|
Nm imaging pulmonary ventilation/perfusion
|
$2,020.00 |
$2,020.00 |
$2,020.00 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,091.00
|
|
No pt prsnt train add 15
|
$59.20 |
$59.20 |
$59.20 |
$47.60
|
|
No pt prsnt train initial 30
|
$120.00 |
$120.00 |
$120.00 |
$61.33
|
|
Nose (Nasal Bone) X-ray (complete)
|
$368.80 |
$368.80 |
$368.80 |
$274.65
|
|
Nuclear Stress Test (Heart)
|
$4,744.80 |
$4,744.80 |
$4,744.80 |
$3,859.98
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$8,316.00 |
$8,316.00 |
$8,316.00 |
$14,865.31
|
|
Observation per hour
|
$70.40 |
$70.40 |
$70.40 |
$82.50
|
|
Obstetrics panel
|
$184.00 |
$184.00 |
$184.00 |
$214.50
|
|
Occupational Therapy Evaluation (high complexity)
|
$348.80 |
$348.80 |
$348.80 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$280.00 |
$280.00 |
$280.00 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$313.60 |
$313.60 |
$313.60 |
$263.90
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$60.92 |
$60.92 |
$60.92 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$9,455.43 |
$9,455.43 |
$9,455.43 |
$12,080.43
|
|
Off/op cnsltj new/est low 30
|
$178.40 |
$178.40 |
$178.40 |
$183.00
|
|
Off/op consltj new/est sf 20
|
$150.40 |
$150.40 |
$150.40 |
$137.80
|
|
Olanzapine 10 mg intramuscular solution
|
$89.23 |
$89.23 |
$89.23 |
$109.62
|
|
Onco (ovar) five proteins
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$986.70
|
|
Ondansetron 4 mg s0119
|
$1.20 |
$1.20 |
$1.20 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$69.28 |
$69.28 |
$69.28 |
$22.62
|
|
Osmolality blood
|
$47.20 |
$47.20 |
$47.20 |
$70.85
|
|
Osmolality urine
|
$52.80 |
$52.80 |
$52.80 |
$65.52
|
|
Oth resp proc, group
|
$179.20 |
$179.20 |
$179.20 |
$126.00
|
|
Oth resp proc, indiv
|
$121.60 |
$121.60 |
$121.60 |
$83.50
|
|
Ot re-evaluation patient/family
|
$182.40 |
$182.40 |
$182.40 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$119.20 |
$119.20 |
$119.20 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$157.60 |
$157.60 |
$157.60 |
$93.12
|
|
Oxytocin 10 unit/ml injection solution
|
$60.75 |
$60.75 |
$60.75 |
$50.40
|
|
Paliperidone 117 mg/0.75 ml inj
|
$3,495.00 |
$3,495.00 |
$3,495.00 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$2,313.62 |
$2,313.62 |
$2,313.62 |
$5,580.28
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$83.12 |
$83.12 |
$83.12 |
$123.55
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$61.48 |
$61.48 |
$61.48 |
$28.90
|
|
Parathormone (pth) intact
|
$276.00 |
$276.00 |
$276.00 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$1,171.20 |
$1,171.20 |
$1,171.20 |
$1,574.40
|
|
Parathyroid planar img w/tomo spect
|
$2,384.00 |
$2,384.00 |
$2,384.00 |
$1,374.75
|
|
Paricalcitol
|
$76.83 |
$76.83 |
$76.83 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$273.60 |
$273.60 |
$273.60 |
$245.67
|
|
Passy muir valve metal trach
|
$289.60 |
$289.60 |
$289.60 |
$275.75
|
|
Pca3/klk3 antigen
|
$662.40 |
$662.40 |
$662.40 |
$510.40
|
|
Pcv21 vaccine im
|
$418.77 |
$418.77 |
$418.77 |
$410.26
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$3,217.04 |
$3,217.04 |
$3,217.04 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$3,346.60 |
$3,346.60 |
$3,346.60 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$6,736.15 |
$6,736.15 |
$6,736.15 |
$4,300.20
|
|
Pelvic CT scan (with and without contrast)
|
$2,722.40 |
$2,722.40 |
$2,722.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,271.20 |
$2,271.20 |
$2,271.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,952.80 |
$1,952.80 |
$1,952.80 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$4,303.20 |
$4,303.20 |
$4,303.20 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$4,099.20 |
$4,099.20 |
$4,099.20 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,237.60 |
$3,237.60 |
$3,237.60 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$819.20 |
$819.20 |
$819.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$586.40 |
$586.40 |
$586.40 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$376.80 |
$376.80 |
$376.80 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$438.40 |
$438.40 |
$438.40 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$5,240.20 |
$5,240.20 |
$5,240.20 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$3,626.43 |
$3,626.43 |
$3,626.43 |
$7,089.13
|
|
Pemivibart infusion
|
$760.00 |
$760.00 |
$760.00 |
$533.10
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$471.48 |
$471.48 |
$471.48 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$255.81 |
$255.81 |
$255.81 |
$97.85
|
|
Pentamidine non-comp unit
|
$130.29 |
$130.29 |
$130.29 |
$294.39
|
|
Peripheral vascular rehab
|
$142.40 |
$142.40 |
$142.40 |
$132.50
|
|
Pfc sigma fem post aug sz3 8mm
|
$7,560.00 |
$7,560.00 |
$7,560.00 |
$39,920.50
|
|
Ph body fluid
|
$32.80 |
$32.80 |
$32.80 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$71.58 |
$71.58 |
$71.58 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$139.20 |
$139.20 |
$139.20 |
$105.00
|
|
Phentolaine mesylate inj
|
$722.55 |
$722.55 |
$722.55 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$63.60 |
$63.60 |
$63.60 |
$62.98
|
|
Phenytoin total therapeutic drug level
|
$153.60 |
$153.60 |
$153.60 |
$111.27
|
|
Phlebotomy therapeutic
|
$247.20 |
$247.20 |
$247.20 |
$231.40
|
|
Phosphorus
|
$56.80 |
$56.80 |
$56.80 |
$49.20
|
|
Phosphorus 24 hour urine
|
$15.20 |
$15.20 |
$15.20 |
$42.25
|
|
Physical Therapy Evaluation (high complexity)
|
$323.20 |
$323.20 |
$323.20 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$256.80 |
$256.80 |
$256.80 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$280.00 |
$280.00 |
$280.00 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$177.60 |
$177.60 |
$177.60 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$86.50 |
$86.50 |
$86.50 |
$90.25
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$63.60 |
$63.60 |
$63.60 |
$81.36
|
|
Place right device/marker pros
|
$3,166.40 |
$3,166.40 |
$3,166.40 |
$2,402.50
|
|
Platelet automated
|
$60.80 |
$60.80 |
$60.80 |
$46.00
|
|
Platelets each unit
|
$593.60 |
$593.60 |
$593.60 |
$169.29
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,349.60 |
$1,349.60 |
$1,349.60 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,735.20 |
$1,735.20 |
$1,735.20 |
$1,284.80
|
|
Pm device progr eval dual
|
$148.00 |
$148.00 |
$148.00 |
$149.15
|
|
Pm device progr eval multi
|
$154.40 |
$154.40 |
$154.40 |
$139.10
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$248.00 |
$248.00 |
$248.00 |
$187.32
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,696.00 |
$4,696.00 |
$4,696.00 |
$3,790.61
|
|
Potassium 24 hour urine
|
$31.20 |
$31.20 |
$31.20 |
$51.17
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$130.23 |
$130.23 |
$130.23 |
$62.79
|
|
Potassium serum/plasma/whole blood
|
$48.80 |
$48.80 |
$48.80 |
$47.85
|
|
Pralidoxime 1 gram solution for injection
|
$188.68 |
$188.68 |
$188.68 |
$292.00
|
|
Pr application of long arm splint
|
$381.60 |
$381.60 |
$381.60 |
$332.75
|
|
Pr application splint static short arm
|
$352.00 |
$352.00 |
$352.00 |
$288.00
|
|
Pr biopsy skin punch single lesion
|
$564.80 |
$564.80 |
$564.80 |
$458.25
|
|
Prealbumin
|
$100.00 |
$100.00 |
$100.00 |
$94.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$3.40 |
$3.40 |
$3.40 |
$13.87
|
|
Pr egd flexible transoral w/placement percutaneous gastrostomy tube
|
$3,404.00 |
$3,404.00 |
$3,404.00 |
$2,298.00
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$920.80 |
$920.80 |
$920.80 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$792.80 |
$792.80 |
$792.80 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$587.20 |
$587.20 |
$587.20 |
$459.00
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$2,349.60 |
$2,349.60 |
$2,349.60 |
$1,917.33
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$3,255.20 |
$3,255.20 |
$3,255.20 |
$2,271.01
|
