|
Ob Ultrasound nuchal meas add-on
|
$94.01 |
$481.92 |
$644.50 |
|
|
Occupational Therapy Evaluation (high complexity)
|
$108.47 |
$928.55 |
$2,597.00 |
|
|
Occupational Therapy Evaluation (low complexity)
|
$108.05 |
$759.72 |
$1,968.08 |
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$104.33 |
$844.12 |
$1,730.00 |
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$121,301.04 |
$173,306.07 |
$173,306.07 |
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$524.57 |
$524.57 |
$524.57 |
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$58,875.04 |
$58,875.04 |
$58,875.04 |
|
|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$418.85 |
$33,885.63 |
$33,885.63 |
|
|
Olanzapine 10 mg intramuscular solution
|
$83.89 |
$615.01 |
$1,350.72 |
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$7,937.00 |
$11,909.62 |
$11,909.62 |
|
|
Oncology colon mrna
|
$20,537.00 |
$20,537.00 |
$20,537.00 |
|
|
Oncology prostate prob score
|
$1,257.83 |
$1,257.83 |
$1,257.83 |
|
|
Oncology tissue of origin
|
$12,706.00 |
$12,706.00 |
$12,706.00 |
|
|
Oncology tum unknown origin
|
$17,781.75 |
$31,229.01 |
$31,229.01 |
|
|
Onco (ovar) five proteins
|
$374.05 |
$828.83 |
$1,700.71 |
|
|
Onco (ovar) two proteins
|
$337.82 |
$337.82 |
$337.82 |
|
|
Oncoprotein dcp
|
$44.62 |
$469.64 |
$469.64 |
|
|
Oncoprotein her-2/neu
|
$1,194.97 |
$1,194.97 |
$1,194.97 |
|
|
Ondansetron 8 mg disintegrating tablet
|
$22.96 |
$22.96 |
$23.55 |
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$89.51 |
$109.27 |
$1,137.00 |
|
|
Optx acromclv dislc aqt/chrn
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx clavicular fx w/int fix
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx medial ankle fx
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx radial shaft fracture
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx rdl&uln shft fx rds&uln
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx ulnar shft fx int fixj
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Optx ulnar styloid fracture
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Oral aprepitant
|
$0.21 |
$0.21 |
$912.93 |
|
|
Oral busulfan
|
$25.76 |
$34.00 |
$56.75 |
|
|
Oral everolimus
|
$55.00 |
$59.50 |
$172.50 |
|
|
Oral hiv-1/hiv-2 screen
|
$234.20 |
$647.80 |
$1,489.07 |
|
|
Organic acids total quant ea spec
|
$22.93 |
$261.84 |
$4,212.42 |
|
|
Oritavancin 1,200 mg intravenous solution
|
$21,207.25 |
$21,207.25 |
$21,207.25 |
|
|
Oritavancin 400 mg intravenous solution
|
$3,709.75 |
$6,464.64 |
$13,223.00 |
|
|
Oropharyngeal biopsy 42800
|
$4,045.88 |
$4,045.88 |
$4,045.88 |
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$15.56 |
$405.20 |
$462.00 |
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$822.94 |
$822.94 |
$822.94 |
|
|
Ortho elbow w/lock w/ft&adj
|
$783.41 |
$783.41 |
$783.41 |
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$873.19 |
$873.19 |
$873.19 |
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$771.89 |
$771.89 |
$771.89 |
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$503.12 |
$503.12 |
$503.12 |
|
|
Ortho hnd without jnt w/fit&adj
|
$771.89 |
$771.89 |
$771.89 |
|
|
Orthopantogram
|
$44.70 |
$808.94 |
$3,579.95 |
|
|
Orthosis lso rigd frm hyperex
|
$616.95 |
$616.95 |
$616.95 |
|
|
Orthovisc inj per dose
|
$498.00 |
$498.00 |
$498.00 |
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$468.21 |
$468.21 |
$468.21 |
|
|
Oscillation chest wall mechanical per session
|
$120.78 |
$736.45 |
$3,892.50 |
|
|
Osmolality blood
|
$12.71 |
$333.31 |
$1,326.33 |
|
|
Osmolality urine
|
$12.71 |
$269.35 |
$1,326.33 |
|
|
Ostectomy complete 1st metatarsal head 28111
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Osteopath manip tx/5-6 body region 98927
|
$94.41 |
$94.41 |
$94.41 |
|
|
Osteopath manip tx/7-8 body region 98928
|
$112.11 |
$112.11 |
$112.11 |
|
|
Osteopath manip tx/9-10 body region98929
|
$112.11 |
$112.11 |
$112.11 |
|
|
Osteotomy/graft tarsal/calcaneus/talus 28305
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Ost pch drain w bar & filter
|
$34.00 |
$34.00 |
$34.00 |
|
|
Other immunoelectrophoresis
|
$140.88 |
$2,083.20 |
$2,919.75 |
|
|
Oth resp proc, group
|
$37.91 |
$137.05 |
$1,152.25 |
|
|
Oth resp proc, indiv
|
$19.76 |
$137.05 |
$1,321.10 |
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$23.32 |
$119.77 |
$601.15 |
|
|
Ot re-evaluation patient/family
|
$93.15 |
$571.11 |
$973.18 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$37.41 |
$383.46 |
$542.00 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$38.99 |
$383.46 |
$542.00 |
|
|
Oxaliplatin 5 mg/ml desensitization
|
$731.16 |
$731.16 |
$1,026.00 |
|
|
Oxytocin 10 unit/ml injection solution
|
$98.63 |
$186.11 |
$505.68 |
|
|
P-32 chromic phos ther per mci
|
$43,798.74 |
$43,798.74 |
$43,798.74 |
|
|
P-32 sod phosphate ther per mci
|
$1,642.00 |
$1,642.00 |
$43,798.74 |
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$3.23 |
$2,815.70 |
$2,815.70 |
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$5,321.24 |
$12,434.53 |
$22,195.60 |
|
|
Pad repl cerv collr univ adult
|
$194.66 |
$194.66 |
$194.66 |
|
|
Palingen or palingen xplus
|
$1.00 |
$1.00 |
$1.00 |
|
|
Palivizumab 50 mg/0.5 ml inj
|
$10,404.03 |
$11,862.28 |
$19,929.84 |
|
|
Palonosetron hcl
|
$70.35 |
$2,659.32 |
$3,923.43 |
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$274.00 |
$803.98 |
$6,704.88 |
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$1,939.00 |
$28,208.92 |
$35,979.85 |
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$36.87 |
$294.67 |
$1,036.00 |
|
|
Papaverin hcl injection
|
$419.08 |
$419.08 |
$419.08 |
|
|
Parathormone (pth) intact
|
$28.15 |
$76.38 |
$661.07 |
|
|
Parathyrd planar w/spect&ct
|
$569.54 |
$8,216.02 |
$17,264.00 |
|
|
Parathyroid planar imaging
|
$458.10 |
$4,117.69 |
$11,636.46 |
|
|
Parathyroid planar img w/tomo spect
|
$522.97 |
$6,280.11 |
$24,333.71 |
|
|
Paricalcitol
|
$115.43 |
$556.37 |
$5,036.64 |
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$121.50 |
$529.44 |
$529.44 |
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Partial removal foot fascia
|
$8,017.78 |
$8,017.78 |
$8,017.78 |
|
|
Partial removal of eye fluid
|
$6,293.91 |
$6,293.91 |
$6,293.91 |
|
|
Partial removal of foot bone
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$13.81 |
$13.81 |
$13.81 |
|
|
Part removal of metatarsal
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Passy muir valve metal trach
|
$784.00 |
$784.00 |
$784.00 |
|
|
Path clin consltj high 41-60
|
$211.25 |
$526.01 |
$526.01 |
|
|
Path clin consltj mod 21-40
|
$148.61 |
$148.61 |
$148.61 |
|
|
Path clin consltj prolng svc
|
$101.52 |
$101.52 |
$101.52 |
|
|
Path clin consltj sf 5-20
|
$52.27 |
$52.27 |
$52.27 |
|
|
Pca3/klk3 antigen
|
$1,701.91 |
$1,701.91 |
$1,701.91 |
|
|
Pdgfra gene
|
$137.47 |
$609.93 |
$4,835.85 |
|
|
Pegaspargase injection
|
$107,651.04 |
$128,313.67 |
$136,042.28 |
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$14,712.85 |
$19,919.66 |
$43,326.50 |
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$6,993.24 |
$6,993.24 |
$16,924.75 |
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$10,395.28 |
$14,043.66 |
$14,229.60 |
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$7,446.94 |
$13,464.77 |
$33,281.92 |
|