|
Oil silicone ophth 8.5ml silikon 1000
|
$2,483.65 |
$2,483.65 |
$2,483.65 |
$1,220.80
|
|
Olanzapine 10 mg intramuscular solution
|
$12.35 |
$12.35 |
$220.00 |
$109.62
|
|
Olanzapine long-acting inj
|
$176.15 |
$176.15 |
$176.15 |
$1,847.66
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$268.45 |
$268.45 |
$268.45 |
$4,595.01
|
|
Onc breast mrna 70 genes
|
$6,667.70 |
$6,667.70 |
$6,667.70 |
$6,667.70
|
|
Onc cutan mlnma mrna 31 gene
|
$13,485.55 |
$13,485.55 |
$13,485.55 |
$9,230.85
|
|
Oncology colon mrna
|
$7,016.10 |
$7,016.10 |
$7,016.10 |
$6,232.00
|
|
Oncology tum unknown origin
|
$12,217.40 |
$12,217.40 |
$12,217.40 |
$4,125.00
|
|
Onc prostate 3 genes
|
$5,240.30 |
$5,240.30 |
$5,240.30 |
$2,801.40
|
|
Onc prostate mrna 22 cnt gen
|
$8,715.20 |
$8,715.20 |
$8,715.20 |
$6,347.64
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$3.25 |
$3.25 |
$3.25 |
$22.62
|
|
Open aortic tube prosth repair 34830
|
$6,529.90 |
$6,529.90 |
$6,529.90 |
$4,289.60
|
|
Open aortofemor prosth repr
|
$6,529.90 |
$6,529.90 |
$6,529.90 |
$3,942.84
|
|
Open aortoiliac prosth repr 34831
|
$6,529.90 |
$6,529.90 |
$6,529.90 |
$3,678.92
|
|
Open periprosthetic breast capsule 19370
|
$20,610.85 |
$20,610.85 |
$20,610.85 |
$4,531.42
|
|
Open thrombectomy of av fistula without revision 36831
|
$14,246.70 |
$14,246.70 |
$14,246.70 |
$6,366.08
|
|
Ophthalmic mitomycin
|
$2,591.55 |
$2,591.55 |
$2,591.55 |
$775.44
|
|
Opioids & opiate analogs 3/4
|
$7.15 |
$7.15 |
$7.15 |
$24.00
|
|
Opn ax/subcla art expos
|
$4,723.55 |
$4,723.55 |
$4,723.55 |
$1,464.00
|
|
Opn fem art expos cndt crtj 34714
|
$7,392.45 |
$7,392.45 |
$7,392.45 |
$2,041.65
|
|
Opn ilac art expos cndt crtj
|
$7,398.95 |
$7,398.95 |
$7,398.95 |
$1,169.29
|
|
Oral aprepitant
|
$639.60 |
$639.60 |
$639.60 |
$410.20
|
|
Oral busulfan
|
$43.00 |
$176.80 |
$176.80 |
$176.80
|
|
Oral everolimus
|
$3,645.20 |
$3,645.20 |
$3,645.20 |
$30.30
|
|
Oritavancin 1,200 mg intravenous solution
|
$197.60 |
$197.60 |
$197.60 |
$11,017.26
|
|
Oropharyngeal biopsy 42800
|
$7,536.10 |
$7,536.10 |
$7,536.10 |
$2,443.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$141.70 |
$141.70 |
$304.00 |
$50.63
|
|
Orthopantogram
|
$399.75 |
$399.75 |
$399.75 |
$241.50
|
|
Orthovisc inj per dose
|
$1,324.70 |
$1,324.70 |
$1,324.70 |
$537.58
|
|
Oscillation chest wall mechanical per session
|
$193.05 |
$193.05 |
$667.00 |
$196.30
|
|
Osmolality blood
|
$237.90 |
$237.90 |
$486.00 |
$70.85
|
|
Osmolality urine
|
$237.90 |
$237.90 |
$486.00 |
$65.52
|
|
Ost pch drain for barrier fl
|
$7.15 |
$7.15 |
$7.15 |
$11.45
|
|
Ost pch drain w bar & filter
|
$7.80 |
$7.80 |
$7.80 |
$2.92
|
|
Ost urine pch w b/bltin conv
|
$7.15 |
$7.15 |
$7.15 |
$2.90
|
|
Other immunoelectrophoresis
|
$227.00 |
$227.00 |
$227.00 |
$107.52
|
|
Oth resp proc, group
|
$105.30 |
$105.30 |
$105.30 |
$126.00
|
|
Oth resp proc, indiv
|
$262.60 |
$262.60 |
$262.60 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$121.55 |
$121.55 |
$121.55 |
$97.80
|
|
Ot re-evaluation patient/family
|
$299.00 |
$299.00 |
$451.00 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$188.50 |
$188.50 |
$188.50 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$188.50 |
$188.50 |
$188.50 |
$93.12
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$706.55 |
$706.55 |
$706.55 |
$76.52
|
|
Oxaliplatin 5 mg/ml desensitization
|
$2.60 |
$2.60 |
$384.00 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$130.65 |
$130.65 |
$377.00 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$2.60 |
$2.60 |
$2.60 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$79.95 |
$79.95 |
$13,146.00 |
$3,435.42
|
|
Palifermin injection
|
$144.30 |
$144.30 |
$204.00 |
$5,464.63
|
|
Palingen or palingen xplus
|
$1.00 |
$1.00 |
$1.00 |
$171.12
|
|
Paliperidone 117 mg/0.75 ml inj
|
$9,351.00 |
$9,351.00 |
$9,351.00 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$10,341.50 |
$10,341.50 |
$10,341.50 |
$5,580.28
|
|
Palonosetron hcl
|
$16.90 |
$16.90 |
$4,697.00 |
$163.00
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$180.70 |
$180.70 |
$7,268.00 |
$123.55
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$853.45 |
$853.45 |
$853.45 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$46.15 |
$46.15 |
$53.00 |
$28.90
|
|
Papaverin hcl injection
|
$335.40 |
$335.40 |
$335.40 |
$78.75
|
|
Parathormone (pth) intact
|
$217.75 |
$217.75 |
$217.75 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$2,429.70 |
$2,429.70 |
$2,429.70 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,995.50 |
$1,995.50 |
$3,312.00 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$1,681.00 |
$1,694.55 |
$1,694.55 |
$1,374.75
|
|
Paricalcitol
|
$141.70 |
$141.70 |
$510.00 |
$47.15
|
|
Partial removal of tongue
|
$16,952.65 |
$16,952.65 |
$16,952.65 |
$6,311.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$10,941.45 |
$10,941.45 |
$10,941.45 |
$4,921.76
|
|
Passy muir valve metal trach
|
$808.60 |
$808.60 |
$808.60 |
$275.75
|
|
Paste skin barrier .5oz adapt
|
$7.80 |
$7.80 |
$7.80 |
$5.73
|
|
Pathogen reduced plasma pool
|
$98.80 |
$98.80 |
$98.80 |
$66.40
|
|
Pathogen reduced plasma sing
|
$98.80 |
$98.80 |
$98.80 |
$324.07
|
|
Pdgfra gene
|
$840.45 |
$840.45 |
$840.45 |
$717.23
|
|
Pdt dstr prmlg les phys/qhp
|
$570.70 |
$570.70 |
$570.70 |
$294.77
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,861.10
|
|
Pedicle enel/ntroral 15576
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,692.80
|
|
Pegaspargase injection
|
$109,681.00 |
$109,681.00 |
$179,776.00 |
$41,065.49
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$1,482.00 |
$1,482.00 |
$38,050.91 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$327.00 |
$1,517.75 |
$1,517.75 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$1,614.60 |
$1,614.60 |
$36,681.00 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$2,705.95 |
$2,705.95 |
$2,705.95 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$1,036.10 |
$1,036.10 |
$4,704.38 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$1,659.45 |
$1,659.45 |
$1,659.45 |
$4,120.37
|
|
Pegloticase 8 mg/ml intravenous solution
|
$14,160.25 |
$14,160.25 |
$186,822.00 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$3,695.90 |
$3,695.90 |
$3,939.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$3,380.65 |
$3,380.65 |
$3,602.30 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$3,043.95 |
$3,043.95 |
$3,246.10 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,604.25 |
$3,604.25 |
$16,188.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,424.20 |
$3,424.20 |
$11,902.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,249.35 |
$3,249.35 |
$9,523.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$1,264.25 |
$1,264.25 |
$1,264.25 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$1,123.85 |
$1,123.85 |
$1,123.85 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$650.65 |
$650.65 |
$650.65 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$839.15 |
$839.15 |
$839.15 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$238.55 |
$238.55 |
$48,983.94 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$81.25 |
$81.25 |
$38,228.00 |
$7,089.13
|
|
Pemivibart infusion
|
$1,043.25 |
$1,043.25 |
$1,043.25 |
$533.10
|
|
Peng benzathine/procaine inj
|
$1,181.70 |
$1,181.70 |
$1,181.70 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$958.10 |
$958.10 |
$958.10 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$118.95 |
$118.95 |
$118.95 |
$97.85
|
|
Penicillin g procaine inj
|
$1,040.00 |
$1,040.00 |
$1,040.00 |
$149.20
|
|
Penile injection
|
$580.45 |
$580.45 |
$580.45 |
$424.60
|
|
Penile rear tip xtnd 0.5cm
|
$35,766.25 |
$35,766.25 |
$35,766.25 |
$18,764.94
|
|
Penile vascular study
|
$590.85 |
$590.85 |
$590.85 |
$561.00
|
|
Penile vascular study
|
$574.60 |
$574.60 |
$574.60 |
$574.60
|
