|
Partial removal of tibia
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$4,108.80
|
|
Partial removal of tongue
|
$19,257.00 |
$19,257.00 |
$19,257.00 |
$6,084.97
|
|
Partial removal of ulna
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,986.00
|
|
Partial removal of ulna
|
$5,810.00 |
$5,810.00 |
$5,810.00 |
$3,803.90
|
|
Partial removal of ulna
|
$8,241.00 |
$8,241.00 |
$8,241.00 |
$3,839.54
|
|
Partial removal of vaginal wall 57106
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,762.53
|
|
Partial thyroid excision
|
$6,905.00 |
$6,905.00 |
$6,905.00 |
$6,463.42
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$3.94 |
$3.94 |
$3.94 |
$4,921.76
|
|
Part removal hip bone deep
|
$13,057.00 |
$13,057.00 |
$13,057.00 |
$3,342.87
|
|
Part removal of metatarsal
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,821.05
|
|
Part removal of metatarsal
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$6,653.00 |
$6,653.00 |
$6,653.00 |
$3,839.54
|
|
Passy muir valve metal trach
|
$116.60 |
$116.60 |
$116.60 |
$275.75
|
|
Path clin consltj mod 21-40
|
$58.00 |
$58.00 |
$58.00 |
$202.78
|
|
Pedcle fh/ch/ch/m/n/ax/g/h/f
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$2,837.09
|
|
Pedicle enel/ntroral 15576
|
$7,906.00 |
$7,906.00 |
$7,906.00 |
$2,508.24
|
|
Pegaspargase injection
|
$45,285.77 |
$45,285.77 |
$45,285.77 |
$41,065.49
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$1,310.91 |
$1,310.91 |
$1,310.91 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$1,322.09 |
$1,322.09 |
$1,322.09 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$860.05 |
$860.05 |
$860.05 |
$4,133.25
|
|
Peg interferon alfa-2a/180
|
$2,525.56 |
$2,525.56 |
$2,525.56 |
$2,672.20
|
|
Pegunigalsidase alfa-iwxj
|
$536.63 |
$536.63 |
$536.63 |
$2,146.13
|
|
Pelvic CT scan (with and without contrast)
|
$2,650.00 |
$2,650.00 |
$2,650.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,204.00 |
$2,204.00 |
$2,204.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,289.00 |
$1,289.00 |
$1,289.00 |
$1,333.20
|
|
Pelvic MRI (with and without contrast)
|
$3,812.00 |
$3,812.00 |
$3,812.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,742.00 |
$2,742.00 |
$2,742.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,296.00 |
$2,296.00 |
$2,296.00 |
$1,916.50
|
|
Pelvic ring fracture uni/bil
|
$840.00 |
$840.00 |
$840.00 |
$4,599.00
|
|
Pelvic Ultrasound (complete)
|
$1,898.00 |
$1,898.00 |
$1,898.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$1,222.00 |
$1,222.00 |
$1,222.00 |
$432.50
|
|
Pelvis X-ray (1 to 2 views)
|
$388.00 |
$388.00 |
$388.00 |
$282.00
|
|
Pelvis X-ray (complete, 4 or more views)
|
$468.00 |
$468.00 |
$468.00 |
$355.50
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$137.83 |
$137.83 |
$137.83 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$12.48 |
$12.48 |
$12.48 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$712.98 |
$712.98 |
$712.98 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$9.27 |
$9.27 |
$9.27 |
$97.85
|
|
Penile injection
|
$672.00 |
$672.00 |
$672.00 |
$418.86
|
|
Penile vascular study
|
$325.00 |
$325.00 |
$325.00 |
$561.00
|
|
Penis plastic surgery
|
$6,588.00 |
$6,588.00 |
$6,588.00 |
$4,081.37
|
|
Pentamidine non-comp unit
|
$699.66 |
$699.66 |
$699.66 |
$294.39
|
|
Pentostatin 10 mg intravenous solution
|
$5,125.09 |
$5,125.09 |
$5,125.09 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$23,597.00 |
$23,597.00 |
$23,597.00 |
$11,523.76
|
|
Perc d-e cor revasc chro add
|
$15,676.00 |
$15,676.00 |
$15,676.00 |
$13,103.00
|
|
Perc d-e cor revasc chro sin
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$18,435.36
|
|
Perc d-e cor revasc t cabg b
|
$15,676.00 |
$15,676.00 |
$15,676.00 |
$11,976.00
|
|
Perc d-e cor revasc t cabg s
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$15,676.00 |
$15,676.00 |
$15,676.00 |
$12,449.00
|
|
Perc d-e cor stent ather s
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$18,545.83
|
|
Perc drug-el cor stent bran
|
$15,676.00 |
$15,676.00 |
$15,676.00 |
$11,667.75
|
|
Perc drug-el cor stent sing
|
$8,687.00 |
$8,687.00 |
$8,687.00 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$23,597.00 |
$23,597.00 |
$23,597.00 |
$7,243.60
|
|
Percut ablate liver rf
|
$11,936.00 |
$11,936.00 |
$11,936.00 |
$6,904.15
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$746.69 |
$746.69 |
$746.69 |
$332.84
|
|
Pericardial drain w/cath pq w/ct guid
|
$1,459.00 |
$1,459.00 |
$1,459.00 |
$2,440.31
|
|
Pericardiocentesis wwo imaging
|
$3,327.00 |
$3,327.00 |
$3,327.00 |
$2,418.99
|
|
Peri-implt capslc brst compl
|
$10,780.00 |
$10,780.00 |
$10,780.00 |
$4,184.94
|
|
Perineoplasty rpr per nonob
|
$8,446.00 |
$8,446.00 |
$8,446.00 |
$3,720.50
|
|
Peri-proc device eval icd
|
$120.00 |
$120.00 |
$120.00 |
$192.40
|
|
Peri-proc device eval pm
|
$102.00 |
$102.00 |
$102.00 |
$155.00
|
|
Peritoneal cath sub q resv per
|
$12,009.00 |
$12,009.00 |
$12,009.00 |
$5,625.74
|
|
Peritoneogram rs&i
|
$1,784.00 |
$1,784.00 |
$1,784.00 |
$698.50
|
|
Perphenazine 4mg oral
|
$12.65 |
$12.65 |
$12.65 |
$2.58
|
|
Perq art m-thrombect &/nfs
|
$30,188.00 |
$30,188.00 |
$30,188.00 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$5,638.00 |
$5,638.00 |
$5,638.00 |
$9,286.40
|
|
Perq dev breast 1st mr guide
|
$1,394.00 |
$1,394.00 |
$1,394.00 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$1,394.00 |
$1,394.00 |
$1,394.00 |
$1,456.00
|
|
Perq p-art revsc 1 abnor bi
|
$25,477.00 |
$25,477.00 |
$25,477.00 |
$18,035.00
|
|
Perq p-art revsc 1 abnor uni
|
$41,226.00 |
$41,226.00 |
$41,226.00 |
$22,626.00
|
|
Perq p-art revsc 1 nm nt bi
|
$25,477.00 |
$25,477.00 |
$25,477.00 |
$15,916.29
|
|
Perq p-art revsc 1 nm nt uni
|
$25,477.00 |
$25,477.00 |
$25,477.00 |
$17,321.20
|
|
Perq p-art revsc each addl
|
$14,707.00 |
$14,707.00 |
$14,707.00 |
$8,824.30
|
|
Perq plmt bile duct stent
|
$15,516.00 |
$15,516.00 |
$15,516.00 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$25,285.00 |
$25,285.00 |
$25,285.00 |
$6,857.50
|
|
Perq plmt bile duct stent
|
$26,095.00 |
$26,095.00 |
$26,095.00 |
$7,082.99
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$650.00 |
$650.00 |
$650.00 |
$625.93
|
|
Perq skel fix rad/uln dislc
|
$4,609.00 |
$4,609.00 |
$4,609.00 |
$3,839.54
|
|
Perq skel fix ulnar styld fx
|
$6,307.00 |
$6,307.00 |
$6,307.00 |
$3,839.54
|
|
Perqt bx lung/mediastinum 32405
|
$4,467.00 |
$4,467.00 |
$4,467.00 |
$1,770.60
|
|
Perq transcath closure each
|
$6,726.00 |
$6,726.00 |
$6,726.00 |
$9,204.00
|
|
Perq transcath closure pda
|
$13,302.00 |
$13,302.00 |
$13,302.00 |
$18,408.00
|
|
Perq transcath cls aortic
|
$13,451.00 |
$13,451.00 |
$13,451.00 |
$22,633.26
|
|
Perq transcath cls mitral
|
$13,451.00 |
$13,451.00 |
$13,451.00 |
$23,617.60
|
|
Perq transcath septal reduxn
|
$19,856.00 |
$19,856.00 |
$19,856.00 |
$8,828.16
|
|
Perq trluml angp nt/recr coa
|
$1,726.00 |
$1,726.00 |
$1,726.00 |
$6,658.00
|
|
Perq tx big toe fracture w/manip 28496
|
$5,507.00 |
$5,507.00 |
$5,507.00 |
$3,981.06
|
|
Pertuzumab 30 mg/ml desensitization
|
$37.58 |
$37.58 |
$37.58 |
$14,272.91
|
|
Pertuzu, trastuzu, 10 mg
|
$179.75 |
$179.75 |
$179.75 |
$27,858.08
|
|
Pet CT skull-mid thgh initial
|
$9,918.00 |
$9,918.00 |
$9,918.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$9,918.00 |
$9,918.00 |
$9,918.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$10,886.00 |
$10,886.00 |
$10,886.00 |
$4,060.00
|
|
Pet image full body
|
$9,266.00 |
$9,266.00 |
$9,266.00 |
$5,148.14
|
|
Pet image ltd area
|
$9,266.00 |
$9,266.00 |
$9,266.00 |
$3,809.11
|
|
Pet image skull-thigh
|
$9,266.00 |
$9,266.00 |
$9,266.00 |
$4,589.00
|
|
Pet image w/ct lmtd
|
$9,918.00 |
$9,918.00 |
$9,918.00 |
$4,349.76
|
|
Pfc sigma fem post aug sz3 8mm
|
$49,280.00 |
$49,280.00 |
$49,280.00 |
$40,252.07
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$69.00 |
$69.00 |
$69.00 |
$91.30
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$23.00 |
$23.00 |
$23.00 |
$31.20
|
|
Ph body fluid
|
$98.00 |
$98.00 |
$98.00 |
$42.00
|
|
Phencyclidine (pcp)
|
$273.00 |
$273.00 |
$273.00 |
$96.39
|
