|
Methylprednisolone acetate 40 mg/ml suspension for injection
|
$39.00 |
$39.00 |
$39.00 |
$59.60
|
|
Methylprednisolone sodium succinate 1,000 mg intravenous solution
|
$259.20 |
$259.20 |
$259.20 |
$193.00
|
|
Metoclopramide in d5w IV syringe 0.2 mg/ml (neo/ped) - cnr
|
$11.40 |
$11.40 |
$11.40 |
$14.85
|
|
Metoprolol tartrate 5 mg/5 ml intravenous (wrapper)
|
$5.40 |
$5.40 |
$5.40 |
$7.59
|
|
Metronidazole 500 mg/100 ml in sodium chlor(iso) intravenous piggyback
|
$9.60 |
$9.60 |
$9.60 |
$22.10
|
|
Micafungin 100 mg intravenous solution
|
$301.20 |
$301.20 |
$301.20 |
$324.36
|
|
Microalbumin urine screen
|
$54.00 |
$54.00 |
$54.00 |
$19.04
|
|
Midazolam 1 mg/ml injection solution
|
$27.00 |
$27.00 |
$27.00 |
$64.34
|
|
Midazolam 1 mg/ml in sodium chloride IV infusion (wrapper)
|
$116.40 |
$116.40 |
$116.40 |
$104.50
|
|
Morphine 4 mg/ml injection (wrapper)
|
$10.20 |
$10.20 |
$10.20 |
$72.07
|
|
Morphine 4 mg/ml injection (wrapper)|discarded drug not administered
|
$9.60 |
$9.60 |
$9.60 |
$22.12
|
|
MRA abdomen post contrast
|
$2,290.20 |
$2,290.20 |
$2,290.20 |
$2,184.00
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$2,907.00 |
$2,907.00 |
$2,907.00 |
$2,110.00
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,855.40
|
|
MRI orbit/face/neck without & w/contrast
|
$4,873.20 |
$4,873.20 |
$4,873.20 |
$2,854.80
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$2,196.60 |
$2,196.60 |
$2,196.60 |
$2,020.80
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,713.80
|
|
Mycophenolate mofetil 250 mg capsule
|
$3.60 |
$3.60 |
$3.60 |
$10.79
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$180.60 |
$180.60 |
$180.60 |
$131.07
|
|
Nalbuphine 10 mg/ml injection solution
|
$12.60 |
$12.60 |
$12.60 |
$38.69
|
|
Naloxone 0.4 mg/ml injection (wrapper)
|
$110.40 |
$110.40 |
$110.40 |
$70.87
|
|
Natriuretic peptide
|
$230.40 |
$230.40 |
$230.40 |
$176.15
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$2,344.80 |
$2,344.80 |
$2,344.80 |
$1,732.50
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,416.80 |
$2,416.80 |
$2,416.80 |
$1,513.95
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$4,633.20 |
$4,633.20 |
$4,633.20 |
$2,881.80
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,907.00 |
$2,907.00 |
$2,907.00 |
$2,054.72
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,520.60 |
$2,520.60 |
$2,520.60 |
$1,824.90
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$103.20 |
$103.20 |
$103.20 |
$264.31
|
|
Nushield 1 square cm
|
$817.69 |
$817.69 |
$817.69 |
$937.50
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$22.20 |
$22.20 |
$22.20 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$19,353.00 |
$19,353.00 |
$19,353.00 |
$12,151.03
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$1.20 |
$1.20 |
$1.20 |
$22.62
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$53.40 |
$53.40 |
$53.40 |
$50.63
|
|
Ot evaluation high complexity patient/family
|
$161.40 |
$161.40 |
$161.40 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$161.40 |
$161.40 |
$161.40 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$161.40 |
$161.40 |
$161.40 |
$263.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$93.60 |
$93.60 |
$93.60 |
$105.00
|
|
Ot re-evaluation patient/family
|
$78.00 |
$78.00 |
$78.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$67.80 |
$67.80 |
$67.80 |
$98.90
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$111.00 |
$111.00 |
$111.00 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$105.00 |
$105.00 |
$105.00 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$67.20 |
$67.20 |
$67.20 |
$93.60
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$11.40 |
$11.40 |
$11.40 |
$27.16
|
|
Pelvic CT scan (without contrast)
|
$1,619.40 |
$1,619.40 |
$1,619.40 |
$1,366.50
|
|
Pelvic MRI (without contrast)
|
$2,907.00 |
$2,907.00 |
$2,907.00 |
$1,929.85
|
|
Peng benzathine/procaine inj
|
$37.20 |
$37.20 |
$37.20 |
$338.23
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$43.20 |
$43.20 |
$43.20 |
$97.85
|
|
Ph body fluid
|
$158.40 |
$158.40 |
$158.40 |
$40.04
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$16.80 |
$16.80 |
$16.80 |
$85.79
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$26.40 |
$26.40 |
$26.40 |
$83.57
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$15.90 |
$15.90 |
$15.90 |
$64.09
|
|
Potassium serum/plasma/whole blood
|
$19.20 |
$19.20 |
$19.20 |
$46.00
|
|
Pr discharge day management hospital ip/obs > 30 min on encounter date
|
$118.80 |
$118.80 |
$118.80 |
$189.80
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$3.60 |
$3.60 |
$3.60 |
$13.80
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$62.40 |
$62.40 |
$62.40 |
$36.33
|
|
Propofol infusion 10 mg/ml
|
$86.40 |
$86.40 |
$86.40 |
$73.36
|
|
Protein total serum plasma whole blood
|
$111.00 |
$111.00 |
$111.00 |
$42.81
|
|
Prothrombin complex kcentra
|
$6.60 |
$6.60 |
$6.60 |
$7.55
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$93.60 |
$93.60 |
$93.60 |
$87.45
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$93.00 |
$93.00 |
$93.00 |
$102.00
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$121.80 |
$121.80 |
$121.80 |
$79.76
|
|
Pt application of modality traction mechanical
|
$137.40 |
$137.40 |
$137.40 |
$87.00
|
|
Pt evaluation high complexity patient/family
|
$172.20 |
$172.20 |
$172.20 |
$289.50
|
|
Pt evaluation low complexity patient/family
|
$172.20 |
$172.20 |
$172.20 |
$222.24
|
|
Pt evaluation moderate complexity patient/family
|
$172.20 |
$172.20 |
$172.20 |
$249.26
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$78.00 |
$78.00 |
$78.00 |
$87.10
|
|
Pt wheelchair management each 15 minutes
|
$67.20 |
$67.20 |
$67.20 |
$86.53
|
|
Rabies ig ht&sol human im/sc
|
$2,997.00 |
$2,997.00 |
$2,997.00 |
$2,997.00
|
|
Rapid Strep Test
|
$63.60 |
$63.60 |
$63.60 |
$74.25
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$811.20 |
$811.20 |
$811.20 |
$378.22
|
|
Remdesivir 100 mg intravenous powder for solution
|
$1,909.80 |
$1,909.80 |
$1,909.80 |
$1,524.70
|
|
Renal function panel
|
$235.20 |
$235.20 |
$235.20 |
$113.52
|
|
Screening colorectal cancer fecal occult blood immunoassay 1-3 simultaneous determinations
|
$37.80 |
$37.80 |
$37.80 |
$57.60
|
|
Screening Mammogram
|
$207.00 |
$207.00 |
$207.00 |
$310.20
|
|
Semen analysis w/count
|
$121.80 |
$121.80 |
$121.80 |
$56.44
|
|
Sevelamer carbonate 800 mg tablet
|
$3.00 |
$3.00 |
$3.00 |
$7.14
|
|
Shoulder MRI (with and without contrast)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,743.02
|
|
Shoulder MRI (without contrast)
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$2,110.00
|
|
Sincalide 5 mcg solution for injection
|
$545.40 |
$545.40 |
$545.40 |
$309.14
|
|
Sinus CT scan (with and without contrast)
|
$2,235.00 |
$2,235.00 |
$2,235.00 |
$1,800.90
|
|
Sinus CT scan (with contrast)
|
$1,904.40 |
$1,904.40 |
$1,904.40 |
$1,562.50
|
|
Sinus CT scan (without contrast)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,281.80
|
|
Sodium chloride 0.9 % IV bolus
|
$18.60 |
$18.60 |
$18.60 |
$44.34
|
|
Sodium serum/plasma/whole blood
|
$89.40 |
$89.40 |
$89.40 |
$45.00
|
|
Succinylcholine chloride 20 mg/ml injection solution (wrapper)
|
$64.80 |
$64.80 |
$64.80 |
$50.22
|
|
Sumatriptan 6 mg/0.5 ml subcutaneous solution
|
$247.20 |
$247.20 |
$247.20 |
$123.58
|
|
Tc-99m maa
|
$103.20 |
$103.20 |
$103.20 |
$283.41
|
|
Tc-99m mebrofenin
|
$121.80 |
$121.80 |
$121.80 |
$160.58
|
|
Tc-99m medronate
|
$103.20 |
$103.20 |
$103.20 |
$109.50
|
|
Tc-99m pentetate dtpa
|
$103.20 |
$103.20 |
$103.20 |
$222.60
|
|
Tc-99m sulfur colloid
|
$103.20 |
$103.20 |
$103.20 |
$239.40
|
|
Tenecteplase 5 mg/ml intravenous solution for ischemic stroke (50 mg vial)
|
$21,126.00 |
$21,126.00 |
$21,126.00 |
$15,600.75
|
|
Thiamine hcl (vitamin b1) 100 mg/ml injection solution
|
$17.40 |
$17.40 |
$17.40 |
$25.54
|
|
Thyroid (TSH) Test
|
$183.60 |
$183.60 |
$183.60 |
$112.00
|
|
Tobramycin in ns IV syringe 4 mg/ml (neo/ped) - cnr
|
$12.00 |
$12.00 |
$12.00 |
$152.80
|
|
Tocilizumab 162 mg/0.9 ml subcutaneous pen injector
|
$7,282.20 |
$7,282.20 |
$7,282.20 |
$4,779.11
|
|
Treponema pallidum antibody
|
$183.60 |
$183.60 |
$183.60 |
$70.85
|
|
Triglycerides
|
$95.40 |
$95.40 |
$95.40 |
$57.85
|
|
Upper Back (Thoracic Spine) MRI (with and without contrast)
|
$4,633.20 |
$4,633.20 |
$4,633.20 |
$3,039.60
|