|
Phentolaine mesylate inj
|
$1,298.66 |
$1,298.66 |
$1,298.66 |
$935.28
|
|
Phenylephrine 10 mg/ml injection solution
|
$225.28 |
$225.28 |
$225.28 |
$50.56
|
|
Phenytoin total therapeutic drug level
|
$1,050.51 |
$1,050.51 |
$1,050.51 |
$110.19
|
|
Phlebotomy therapeutic
|
$995.58 |
$995.58 |
$995.58 |
$243.54
|
|
Phosphorus 24 hour urine
|
$960.00 |
$960.00 |
$960.00 |
$42.35
|
|
Pinworm exam
|
$753.71 |
$753.71 |
$753.71 |
$40.00
|
|
Platelet automated
|
$420.39 |
$420.39 |
$420.39 |
$43.55
|
|
Platelets pheresis leukocytes reduced each unit
|
$3,608.89 |
$3,608.89 |
$3,608.89 |
$1,147.30
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$21,779.84 |
$21,779.84 |
$21,779.84 |
$4,268.16
|
|
Potassium 24 hour urine
|
$525.75 |
$525.75 |
$525.75 |
$50.00
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$20.00 |
$20.00 |
$20.00 |
$4.67
|
|
Pq biliary strict dil s&i
|
$11,295.25 |
$11,295.25 |
$11,295.25 |
$979.55
|
|
Pralidoxime 1 gram solution for injection
|
$912.33 |
$912.33 |
$912.33 |
$352.08
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$808.76 |
$808.76 |
$808.76 |
$350.98
|
|
Prealbumin
|
$1,040.23 |
$1,040.23 |
$1,040.23 |
$87.10
|
|
Pretreat rbc absorption reference
|
$942.81 |
$942.81 |
$942.81 |
$139.00
|
|
Pretreat rbc w chem/drugs reference
|
$520.63 |
$520.63 |
$520.63 |
$106.00
|
|
Pretreat rbc w enzyme reference
|
$696.72 |
$696.72 |
$696.72 |
$164.99
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$565.75 |
$565.75 |
$565.75 |
$565.75
|
|
Procalcitonin
|
$475.90 |
$475.90 |
$475.90 |
$142.50
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$387.14 |
$387.14 |
$387.14 |
$46.36
|
|
Progesterone
|
$982.93 |
$982.93 |
$982.93 |
$100.20
|
|
Prolactin
|
$982.93 |
$982.93 |
$982.93 |
$128.80
|
|
Promethazine hcl injection
|
$76.34 |
$76.34 |
$76.34 |
$26.40
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$97.07 |
$97.07 |
$97.07 |
$37.35
|
|
Prost sock sgl ply blw knee ea
|
$189.00 |
$189.00 |
$189.00 |
$46.77
|
|
Protamine 10 mg/ml intravenous solution
|
$354.07 |
$354.07 |
$354.07 |
$50.70
|
|
Protein c activity
|
$1,648.48 |
$1,648.48 |
$1,648.48 |
$116.25
|
|
Protein electrophoretic fractionation & quantitation serum
|
$996.68 |
$996.68 |
$996.68 |
$84.00
|
|
Protein s total
|
$1,648.48 |
$1,648.48 |
$1,648.48 |
$78.77
|
|
Protein total 24 hour urine
|
$525.75 |
$525.75 |
$525.75 |
$52.50
|
|
Prothrombin time substitution plasma fractions each
|
$883.23 |
$883.23 |
$883.23 |
$37.60
|
|
PSA (Prostate) Test
|
$963.42 |
$963.42 |
$963.42 |
$108.27
|
|
Psychotherapy group therapy
|
$388.87 |
$388.87 |
$388.87 |
$268.80
|
|
Psychotherapy patient individual therapy 45 minutes
|
$641.98 |
$641.98 |
$641.98 |
$265.10
|
|
Psychotherapy patient individual therapy 60 minutes
|
$641.98 |
$641.98 |
$641.98 |
$294.00
|
|
Pt application of modality traction mechanical
|
$620.08 |
$620.08 |
$620.08 |
$91.20
|
|
Pt evaluation high complexity patient/family
|
$980.21 |
$980.21 |
$980.21 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$980.21 |
$980.21 |
$980.21 |
$226.80
|
|
Pt evaluation moderate complexity patient/family
|
$980.21 |
$980.21 |
$980.21 |
$264.00
|
|
Pt re-evaluation patient/family
|
$490.99 |
$490.99 |
$490.99 |
$157.50
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$410.67 |
$410.67 |
$410.67 |
$86.80
|
|
Pulmonary vent imaging
|
$12,620.20 |
$12,620.20 |
$12,620.20 |
$828.73
|
|
Pulse ox continuous overnight monitoring
|
$6,568.11 |
$6,568.11 |
$6,568.11 |
$357.60
|
|
Puncture arterial withdrawal blood for diagnosis
|
$185.53 |
$185.53 |
$185.53 |
$127.50
|
|
Pyridoxine hcl 100 mg
|
$254.72 |
$254.72 |
$254.72 |
$39.72
|
|
Pyruvate
|
$339.16 |
$339.16 |
$339.16 |
$65.00
|
|
Quant diff pulm perf and vent w/imaging
|
$24,648.28 |
$24,648.28 |
$24,648.28 |
$1,425.08
|
|
Quant diff pulm perf w/imaging
|
$12,028.06 |
$12,028.06 |
$12,028.06 |
$1,209.44
|
|
Quest t3 uptake
|
$633.48 |
$633.48 |
$633.48 |
$58.95
|
|
Quinupristin/dalfopristin
|
$2,335.50 |
$2,335.50 |
$2,335.50 |
$647.41
|
|
Rabies ig ht&sol human im/sc
|
$3,051.63 |
$3,051.63 |
$3,051.63 |
$5,401.91
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$5,708.10 |
$5,708.10 |
$5,708.10 |
$3,213.80
|
|
Radiation therapy dose plan
|
$1,090.41 |
$1,090.41 |
$1,090.41 |
$523.90
|
|
Radiation treatment aid(s)
|
$1,775.68 |
$1,775.68 |
$1,775.68 |
$1,075.03
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$14,034.11 |
$14,034.11 |
$14,034.11 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$13,519.01 |
$13,519.01 |
$13,519.01 |
$2,705.95
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$12,697.20 |
$12,697.20 |
$12,697.20 |
$2,566.53
|
|
Radphm lcl tomogr sgl area sgl day
|
$12,697.20 |
$12,697.20 |
$12,697.20 |
$2,290.77
|
|
Radphm lcl tumor plr sgl day
|
$5,635.72 |
$5,635.72 |
$5,635.72 |
$1,120.50
|
|
Radphm quant measure sgl area add-on
|
$2,074.59 |
$2,074.59 |
$2,074.59 |
$665.00
|
|
Rbc count only automated
|
$177.55 |
$177.55 |
$177.55 |
$19.50
|
|
Rbc deglycerolized each unit
|
$2,201.87 |
$2,201.87 |
$2,201.87 |
$740.15
|
|
Rbc serum pretx incubj drugs
|
$585.90 |
$585.90 |
$585.90 |
$223.08
|
|
Red blood cells washed each unit
|
$2,117.84 |
$2,117.84 |
$2,117.84 |
$536.25
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$3,847.78 |
$3,847.78 |
$3,847.78 |
$626.62
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$813.79 |
$813.79 |
$813.79 |
$236.64
|
|
Remove cva lumen obstruct
|
$5,674.19 |
$5,674.19 |
$5,674.19 |
$490.80
|
|
Renal cyst study s&i
|
$5,805.61 |
$5,805.61 |
$5,805.61 |
$648.84
|
|
Renal function panel
|
$1,871.83 |
$1,871.83 |
$1,871.83 |
$113.35
|
|
Reptilase test
|
$1,237.97 |
$1,237.97 |
$1,237.97 |
$65.65
|
|
Resuscitation delivery/birthing room
|
$2,305.75 |
$2,305.75 |
$2,305.75 |
$774.37
|
|
Reticulocyte automated
|
$305.86 |
$305.86 |
$305.86 |
$54.75
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$2,244.31 |
$2,244.31 |
$2,244.31 |
$255.26
|
|
Rho(d) immune globulin h, sd
|
$3,901.53 |
$3,901.53 |
$3,901.53 |
$1,467.90
|
|
Rho d immune globulin inj
|
$2,244.31 |
$2,244.31 |
$2,244.31 |
$319.46
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$1,463.56 |
$1,463.56 |
$1,463.56 |
$489.26
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$4,680.00 |
$4,680.00 |
$4,680.00 |
$1,771.44
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$7,160.73 |
$7,160.73 |
$7,160.73 |
$8,883.80
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$5,526.20 |
$5,526.20 |
$5,526.20 |
$5,225.71
|
|
Rp loclzj tum spect w/ct 1
|
$12,697.20 |
$12,697.20 |
$12,697.20 |
$2,531.25
|
|
Rp loclzj tum spect w/ct 2
|
$12,697.20 |
$12,697.20 |
$12,697.20 |
$3,055.65
|
|
Russell viper venom diluted
|
$708.03 |
$708.03 |
$708.03 |
$73.03
|
|
Salmonella antibody
|
$758.45 |
$758.45 |
$758.45 |
$37.58
|
|
Sarscov & inf vir a&b ag ia
|
$159.47 |
$159.47 |
$159.47 |
$91.14
|
|
Screening HIV antigen/antibody combination assay
|
$753.71 |
$753.71 |
$753.71 |
$26.49
|
|
Screening prostate cancer PSA
|
$164.19 |
$164.19 |
$164.19 |
$80.84
|
|
Semen analysis presence/motility
|
$122.08 |
$122.08 |
$122.08 |
$74.75
|
|
Serpina1 gene
|
$5,307.03 |
$5,307.03 |
$5,307.03 |
$195.65
|
|
Set radiation therapy field
|
$3,271.20 |
$3,271.20 |
$3,271.20 |
$1,636.36
|
|
Shrinker prosth below knee
|
$720.00 |
$720.00 |
$720.00 |
$153.13
|
|
Sialography s&i
|
$2,640.62 |
$2,640.62 |
$2,640.62 |
$452.40
|
|
Sickling rbc
|
$302.14 |
$302.14 |
$302.14 |
$52.80
|
|
Sincalide 5 mcg solution for injection
|
$1,228.92 |
$1,228.92 |
$1,228.92 |
$402.80
|
|
Sinus/juglr venogram s&i
|
$6,217.18 |
$6,217.18 |
$6,217.18 |
$2,489.25
|
|
Sleep Study (Polysomnography)
|
$16,848.98 |
$16,848.98 |
$16,848.98 |
$3,920.95
|
|
Smear nasal eosinophil
|
$620.92 |
$620.92 |
$620.92 |
$50.00
|
|
Sock wool above knee
|
$382.00 |
$382.00 |
$382.00 |
$249.75
|
|
Sodium 24 hour urine
|
$743.47 |
$743.47 |
$743.47 |
$48.68
|
|
Sodium chloride 0.9 % intravenous solution
|
$666.02 |
$666.02 |
$666.02 |
$45.94
|
