|
Observation per hour
|
$66.60 |
$66.60 |
$66.60 |
$75.15
|
|
Obstetrics panel
|
$396.00 |
$396.00 |
$396.00 |
$214.50
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$30,620.87 |
$30,620.87 |
$30,620.87 |
$35,293.52
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$97.11 |
$97.11 |
$97.11 |
$59.15
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$9,617.10 |
$9,617.10 |
$9,617.10 |
$8,720.95
|
|
Olanzapine 10 mg intramuscular solution
|
$120.17 |
$120.17 |
$120.17 |
$120.17
|
|
Oncoprotein dcp
|
$344.40 |
$344.40 |
$344.40 |
$175.25
|
|
Ondansetron 8 mg disintegrating tablet
|
$1.90 |
$1.90 |
$1.90 |
$2.09
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$38.99 |
$38.99 |
$38.99 |
$12.51
|
|
Organic acids total quant ea spec
|
$408.00 |
$408.00 |
$408.00 |
$152.50
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$40.92 |
$40.92 |
$40.92 |
$40.92
|
|
Osmolality blood
|
$135.60 |
$135.60 |
$135.60 |
$57.00
|
|
Osmolality urine
|
$135.00 |
$135.00 |
$135.00 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$285.60 |
$285.60 |
$285.60 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$191.40 |
$191.40 |
$191.40 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$236.40 |
$236.40 |
$236.40 |
$249.60
|
|
Other immunoelectrophoresis
|
$405.60 |
$405.60 |
$405.60 |
$92.70
|
|
Oth resp proc, group
|
$318.60 |
$318.60 |
$318.60 |
$100.80
|
|
Oth resp proc, indiv
|
$160.20 |
$160.20 |
$160.20 |
$67.60
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$221.40 |
$221.40 |
$221.40 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$102.60 |
$102.60 |
$102.60 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$106.80 |
$106.80 |
$106.80 |
$105.50
|
|
Ot re-evaluation patient/family
|
$174.00 |
$174.00 |
$174.00 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$100.20 |
$100.20 |
$100.20 |
$96.11
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$79.80 |
$79.80 |
$79.80 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$91.80 |
$91.80 |
$91.80 |
$90.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$103.80 |
$103.80 |
$103.80 |
$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
|
$87.00 |
$87.00 |
$87.00 |
$93.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$3.82 |
$3.82 |
$3.82 |
$17.82
|
|
Oxytocin 10 unit/ml injection solution
|
$39.23 |
$39.23 |
$39.23 |
$30.78
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$201.09 |
$201.09 |
$201.09 |
$135.25
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$29.18 |
$29.18 |
$29.18 |
$28.29
|
|
Palonosetron hcl
|
$1,094.62 |
$1,094.62 |
$1,094.62 |
$372.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$129.80 |
$129.80 |
$129.80 |
$129.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$65.80 |
$65.80 |
$65.80 |
$18.49
|
|
Parathormone (pth) intact
|
$471.60 |
$471.60 |
$471.60 |
$204.00
|
|
Parathyroid planar imaging
|
$1,593.00 |
$1,593.00 |
$1,593.00 |
$1,041.95
|
|
Parathyroid planar img w/tomo spect
|
$1,531.80 |
$1,531.80 |
$1,531.80 |
$1,317.94
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$321.60 |
$321.60 |
$321.60 |
$270.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$5,901.00
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$9,121.58 |
$9,121.58 |
$9,121.58 |
$9,121.58
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$5,688.56 |
$5,688.56 |
$5,688.56 |
$5,688.56
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$5,159.82 |
$5,159.82 |
$5,159.82 |
$8,141.25
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$5,961.60 |
$5,961.60 |
$5,961.60 |
$5,961.60
|
|
Pelvic CT scan (with and without contrast)
|
$1,834.80 |
$1,834.80 |
$1,834.80 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$1,528.80 |
$1,528.80 |
$1,528.80 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$1,222.20 |
$1,222.20 |
$1,222.20 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$3,318.00 |
$3,318.00 |
$3,318.00 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$2,766.00 |
$2,766.00 |
$2,766.00 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$2,211.60 |
$2,211.60 |
$2,211.60 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$565.80 |
$565.80 |
$565.80 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$430.80 |
$430.80 |
$430.80 |
$429.66
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$85.04 |
$85.04 |
$85.04 |
$86.90
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$16.16 |
$16.16 |
$16.16 |
$122.56
|
|
Peng benzathine/procaine inj
|
$338.23 |
$338.23 |
$338.23 |
$108.11
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$48.74 |
$48.74 |
$48.74 |
$48.74
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$122.55 |
$122.55 |
$122.55 |
$53.75
|
|
Pentamidine non-comp unit
|
$279.76 |
$279.76 |
$279.76 |
$279.76
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$83.70 |
$83.70 |
$83.70 |
$269.36
|
|
Pertussis ag if
|
$234.00 |
$234.00 |
$234.00 |
$53.95
|
|
Pertuzumab 30 mg/ml desensitization
|
$10,118.19 |
$10,118.19 |
$10,118.19 |
$15,007.91
|
|
Ph body fluid
|
$89.40 |
$89.40 |
$89.40 |
$35.75
|
|
Phencyclidine (pcp)
|
$171.00 |
$171.00 |
$171.00 |
$74.40
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$77.20 |
$77.20 |
$77.20 |
$84.60
|
|
Phenobarbital therapeutic drug level
|
$248.40 |
$248.40 |
$248.40 |
$97.50
|
|
Phentolaine mesylate inj
|
$881.36 |
$881.36 |
$881.36 |
$881.36
|
|
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
|
$39.08 |
$39.08 |
$39.08 |
$7.71
|
|
Phenytoin total therapeutic drug level
|
$236.40 |
$236.40 |
$236.40 |
$100.75
|
|
Phlebotomy therapeutic
|
$383.40 |
$383.40 |
$383.40 |
$240.24
|
|
Phosphorus
|
$90.60 |
$90.60 |
$90.60 |
$42.37
|
|
Phosphorus 24 hour urine
|
$129.00 |
$129.00 |
$129.00 |
$41.51
|
|
Phys blood bank serv reactj
|
$484.20 |
$484.20 |
$484.20 |
$219.94
|
|
Phys blood bank serv xmatch
|
$77.40 |
$77.40 |
$77.40 |
$56.08
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$133.36 |
$133.36 |
$133.36 |
$75.04
|
|
Pinworm exam
|
$64.20 |
$64.20 |
$64.20 |
$38.58
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$104.73 |
$104.73 |
$104.73 |
$51.80
|
|
Place gastrostomy tube perc
|
$4,474.80 |
$4,474.80 |
$4,474.80 |
$2,286.40
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$3,329.40 |
$3,329.40 |
$3,329.40 |
$1,679.20
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$3,329.40 |
$3,329.40 |
$3,329.40 |
$1,094.83
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,985.40 |
$1,985.40 |
$1,985.40 |
$1,372.15
|
|
Plasma cryoprecipitate reduced each unit
|
$206.40 |
$206.40 |
$206.40 |
$160.55
|
|
Platelet aggregation each agent teg
|
$288.00 |
$288.00 |
$288.00 |
$145.60
|
|
Platelet automated
|
$95.40 |
$95.40 |
$95.40 |
$33.60
|
|
Platelets each unit
|
$294.60 |
$294.60 |
$294.60 |
$187.20
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$2,849.40 |
$2,849.40 |
$2,849.40 |
$1,532.70
|
|
Platelets leukocytes reduced each unit
|
$344.40 |
$344.40 |
$344.40 |
$274.95
|
|
Platelets leukoreduced cmv negative apheresis/phresis each unit
|
$1,927.80 |
$1,927.80 |
$1,927.80 |
$1,146.60
|
|
Platelets pheresis leukocytes reduced cmv negative irradiated each unit
|
$2,052.00 |
$2,052.00 |
$2,052.00 |
$1,424.80
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,601.60 |
$2,601.60 |
$2,601.60 |
$1,642.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,352.00 |
$2,352.00 |
$2,352.00 |
$1,530.10
|
|
Platelets pheresis pathogen-reduced each unit
|
$711.00 |
$711.00 |
$711.00 |
$1,046.50
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$2,907.00 |
$2,907.00 |
$2,907.00 |
$1,331.53
|
|
Plcmt sft tiss loc pq w/img ea addl lsn
|
$2,181.60 |
$2,181.60 |
$2,181.60 |
$878.22
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$1,985.40 |
$1,985.40 |
$1,985.40 |
$969.00
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$369.60 |
$369.60 |
$369.60 |
$146.15
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$3,991.80 |
$3,991.80 |
$3,991.80 |
$4,313.58
|
|
Potassium 24 hour urine
|
$111.60 |
$111.60 |
$111.60 |
$45.00
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$64.50 |
$64.50 |
$64.50 |
$60.99
|