|
Orphenadrine citrate 30 mg/ml injection solution
|
$92.00 |
$92.00 |
$92.00 |
$65.07
|
|
Osmolality blood
|
$827.88 |
$827.88 |
$827.88 |
$67.60
|
|
Osmolality urine
|
$827.88 |
$827.88 |
$827.88 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$1,992.51 |
$1,992.51 |
$1,992.51 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$1,992.51 |
$1,992.51 |
$1,992.51 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$1,992.51 |
$1,992.51 |
$1,992.51 |
$270.58
|
|
Oth resp proc, group
|
$964.98 |
$964.98 |
$964.98 |
$154.00
|
|
Oth resp proc, indiv
|
$173.03 |
$173.03 |
$173.03 |
$87.45
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$435.24 |
$435.24 |
$435.24 |
$100.75
|
|
Ot re-evaluation patient/family
|
$1,008.90 |
$1,008.90 |
$1,008.90 |
$174.00
|
|
Oxaliplatin 5 mg/ml desensitization
|
$8,460.00 |
$8,460.00 |
$8,460.00 |
$364.29
|
|
Oxytocin 10 unit/ml injection solution
|
$38.00 |
$38.00 |
$38.00 |
$45.86
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$167.00 |
$167.00 |
$167.00 |
$231.46
|
|
Palivizumab 50 mg/0.5 ml inj
|
$11,646.00 |
$11,646.00 |
$11,646.00 |
$5,156.88
|
|
Palonosetron hcl
|
$4,266.00 |
$4,266.00 |
$4,266.00 |
$372.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$7,520.00 |
$7,520.00 |
$7,520.00 |
$146.80
|
|
Parathyroid planar imaging
|
$4,154.05 |
$4,154.05 |
$4,154.05 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$8,308.10 |
$8,308.10 |
$8,308.10 |
$1,398.75
|
|
Pelvic CT scan (with and without contrast)
|
$20,961.46 |
$20,961.46 |
$20,961.46 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$15,906.86 |
$15,906.86 |
$15,906.86 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$15,584.83 |
$15,584.83 |
$15,584.83 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$12,725.57 |
$12,725.57 |
$12,725.57 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$11,044.88 |
$11,044.88 |
$11,044.88 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$10,381.80 |
$10,381.80 |
$10,381.80 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$5,930.94 |
$5,930.94 |
$5,930.94 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$1,661.09 |
$1,661.09 |
$1,661.09 |
$445.00
|
|
Peng benzathine/procaine inj
|
$448.00 |
$448.00 |
$448.00 |
$258.72
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$304.00 |
$304.00 |
$304.00 |
$100.50
|
|
Penile vascular study
|
$6,195.81 |
$6,195.81 |
$6,195.81 |
$561.00
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$547.00 |
$547.00 |
$547.00 |
$321.71
|
|
Peritoneogram rs&i
|
$1,378.92 |
$1,378.92 |
$1,378.92 |
$648.84
|
|
Perit-vens shunt pat tst
|
$3,175.77 |
$3,175.77 |
$3,175.77 |
$695.40
|
|
Perphenazine 4mg oral
|
$19.00 |
$19.00 |
$19.00 |
$9.93
|
|
Pertussis ag if
|
$15.00 |
$15.00 |
$15.00 |
$49.00
|
|
Phencyclidine (pcp)
|
$100.00 |
$100.00 |
$100.00 |
$88.00
|
|
Phenobarbital therapeutic drug level
|
$573.66 |
$573.66 |
$573.66 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,378.00 |
$1,378.00 |
$1,378.00 |
$1,011.98
|
|
Phenytoin total therapeutic drug level
|
$1,297.73 |
$1,297.73 |
$1,297.73 |
$111.27
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$237.00 |
$237.00 |
$237.00 |
$86.36
|
|
Platelet automated
|
$516.43 |
$516.43 |
$516.43 |
$44.00
|
|
Platelet survival
|
$5,324.00 |
$5,324.00 |
$5,324.00 |
$475.51
|
|
Plethysmography lung volumes/airway resistance
|
$1,839.44 |
$1,839.44 |
$1,839.44 |
$411.51
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$10,096.97 |
$10,096.97 |
$10,096.97 |
$4,293.60
|
|
Potassium 24 hour urine
|
$379.34 |
$379.34 |
$379.34 |
$50.00
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$13.28 |
$13.28 |
$13.28 |
$4.67
|
|
Pouch uros new (both sides) 2.75in clr
|
$14.48 |
$14.48 |
$14.48 |
$14.48
|
|
Pq biliary strict dil s&i
|
$9,754.90 |
$9,754.90 |
$9,754.90 |
$1,006.00
|
|
Pq dr cath chg w cont s&i
|
$4,960.64 |
$4,960.64 |
$4,960.64 |
$711.36
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$89.18 |
$89.18 |
$89.18 |
$48.71
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$3,553.77 |
$3,553.77 |
$3,553.77 |
$356.40
|
|
Pregnancy associated plasma protein-a
|
$112.00 |
$112.00 |
$112.00 |
$67.60
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$7,781.03 |
$7,781.03 |
$7,781.03 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$4,898.08 |
$4,898.08 |
$4,898.08 |
$541.45
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$409.95 |
$409.95 |
$409.95 |
$141.00
|
|
Pretreat rbc absorption reference
|
$315.45 |
$315.45 |
$315.45 |
$138.60
|
|
Pretreat rbc w enzyme reference
|
$385.99 |
$385.99 |
$385.99 |
$166.10
|
|
Prgrmg dev eval scrms ip
|
$6,816.01 |
$6,816.01 |
$6,816.01 |
$126.00
|
|
Prgr stim/pace a/iv drug
|
$6,816.01 |
$6,816.01 |
$6,816.01 |
$4,889.30
|
|
Procalcitonin
|
$283.00 |
$283.00 |
$283.00 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$56.00 |
$56.00 |
$56.00 |
$46.50
|
|
Prochlorperazine maleate 5 mg tablet
|
$19.00 |
$19.00 |
$19.00 |
$4.25
|
|
Progesterone
|
$242.00 |
$242.00 |
$242.00 |
$105.00
|
|
Prolactin
|
$242.00 |
$242.00 |
$242.00 |
$127.50
|
|
Promethazine 25 mg tablet
|
$16.00 |
$16.00 |
$16.00 |
$7.01
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$54.00 |
$54.00 |
$54.00 |
$39.59
|
|
Protein c activity
|
$22.00 |
$22.00 |
$22.00 |
$115.00
|
|
Protein electrophoretic fractionation & quantitation serum
|
$247.00 |
$247.00 |
$247.00 |
$85.20
|
|
Protein s total
|
$22.00 |
$22.00 |
$22.00 |
$78.87
|
|
Protein total 24 hour urine
|
$726.73 |
$726.73 |
$726.73 |
$52.50
|
|
Protein total serum plasma whole blood
|
$452.54 |
$452.54 |
$452.54 |
$42.81
|
|
Prothrombin time substitution plasma fractions each
|
$102.49 |
$102.49 |
$102.49 |
$37.05
|
|
Psychotherapy group therapy
|
$580.00 |
$580.00 |
$580.00 |
$264.32
|
|
Psychotherapy patient individual therapy 45 minutes
|
$521.00 |
$521.00 |
$521.00 |
$267.00
|
|
Pt application of modality traction mechanical
|
$509.77 |
$509.77 |
$509.77 |
$88.20
|
|
Pt evaluation high complexity patient/family
|
$1,953.91 |
$1,953.91 |
$1,953.91 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$1,953.91 |
$1,953.91 |
$1,953.91 |
$226.00
|
|
Pt evaluation moderate complexity patient/family
|
$1,953.91 |
$1,953.91 |
$1,953.91 |
$263.90
|
|
Pt re-evaluation patient/family
|
$998.25 |
$998.25 |
$998.25 |
$157.30
|
|
Pulmonary vent imaging
|
$5,812.48 |
$5,812.48 |
$5,812.48 |
$845.28
|
|
Pyridoxine hcl 100 mg
|
$36.00 |
$36.00 |
$36.00 |
$43.24
|
|
Quant diff pulm perf and vent w/imaging
|
$10,220.75 |
$10,220.75 |
$10,220.75 |
$1,524.16
|
|
Quant diff pulm perf w/imaging
|
$6,836.02 |
$6,836.02 |
$6,836.02 |
$1,209.44
|
|
Rabies ig heat-treated human im/subq 90376
|
$2,659.00 |
$2,659.00 |
$2,659.00 |
$1,059.01
|
|
Rabies ig ht&sol human im/sc
|
$2,304.00 |
$2,304.00 |
$2,304.00 |
$5,401.91
|
|
Radiation physics consult
|
$1,556.00 |
$1,556.00 |
$1,556.00 |
$574.75
|
|
Radiation therapy dose plan
|
$485.00 |
$485.00 |
$485.00 |
$530.53
|
|
Radiation treatment aid(s)
|
$1,151.00 |
$1,151.00 |
$1,151.00 |
$1,103.09
|
|
Radiation treatment delivery
|
$1,315.00 |
$1,315.00 |
$1,315.00 |
$552.40
|
|
Radiation treatment delivery
|
$2,475.00 |
$2,475.00 |
$2,475.00 |
$909.98
|
|
Radiology port images(s)
|
$553.00 |
$553.00 |
$553.00 |
$260.07
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$7,021.03 |
$7,021.03 |
$7,021.03 |
$2,014.64
|
|
Radphm lcl tmr plnr bdy two day img
|
$24,383.92 |
$24,383.92 |
$24,383.92 |
$2,728.42
|
|
Radphm lcl tomogr sgl area sgl day
|
$10,459.00 |
$10,459.00 |
$10,459.00 |
$2,377.65
|
|
Radphm lcl tumor plr sgl day
|
$4,513.42 |
$4,513.42 |
$4,513.42 |
$1,139.40
|
|
Rasburicase 1.5 mg intravenous solution
|
$3,633.00 |
$3,633.00 |
$3,633.00 |
$3,184.20
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$986.00 |
$986.00 |
$986.00 |
$656.83
|
|
Remdesivir 100 mg intravenous powder for solution
|
$1,607.00 |
$1,607.00 |
$1,607.00 |
$1,864.71
|
|
Remove cva lumen obstruct
|
$4,433.56 |
$4,433.56 |
$4,433.56 |
$494.00
|
|
Renal function panel
|
$674.82 |
$674.82 |
$674.82 |
$110.10
|
|
Renal venogram bil s&i
|
$24,525.01 |
$24,525.01 |
$24,525.01 |
$3,615.28
|
