|
Neck (Cervical Spine) MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,562.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,164.88
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$1,830.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$1,890.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$1,741.80
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$45.30 |
$45.30 |
$45.30 |
$34.13
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$189.42 |
$189.42 |
$189.42 |
$251.32
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$65.30 |
$65.30 |
$65.30 |
$65.30
|
|
Nuclear Stress Test (Heart)
|
$4,942.20 |
$4,942.20 |
$4,942.20 |
$3,739.20
|
|
Observation direct referral from physician office for admission
|
$348.00 |
$348.00 |
$348.00 |
$359.40
|
|
Obstetrics panel
|
$332.40 |
$332.40 |
$332.40 |
$214.50
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$40.37 |
$40.37 |
$40.37 |
$59.15
|
|
Olanzapine 10 mg intramuscular solution
|
$120.17 |
$120.17 |
$120.17 |
$120.17
|
|
Ondansetron 8 mg disintegrating tablet
|
$1.90 |
$1.90 |
$1.90 |
$2.09
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$38.58 |
$38.58 |
$38.58 |
$12.51
|
|
Organic acids total quant ea spec
|
$106.20 |
$106.20 |
$106.20 |
$152.50
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$40.92 |
$40.92 |
$40.92 |
$40.92
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$487.20 |
$487.20 |
$487.20 |
$284.85
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$231.00 |
$231.00 |
$231.00 |
$213.39
|
|
Ortho hnd without jnt w/fit&adj
|
$238.20 |
$238.20 |
$238.20 |
$210.96
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$489.00 |
$489.00 |
$489.00 |
$267.57
|
|
Osmolality blood
|
$71.40 |
$71.40 |
$71.40 |
$57.00
|
|
Osmolality urine
|
$79.80 |
$79.80 |
$79.80 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$276.60 |
$276.60 |
$276.60 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$187.20 |
$187.20 |
$187.20 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$249.60 |
$249.60 |
$249.60 |
$249.60
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$93.60 |
$93.60 |
$93.60 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$105.60 |
$105.60 |
$105.60 |
$105.50
|
|
Ot re-evaluation patient/family
|
$114.60 |
$114.60 |
$114.60 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$98.40 |
$98.40 |
$98.40 |
$96.11
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$84.60 |
$84.60 |
$84.60 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$97.80 |
$97.80 |
$97.80 |
$90.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$97.80 |
$97.80 |
$97.80 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$93.00 |
$93.00 |
$93.00 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$93.00 |
$93.00 |
$93.00 |
$93.60
|
|
Paliperidone 117 mg/0.75 ml inj
|
$4,898.66 |
$4,898.66 |
$4,898.66 |
$4,898.66
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$40.46 |
$40.46 |
$40.46 |
$18.49
|
|
Parathormone (pth) intact
|
$265.20 |
$265.20 |
$265.20 |
$204.00
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$9,121.58 |
$9,121.58 |
$9,121.58 |
$9,121.58
|
|
Pelvic CT scan (with and without contrast)
|
$1,707.60 |
$1,707.60 |
$1,707.60 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$1,680.60 |
$1,680.60 |
$1,680.60 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$885.00 |
$885.00 |
$885.00 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$2,176.20 |
$2,176.20 |
$2,176.20 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$1,270.20 |
$1,270.20 |
$1,270.20 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$544.20 |
$544.20 |
$544.20 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$544.20 |
$544.20 |
$544.20 |
$429.66
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$35.36 |
$35.36 |
$35.36 |
$48.74
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$41.87 |
$41.87 |
$41.87 |
$53.75
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$70.20 |
$70.20 |
$70.20 |
$269.36
|
|
Ph body fluid
|
$33.60 |
$33.60 |
$33.60 |
$35.75
|
|
Phenobarbital therapeutic drug level
|
$168.00 |
$168.00 |
$168.00 |
$97.50
|
|
Phenylephrine 10 mg/ml injection solution
|
$41.63 |
$41.63 |
$41.63 |
$28.92
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$18.44 |
$18.44 |
$18.44 |
$7.71
|
|
Phenytoin total therapeutic drug level
|
$97.80 |
$97.80 |
$97.80 |
$100.75
|
|
Phosphorus
|
$60.00 |
$60.00 |
$60.00 |
$42.37
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$128.30 |
$128.30 |
$128.30 |
$75.04
|
|
Pinworm exam
|
$37.80 |
$37.80 |
$37.80 |
$38.58
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$104.73 |
$104.73 |
$104.73 |
$51.80
|
|
Platelet aggregation each agent teg
|
$190.20 |
$190.20 |
$190.20 |
$145.60
|
|
Platelet automated
|
$26.40 |
$26.40 |
$26.40 |
$33.60
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,540.40 |
$2,540.40 |
$2,540.40 |
$1,642.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,759.80 |
$1,759.80 |
$1,759.80 |
$1,530.10
|
|
Plethysmography lung volumes/airway resistance
|
$342.00 |
$342.00 |
$342.00 |
$411.51
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$186.00 |
$186.00 |
$186.00 |
$146.15
|
|
Potassium 24 hour urine
|
$58.80 |
$58.80 |
$58.80 |
$45.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$63.27 |
$63.27 |
$63.27 |
$60.99
|
|
Potassium serum/plasma/whole blood
|
$46.20 |
$46.20 |
$46.20 |
$40.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$30.00 |
$30.00 |
$30.00 |
$48.71
|
|
Pr debridement open wound topical appl/wound asmt per session 20 sq cm/<
|
$367.20 |
$367.20 |
$367.20 |
$350.98
|
|
Prealbumin
|
$116.40 |
$116.40 |
$116.40 |
$80.40
|
|
Pr ecg 12 lead report only
|
$66.00 |
$66.00 |
$66.00 |
$22.10
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$8.88 |
$8.88 |
$8.88 |
$4.87
|
|
Prednisone 1 mg tablet
|
$1.90 |
$1.90 |
$1.90 |
$4.87
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$523.80 |
$523.80 |
$523.80 |
$573.21
|
|
Pregnancy Ultrasound (first trimester)
|
$523.80 |
$523.80 |
$523.80 |
$539.37
|
|
Pr incision & drainage abscess complicated/multiple
|
$955.20 |
$955.20 |
$955.20 |
$605.00
|
|
Pr incision & drainage abscess simple/single
|
$701.40 |
$701.40 |
$701.40 |
$437.53
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$606.60
|
|
Pr moderate sedation same physician >= 5 years initial 15 minutes
|
$584.40 |
$584.40 |
$584.40 |
$266.64
|
|
Procalcitonin
|
$133.20 |
$133.20 |
$133.20 |
$133.20
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$44.48 |
$44.48 |
$44.48 |
$35.00
|
|
Progesterone
|
$150.60 |
$150.60 |
$150.60 |
$100.24
|
|
Prolactin
|
$212.40 |
$212.40 |
$212.40 |
$123.20
|
|
Promethazine hcl injection
|
$38.85 |
$38.85 |
$38.85 |
$10.51
|
|
Propofol infusion 10 mg/ml
|
$45.25 |
$45.25 |
$45.25 |
$45.25
|
|
Protein c activity
|
$244.80 |
$244.80 |
$244.80 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$67.80 |
$67.80 |
$67.80 |
$84.00
|
|
Protein total 24 hour urine
|
$59.40 |
$59.40 |
$59.40 |
$45.00
|
|
Protein total body fluid
|
$49.20 |
$49.20 |
$49.20 |
$49.20
|
|
Protein total serum plasma whole blood
|
$23.40 |
$23.40 |
$23.40 |
$40.70
|
|
Prothrombin time substitution plasma fractions each
|
$71.40 |
$71.40 |
$71.40 |
$37.05
|
|
Provide inr test mater/equip
|
$292.80 |
$292.80 |
$292.80 |
$151.14
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$254.40 |
$254.40 |
$254.40 |
$278.20
|
|
PSA (Prostate) Test
|
$90.00 |
$90.00 |
$90.00 |
$103.85
|
|
Psychotherapy group therapy
|
$201.60 |
$201.60 |
$201.60 |
$268.80
|
|
Psychotherapy patient individual therapy 30 minutes
|
$196.80 |
$196.80 |
$196.80 |
$196.80
|
|
Psychotherapy patient individual therapy 45 minutes
|
$327.60 |
$327.60 |
$327.60 |
$267.00
|
|
Psychotherapy patient individual therapy 60 minutes
|
$393.00 |
$393.00 |
$393.00 |
$294.00
|
|
Psytx complex interactive
|
$94.80 |
$94.80 |
$94.80 |
$54.00
|