|
Nm imaging gastrointestinal acute blood loss
|
$433.44 |
$433.44 |
$433.44 |
$1,125.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$450.24 |
$450.24 |
$450.24 |
$1,586.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$591.92 |
$591.92 |
$591.92 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$484.96 |
$484.96 |
$484.96 |
$1,566.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$381.92 |
$381.92 |
$381.92 |
$1,075.00
|
|
Noonan spectrum disorders
|
$1,794.80 |
$1,794.80 |
$1,794.80 |
$2,412.00
|
|
Nr lnr acclrtr tx max 5 sessions
|
$877.52 |
$877.52 |
$877.52 |
$8,344.87
|
|
Ntsty modul rad tx dlvr cplx
|
$960.96 |
$960.96 |
$960.96 |
$2,594.96
|
|
Ntsty modul rad tx dlvr smpl
|
$857.92 |
$857.92 |
$857.92 |
$2,591.00
|
|
Nuclear rx intra-arterial
|
$219.52 |
$219.52 |
$219.52 |
$761.95
|
|
Nuclear Stress Test (Heart)
|
$2,688.56 |
$2,688.56 |
$2,688.56 |
$3,739.20
|
|
Nushield 1 square cm
|
$187.04 |
$187.04 |
$187.04 |
$462.75
|
|
Observation per hour
|
$59.92 |
$59.92 |
$59.92 |
$75.15
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$36.44 |
$36.44 |
$36.44 |
$35,293.52
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$3.98 |
$3.98 |
$3.98 |
$59.15
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$119.13 |
$119.13 |
$119.13 |
$8,720.95
|
|
Onco (ovar) two proteins
|
$291.76 |
$291.76 |
$291.76 |
$260.50
|
|
Ophthalmic mitomycin
|
$224.49 |
$224.49 |
$224.49 |
$1,327.41
|
|
Oral aprepitant
|
$9.66 |
$9.66 |
$9.66 |
$260.40
|
|
Organic acids total quant ea spec
|
$42.84 |
$42.84 |
$42.84 |
$152.50
|
|
Oritavancin 400 mg intravenous solution
|
$16.33 |
$16.33 |
$16.33 |
$1,212.12
|
|
Orthopantogram
|
$40.32 |
$40.32 |
$40.32 |
$219.22
|
|
Osmolality blood
|
$25.76 |
$25.76 |
$25.76 |
$57.00
|
|
Osmolality urine
|
$25.76 |
$25.76 |
$25.76 |
$57.85
|
|
Ot evaluation high complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$265.50
|
|
Ot evaluation low complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$222.50
|
|
Ot evaluation moderate complexity patient/family
|
$135.52 |
$135.52 |
$135.52 |
$249.60
|
|
Other immunoelectrophoresis
|
$50.96 |
$50.96 |
$50.96 |
$92.70
|
|
Oth resp proc, group
|
$130.48 |
$130.48 |
$130.48 |
$100.80
|
|
Oth resp proc, indiv
|
$115.36 |
$115.36 |
$115.36 |
$67.60
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$56.56 |
$56.56 |
$56.56 |
$94.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$102.60
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$105.50
|
|
Ot re-evaluation patient/family
|
$84.00 |
$84.00 |
$84.00 |
$146.90
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$96.11
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$27.44 |
$27.44 |
$27.44 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$27.44 |
$27.44 |
$27.44 |
$90.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$95.65
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$41.44 |
$41.44 |
$41.44 |
$94.25
|
|
Ot training self care/home management direct contact each 15 minutes
|
$54.88 |
$54.88 |
$54.88 |
$93.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$3.08 |
$3.08 |
$3.08 |
$17.82
|
|
Paliperidone 117 mg/0.75 ml inj
|
$8.16 |
$8.16 |
$8.16 |
$4,898.66
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$77.04 |
$77.04 |
$77.04 |
$129.80
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$37.24 |
$37.24 |
$37.24 |
$187.16
|
|
Papaverin hcl injection
|
$9.22 |
$9.22 |
$9.22 |
$85.02
|
|
Parathormone (pth) intact
|
$118.16 |
$118.16 |
$118.16 |
$204.00
|
|
Parathyroid planar imaging
|
$434.56 |
$434.56 |
$434.56 |
$1,041.95
|
|
Parathyroid planar img w/tomo spect
|
$505.12 |
$505.12 |
$505.12 |
$1,317.94
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$291.76 |
$291.76 |
$291.76 |
$270.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$6.16 |
$6.16 |
$6.16 |
$5,901.00
|
|
Pelvic CT scan (with and without contrast)
|
$1,156.40 |
$1,156.40 |
$1,156.40 |
$1,872.00
|
|
Pelvic CT scan (with contrast)
|
$995.12 |
$995.12 |
$995.12 |
$1,602.75
|
|
Pelvic CT scan (without contrast)
|
$832.72 |
$832.72 |
$832.72 |
$1,290.90
|
|
Pelvic MRI (with and without contrast)
|
$1,972.32 |
$1,972.32 |
$1,972.32 |
$2,603.25
|
|
Pelvic MRI (with contrast)
|
$1,726.48 |
$1,726.48 |
$1,726.48 |
$1,854.06
|
|
Pelvic MRI (without contrast)
|
$1,480.08 |
$1,480.08 |
$1,480.08 |
$1,702.00
|
|
Pelvic Ultrasound (complete)
|
$536.48 |
$536.48 |
$536.48 |
$614.64
|
|
Pelvic Ultrasound (limited)
|
$172.48 |
$172.48 |
$172.48 |
$429.66
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$42.84 |
$42.84 |
$42.84 |
$122.56
|
|
Peng benzathine/procaine inj
|
$14.63 |
$14.63 |
$14.63 |
$108.11
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$211.75 |
$211.75 |
$211.75 |
$48.74
|
|
Penicillin g procaine inj
|
$18.49 |
$18.49 |
$18.49 |
$40.94
|
|
Penile rear tip xtnd 0.5cm
|
$10,917.76 |
$10,917.76 |
$10,917.76 |
$26,765.44
|
|
Pentobarbital sodium inj
|
$49.92 |
$49.92 |
$49.92 |
$64.60
|
|
Perc cryo ablate renal tum
|
$23,675.68 |
$23,675.68 |
$23,675.68 |
$13,038.50
|
|
Perc d-e cor revasc chro add
|
$4,304.72 |
$4,304.72 |
$4,304.72 |
$17,898.00
|
|
Perc d-e cor revasc chro sin
|
$13,383.44 |
$13,383.44 |
$13,383.44 |
$21,146.91
|
|
Perc d-e cor revasc t cabg b
|
$4,304.72 |
$4,304.72 |
$4,304.72 |
$23,011.50
|
|
Perc d-e cor revasc t cabg s
|
$12,009.20 |
$12,009.20 |
$12,009.20 |
$18,917.20
|
|
Perc d-e cor stent ather br
|
$4,304.72 |
$4,304.72 |
$4,304.72 |
$23,282.40
|
|
Perc d-e cor stent ather s
|
$13,335.84 |
$13,335.84 |
$13,335.84 |
$21,146.91
|
|
Perc drug-el cor stent bran
|
$4,304.72 |
$4,304.72 |
$4,304.72 |
$15,130.40
|
|
Perc drug-el cor stent sing
|
$8,954.40 |
$8,954.40 |
$8,954.40 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$6,093.36 |
$6,093.36 |
$6,093.36 |
$6,949.48
|
|
Percut ablate liver rf
|
$6,506.64 |
$6,506.64 |
$6,506.64 |
$7,024.12
|
|
Peripheral vascular rehab
|
$43.12 |
$43.12 |
$43.12 |
$142.11
|
|
Peri-proc device eval icd
|
$167.44 |
$167.44 |
$167.44 |
$220.35
|
|
Peri-proc device eval pm
|
$154.56 |
$154.56 |
$154.56 |
$200.92
|
|
Perq nl/pl lithotrp cplx>2cm
|
$10,147.20 |
$10,147.20 |
$10,147.20 |
$10,114.58
|
|
Perq plmt bile duct stent
|
$9,811.20 |
$9,811.20 |
$9,811.20 |
$8,164.80
|
|
Perq plmt bile duct stent
|
$16,273.04 |
$16,273.04 |
$16,273.04 |
$7,082.99
|
|
Pertussis ag if
|
$10.76 |
$10.76 |
$10.76 |
$53.95
|
|
Pet CT skull-mid thgh initial
|
$2,013.20 |
$2,013.20 |
$2,013.20 |
$4,850.00
|
|
Pet CT whole body initial
|
$2,013.20 |
$2,013.20 |
$2,013.20 |
$4,915.50
|
|
Pet fdg brain metoblic eval sb
|
$2,783.20 |
$2,783.20 |
$2,783.20 |
$3,274.20
|
|
Pfc sigma fem post aug sz3 8mm
|
$20,503.84 |
$20,503.84 |
$20,503.84 |
$22,916.00
|
|
Ph body fluid
|
$11.76 |
$11.76 |
$11.76 |
$35.75
|
|
Phencyclidine (pcp)
|
$80.64 |
$80.64 |
$80.64 |
$74.40
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$22.06 |
$22.06 |
$22.06 |
$84.60
|
|
Phenobarbital therapeutic drug level
|
$46.48 |
$46.48 |
$46.48 |
$97.50
|
|
Phentolaine mesylate inj
|
$305.34 |
$305.34 |
$305.34 |
$881.36
|
|
Phenytoin total therapeutic drug level
|
$45.36 |
$45.36 |
$45.36 |
$100.75
|
|
Phosphorus
|
$12.32 |
$12.32 |
$12.32 |
$42.37
|
|
Phosphorus 24 hour urine
|
$16.24 |
$16.24 |
$16.24 |
$41.51
|
|
Pin caspar distraction 12mm
|
$6,048.00 |
$6,048.00 |
$6,048.00 |
$29,164.20
|
|
Pinworm exam
|
$26.32 |
$26.32 |
$26.32 |
$38.58
|
|
Place cath intracranial art
|
$5,349.12 |
$5,349.12 |
$5,349.12 |
$4,656.83
|
|
Place cath xtrnl carotid
|
$2,984.24 |
$2,984.24 |
$2,984.24 |
$4,202.90
|
|
Place duod/jej tube perc
|
$2,619.68 |
$2,619.68 |
$2,619.68 |
$2,588.00
|
|
Place endorectal app
|
$898.80 |
$898.80 |
$898.80 |
$1,010.01
|