|
MRI lower extremity other than joint without contrast (both sides)
|
$5,034.17 |
$5,034.17 |
$5,034.17 |
$2,096.84
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$7,513.07 |
$7,513.07 |
$7,513.07 |
$2,713.80
|
|
MRI orbit/face/neck without contrast
|
$4,884.11 |
$4,884.11 |
$4,884.11 |
$1,813.00
|
|
MRI orbit/face/neck without & w/contrast
|
$5,023.15 |
$5,023.15 |
$5,023.15 |
$2,674.83
|
|
MRI tmj
|
$3,816.39 |
$3,816.39 |
$3,816.39 |
$1,818.25
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$5,812.43 |
$5,812.43 |
$5,812.43 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$7,171.70 |
$7,171.70 |
$7,171.70 |
$2,655.25
|
|
Mr safety determination physician/other qhp
|
$210.74 |
$210.74 |
$210.74 |
$160.20
|
|
Mr safety implant elec prepj
|
$220.91 |
$220.91 |
$220.91 |
$168.60
|
|
Mr safety implt pos&/immoblj
|
$140.35 |
$140.35 |
$140.35 |
$137.25
|
|
Mr sfty implt&/fb asmt stf 1
|
$58.85 |
$58.85 |
$58.85 |
$45.00
|
|
Mr sfty med physics xm cstmz
|
$580.70 |
$580.70 |
$580.70 |
$402.40
|
|
Mthfr gene analy common variants
|
$247.97 |
$247.97 |
$247.97 |
$211.70
|
|
Multiple sleep latency test
|
$1,326.50 |
$1,326.50 |
$1,326.50 |
$2,585.70
|
|
Mumps antibody igg
|
$44.00 |
$44.00 |
$44.00 |
$78.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$139.44 |
$139.44 |
$139.44 |
$18.12
|
|
Mycoplasma antibody igm
|
$72.27 |
$72.27 |
$72.27 |
$79.20
|
|
Myelogphy 2/> spine regions
|
$1,997.79 |
$1,997.79 |
$1,997.79 |
$1,366.30
|
|
Myelography neck spine
|
$1,495.86 |
$1,495.86 |
$1,495.86 |
$1,103.70
|
|
Myelography via inj w/s&i 2+ regions
|
$2,862.92 |
$2,862.92 |
$2,862.92 |
$2,352.78
|
|
Myelography via inj w/s&i lumbosacral
|
$2,057.18 |
$2,057.18 |
$2,057.18 |
$2,006.40
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$183.75 |
$183.75 |
$183.75 |
$134.40
|
|
Nalbuphine 10 mg/ml injection solution
|
$42.94 |
$42.94 |
$42.94 |
$38.00
|
|
Nasal endoscopy with removal of nasal foreign body
|
$378.01 |
$378.01 |
$378.01 |
$691.35
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$27,115.08 |
$27,115.08 |
$27,115.08 |
$22,257.60
|
|
Natriuretic peptide
|
$346.62 |
$346.62 |
$346.62 |
$176.15
|
|
Natural killer cells total count
|
$514.48 |
$514.48 |
$514.48 |
$131.82
|
|
Ndl insj without njx 3+ musc
|
$83.44 |
$83.44 |
$83.44 |
$54.60
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$3,685.36 |
$3,685.36 |
$3,685.36 |
$1,766.05
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$3,621.98 |
$3,621.98 |
$3,621.98 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$7,449.15 |
$7,449.15 |
$7,449.15 |
$2,854.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$6,584.89 |
$6,584.89 |
$6,584.89 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$5,918.21 |
$5,918.21 |
$5,918.21 |
$2,001.81
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$5,996.36 |
$5,996.36 |
$5,996.36 |
$2,651.36
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$4,797.45 |
$4,797.45 |
$4,797.45 |
$1,790.58
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$70.52 |
$70.52 |
$70.52 |
$56.70
|
|
New Patient Office Visit (level 3)
|
$541.24 |
$541.24 |
$541.24 |
$221.20
|
|
New Patient Office Visit (level 4)
|
$695.07 |
$695.07 |
$695.07 |
$300.00
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$597.56 |
$597.56 |
$597.56 |
$356.09
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$17.98 |
$17.98 |
$17.98 |
$65.30
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$20,107.55 |
$20,107.55 |
$20,107.55 |
$17,658.98
|
|
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution
|
$96,427.54 |
$96,427.54 |
$96,427.54 |
$85,051.55
|
|
Nm imaging bone/joint 3 phase study
|
$5,128.19 |
$5,128.19 |
$5,128.19 |
$1,798.90
|
|
Nm imaging bone/joint whole body
|
$4,243.53 |
$4,243.53 |
$4,243.53 |
$1,736.40
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$2,865.42 |
$2,865.42 |
$2,865.42 |
$1,428.50
|
|
Nm imaging gastric emptying study
|
$2,949.56 |
$2,949.56 |
$2,949.56 |
$1,431.75
|
|
Nm imaging gastrointestinal acute blood loss
|
$2,788.10 |
$2,788.10 |
$2,788.10 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$1,413.42 |
$1,413.42 |
$1,413.42 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$3,488.52 |
$3,488.52 |
$3,488.52 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,524.16 |
$1,524.16 |
$1,524.16 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$2,085.18 |
$2,085.18 |
$2,085.18 |
$1,186.03
|
|
Nm radiopharmaceutical therapy oral administration
|
$617.57 |
$617.57 |
$617.57 |
$1,020.34
|
|
Nr lnr acclrtr tx max 5 sessions
|
$5,994.68 |
$5,994.68 |
$5,994.68 |
$7,875.40
|
|
Ntsty modul rad tx dlvr cplx
|
$2,062.18 |
$2,062.18 |
$2,062.18 |
$2,590.00
|
|
Ntsty modul rad tx dlvr smpl
|
$2,062.18 |
$2,062.18 |
$2,062.18 |
$2,364.96
|
|
Nuclear Stress Test (Heart)
|
$9,158.19 |
$9,158.19 |
$9,158.19 |
$3,921.45
|
|
Nudt15 gene common variants
|
$963.67 |
$963.67 |
$963.67 |
$320.50
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$3,728.48 |
$3,728.48 |
$3,728.48 |
$14,996.94
|
|
Observation direct referral from physician office for admission
|
$1,354.50 |
$1,354.50 |
$1,354.50 |
$411.10
|
|
Observation per hour
|
$67.45 |
$67.45 |
$67.45 |
$79.30
|
|
Obstetrics panel
|
$739.53 |
$739.53 |
$739.53 |
$204.80
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$141,010.87 |
$141,010.87 |
$141,010.87 |
$54,942.65
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$79.66 |
$79.66 |
$79.66 |
$73.13
|
|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$27,567.35 |
$27,567.35 |
$27,567.35 |
$5,346.32
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$9,685.93 |
$9,685.93 |
$9,685.93 |
$4,797.94
|
|
Onco (ovar) five proteins
|
$1,225.76 |
$1,225.76 |
$1,225.76 |
$897.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$33.23 |
$33.23 |
$33.23 |
$34.32
|
|
Organic acids total quant ea spec
|
$68.30 |
$68.30 |
$68.30 |
$151.36
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$63.72 |
$63.72 |
$63.72 |
$65.07
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$1,996.34 |
$1,996.34 |
$1,996.34 |
$801.60
|
|
Orthovisc inj per dose
|
$400.54 |
$400.54 |
$400.54 |
$498.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$1,026.48 |
$1,026.48 |
$1,026.48 |
$269.58
|
|
Oscillation chest wall mechanical per session
|
$697.05 |
$697.05 |
$697.05 |
$221.34
|
|
Osmolality blood
|
$145.45 |
$145.45 |
$145.45 |
$67.60
|
|
Osmolality urine
|
$145.45 |
$145.45 |
$145.45 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$511.04 |
$511.04 |
$511.04 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$511.04 |
$511.04 |
$511.04 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$557.13 |
$557.13 |
$557.13 |
$270.58
|
|
Oth resp proc, indiv
|
$106.73 |
$106.73 |
$106.73 |
$87.45
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$124.78 |
$124.78 |
$124.78 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$231.16 |
$231.16 |
$231.16 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$204.97 |
$204.97 |
$204.97 |
$107.32
|
|
Ot re-evaluation patient/family
|
$243.81 |
$243.81 |
$243.81 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$202.50 |
$202.50 |
$202.50 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$143.38 |
$143.38 |
$143.38 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$171.48 |
$171.48 |
$171.48 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$155.09 |
$155.09 |
$155.09 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$180.56 |
$180.56 |
$180.56 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$195.21 |
$195.21 |
$195.21 |
$93.75
|
|
Oxaliplatin 5 mg/ml desensitization
|
$317.72 |
$317.72 |
$317.72 |
$364.29
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$1,075.56 |
$1,075.56 |
$1,075.56 |
$231.46
|
|
Palonosetron hcl
|
$973.13 |
$973.13 |
$973.13 |
$372.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$160.14 |
$160.14 |
$160.14 |
$146.80
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$21,429.55 |
$21,429.55 |
$21,429.55 |
$18,554.59
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$65.20 |
$65.20 |
$65.20 |
$44.25
|
|
Papaverin hcl injection
|
$87.52 |
$87.52 |
$87.52 |
$76.40
|
|
Parathormone (pth) intact
|
$853.72 |
$853.72 |
$853.72 |
$200.23
|
|
Parathyroid planar imaging
|
$1,373.87 |
$1,373.87 |
$1,373.87 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$2,135.62 |
$2,135.62 |
$2,135.62 |
$1,398.75
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$16,203.54 |
$16,203.54 |
$16,203.54 |
$12,556.80
|