|
MRA abdomen post contrast
|
$4,773.00 |
$4,773.00 |
$4,773.00 |
$2,144.35
|
|
MRA aorta thoracic w/wo contrast
|
$2,959.20 |
$2,959.20 |
$2,959.20 |
$2,552.76
|
|
MRA ext low(run-off)pst cntrst
|
$9,799.20 |
$9,799.20 |
$9,799.20 |
$2,481.10
|
|
MRA pelvis
|
$2,863.20 |
$2,863.20 |
$2,863.20 |
$2,344.00
|
|
MRA spinal canal
|
$3,495.60 |
$3,495.60 |
$3,495.60 |
$1,803.94
|
|
MRA upper extremity post contrast-bil
|
$3,425.40 |
$3,425.40 |
$3,425.40 |
$1,929.00
|
|
MRI cardiac morph & func wo IV cont
|
$2,421.60 |
$2,421.60 |
$2,421.60 |
$1,367.88
|
|
MRI chest without contrast
|
$2,612.40 |
$2,612.40 |
$2,612.40 |
$1,661.55
|
|
MRI chest without & w/contrast
|
$3,919.20 |
$3,919.20 |
$3,919.20 |
$2,321.61
|
|
MRI chest w IV cont
|
$3,265.80 |
$3,265.80 |
$3,265.80 |
$2,105.25
|
|
MRI fetal ea addl gestation
|
$2,645.40 |
$2,645.40 |
$2,645.40 |
$477.93
|
|
MRI fetal sngl/1st gestation
|
$2,645.40 |
$2,645.40 |
$2,645.40 |
$1,136.26
|
|
MRI loex nonjt w IV cont
|
$6,998.40 |
$6,998.40 |
$6,998.40 |
$1,953.60
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$5,600.40 |
$5,600.40 |
$5,600.40 |
$2,051.28
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$8,400.00 |
$8,400.00 |
$8,400.00 |
$2,614.43
|
|
MRI orbit/face/neck without contrast
|
$2,529.00 |
$2,529.00 |
$2,529.00 |
$1,782.69
|
|
MRI orbit/face/neck without & w/contrast
|
$3,792.60 |
$3,792.60 |
$3,792.60 |
$2,552.60
|
|
MRI orbit fac&nck w IV cont
|
$3,160.20 |
$3,160.20 |
$3,160.20 |
$2,002.00
|
|
MRI tmj
|
$2,986.80 |
$2,986.80 |
$2,986.80 |
$1,658.77
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$5,056.80 |
$5,056.80 |
$5,056.80 |
$1,902.00
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$7,582.80 |
$7,582.80 |
$7,582.80 |
$2,628.75
|
|
MRI upper extremity w/dye
|
$6,319.20 |
$6,319.20 |
$6,319.20 |
$1,854.07
|
|
Mr spectroscopy
|
$1,719.60 |
$1,719.60 |
$1,719.60 |
$1,117.20
|
|
Mthfr gene analy common variants
|
$403.20 |
$403.20 |
$403.20 |
$248.82
|
|
Mucin synovial fluid
|
$72.00 |
$72.00 |
$72.00 |
$32.55
|
|
Multiple sleep latency test
|
$3,732.60 |
$3,732.60 |
$3,732.60 |
$2,672.68
|
|
Mumps antibody igg
|
$151.20 |
$151.20 |
$151.20 |
$81.45
|
|
Mycoplasma antibody igm
|
$246.00 |
$246.00 |
$246.00 |
$87.50
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$251.40 |
$251.40 |
$251.40 |
$115.05
|
|
Nalbuphine 10 mg/ml injection solution
|
$49.64 |
$49.64 |
$49.64 |
$22.20
|
|
Natriuretic peptide
|
$345.00 |
$345.00 |
$345.00 |
$161.60
|
|
Natural killer cells total count
|
$190.20 |
$190.20 |
$190.20 |
$121.70
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$2,980.80 |
$2,980.80 |
$2,980.80 |
$1,750.20
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,485.20 |
$2,485.20 |
$2,485.20 |
$1,685.58
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,854.60 |
$1,854.60 |
$1,854.60 |
$1,435.80
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$3,324.60 |
$3,324.60 |
$3,324.60 |
$2,562.00
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,772.00 |
$2,772.00 |
$2,772.00 |
$2,164.88
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,217.60 |
$2,217.60 |
$2,217.60 |
$1,830.00
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$4,425.00 |
$4,425.00 |
$4,425.00 |
$2,547.30
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$3,792.60 |
$3,792.60 |
$3,792.60 |
$1,890.00
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$3,160.20 |
$3,160.20 |
$3,160.20 |
$1,741.80
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$45.30 |
$45.30 |
$45.30 |
$34.13
|
|
New Patient Office Visit (level 2)
|
$358.20 |
$358.20 |
$358.20 |
$151.45
|
|
New Patient Office Visit (level 3)
|
$430.20 |
$430.20 |
$430.20 |
$205.40
|
|
New Patient Office Visit (level 4)
|
$570.60 |
$570.60 |
$570.60 |
$289.60
|
|
New Patient Office Visit (level 5)
|
$819.60 |
$819.60 |
$819.60 |
$367.20
|
|
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
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$60.11 |
$60.11 |
$60.11 |
$60.11
|
|
Observation direct referral from physician office for admission
|
$313.80 |
$313.80 |
$313.80 |
$359.40
|
|
Observation per hour
|
$66.00 |
$66.00 |
$66.00 |
$75.15
|
|
Obstetrics panel
|
$425.40 |
$425.40 |
$425.40 |
$214.50
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$97.11 |
$97.11 |
$97.11 |
$59.15
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$6,422.43 |
$6,422.43 |
$6,422.43 |
$8,720.95
|
|
Oncoprotein dcp
|
$314.40 |
$314.40 |
$314.40 |
$175.25
|
|
Ondansetron 8 mg disintegrating tablet
|
$1.90 |
$1.90 |
$1.90 |
$2.09
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$398.16 |
$398.16 |
$398.16 |
$12.51
|
|
Organic acids total quant ea spec
|
$438.00 |
$438.00 |
$438.00 |
$152.50
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$40.92 |
$40.92 |
$40.92 |
$40.92
|
|
Osmolality blood
|
$147.60 |
$147.60 |
$147.60 |
$57.00
|
|
Osmolality urine
|
$147.60 |
$147.60 |
$147.60 |
$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
|
|
Oth resp proc, group
|
$235.80 |
$235.80 |
$235.80 |
$100.80
|
|
Oth resp proc, indiv
|
$104.40 |
$104.40 |
$104.40 |
$67.60
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$106.80 |
$106.80 |
$106.80 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$109.80 |
$109.80 |
$109.80 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$99.60 |
$99.60 |
$99.60 |
$105.50
|
|
Ot re-evaluation patient/family
|
$174.00 |
$174.00 |
$174.00 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$75.60 |
$75.60 |
$75.60 |
$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
|
$91.80 |
$91.80 |
$91.80 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$86.40 |
$86.40 |
$86.40 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$86.40 |
$86.40 |
$86.40 |
$93.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$3.82 |
$3.82 |
$3.82 |
$17.82
|
|
Oxytocin 10 unit/ml injection solution
|
$64.52 |
$64.52 |
$64.52 |
$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
|
$40.46 |
$40.46 |
$40.46 |
$18.49
|
|
Parathormone (pth) intact
|
$610.80 |
$610.80 |
$610.80 |
$204.00
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$9,121.58 |
$9,121.58 |
$9,121.58 |
$9,121.58
|
|
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)
|
$2,295.60 |
$2,295.60 |
$2,295.60 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$1,911.60 |
$1,911.60 |
$1,911.60 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$1,530.00 |
$1,530.00 |
$1,530.00 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$3,967.80 |
$3,967.80 |
$3,967.80 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$3,307.20 |
$3,307.20 |
$3,307.20 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$2,645.40 |
$2,645.40 |
$2,645.40 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$591.60 |
$591.60 |
$591.60 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$508.80 |
$508.80 |
$508.80 |
$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
|
|
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
|
$151.99 |
$151.99 |
$151.99 |
$53.75
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$83.70 |
$83.70 |
$83.70 |
$269.36
|
|
Pertussis ag if
|
$252.00 |
$252.00 |
$252.00 |
$53.95
|