|
Ot re-evaluation patient/family
|
$49.60 |
$49.60 |
$49.60 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$48.40 |
$48.40 |
$48.40 |
$100.20
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$85.20 |
$85.20 |
$85.20 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$111.60 |
$111.60 |
$111.60 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$40.00 |
$40.00 |
$40.00 |
$93.75
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$2.16 |
$2.16 |
$2.16 |
$68.31
|
|
Oxaliplatin 5 mg/ml desensitization
|
$18.80 |
$18.80 |
$18.80 |
$311.60
|
|
Oxytocin 10 unit/ml injection solution
|
$32.76 |
$32.76 |
$32.76 |
$48.29
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$1.28 |
$1.28 |
$1.28 |
$222.51
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$10.08 |
$10.08 |
$10.08 |
$2,946.55
|
|
Palivizumab 50 mg/0.5 ml inj
|
$1,445.92 |
$1,445.92 |
$1,445.92 |
$5,156.88
|
|
Palonosetron hcl
|
$50.88 |
$50.88 |
$50.88 |
$306.70
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$115.84 |
$115.84 |
$115.84 |
$131.90
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$136.60 |
$136.60 |
$136.60 |
$12,452.74
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$13.20 |
$13.20 |
$13.20 |
$35.43
|
|
Parathormone (pth) intact
|
$209.44 |
$209.44 |
$209.44 |
$200.23
|
|
Parathyroid planar imaging
|
$3,016.80 |
$3,016.80 |
$3,016.80 |
$1,166.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$5.32 |
$5.32 |
$5.32 |
$4,235.56
|
|
Pdgfra gene
|
$200.00 |
$200.00 |
$200.00 |
$659.20
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$228.06 |
$228.06 |
$228.06 |
$11,569.18
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$170.62 |
$170.62 |
$170.62 |
$5,828.48
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$241.44 |
$241.44 |
$241.44 |
$7,531.80
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$122.32 |
$122.32 |
$122.32 |
$4,458.74
|
|
Pelvic CT scan (with and without contrast)
|
$1,266.80 |
$1,266.80 |
$1,266.80 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,335.20 |
$1,335.20 |
$1,335.20 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$974.00 |
$974.00 |
$974.00 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$1,797.20 |
$1,797.20 |
$1,797.20 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$1,339.20 |
$1,339.20 |
$1,339.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$469.60 |
$469.60 |
$469.60 |
$445.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$88.04 |
$88.04 |
$88.04 |
$11,589.18
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$115.84 |
$115.84 |
$115.84 |
$3,448.94
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$24.98 |
$24.98 |
$24.98 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$2.35 |
$2.35 |
$2.35 |
$88.70
|
|
Penile vascular study
|
$381.60 |
$381.60 |
$381.60 |
$561.00
|
|
Penile vascular study
|
$381.60 |
$381.60 |
$381.60 |
$460.20
|
|
Pentamidine non-comp unit
|
$186.60 |
$186.60 |
$186.60 |
$279.76
|
|
Pentobarbital sodium inj
|
$84.04 |
$84.04 |
$84.04 |
$234.75
|
|
Perc d-e cor revasc chro add
|
$9,984.00 |
$9,984.00 |
$9,984.00 |
$12,941.50
|
|
Perc d-e cor revasc chro sin
|
$12,389.20 |
$12,389.20 |
$12,389.20 |
$21,249.26
|
|
Perc d-e cor revasc t cabg b
|
$9,984.00 |
$9,984.00 |
$9,984.00 |
$11,941.20
|
|
Perc d-e cor revasc t cabg s
|
$10,281.20 |
$10,281.20 |
$10,281.20 |
$17,162.50
|
|
Perc d-e cor stent ather br
|
$9,984.00 |
$9,984.00 |
$9,984.00 |
$12,287.00
|
|
Perc d-e cor stent ather s
|
$12,389.20 |
$12,389.20 |
$12,389.20 |
$21,249.26
|
|
Perc drug-el cor stent bran
|
$10,133.20 |
$10,133.20 |
$10,133.20 |
$12,091.30
|
|
Perc drug-el cor stent sing
|
$10,281.20 |
$10,281.20 |
$10,281.20 |
$16,846.20
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$198.52 |
$198.52 |
$198.52 |
$321.71
|
|
Peritoneogram rs&i
|
$1,246.80 |
$1,246.80 |
$1,246.80 |
$648.84
|
|
Pertuzu, trastuzu, 10 mg
|
$64.83 |
$64.83 |
$64.83 |
$27,858.08
|
|
Ph body fluid
|
$12.40 |
$12.40 |
$12.40 |
$39.20
|
|
Phencyclidine (pcp)
|
$53.57 |
$53.57 |
$53.57 |
$88.00
|
|
Phenobarbital therapeutic drug level
|
$72.20 |
$72.20 |
$72.20 |
$104.50
|
|
Phentolaine mesylate inj
|
$609.55 |
$609.55 |
$609.55 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$3.00 |
$3.00 |
$3.00 |
$53.43
|
|
Phenytoin total therapeutic drug level
|
$64.88 |
$64.88 |
$64.88 |
$111.27
|
|
Phosphorus
|
$21.08 |
$21.08 |
$21.08 |
$47.81
|
|
Phosphorus 24 hour urine
|
$24.32 |
$24.32 |
$24.32 |
$42.81
|
|
Phys blood bank serv reactj
|
$163.24 |
$163.24 |
$163.24 |
$219.94
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$46.18 |
$46.18 |
$46.18 |
$92.07
|
|
Pik3ca gene trgt seq alys
|
$153.20 |
$153.20 |
$153.20 |
$400.95
|
|
Pinworm exam
|
$18.92 |
$18.92 |
$18.92 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$21.88 |
$21.88 |
$21.88 |
$95.01
|
|
Platelet aggregation each agent teg
|
$75.64 |
$75.64 |
$75.64 |
$147.96
|
|
Platelet automated
|
$23.04 |
$23.04 |
$23.04 |
$44.00
|
|
#pnh-flow cytometry interp
|
$30.00 |
$30.00 |
$30.00 |
$154.14
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$48.96 |
$48.96 |
$48.96 |
$173.00
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$83.36 |
$83.36 |
$83.36 |
$36,493.80
|
|
Polysom <6 yrs cpap/bilvl
|
$3,470.00 |
$3,470.00 |
$3,470.00 |
$3,928.40
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,130.00 |
$4,130.00 |
$4,130.00 |
$4,293.60
|
|
Potassium 24 hour urine
|
$27.12 |
$27.12 |
$27.12 |
$50.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$18.68 |
$18.68 |
$18.68 |
$69.30
|
|
Potassium hydroxide preps
|
$4.40 |
$4.40 |
$4.40 |
$15.00
|
|
Potassium serum/plasma/whole blood
|
$20.20 |
$20.20 |
$20.20 |
$44.64
|
|
Pq dr cath chg w cont s&i
|
$847.60 |
$847.60 |
$847.60 |
$711.36
|
|
Prealbumin
|
$24.88 |
$24.88 |
$24.88 |
$87.20
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$0.64 |
$0.64 |
$0.64 |
$13.87
|
|
Prednisone 1 mg tablet
|
$0.47 |
$0.47 |
$0.47 |
$3.84
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$338.80 |
$338.80 |
$338.80 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$496.80 |
$496.80 |
$496.80 |
$541.45
|
|
Pretreat rbc absorption reference
|
$175.88 |
$175.88 |
$175.88 |
$138.60
|
|
Pretreat rbc density gradient separation reference
|
$200.04 |
$200.04 |
$200.04 |
$189.84
|
|
Pretreat rbc w chem/drugs reference
|
$175.88 |
$175.88 |
$175.88 |
$106.00
|
|
Prgr stim/pace a/iv drug
|
$2,526.80 |
$2,526.80 |
$2,526.80 |
$4,889.30
|
|
Pr hospital ip/obs care subsequent high level per day
|
$86.40 |
$86.40 |
$86.40 |
$217.60
|
|
Pr hospital ip/obs care subsequent moderate level per day
|
$62.80 |
$62.80 |
$62.80 |
$145.60
|
|
Pr hospital ip/obs care subsequent straightforward or low level per day
|
$39.20 |
$39.20 |
$39.20 |
$78.60
|
|
Procalcitonin
|
$56.60 |
$56.60 |
$56.60 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$39.80 |
$39.80 |
$39.80 |
$44.76
|
|
Progesterone
|
$36.12 |
$36.12 |
$36.12 |
$105.00
|
|
Prolactin
|
$114.96 |
$114.96 |
$114.96 |
$127.50
|
|
Promethazine 25 mg tablet
|
$0.88 |
$0.88 |
$0.88 |
$6.68
|
|
Promethazine hcl injection
|
$28.68 |
$28.68 |
$28.68 |
$23.45
|
|
Propofol infusion 10 mg/ml
|
$0.72 |
$0.72 |
$0.72 |
$64.32
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$38.96 |
$38.96 |
$38.96 |
$35.22
|
|
Prostate biopsy, any mthd
|
$431.60 |
$431.60 |
$431.60 |
$492.88
|
|
Protamine 10 mg/ml intravenous solution
|
$5.76 |
$5.76 |
$5.76 |
$56.70
|
|
Protein c activity
|
$308.16 |
$308.16 |
$308.16 |
$115.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$29.16 |
$29.16 |
$29.16 |
$85.20
|
|
Protein s total
|
$629.32 |
$629.32 |
$629.32 |
$78.87
|