|
MRI chest without contrast
|
$12,880.04 |
$12,880.04 |
$12,880.04 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$15,582.73 |
$15,582.73 |
$15,582.73 |
$2,652.73
|
|
MRI chest w IV cont
|
$14,164.01 |
$14,164.01 |
$14,164.01 |
$2,210.00
|
|
MRI compatible system
|
$21,812.00 |
$21,812.00 |
$21,812.00 |
$2,672.33
|
|
MRI fetal ea addl gestation
|
$1,035.48 |
$1,035.48 |
$1,035.48 |
$582.60
|
|
MRI fetal sngl/1st gestation
|
$2,127.61 |
$2,127.61 |
$2,127.61 |
$1,136.26
|
|
MRI guid ndl plc s&i
|
$9,352.84 |
$9,352.84 |
$9,352.84 |
$1,267.50
|
|
MRI orbit/face/neck without contrast
|
$11,182.90 |
$11,182.90 |
$11,182.90 |
$1,883.25
|
|
MRI orbit/face/neck without & w/contrast
|
$13,422.51 |
$13,422.51 |
$13,422.51 |
$2,812.50
|
|
MRI orbit fac&nck w IV cont
|
$12,305.39 |
$12,305.39 |
$12,305.39 |
$2,176.20
|
|
MRI tmj
|
$11,182.90 |
$11,182.90 |
$11,182.90 |
$1,736.28
|
|
MRI w/cont, breast, bi
|
$11,608.53 |
$11,608.53 |
$11,608.53 |
$2,119.87
|
|
MRI w/cont, breast, uni
|
$5,858.69 |
$5,858.69 |
$5,858.69 |
$1,443.12
|
|
MRI without fol w/cont, breast
|
$14,188.08 |
$14,188.08 |
$14,188.08 |
$2,449.20
|
|
MRI without fol w/cont, brst, un
|
$8,874.60 |
$8,874.60 |
$8,874.60 |
$1,720.40
|
|
Mr spectroscopy
|
$8,336.54 |
$8,336.54 |
$8,336.54 |
$1,340.00
|
|
Mucin synovial fluid
|
$216.33 |
$216.33 |
$216.33 |
$33.57
|
|
Multiple sleep latency test
|
$14,002.60 |
$14,002.60 |
$14,002.60 |
$2,440.50
|
|
Muscle test cran nerv unilat
|
$1,543.96 |
$1,543.96 |
$1,543.96 |
$385.07
|
|
Myocrd img pet 1 std w/ct
|
$4,769.59 |
$4,769.59 |
$4,769.59 |
$3,252.00
|
|
Myocrd img pet 2rtracer CT
|
$6,378.14 |
$6,378.14 |
$6,378.14 |
$5,083.90
|
|
Myocrd img pet rst&strs CT
|
$7,359.14 |
$7,359.14 |
$7,359.14 |
$4,846.40
|
|
Myocrd img pet rst/strs w/ct
|
$4,769.59 |
$4,769.59 |
$4,769.59 |
$3,311.85
|
|
Natural killer cells total count
|
$506.26 |
$506.26 |
$506.26 |
$132.63
|
|
Ndl emg musc 1 xtr/non-limb
|
$871.66 |
$871.66 |
$871.66 |
$213.75
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$15,377.49 |
$15,377.49 |
$15,377.49 |
$2,855.40
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$12,992.44 |
$12,992.44 |
$12,992.44 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$12,992.44 |
$12,992.44 |
$12,992.44 |
$2,003.30
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$16,860.45 |
$16,860.45 |
$16,860.45 |
$2,650.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$15,459.57 |
$15,459.57 |
$15,459.57 |
$2,055.58
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$14,041.77 |
$14,041.77 |
$14,041.77 |
$1,790.58
|
|
Neuromuscular junction testing ea nerve any 1 method
|
$517.39 |
$517.39 |
$517.39 |
$250.14
|
|
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution
|
$48,888.56 |
$48,888.56 |
$48,888.56 |
$41,635.10
|
|
Nm imaging bone/joint 3 phase study
|
$8,658.01 |
$8,658.01 |
$8,658.01 |
$1,676.35
|
|
Nm imaging bone/joint whole body
|
$7,135.06 |
$7,135.06 |
$7,135.06 |
$1,570.65
|
|
Nm imaging gastrointestinal acute blood loss
|
$4,358.19 |
$4,358.19 |
$4,358.19 |
$1,200.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$8,144.00 |
$8,144.00 |
$8,144.00 |
$1,612.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$6,468.75 |
$6,468.75 |
$6,468.75 |
$1,517.10
|
|
Nm imaging pulmonary ventilation/perfusion
|
$13,000.94 |
$13,000.94 |
$13,000.94 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$5,835.44 |
$5,835.44 |
$5,835.44 |
$1,079.00
|
|
Non-card vasc flow imaging
|
$3,215.96 |
$3,215.96 |
$3,215.96 |
$608.56
|
|
Npm1 gene
|
$907.70 |
$907.70 |
$907.70 |
$457.50
|
|
Nras gene variants exon 2&3
|
$3,669.31 |
$3,669.31 |
$3,669.31 |
$592.00
|
|
Nuclear rx IV admin
|
$9,915.69 |
$9,915.69 |
$9,915.69 |
$864.50
|
|
Obstetric panel inc HIV tstg
|
$896.05 |
$896.05 |
$896.05 |
$264.60
|
|
Obstetrics panel
|
$535.25 |
$535.25 |
$535.25 |
$214.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$926.22 |
$926.22 |
$926.22 |
$359.20
|
|
Ob Ultrasound nuchal meas add-on
|
$617.72 |
$617.72 |
$617.72 |
$249.60
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$3,796.31 |
$3,796.31 |
$3,796.31 |
$4,595.01
|
|
Oncoprotein her-2/neu
|
$1,145.19 |
$1,145.19 |
$1,145.19 |
$219.00
|
|
Ondansetron 8 mg disintegrating tablet
|
$10.76 |
$10.76 |
$10.76 |
$9.30
|
|
Oral busulfan
|
$7.00 |
$7.00 |
$7.00 |
$176.80
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$84.17 |
$84.17 |
$84.17 |
$50.63
|
|
Ostomy clamp, replacement
|
$3.00 |
$3.00 |
$3.00 |
$4.66
|
|
Ost pch drain w bar & filter
|
$3.00 |
$3.00 |
$3.00 |
$7.39
|
|
Ost skn barr extnd >4 sq
|
$23.00 |
$23.00 |
$23.00 |
$5.40
|
|
Ost urine pch w b/bltin conv
|
$3.00 |
$3.00 |
$3.00 |
$2.90
|
|
Oxytocin 10 unit/ml injection solution
|
$134.69 |
$134.69 |
$134.69 |
$50.40
|
|
Palonosetron hcl
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$170.48
|
|
Papaverin hcl injection
|
$202.45 |
$202.45 |
$202.45 |
$77.05
|
|
Parathyroid planar imaging
|
$13,408.35 |
$13,408.35 |
$13,408.35 |
$1,129.91
|
|
Paricalcitol
|
$159.20 |
$159.20 |
$159.20 |
$47.15
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$7.46 |
$7.46 |
$7.46 |
$4,921.76
|
|
Paste skin barrier .5oz adapt
|
$37.00 |
$37.00 |
$37.00 |
$5.73
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$21,676.78 |
$21,676.78 |
$21,676.78 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$13,168.79 |
$13,168.79 |
$13,168.79 |
$6,370.52
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$6,586.13 |
$6,586.13 |
$6,586.13 |
$4,133.25
|
|
Pegloticase 8 mg/ml intravenous solution
|
$71,480.36 |
$71,480.36 |
$71,480.36 |
$49,135.11
|
|
Pelvic MRI (with and without contrast)
|
$15,487.24 |
$15,487.24 |
$15,487.24 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$14,204.15 |
$14,204.15 |
$14,204.15 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$12,903.22 |
$12,903.22 |
$12,903.22 |
$1,902.00
|
|
Pentamidine non-comp unit
|
$245.00 |
$245.00 |
$245.00 |
$294.39
|
|
Pentazocine injection
|
$143.86 |
$143.86 |
$143.86 |
$128.80
|
|
Pentobarbital sodium inj
|
$2,593.33 |
$2,593.33 |
$2,593.33 |
$2,205.38
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$796.32 |
$796.32 |
$796.32 |
$321.71
|
|
Perit-vens shunt pat tst
|
$5,042.22 |
$5,042.22 |
$5,042.22 |
$758.37
|
|
Pertuzumab 30 mg/ml desensitization
|
$22,178.38 |
$22,178.38 |
$22,178.38 |
$13,666.00
|
|
Pet CT skull-mid thgh initial
|
$4,769.59 |
$4,769.59 |
$4,769.59 |
$4,707.00
|
|
Pet image w/ct lmtd
|
$4,769.59 |
$4,769.59 |
$4,769.59 |
$4,305.60
|
|
Phencyclidine (pcp)
|
$158.36 |
$158.36 |
$158.36 |
$96.00
|
|
Phentolaine mesylate inj
|
$885.10 |
$885.10 |
$885.10 |
$1,028.40
|
|
Phys blood bank serv reactj
|
$148.41 |
$148.41 |
$148.41 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$144.33 |
$144.33 |
$144.33 |
$87.50
|
|
Piflu f-18, dia 1 millicurie
|
$1,057.16 |
$1,057.16 |
$1,057.16 |
$1,035.81
|
|
Pinworm exam
|
$396.95 |
$396.95 |
$396.95 |
$39.75
|
|
Plasma cryoprecipitate reduced each unit
|
$200.57 |
$200.57 |
$200.57 |
$157.95
|
|
Plastic mod low ext pad/line
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$241.54
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,138.51 |
$2,138.51 |
$2,138.51 |
$1,278.55
|
|
Plethysmography lung volumes/airway resistance
|
$1,962.33 |
$1,962.33 |
$1,962.33 |
$405.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$29,929.81 |
$29,929.81 |
$29,929.81 |
$3,751.48
|
|
Postop app non-wgt bear dsg
|
$4,166.00 |
$4,166.00 |
$4,166.00 |
$977.13
|
|
Pouch ostmy flat lk n 2.5in roll premier 1pc trnsp
|
$3.00 |
$3.00 |
$3.00 |
$6.16
|
|
Powder prem protct 1oz
|
$31.00 |
$31.00 |
$31.00 |
$5.43
|
|
Pq biliary strict dil s&i
|
$2,532.19 |
$2,532.19 |
$2,532.19 |
$1,097.60
|
|
Pq dr cath chg w cont s&i
|
$1,359.94 |
$1,359.94 |
$1,359.94 |
$720.00
|
|
Pralidoxime 1 gram solution for injection
|
$0.50 |
$0.50 |
$0.50 |
$271.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$112.04 |
$112.04 |
$112.04 |
$46.56
|
|
Pregnancy associated plasma protein-a
|
$1,314.68 |
$1,314.68 |
$1,314.68 |
$71.28
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$338.80 |
$338.80 |
$338.80 |
$152.85
|
|
Pretreat rbc absorption reference
|
$157.07 |
$157.07 |
$157.07 |
$150.00
|
