|
Platelet pheresis irr ea
|
$5,030.44 |
$5,030.44 |
$5,030.44 |
$970.54
|
|
Platelets each unit
|
$1,387.77 |
$1,387.77 |
$1,387.77 |
$169.29
|
|
Platelets pheresis leukocytes reduced each unit
|
$4,548.77 |
$4,548.77 |
$4,548.77 |
$1,070.30
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$5,030.44 |
$5,030.44 |
$5,030.44 |
$1,180.31
|
|
Platelets pheresis pathogen-reduced each unit
|
$4,815.30 |
$4,815.30 |
$4,815.30 |
$879.36
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$20,197.80 |
$20,197.80 |
$20,197.80 |
$4,293.60
|
|
Porfimer sodium injection
|
$26,682.81 |
$26,682.81 |
$26,682.81 |
$26,682.81
|
|
Potassium 24 hour urine
|
$821.34 |
$821.34 |
$821.34 |
$50.00
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$11.00 |
$11.00 |
$11.00 |
$4.67
|
|
Pq biliary strict dil s&i
|
$9,312.62 |
$9,312.62 |
$9,312.62 |
$1,006.00
|
|
Pralidoxime 1 gram solution for injection
|
$905.20 |
$905.20 |
$905.20 |
$374.55
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$206.24 |
$206.24 |
$206.24 |
$48.71
|
|
Prealbumin
|
$371.93 |
$371.93 |
$371.93 |
$87.20
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$437.62 |
$437.62 |
$437.62 |
$141.00
|
|
Pretreat rbc absorption reference
|
$1,279.83 |
$1,279.83 |
$1,279.83 |
$138.60
|
|
Pretreat rbc w chem/drugs reference
|
$559.51 |
$559.51 |
$559.51 |
$106.00
|
|
Prgrmg dev eval impltbl sys
|
$296.46 |
$296.46 |
$296.46 |
$148.00
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$721.03 |
$721.03 |
$721.03 |
$666.10
|
|
Procalcitonin
|
$690.17 |
$690.17 |
$690.17 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$37.03 |
$37.03 |
$37.03 |
$46.50
|
|
Progesterone
|
$1,640.67 |
$1,640.67 |
$1,640.67 |
$105.00
|
|
Prolactin
|
$1,317.26 |
$1,317.26 |
$1,317.26 |
$127.50
|
|
Promethazine hcl injection
|
$31.19 |
$31.19 |
$31.19 |
$33.34
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$248.48 |
$248.48 |
$248.48 |
$39.59
|
|
Prost sock sgl ply blw knee ea
|
$156.00 |
$156.00 |
$156.00 |
$46.77
|
|
Protein c activity
|
$1,867.93 |
$1,867.93 |
$1,867.93 |
$115.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$532.05 |
$532.05 |
$532.05 |
$85.20
|
|
Protein s total
|
$1,542.52 |
$1,542.52 |
$1,542.52 |
$78.87
|
|
Protein total 24 hour urine
|
$553.83 |
$553.83 |
$553.83 |
$52.50
|
|
Prothrombin time substitution plasma fractions each
|
$651.94 |
$651.94 |
$651.94 |
$37.05
|
|
PSA (Prostate) Test
|
$585.81 |
$585.81 |
$585.81 |
$109.35
|
|
Psychotherapy group therapy
|
$423.87 |
$423.87 |
$423.87 |
$264.32
|
|
Psychotherapy patient individual therapy 60 minutes
|
$769.74 |
$769.74 |
$769.74 |
$294.45
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$384.22 |
$384.22 |
$384.22 |
$65.97
|
|
Puraply 1 sq cm
|
$1,467.00 |
$1,467.00 |
$1,467.00 |
$8,176.14
|
|
Pyridoxine hcl 100 mg
|
$193.91 |
$193.91 |
$193.91 |
$43.24
|
|
Pyruvate
|
$571.34 |
$571.34 |
$571.34 |
$65.00
|
|
Pyruvate kinase
|
$599.31 |
$599.31 |
$599.31 |
$65.00
|
|
Quest t3 uptake
|
$561.00 |
$561.00 |
$561.00 |
$56.10
|
|
Quinupristin/dalfopristin
|
$1,824.99 |
$1,824.99 |
$1,824.99 |
$647.41
|
|
Rabies ig heat-treated human im/subq 90376
|
$4,465.49 |
$4,465.49 |
$4,465.49 |
$1,059.01
|
|
Radiation treatment aid(s)
|
$3,772.87 |
$3,772.87 |
$3,772.87 |
$541.45
|
|
Radiation treatment aid(s)
|
$7,074.19 |
$7,074.19 |
$7,074.19 |
$665.00
|
|
Radiation treatment delivery
|
$3,551.58 |
$3,551.58 |
$3,551.58 |
$552.40
|
|
Radiesse injection
|
$8,187.00 |
$8,187.00 |
$8,187.00 |
$1,010.63
|
|
Radiotherapy dose plan imrt
|
$113,845.08 |
$113,845.08 |
$113,845.08 |
$5,996.21
|
|
Radium ra223 dichl ther/uci
|
$766.26 |
$766.26 |
$766.26 |
$237.25
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$14,316.03 |
$14,316.03 |
$14,316.03 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$13,459.16 |
$13,459.16 |
$13,459.16 |
$2,728.42
|
|
Radphm quant measure sgl area add-on
|
$1,835.44 |
$1,835.44 |
$1,835.44 |
$678.81
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$530.05 |
$530.05 |
$530.05 |
$16,029.45
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$34,427.90 |
$34,427.90 |
$34,427.90 |
$35,836.29
|
|
Rbc count only automated
|
$43.01 |
$43.01 |
$43.01 |
$20.00
|
|
Rbc deglycerolized each unit
|
$3,371.00 |
$3,371.00 |
$3,371.00 |
$724.23
|
|
Rbc serum pretx incubj drugs
|
$644.69 |
$644.69 |
$644.69 |
$223.08
|
|
Red blood cells leukocytes reduced each unit
|
$3,167.62 |
$3,167.62 |
$3,167.62 |
$398.20
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$2,043.47 |
$2,043.47 |
$2,043.47 |
$489.60
|
|
Red blood cells washed each unit
|
$5,034.85 |
$5,034.85 |
$5,034.85 |
$494.40
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$2,790.57 |
$2,790.57 |
$2,790.57 |
$656.83
|
|
Remove cva lumen obstruct
|
$2,402.47 |
$2,402.47 |
$2,402.47 |
$494.00
|
|
Renal cyst study s&i
|
$1,647.30 |
$1,647.30 |
$1,647.30 |
$648.84
|
|
Renal function panel
|
$1,674.69 |
$1,674.69 |
$1,674.69 |
$110.10
|
|
Reptilase test
|
$758.39 |
$758.39 |
$758.39 |
$65.65
|
|
Respirator motion mgmt simul
|
$2,723.39 |
$2,723.39 |
$2,723.39 |
$1,200.53
|
|
Resuscitation delivery/birthing room
|
$895.79 |
$895.79 |
$895.79 |
$797.29
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$1,579.45 |
$1,579.45 |
$1,579.45 |
$255.26
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$1,811.52 |
$1,811.52 |
$1,811.52 |
$539.70
|
|
Right ventric recording
|
$50,552.38 |
$50,552.38 |
$50,552.38 |
$1,980.36
|
|
Ring barrier skin cx 1 9/16 adapt
|
$49.00 |
$49.00 |
$49.00 |
$10.02
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$629.70 |
$629.70 |
$629.70 |
$6,877.90
|
|
Russell viper venom diluted
|
$555.87 |
$555.87 |
$555.87 |
$70.16
|
|
Salmonella antibody
|
$679.84 |
$679.84 |
$679.84 |
$37.58
|
|
Sargramostim injection
|
$2,161.14 |
$2,161.14 |
$2,161.14 |
$451.34
|
|
Sarscov & inf vir a&b ag ia
|
$162.95 |
$162.95 |
$162.95 |
$91.14
|
|
Semen analysis presence/motility
|
$228.30 |
$228.30 |
$228.30 |
$70.85
|
|
Set radiation therapy field
|
$5,175.94 |
$5,175.94 |
$5,175.94 |
$731.50
|
|
Set radiation therapy field
|
$9,250.31 |
$9,250.31 |
$9,250.31 |
$1,102.40
|
|
Shrinker prosth above knee
|
$910.00 |
$910.00 |
$910.00 |
$157.49
|
|
Shuntogram nonvascular supervision & interpretation
|
$2,391.61 |
$2,391.61 |
$2,391.61 |
$345.00
|
|
Sickling rbc
|
$228.30 |
$228.30 |
$228.30 |
$53.55
|
|
Sinus/juglr venogram s&i
|
$6,258.63 |
$6,258.63 |
$6,258.63 |
$2,489.25
|
|
Sleep Study (Polysomnography)
|
$19,442.50 |
$19,442.50 |
$19,442.50 |
$3,936.80
|
|
Sleep study unattended
|
$2,045.69 |
$2,045.69 |
$2,045.69 |
$595.50
|
|
Sock wool above knee
|
$296.00 |
$296.00 |
$296.00 |
$216.33
|
|
Sodium 24 hour urine
|
$470.09 |
$470.09 |
$470.09 |
$48.50
|
|
Sodium chloride 0.9 % intravenous solution
|
$1,042.57 |
$1,042.57 |
$1,042.57 |
$46.43
|
|
Sodium chloride 0.9 % IV bolus
|
$913.95 |
$913.95 |
$913.95 |
$51.51
|
|
Sodium chloride 3 % ivpb
|
$233.20 |
$233.20 |
$233.20 |
$65.33
|
|
Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous
|
$573.91 |
$573.91 |
$573.91 |
$104.00
|
|
Sodium serum/plasma/whole blood
|
$344.73 |
$344.73 |
$344.73 |
$42.70
|
|
Special radiation dosimetry
|
$7,133.15 |
$7,133.15 |
$7,133.15 |
$445.50
|
|
Special teletx port plan
|
$12,987.36 |
$12,987.36 |
$12,987.36 |
$1,046.65
|
|
Specific gravity body fluid
|
$388.43 |
$388.43 |
$388.43 |
$23.63
|
|
Split blood or products
|
$335.55 |
$335.55 |
$335.55 |
$148.98
|
|
Srs linear based
|
$399,191.36 |
$399,191.36 |
$399,191.36 |
$14,124.25
|
|
Srs multisource
|
$314,161.34 |
$314,161.34 |
$314,161.34 |
$31,800.00
|
|
Strapping of chest
|
$1,158.58 |
$1,158.58 |
$1,158.58 |
$201.60
|
|
Strapping of hand or finger
|
$1,158.58 |
$1,158.58 |
$1,158.58 |
$194.40
|
|
Strep b assay w/optic
|
$476.28 |
$476.28 |
$476.28 |
$32.00
|
|
Strep b dna amp probe
|
$695.56 |
$695.56 |
$695.56 |
$139.20
|
