|
MRI tmj
|
$14,061.00 |
$14,061.00 |
$14,061.00 |
$1,847.40
|
|
MRI w/cont, breast, bi
|
$3,147.00 |
$3,147.00 |
$3,147.00 |
$1,831.25
|
|
MRI without fol w/cont, breast
|
$13,057.00 |
$13,057.00 |
$13,057.00 |
$2,071.85
|
|
M.tuberculo dna dir probe
|
$283.00 |
$283.00 |
$283.00 |
$58.40
|
|
Mucopolysaccharides
|
$273.00 |
$273.00 |
$273.00 |
$211.20
|
|
Multiple sleep latency test
|
$11,343.00 |
$11,343.00 |
$11,343.00 |
$2,547.05
|
|
Mycophenolate mofetil 250 mg capsule
|
$70.00 |
$70.00 |
$70.00 |
$17.77
|
|
Myelogphy 2/> spine regions
|
$23,304.00 |
$23,304.00 |
$23,304.00 |
$1,362.69
|
|
Myelography l-s spine
|
$5,948.00 |
$5,948.00 |
$5,948.00 |
$1,334.09
|
|
Myelography neck spine
|
$6,393.00 |
$6,393.00 |
$6,393.00 |
$1,103.70
|
|
Myelography thoracic spine
|
$6,040.00 |
$6,040.00 |
$6,040.00 |
$1,077.92
|
|
Naltrexone, depot form
|
$17,564.00 |
$17,564.00 |
$17,564.00 |
$5,075.16
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$17,310.00 |
$17,310.00 |
$17,310.00 |
$2,854.80
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$13,918.00 |
$13,918.00 |
$13,918.00 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$16,091.00 |
$16,091.00 |
$16,091.00 |
$2,001.81
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$13,057.00 |
$13,057.00 |
$13,057.00 |
$2,659.98
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$10,637.00 |
$10,637.00 |
$10,637.00 |
$2,030.23
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$19,890.00 |
$19,890.00 |
$19,890.00 |
$1,790.58
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$905.00 |
$905.00 |
$905.00 |
$63.59
|
|
Nerve teasing preparations
|
$703.00 |
$703.00 |
$703.00 |
$698.49
|
|
Nesiritide injection
|
$4,840.00 |
$4,840.00 |
$4,840.00 |
$2,365.81
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$7,374.14 |
$7,374.14 |
$7,374.14 |
$17,123.74
|
|
Nm imaging bone/joint 3 phase study
|
$11,588.00 |
$11,588.00 |
$11,588.00 |
$1,798.90
|
|
Nm imaging bone/joint whole body
|
$7,921.00 |
$7,921.00 |
$7,921.00 |
$1,723.50
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$3,823.00 |
$3,823.00 |
$3,823.00 |
$1,446.64
|
|
Nm imaging gastric emptying study
|
$5,242.00 |
$5,242.00 |
$5,242.00 |
$1,431.75
|
|
Nm imaging gastrointestinal acute blood loss
|
$4,573.00 |
$4,573.00 |
$4,573.00 |
$1,272.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$8,021.00 |
$8,021.00 |
$8,021.00 |
$1,800.15
|
|
Nm imaging pulmonary ventilation/perfusion
|
$11,255.00 |
$11,255.00 |
$11,255.00 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,508.00 |
$1,508.00 |
$1,508.00 |
$1,186.03
|
|
Nm radiopharmaceutical therapy oral administration
|
$11,933.00 |
$11,933.00 |
$11,933.00 |
$1,024.52
|
|
Nuclear rx IV admin
|
$2,313.00 |
$2,313.00 |
$2,313.00 |
$863.20
|
|
Nuclear Stress Test (Heart)
|
$1,315.00 |
$1,315.00 |
$1,315.00 |
$3,916.80
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$78,972.00 |
$78,972.00 |
$78,972.00 |
$14,996.94
|
|
Olanzapine 10 mg intramuscular solution
|
$507.01 |
$507.01 |
$507.01 |
$122.80
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$12,811.00 |
$12,811.00 |
$12,811.00 |
$4,797.94
|
|
Oprelvekin injection
|
$2,635.00 |
$2,635.00 |
$2,635.00 |
$848.31
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$380.00 |
$380.00 |
$380.00 |
$65.07
|
|
Oscillation chest wall mechanical per session
|
$342.00 |
$342.00 |
$342.00 |
$214.80
|
|
Ot evaluation high complexity patient/family
|
$1,193.00 |
$1,193.00 |
$1,193.00 |
$301.41
|
|
Ot evaluation low complexity patient/family
|
$1,193.00 |
$1,193.00 |
$1,193.00 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$1,193.00 |
$1,193.00 |
$1,193.00 |
$270.58
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$609.00 |
$609.00 |
$609.00 |
$100.80
|
|
Ot re-evaluation patient/family
|
$747.00 |
$747.00 |
$747.00 |
$174.00
|
|
Oxaliplatin 5 mg/ml desensitization
|
$1,972.00 |
$1,972.00 |
$1,972.00 |
$366.28
|
|
Oxytocin 10 unit/ml injection solution
|
$160.00 |
$160.00 |
$160.00 |
$46.75
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$2.00 |
$2.00 |
$2.00 |
$222.09
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,562.88 |
$1,562.88 |
$1,562.88 |
$4,014.63
|
|
Palonosetron hcl
|
$163.00 |
$163.00 |
$163.00 |
$409.64
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$2,356.00 |
$2,356.00 |
$2,356.00 |
$148.35
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$16,012.00 |
$16,012.00 |
$16,012.00 |
$18,390.86
|
|
Parathyroid planar imaging
|
$1,635.00 |
$1,635.00 |
$1,635.00 |
$1,159.15
|
|
Parathyroid planar img w/tomo spect
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$1,406.42
|
|
Paricalcitol
|
$435.00 |
$435.00 |
$435.00 |
$47.38
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$4,253.24 |
$4,253.24 |
$4,253.24 |
$12,717.60
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$9,469.08 |
$9,469.08 |
$9,469.08 |
$7,908.88
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,028.88 |
$4,028.88 |
$4,028.88 |
$8,401.26
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$7,094.00 |
$7,094.00 |
$7,094.00 |
$5,961.60
|
|
Pelvic MRI (with and without contrast)
|
$12,262.00 |
$12,262.00 |
$12,262.00 |
$2,748.85
|
|
Pelvic MRI (with contrast)
|
$11,329.00 |
$11,329.00 |
$11,329.00 |
$2,096.25
|
|
Pelvic MRI (without contrast)
|
$7,831.00 |
$7,831.00 |
$7,831.00 |
$1,879.15
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$22,754.72 |
$22,754.72 |
$22,754.72 |
$16,273.24
|
|
Peng benzathine/procaine inj
|
$450.00 |
$450.00 |
$450.00 |
$254.00
|
|
Perit-vens shunt pat tst
|
$1,572.00 |
$1,572.00 |
$1,572.00 |
$694.48
|
|
Pertussis ag if
|
$334.00 |
$334.00 |
$334.00 |
$49.00
|
|
Pertuzumab 30 mg/ml desensitization
|
$54,053.39 |
$54,053.39 |
$54,053.39 |
$18,443.20
|
|
Pertuzu, trastuzu, 10 mg
|
$13,024.68 |
$13,024.68 |
$13,024.68 |
$51,278.21
|
|
Phentolaine mesylate inj
|
$451.00 |
$451.00 |
$451.00 |
$973.85
|
|
Phosphorus 24 hour urine
|
$211.00 |
$211.00 |
$211.00 |
$42.81
|
|
Pinworm exam
|
$190.00 |
$190.00 |
$190.00 |
$39.75
|
|
Placement occlusive device venous/arterial access site post procedure
|
$2,197.00 |
$2,197.00 |
$2,197.00 |
$561.15
|
|
Placental lactogen
|
$648.00 |
$648.00 |
$648.00 |
$143.67
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$492.00 |
$492.00 |
$492.00 |
$176.80
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$12,449.00 |
$12,449.00 |
$12,449.00 |
$4,293.60
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$16.00 |
$16.00 |
$16.00 |
$4.67
|
|
Pq biliary strict dil s&i
|
$9,327.00 |
$9,327.00 |
$9,327.00 |
$999.17
|
|
Pq dr cath chg w cont s&i
|
$1,865.00 |
$1,865.00 |
$1,865.00 |
$711.36
|
|
Pralidoxime 1 gram solution for injection
|
$431.00 |
$431.00 |
$431.00 |
$374.55
|
|
Pr application of long arm splint
|
$880.00 |
$880.00 |
$880.00 |
$332.07
|
|
Pr application splint static short arm
|
$880.00 |
$880.00 |
$880.00 |
$300.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$104.00 |
$104.00 |
$104.00 |
$48.71
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$2.50 |
$2.50 |
$2.50 |
$17.00
|
|
Pretreat rbc absorption reference
|
$151.00 |
$151.00 |
$151.00 |
$137.80
|
|
Pretreat rbc w enzyme reference
|
$1,508.00 |
$1,508.00 |
$1,508.00 |
$164.99
|
|
Prgrmg eval implantable dfb
|
$431.00 |
$431.00 |
$431.00 |
$144.30
|
|
Prgrmg eval implantable dfb
|
$431.00 |
$431.00 |
$431.00 |
$173.25
|
|
Prgr stim/pace a/iv drug
|
$50,675.00 |
$50,675.00 |
$50,675.00 |
$4,889.30
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$700.00 |
$700.00 |
$700.00 |
$633.52
|
|
Procalcitonin
|
$393.00 |
$393.00 |
$393.00 |
$142.50
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$207.00 |
$207.00 |
$207.00 |
$46.61
|
|
Progesterone
|
$175.00 |
$175.00 |
$175.00 |
$104.40
|
|
Promethazine hcl injection
|
$160.00 |
$160.00 |
$160.00 |
$33.17
|
|
Pt application of modality traction mechanical
|
$1,267.00 |
$1,267.00 |
$1,267.00 |
$88.80
|
|
Pt evaluation high complexity patient/family
|
$1,598.00 |
$1,598.00 |
$1,598.00 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$1,598.00 |
$1,598.00 |
$1,598.00 |
$226.80
|
|
Pt evaluation moderate complexity patient/family
|
$1,598.00 |
$1,598.00 |
$1,598.00 |
$264.00
|
|
Pt re-evaluation patient/family
|
$1,598.00 |
$1,598.00 |
$1,598.00 |
$158.40
|
|
Pulmonary vent imaging
|
$11,255.00 |
$11,255.00 |
$11,255.00 |
$841.26
|
|
Pulse ox multiple
|
$58.00 |
$58.00 |
$58.00 |
$194.33
|
|
Pulse ox single
|
$262.00 |
$262.00 |
$262.00 |
$88.63
|
