
$3,282.24 |
$3,282.24 |
$3,282.24 |
$2,041.65
|
|
Opn impltj nea sacral nerve
|
$9,392.16 |
$9,392.16 |
$9,392.16 |
$7,359.38
|
|
Opn tx orbit fx without impl 21406
|
$9,674.40 |
$9,674.40 |
$9,674.40 |
$6,553.49
|
|
Optx clavicular fx w/int fix
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$8,453.60
|
|
Optx lunate dislocation
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$7,907.11
|
|
Optx medial ankle fx
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$7,807.24
|
|
Optx mndblr/max alv ridge fx
|
$9,674.40 |
$9,674.40 |
$9,674.40 |
$6,808.50
|
|
Optx prox humrl fx w/int fix
|
$8,457.12 |
$8,457.12 |
$8,457.12 |
$12,734.70
|
|
Optx ulnar shft fx int fixj
|
$4,006.08 |
$4,006.08 |
$4,006.08 |
$7,913.97
|
|
Oral aprepitant
|
$478.37 |
$478.37 |
$478.37 |
$413.91
|
|
Orchiopexy ingun/scrot appr
|
$2,296.32 |
$2,296.32 |
$2,296.32 |
$4,176.15
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$56.05 |
$56.05 |
$56.05 |
$56.42
|
|
Orthosis lso rigd frm hyperex
|
$1,555.56 |
$1,555.56 |
$1,555.56 |
$813.61
|
|
Oscillation chest wall mechanical per session
|
$378.72 |
$378.72 |
$378.72 |
$221.34
|
|
Osmolality blood
|
$44.16 |
$44.16 |
$44.16 |
$67.60
|
|
Osmolality urine
|
$44.16 |
$44.16 |
$44.16 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$280.32 |
$280.32 |
$280.32 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$140.16 |
$140.16 |
$140.16 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$210.24 |
$210.24 |
$210.24 |
$270.58
|
|
Oth resp proc, group
|
$118.08 |
$118.08 |
$118.08 |
$137.05
|
|
Oth resp proc, indiv
|
$129.60 |
$129.60 |
$129.60 |
$89.70
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$125.28 |
$125.28 |
$125.28 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$125.28 |
$125.28 |
$125.28 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$88.32 |
$88.32 |
$88.32 |
$107.32
|
|
Ot re-evaluation patient/family
|
$88.80 |
$88.80 |
$88.80 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$72.48 |
$72.48 |
$72.48 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$82.08 |
$82.08 |
$82.08 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$82.08 |
$82.08 |
$82.08 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$88.80 |
$88.80 |
$88.80 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$88.32 |
$88.32 |
$88.32 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$78.24 |
$78.24 |
$78.24 |
$93.75
|
|
Oxaliplatin 5 mg/ml desensitization
|
$154.68 |
$154.68 |
$154.68 |
$342.84
|
|
Oxytocin 10 unit/ml injection solution
|
$44.76 |
$44.76 |
$44.76 |
$48.29
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$38,131.20 |
$38,131.20 |
$38,131.20 |
$44,654.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$225.94 |
$225.94 |
$225.94 |
$231.63
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$2,189.80 |
$2,189.80 |
$2,189.80 |
$3,656.90
|
|
Paliperidone 117 mg/0.75 ml inj
|
$0.00 |
$0.00 |
$0.00 |
$6,272.41
|
|
Palonosetron hcl
|
$44.76 |
$44.76 |
$44.76 |
$306.70
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$53.81 |
$53.81 |
$53.81 |
$131.62
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$44.76 |
$44.76 |
$44.76 |
$35.43
|
|
Papaverin hcl injection
|
$65.97 |
$65.97 |
$65.97 |
$83.77
|
|
Parathormone (pth) intact
|
$123.36 |
$123.36 |
$123.36 |
$200.23
|
|
Parathyrd planar w/spect&ct
|
$2,117.28 |
$2,117.28 |
$2,117.28 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,587.84 |
$1,587.84 |
$1,587.84 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$1,628.64 |
$1,628.64 |
$1,628.64 |
$1,398.75
|
|
Paricalcitol
|
$44.76 |
$44.76 |
$44.76 |
$47.38
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$489.60 |
$489.60 |
$489.60 |
$270.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$4,177.44 |
$4,177.44 |
$4,177.44 |
$3,762.53
|
|
Partial removal finger bone
|
$1,720.32 |
$1,720.32 |
$1,720.32 |
$2,021.04
|
|
Partial removal finger bone
|
$1,720.32 |
$1,720.32 |
$1,720.32 |
$2,211.05
|
|
Partial removal of toe
|
$4,596.00 |
$4,596.00 |
$4,596.00 |
$3,821.05
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$5,604.23 |
$5,604.23 |
$5,604.23 |
$4,418.35
|
|
Passy muir valve metal trach
|
$409.35 |
$409.35 |
$409.35 |
$242.47
|
|
Pedicle enel/ntroral 15576
|
$2,707.20 |
$2,707.20 |
$2,707.20 |
$2,436.20
|
|
Pelvic CT scan (with and without contrast)
|
$1,866.24 |
$1,866.24 |
$1,866.24 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,725.60 |
$1,725.60 |
$1,725.60 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$1,596.48 |
$1,596.48 |
$1,596.48 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$5,727.36 |
$5,727.36 |
$5,727.36 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$4,992.96 |
$4,992.96 |
$4,992.96 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$4,555.20 |
$4,555.20 |
$4,555.20 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$1,218.72 |
$1,218.72 |
$1,218.72 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$634.56 |
$634.56 |
$634.56 |
$445.00
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$5,605.03 |
$5,605.03 |
$5,605.03 |
$4,181.29
|
|
Peng benzathine/procaine inj
|
$748.68 |
$748.68 |
$748.68 |
$284.45
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$568.42 |
$568.42 |
$568.42 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$116.69 |
$116.69 |
$116.69 |
$90.35
|
|
Penile injection
|
$543.36 |
$543.36 |
$543.36 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$17,238.17 |
$17,238.17 |
$17,238.17 |
$19,815.11
|
|
Pentobarbital sodium inj
|
$150.12 |
$150.12 |
$150.12 |
$185.00
|
|
Perc cryo ablate renal tum
|
$16,967.52 |
$16,967.52 |
$16,967.52 |
$12,320.22
|
|
Perc d-e cor revasc chro sin
|
$11,220.48 |
$11,220.48 |
$11,220.48 |
$21,249.26
|
|
Perc d-e cor revasc t cabg s
|
$10,404.48 |
$10,404.48 |
$10,404.48 |
$17,162.50
|
|
Perc d-e cor stent ather br
|
$10,404.48 |
$10,404.48 |
$10,404.48 |
$12,467.24
|
|
Perc d-e cor stent ather s
|
$10,099.20 |
$10,099.20 |
$10,099.20 |
$21,249.26
|
|
Perc drug-el cor stent bran
|
$9,364.80 |
$9,364.80 |
$9,364.80 |
$12,091.30
|
|
Perc drug-el cor stent sing
|
$9,364.80 |
$9,364.80 |
$9,364.80 |
$16,846.20
|
|
Perc rf ablate renal tumor
|
$8,081.76 |
$8,081.76 |
$8,081.76 |
$6,949.48
|
|
Percut ablate liver rf
|
$7,123.20 |
$7,123.20 |
$7,123.20 |
$7,024.12
|
|
Pericardial drain w/cath pq w/ct guid
|
$5,500.32 |
$5,500.32 |
$5,500.32 |
$2,816.25
|
|
Pericardiocentesis wwo imaging
|
$1,379.04 |
$1,379.04 |
$1,379.04 |
$2,573.60
|
|
Pericardiotomy/clot/for bod remove 33020
|
$5,500.32 |
$5,500.32 |
$5,500.32 |
$2,013.60
|
|
Peri-proc device eval icd
|
$271.68 |
$271.68 |
$271.68 |
$220.35
|
|
Peri-proc device eval pm
|
$263.52 |
$263.52 |
$263.52 |
$195.80
|
|
Peritoneogram rs&i
|
$1,377.12 |
$1,377.12 |
$1,377.12 |
$648.84
|
|
Perit-vens shunt pat tst
|
$832.80 |
$832.80 |
$832.80 |
$695.40
|
|
Perphenazine 4mg oral
|
$5.28 |
$5.28 |
$5.28 |
$2.58
|
|
Perq art m-thrombect &/nfs
|
$8,507.52 |
$8,507.52 |
$8,507.52 |
$7,796.10
|
|
Perq clsr tcat l atr apndge
|
$5,164.32 |
$5,164.32 |
$5,164.32 |
$12,032.67
|