|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$3,612.00 |
$3,612.00 |
$3,612.00 |
$1,446.64
|
|
Nm imaging gastric emptying study
|
$2,336.00 |
$2,336.00 |
$2,336.00 |
$1,457.30
|
|
Nm imaging gastrointestinal acute blood loss
|
$2,631.00 |
$2,631.00 |
$2,631.00 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$12,249.00 |
$12,249.00 |
$12,249.00 |
$1,813.50
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$9,103.00 |
$9,103.00 |
$9,103.00 |
$1,600.20
|
|
Nm imaging pulmonary ventilation/perfusion
|
$12,329.00 |
$12,329.00 |
$12,329.00 |
$1,574.40
|
|
Nm radiopharmaceutical therapy oral administration
|
$5,361.00 |
$5,361.00 |
$5,361.00 |
$1,030.07
|
|
Non-card vasc flow imaging
|
$2,546.00 |
$2,546.00 |
$2,546.00 |
$608.56
|
|
Nuclear rx IV admin
|
$8,715.00 |
$8,715.00 |
$8,715.00 |
$854.96
|
|
Nuclear Stress Test (Heart)
|
$11,894.00 |
$11,894.00 |
$11,894.00 |
$3,921.45
|
|
Olanzapine 10 mg intramuscular solution
|
$218.00 |
$218.00 |
$218.00 |
$122.78
|
|
Ondansetron 8 mg disintegrating tablet
|
$174.00 |
$174.00 |
$174.00 |
$10.08
|
|
Oprelvekin injection
|
$865.00 |
$865.00 |
$865.00 |
$848.31
|
|
Oral busulfan
|
$15.00 |
$15.00 |
$15.00 |
$84.21
|
|
Oritavancin 400 mg intravenous solution
|
$12,522.00 |
$12,522.00 |
$12,522.00 |
$3,513.35
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$339.00 |
$339.00 |
$339.00 |
$63.72
|
|
Ot evaluation high complexity patient/family
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$303.20
|
|
Ot evaluation low complexity patient/family
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$1,003.00 |
$1,003.00 |
$1,003.00 |
$270.58
|
|
Ot re-evaluation patient/family
|
$471.00 |
$471.00 |
$471.00 |
$175.72
|
|
Oxytocin 10 unit/ml injection solution
|
$173.00 |
$173.00 |
$173.00 |
$45.86
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$14,539.00 |
$14,539.00 |
$14,539.00 |
$4,072.50
|
|
Palonosetron hcl
|
$1,742.00 |
$1,742.00 |
$1,742.00 |
$472.46
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$1,772.00 |
$1,772.00 |
$1,772.00 |
$148.35
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$55,323.00 |
$55,323.00 |
$55,323.00 |
$18,390.86
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$26.00 |
$26.00 |
$26.00 |
$36.87
|
|
Parathyroid planar imaging
|
$4,768.00 |
$4,768.00 |
$4,768.00 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$4,768.00 |
$4,768.00 |
$4,768.00 |
$1,419.20
|
|
Paricalcitol
|
$142.00 |
$142.00 |
$142.00 |
$47.38
|
|
Pelvic MRI (with and without contrast)
|
$9,384.00 |
$9,384.00 |
$9,384.00 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$9,336.00 |
$9,336.00 |
$9,336.00 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$7,828.00 |
$7,828.00 |
$7,828.00 |
$1,878.41
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$56,928.00 |
$56,928.00 |
$56,928.00 |
$16,273.24
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$8,458.00 |
$8,458.00 |
$8,458.00 |
$2,664.25
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,341.00 |
$1,341.00 |
$1,341.00 |
$626.67
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$227.00 |
$227.00 |
$227.00 |
$90.75
|
|
Perphenazine 4mg oral
|
$12.00 |
$12.00 |
$12.00 |
$14.04
|
|
Pertuzumab 30 mg/ml desensitization
|
$60,750.00 |
$60,750.00 |
$60,750.00 |
$18,443.20
|
|
Pet CT skull-mid thgh initial
|
$16,426.00 |
$16,426.00 |
$16,426.00 |
$4,850.00
|
|
Pet CT whole body initial
|
$16,426.00 |
$16,426.00 |
$16,426.00 |
$5,017.50
|
|
Pet image full body
|
$13,147.00 |
$13,147.00 |
$13,147.00 |
$4,567.11
|
|
Pet image ltd area
|
$13,147.00 |
$13,147.00 |
$13,147.00 |
$2,519.20
|
|
Pet image skull-thigh
|
$13,147.00 |
$13,147.00 |
$13,147.00 |
$4,024.80
|
|
Pet image w/ct lmtd
|
$16,426.00 |
$16,426.00 |
$16,426.00 |
$4,422.60
|
|
Phentolaine mesylate inj
|
$244.00 |
$244.00 |
$244.00 |
$961.38
|
|
Phlebotomy therapeutic
|
$321.00 |
$321.00 |
$321.00 |
$249.00
|
|
Phosphorus 24 hour urine
|
$854.00 |
$854.00 |
$854.00 |
$42.81
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$422.00 |
$422.00 |
$422.00 |
$86.36
|
|
Pinworm exam
|
$784.00 |
$784.00 |
$784.00 |
$39.75
|
|
Placement occlusive device venous/arterial access site post procedure
|
$8,331.00 |
$8,331.00 |
$8,331.00 |
$555.33
|
|
Placental lactogen
|
$608.00 |
$608.00 |
$608.00 |
$143.67
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$639.00 |
$639.00 |
$639.00 |
$173.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$17,594.00 |
$17,594.00 |
$17,594.00 |
$4,293.60
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$13.00 |
$13.00 |
$13.00 |
$4.67
|
|
Pouch uros new (both sides) 2.75in clr
|
$7.00 |
$7.00 |
$7.00 |
$14.48
|
|
Powder prem protct 1oz
|
$11.39 |
$11.39 |
$11.39 |
$5.20
|
|
Pq biliary strict dil s&i
|
$11,732.00 |
$11,732.00 |
$11,732.00 |
$984.40
|
|
Pralatrexate injection
|
$59,260.00 |
$59,260.00 |
$59,260.00 |
$534.21
|
|
Pralidoxime 1 gram solution for injection
|
$755.28 |
$755.28 |
$755.28 |
$366.31
|
|
Pr application of long arm splint
|
$774.00 |
$774.00 |
$774.00 |
$329.00
|
|
Pr application splint static short arm
|
$774.00 |
$774.00 |
$774.00 |
$300.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$79.00 |
$79.00 |
$79.00 |
$48.71
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$6.00 |
$6.00 |
$6.00 |
$18.28
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$587.52
|
|
Procalcitonin
|
$676.00 |
$676.00 |
$676.00 |
$142.47
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$32.19 |
$32.19 |
$32.19 |
$46.39
|
|
Progesterone
|
$60.50 |
$60.50 |
$60.50 |
$100.93
|
|
Promethazine hcl injection
|
$17.00 |
$17.00 |
$17.00 |
$29.21
|
|
_propoxygc/msur
|
$456.00 |
$456.00 |
$456.00 |
$104.23
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$144.00 |
$144.00 |
$144.00 |
$39.59
|
|
Prothrombin time substitution plasma fractions each
|
$937.00 |
$937.00 |
$937.00 |
$39.60
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$756.00 |
$756.00 |
$756.00 |
$107.20
|
|
Pt evaluation high complexity patient/family
|
$2,908.00 |
$2,908.00 |
$2,908.00 |
$300.13
|
|
Pt evaluation low complexity patient/family
|
$2,908.00 |
$2,908.00 |
$2,908.00 |
$226.85
|
|
Pt evaluation moderate complexity patient/family
|
$2,908.00 |
$2,908.00 |
$2,908.00 |
$264.00
|
|
Pt re-evaluation patient/family
|
$1,463.00 |
$1,463.00 |
$1,463.00 |
$162.29
|
|
Pt wheelchair management each 15 minutes
|
$647.00 |
$647.00 |
$647.00 |
$86.40
|
|
Pulmonary vent imaging
|
$7,671.00 |
$7,671.00 |
$7,671.00 |
$828.73
|
|
Pulse ox continuous overnight monitoring
|
$974.00 |
$974.00 |
$974.00 |
$360.60
|
|
Pulse ox multiple
|
$560.00 |
$560.00 |
$560.00 |
$194.33
|
|
Pulse ox single
|
$282.00 |
$282.00 |
$282.00 |
$88.80
|
|
Pyridoxine hcl 100 mg
|
$26.00 |
$26.00 |
$26.00 |
$43.24
|
|
Pyruvate
|
$289.00 |
$289.00 |
$289.00 |
$65.00
|
|
Pyruvate kinase
|
$153.00 |
$153.00 |
$153.00 |
$65.00
|
|
Quest t3 uptake
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$57.12
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$6,975.00 |
$6,975.00 |
$6,975.00 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$4,004.00 |
$4,004.00 |
$4,004.00 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$7,144.00 |
$7,144.00 |
$7,144.00 |
$2,315.52
|
|
Radphm lcl tumor plr sgl day
|
$2,867.00 |
$2,867.00 |
$2,867.00 |
$1,126.32
|
|
Refill maint impl spine pump
|
$5,154.00 |
$5,154.00 |
$5,154.00 |
$366.60
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$2,935.00 |
$2,935.00 |
$2,935.00 |
$644.62
|
|
Remdesivir 100 mg intravenous powder for solution
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,864.71
|
|
Rem interrog evl pm/ids
|
$414.00 |
$414.00 |
$414.00 |
$139.10
|
|
Renal venogram bil s&i
|
$11,749.00 |
$11,749.00 |
$11,749.00 |
$3,486.86
|
|
Reptilase test
|
$1,398.00 |
$1,398.00 |
$1,398.00 |
$65.65
|
|
#resp virpnl dfa-adenovirus
|
$604.00 |
$604.00 |
$604.00 |
$44.80
|
|
Reteplase injection
|
$8,690.00 |
$8,690.00 |
$8,690.00 |
$3,155.69
|
|
Reticulocyte automated
|
$39.00 |
$39.00 |
$39.00 |
$54.60
|
|
Reticulocyte direct measurement automated
|
$121.00 |
$121.00 |
$121.00 |
$32.50
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$255.26
|
