|
Nm imaging gastrointestinal acute blood loss
|
$2,499.00 |
$2,499.00 |
$2,499.00 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$4,518.00 |
$4,518.00 |
$4,518.00 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$4,026.00 |
$4,026.00 |
$4,026.00 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$8,110.00 |
$8,110.00 |
$8,110.00 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$10,568.00 |
$10,568.00 |
$10,568.00 |
$1,186.03
|
|
Nm radiopharmaceutical therapy oral administration
|
$6,248.00 |
$6,248.00 |
$6,248.00 |
$1,020.34
|
|
Noninv pace analysis
|
$908.00 |
$908.00 |
$908.00 |
$761.60
|
|
Nuclear Stress Test (Heart)
|
$12,301.00 |
$12,301.00 |
$12,301.00 |
$3,921.45
|
|
Ob Ultrasound nuchal meas 1 gest
|
$789.00 |
$789.00 |
$789.00 |
$331.29
|
|
Ob Ultrasound nuchal meas add-on
|
$559.00 |
$559.00 |
$559.00 |
$243.29
|
|
Olanzapine 10 mg intramuscular solution
|
$191.47 |
$191.47 |
$191.47 |
$122.78
|
|
Oprelvekin injection
|
$5,599.00 |
$5,599.00 |
$5,599.00 |
$848.31
|
|
Oral busulfan
|
$41.00 |
$41.00 |
$41.00 |
$84.21
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$302.00 |
$302.00 |
$302.00 |
$65.07
|
|
Oscillation chest wall mechanical per session
|
$708.00 |
$708.00 |
$708.00 |
$221.34
|
|
Osmolality blood
|
$499.00 |
$499.00 |
$499.00 |
$67.60
|
|
Osmolality urine
|
$499.00 |
$499.00 |
$499.00 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$1,023.00 |
$1,023.00 |
$1,023.00 |
$270.58
|
|
Ot re-evaluation patient/family
|
$480.00 |
$480.00 |
$480.00 |
$174.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$617.00 |
$617.00 |
$617.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$617.00 |
$617.00 |
$617.00 |
$91.80
|
|
Oxaliplatin 5 mg/ml desensitization
|
$18,536.00 |
$18,536.00 |
$18,536.00 |
$364.29
|
|
Oxytocin 10 unit/ml injection solution
|
$377.00 |
$377.00 |
$377.00 |
$45.86
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$218.00 |
$218.00 |
$218.00 |
$231.46
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$7,264.00 |
$7,264.00 |
$7,264.00 |
$146.80
|
|
Parathyroid planar imaging
|
$2,793.00 |
$2,793.00 |
$2,793.00 |
$1,166.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$3,660.00 |
$3,660.00 |
$3,660.00 |
$4,418.62
|
|
Pelvic CT scan (with and without contrast)
|
$12,335.00 |
$12,335.00 |
$12,335.00 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$11,427.00 |
$11,427.00 |
$11,427.00 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$11,022.00 |
$11,022.00 |
$11,022.00 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$16,208.00 |
$16,208.00 |
$16,208.00 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$11,914.00 |
$11,914.00 |
$11,914.00 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$9,536.00 |
$9,536.00 |
$9,536.00 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$3,982.00 |
$3,982.00 |
$3,982.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$2,198.00 |
$2,198.00 |
$2,198.00 |
$445.00
|
|
Peng benzathine/procaine inj
|
$967.00 |
$967.00 |
$967.00 |
$258.72
|
|
Pentobarbital sodium inj
|
$97.00 |
$97.00 |
$97.00 |
$167.64
|
|
Pentostatin 10 mg intravenous solution
|
$22,377.00 |
$22,377.00 |
$22,377.00 |
$6,112.62
|
|
Pet CT skull-mid thgh initial
|
$9,900.00 |
$9,900.00 |
$9,900.00 |
$4,854.75
|
|
Pet CT whole body initial
|
$9,900.00 |
$9,900.00 |
$9,900.00 |
$5,017.50
|
|
Pet fdg brain metoblic eval sb
|
$9,898.00 |
$9,898.00 |
$9,898.00 |
$3,559.05
|
|
Pet image full body
|
$9,900.00 |
$9,900.00 |
$9,900.00 |
$4,795.47
|
|
Pet image ltd area
|
$9,898.00 |
$9,898.00 |
$9,898.00 |
$2,519.20
|
|
Pet image skull-thigh
|
$9,900.00 |
$9,900.00 |
$9,900.00 |
$4,247.10
|
|
Pet image w/ct lmtd
|
$9,898.00 |
$9,898.00 |
$9,898.00 |
$4,422.60
|
|
Phencyclidine (pcp)
|
$162.00 |
$162.00 |
$162.00 |
$88.00
|
|
Phenobarbital therapeutic drug level
|
$837.00 |
$837.00 |
$837.00 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,664.00 |
$1,664.00 |
$1,664.00 |
$1,011.98
|
|
Phenytoin total therapeutic drug level
|
$778.00 |
$778.00 |
$778.00 |
$111.27
|
|
Phlebotomy therapeutic
|
$1,579.00 |
$1,579.00 |
$1,579.00 |
$249.00
|
|
Phosphorus 24 hour urine
|
$466.00 |
$466.00 |
$466.00 |
$42.81
|
|
Pinworm exam
|
$319.00 |
$319.00 |
$319.00 |
$39.75
|
|
Platelet automated
|
$393.00 |
$393.00 |
$393.00 |
$44.00
|
|
Pm device progr eval dual
|
$114.00 |
$114.00 |
$114.00 |
$148.00
|
|
Pm device progr eval multi
|
$114.00 |
$114.00 |
$114.00 |
$160.55
|
|
Potassium 24 hour urine
|
$458.00 |
$458.00 |
$458.00 |
$50.00
|
|
Potassium serum/plasma/whole blood
|
$418.00 |
$418.00 |
$418.00 |
$44.64
|
|
Pouch uros new (both sides) 2.75in clr
|
$21.00 |
$21.00 |
$21.00 |
$14.48
|
|
Pq biliary strict dil s&i
|
$1,006.00 |
$1,006.00 |
$1,006.00 |
$1,006.00
|
|
Pq dr cath chg w cont s&i
|
$1,191.00 |
$1,191.00 |
$1,191.00 |
$711.36
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$597.00 |
$597.00 |
$597.00 |
$356.40
|
|
Prealbumin
|
$241.00 |
$241.00 |
$241.00 |
$87.20
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$33.00 |
$33.00 |
$33.00 |
$16.30
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$4,126.00 |
$4,126.00 |
$4,126.00 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$5,617.00 |
$5,617.00 |
$5,617.00 |
$541.45
|
|
Pretreat rbc absorption reference
|
$503.00 |
$503.00 |
$503.00 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$694.00 |
$694.00 |
$694.00 |
$189.84
|
|
Pretreat rbc w enzyme reference
|
$478.00 |
$478.00 |
$478.00 |
$166.10
|
|
Prgrmg dev eval impltbl sys
|
$114.00 |
$114.00 |
$114.00 |
$148.00
|
|
Prgrmg dev eval pm/ldls pm
|
$114.00 |
$114.00 |
$114.00 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$114.00 |
$114.00 |
$114.00 |
$143.55
|
|
Prgrmg eval implantable dfb
|
$114.00 |
$114.00 |
$114.00 |
$172.33
|
|
Prgrmg eval implantable dfb
|
$114.00 |
$114.00 |
$114.00 |
$183.00
|
|
Procalcitonin
|
$898.00 |
$898.00 |
$898.00 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$268.00 |
$268.00 |
$268.00 |
$46.50
|
|
Progesterone
|
$490.00 |
$490.00 |
$490.00 |
$105.00
|
|
Prolactin
|
$1,510.00 |
$1,510.00 |
$1,510.00 |
$127.50
|
|
Promethazine 25 mg tablet
|
$64.00 |
$64.00 |
$64.00 |
$7.01
|
|
Promethazine hcl injection
|
$120.00 |
$120.00 |
$120.00 |
$33.34
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$132.00 |
$132.00 |
$132.00 |
$39.59
|
|
Protein c activity
|
$6,269.00 |
$6,269.00 |
$6,269.00 |
$115.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$1,680.00 |
$1,680.00 |
$1,680.00 |
$85.20
|
|
Protein s total
|
$393.00 |
$393.00 |
$393.00 |
$78.87
|
|
Protein total 24 hour urine
|
$926.00 |
$926.00 |
$926.00 |
$52.50
|
|
Protein total serum plasma whole blood
|
$1,017.00 |
$1,017.00 |
$1,017.00 |
$42.81
|
|
Prothrombin time substitution plasma fractions each
|
$1,978.00 |
$1,978.00 |
$1,978.00 |
$37.05
|
|
PSA (Prostate) Test
|
$649.00 |
$649.00 |
$649.00 |
$109.35
|
|
Psytx complex interactive
|
$610.00 |
$610.00 |
$610.00 |
$45.00
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$649.00 |
$649.00 |
$649.00 |
$105.30
|
|
Pt application of modality traction mechanical
|
$772.00 |
$772.00 |
$772.00 |
$88.20
|
|
Pt evaluation high complexity patient/family
|
$3,513.00 |
$3,513.00 |
$3,513.00 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$3,513.00 |
$3,513.00 |
$3,513.00 |
$226.00
|
|
Pt evaluation moderate complexity patient/family
|
$3,513.00 |
$3,513.00 |
$3,513.00 |
$263.90
|
|
Pt re-evaluation patient/family
|
$1,779.00 |
$1,779.00 |
$1,779.00 |
$157.30
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$1,069.00 |
$1,069.00 |
$1,069.00 |
$85.68
|
|
Pulmonary vent imaging
|
$6,464.00 |
$6,464.00 |
$6,464.00 |
$845.28
|
|
Pulse ox multiple
|
$1,089.00 |
$1,089.00 |
$1,089.00 |
$194.33
|
|
Pulse ox single
|
$84.00 |
$84.00 |
$84.00 |
$88.63
|
