|
Ot evaluation high complexity patient/family
|
$268.50 |
$268.50 |
$268.50 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$196.00 |
$196.00 |
$196.00 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$226.50 |
$226.50 |
$226.50 |
$263.50
|
|
Oth resp proc, group
|
$176.00 |
$176.00 |
$176.00 |
$123.05
|
|
Oth resp proc, indiv
|
$162.00 |
$162.00 |
$162.00 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$89.50 |
$89.50 |
$89.50 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$89.50 |
$89.50 |
$89.50 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$72.50 |
$72.50 |
$72.50 |
$105.00
|
|
Ot re-evaluation patient/family
|
$235.50 |
$235.50 |
$235.50 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$81.00 |
$81.00 |
$81.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$97.50 |
$97.50 |
$97.50 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$97.50 |
$97.50 |
$97.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$89.50 |
$89.50 |
$89.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$85.50 |
$85.50 |
$85.50 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$78.50 |
$78.50 |
$78.50 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$106.82 |
$106.82 |
$106.82 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$211.50 |
$211.50 |
$211.50 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$27.80 |
$27.80 |
$27.80 |
$50.40
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$65,625.00 |
$65,625.00 |
$65,625.00 |
$47,880.00
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$113.12 |
$113.12 |
$113.12 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$3,435.42 |
$3,435.42 |
$3,435.42 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$8,247.53 |
$8,247.53 |
$8,247.53 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$8,620.80 |
$8,620.80 |
$8,620.80 |
$5,569.20
|
|
Palonosetron hcl
|
$111.88 |
$111.88 |
$111.88 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$47.45 |
$47.45 |
$47.45 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$16,674.25 |
$16,674.25 |
$16,674.25 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$47.70 |
$47.70 |
$47.70 |
$29.31
|
|
Papaverin hcl injection
|
$106.96 |
$106.96 |
$106.96 |
$77.05
|
|
Parathormone (pth) intact
|
$189.00 |
$189.00 |
$189.00 |
$204.87
|
|
Parathyroid planar imaging
|
$870.00 |
$870.00 |
$870.00 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$913.00 |
$913.00 |
$913.00 |
$1,350.60
|
|
Paricalcitol
|
$72.38 |
$72.38 |
$72.38 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$296.00 |
$296.00 |
$296.00 |
$245.00
|
|
Partial removal finger bone
|
$803.00 |
$803.00 |
$803.00 |
$2,049.27
|
|
Passy muir valve metal trach
|
$288.88 |
$288.88 |
$288.88 |
$275.75
|
|
Pegaspargase injection
|
$46,529.45 |
$46,529.45 |
$46,529.45 |
$39,780.27
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$10,396.75 |
$10,396.75 |
$10,396.75 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$5,045.58 |
$5,045.58 |
$5,045.58 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,188.00 |
$4,188.00 |
$4,188.00 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,004.26 |
$4,004.26 |
$4,004.26 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$5,229.92 |
$5,229.92 |
$5,229.92 |
$4,067.80
|
|
Peg interferon alfa-2a/180
|
$1,944.16 |
$1,944.16 |
$1,944.16 |
$3,289.23
|
|
Pegloticase 8 mg/ml intravenous solution
|
$39,174.78 |
$39,174.78 |
$39,174.78 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$962.00 |
$962.00 |
$962.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$732.00 |
$732.00 |
$732.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$569.00 |
$569.00 |
$569.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$898.00 |
$898.00 |
$898.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$732.50 |
$732.50 |
$732.50 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$434.00 |
$434.00 |
$434.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$405.00 |
$405.00 |
$405.00 |
$430.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$28,348.37 |
$28,348.37 |
$28,348.37 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$140.32 |
$140.32 |
$140.32 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$1,052.20 |
$1,052.20 |
$1,052.20 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$2,075.92 |
$2,075.92 |
$2,075.92 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$119.56 |
$119.56 |
$119.56 |
$101.34
|
|
Penile injection
|
$207.00 |
$207.00 |
$207.00 |
$418.00
|
|
Pentamidine non-comp unit
|
$162.81 |
$162.81 |
$162.81 |
$294.39
|
|
Pentobarbital sodium inj
|
$3,309.25 |
$3,309.25 |
$3,309.25 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$5,948.18 |
$5,948.18 |
$5,948.18 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$6,448.50 |
$6,448.50 |
$6,448.50 |
$11,458.04
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$564.38 |
$564.38 |
$564.38 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$389.00 |
$389.00 |
$389.00 |
$2,251.20
|
|
Peripheral vascular rehab
|
$247.50 |
$247.50 |
$247.50 |
$132.50
|
|
Peri-proc device eval icd
|
$210.50 |
$210.50 |
$210.50 |
$192.40
|
|
Peri-proc device eval pm
|
$156.00 |
$156.00 |
$156.00 |
$159.90
|
|
Perphenazine 4mg oral
|
$1.15 |
$1.15 |
$1.15 |
$2.58
|
|
Perq dev breast 1st mr guide
|
$566.00 |
$566.00 |
$566.00 |
$1,837.20
|
|
Pertuzumab 30 mg/ml desensitization
|
$15,255.16 |
$15,255.16 |
$15,255.16 |
$13,666.00
|
|
Pertuzu, trastuzu, 10 mg
|
$33,319.14 |
$33,319.14 |
$33,319.14 |
$27,833.07
|
|
Pfc sigma fem post aug sz3 8mm
|
$140,000.00 |
$140,000.00 |
$140,000.00 |
$38,834.22
|
|
Ph body fluid
|
$42.00 |
$42.00 |
$42.00 |
$41.28
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$324.39 |
$324.39 |
$324.39 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$176.00 |
$176.00 |
$176.00 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,550.97 |
$1,550.97 |
$1,550.97 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$26.96 |
$26.96 |
$26.96 |
$67.89
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$35.12 |
$35.12 |
$35.12 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$177.50 |
$177.50 |
$177.50 |
$110.88
|
|
Phlebotomy therapeutic
|
$419.00 |
$419.00 |
$419.00 |
$231.66
|
|
Phosphorus
|
$27.50 |
$27.50 |
$27.50 |
$48.80
|
|
Phosphorus 24 hour urine
|
$46.00 |
$46.00 |
$46.00 |
$41.51
|
|
Photodynmc tx 30 min add-on
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$582.40
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$140.88 |
$140.88 |
$140.88 |
$87.50
|
|
Pin caspar distraction 12mm
|
$17,400.00 |
$17,400.00 |
$17,400.00 |
$11,925.00
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$211.21 |
$211.21 |
$211.21 |
$83.03
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$1,517.21
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$652.00 |
$652.00 |
$652.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$915.50 |
$915.50 |
$915.50 |
$1,332.43
|
|
Platelet aggregation each agent teg
|
$78.00 |
$78.00 |
$78.00 |
$148.80
|
|
Platelet automated
|
$29.00 |
$29.00 |
$29.00 |
$45.60
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$1,860.50 |
$1,860.50 |
$1,860.50 |
$1,504.10
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,139.00 |
$2,139.00 |
$2,139.00 |
$1,139.20
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,162.50 |
$1,162.50 |
$1,162.50 |
$1,278.55
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,469.50 |
$1,469.50 |
$1,469.50 |
$1,004.00
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$1,230.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$640.50 |
$640.50 |
$640.50 |
$758.52
|
|
Plerixafor injection
|
$356.78 |
$356.78 |
$356.78 |
$16,079.30
|
|
Plethysmography lung volumes/airway resistance
|
$968.50 |
$968.50 |
$968.50 |
$405.00
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$173.50 |
$173.50 |
$173.50 |
$187.32
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$45,244.50 |
$45,244.50 |
$45,244.50 |
$35,781.91
|