|
Observation per hour
|
$58.80 |
$58.80 |
$58.80 |
$82.50
|
|
Obstetrics panel
|
$151.93 |
$151.93 |
$151.93 |
$214.50
|
|
Occupational Therapy Evaluation (high complexity)
|
$192.92 |
$192.92 |
$192.92 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$192.92 |
$192.92 |
$192.92 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$192.92 |
$192.92 |
$192.92 |
$263.90
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$29,829.98 |
$29,829.98 |
$29,829.98 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$72.67 |
$72.67 |
$72.67 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$9,548.58 |
$9,548.58 |
$9,548.58 |
$12,080.43
|
|
Offset knee joint each
|
$162.01 |
$162.01 |
$162.01 |
$196.00
|
|
Offset knee joint heavy duty
|
$231.50 |
$231.50 |
$231.50 |
$271.15
|
|
Olanzapine 10 mg intramuscular solution
|
$95.14 |
$95.14 |
$95.14 |
$109.62
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$2,643.97 |
$2,643.97 |
$2,643.97 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$2.53 |
$2.53 |
$2.53 |
$9.93
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$22.67 |
$22.67 |
$22.67 |
$22.62
|
|
Oph Ultrasound dx quan a-scan only
|
$237.94 |
$237.94 |
$237.94 |
$298.98
|
|
Oral aprepitant
|
$139.43 |
$139.43 |
$139.43 |
$410.20
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$415.91 |
$415.91 |
$415.91 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$720.27 |
$720.27 |
$720.27 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$1,846.66 |
$1,846.66 |
$1,846.66 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$1,077.66 |
$1,077.66 |
$1,077.66 |
$702.80
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$389.98 |
$389.98 |
$389.98 |
$231.66
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$462.62 |
$462.62 |
$462.62 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$152.04 |
$152.04 |
$152.04 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$389.98 |
$389.98 |
$389.98 |
$229.45
|
|
Orthopantogram
|
$257.66 |
$257.66 |
$257.66 |
$241.50
|
|
Orthopedic shoe add rub insl
|
$62.72 |
$62.72 |
$62.72 |
$70.40
|
|
Ortho shoe add full sole
|
$80.47 |
$80.47 |
$80.47 |
$109.15
|
|
Ortho shoe add half sole
|
$50.34 |
$50.34 |
$50.34 |
$36.40
|
|
Ortho shoe add leather insol
|
$46.26 |
$46.26 |
$46.26 |
$63.22
|
|
Ortho shoe add march bar
|
$66.36 |
$66.36 |
$66.36 |
$90.66
|
|
Ortho sidebar disconnect
|
$206.19 |
$206.19 |
$206.19 |
$145.60
|
|
Orthosis lso rigd frm hyperex
|
$640.64 |
$640.64 |
$640.64 |
$813.61
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$513.02 |
$513.02 |
$513.02 |
$421.00
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$1,428.22 |
$1,428.22 |
$1,428.22 |
$686.79
|
|
Oscillation chest wall mechanical per session
|
$117.21 |
$117.21 |
$117.21 |
$196.30
|
|
O shoe add felt w leath insl
|
$50.34 |
$50.34 |
$50.34 |
$36.40
|
|
O shoe add horseshoe toe tap
|
$36.18 |
$36.18 |
$36.18 |
$49.45
|
|
O shoe add instep extension
|
$134.90 |
$134.90 |
$134.90 |
$201.67
|
|
O shoe add instep velcro clo
|
$102.65 |
$102.65 |
$102.65 |
$140.22
|
|
O shoe add standard toe tap
|
$14.11 |
$14.11 |
$14.11 |
$19.38
|
|
O shoe convert to sof counte
|
$84.56 |
$84.56 |
$84.56 |
$115.53
|
|
Osmolality blood
|
$66.75 |
$66.75 |
$66.75 |
$70.85
|
|
Osmolality urine
|
$69.66 |
$69.66 |
$69.66 |
$65.52
|
|
Oth resp proc, group
|
$39.65 |
$39.65 |
$39.65 |
$126.00
|
|
Oth resp proc, indiv
|
$48.72 |
$48.72 |
$48.72 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$65.46 |
$65.46 |
$65.46 |
$97.80
|
|
Ot re-evaluation patient/family
|
$117.77 |
$117.77 |
$117.77 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$65.46 |
$65.46 |
$65.46 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$65.46 |
$65.46 |
$65.46 |
$93.12
|
|
Outrigger
|
$82.82 |
$82.82 |
$82.82 |
$123.81
|
|
Outrigger bil with vert extens
|
$277.20 |
$277.20 |
$277.20 |
$378.67
|
|
Oxaliplatin 5 mg/ml desensitization
|
$119.53 |
$119.53 |
$119.53 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$61.94 |
$61.94 |
$61.94 |
$50.40
|
|
P-32 chromic phos ther per mci
|
$447.05 |
$447.05 |
$447.05 |
$290.64
|
|
P-32 sod phosphate ther per mci
|
$542.42 |
$542.42 |
$542.42 |
$469.34
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$172.39 |
$172.39 |
$172.39 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,672.40 |
$1,672.40 |
$1,672.40 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$5,973.14 |
$5,973.14 |
$5,973.14 |
$6,238.82
|
|
Palonosetron hcl
|
$55.26 |
$55.26 |
$55.26 |
$163.00
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$48.55 |
$48.55 |
$48.55 |
$123.55
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$3,323.36 |
$3,323.36 |
$3,323.36 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$31.12 |
$31.12 |
$31.12 |
$28.90
|
|
Papaverin hcl injection
|
$51.30 |
$51.30 |
$51.30 |
$78.75
|
|
Parathormone (pth) intact
|
$64.29 |
$64.29 |
$64.29 |
$206.18
|
|
Parathyroid planar imaging
|
$2,306.30 |
$2,306.30 |
$2,306.30 |
$1,126.00
|
|
Passy muir valve metal trach
|
$116.54 |
$116.54 |
$116.54 |
$275.75
|
|
Patten bottom
|
$506.46 |
$506.46 |
$506.46 |
$672.73
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$62.72 |
$62.72 |
$62.72 |
$44.97
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$6,864.91 |
$6,864.91 |
$6,864.91 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$3,124.06 |
$3,124.06 |
$3,124.06 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,338.99 |
$2,338.99 |
$2,338.99 |
$4,133.25
|
|
Pelv band/spread bar thigh c
|
$749.11 |
$749.11 |
$749.11 |
$802.87
|
|
Pelvic band & belt thigh fla
|
$527.58 |
$527.58 |
$527.58 |
$504.00
|
|
Pelvic control band & belt b
|
$497.22 |
$497.22 |
$497.22 |
$566.16
|
|
Pelvic control band & belt u
|
$366.41 |
$366.41 |
$366.41 |
$500.58
|
|
Pelvic control hip heavy dut
|
$395.64 |
$395.64 |
$395.64 |
$591.53
|
|
Pelvic control pelvic sling
|
$686.67 |
$686.67 |
$686.67 |
$781.87
|
|
Pelvic CT scan (with and without contrast)
|
$1,589.34 |
$1,589.34 |
$1,589.34 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,192.13 |
$1,192.13 |
$1,192.13 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,192.13 |
$1,192.13 |
$1,192.13 |
$1,335.34
|
|
Pelvic & hip control thigh c
|
$1,802.86 |
$1,802.86 |
$1,802.86 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$2,825.93 |
$2,825.93 |
$2,825.93 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,329.04 |
$2,329.04 |
$2,329.04 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,018.46 |
$2,018.46 |
$2,018.46 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$472.53 |
$472.53 |
$472.53 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$470.57 |
$470.57 |
$470.57 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$257.66 |
$257.66 |
$257.66 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$171.81 |
$171.81 |
$171.81 |
$351.75
|
|
Pelv & thor control gluteal
|
$218.96 |
$218.96 |
$218.96 |
$299.21
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$8,655.61 |
$8,655.61 |
$8,655.61 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$238.07 |
$238.07 |
$238.07 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$706.77 |
$706.77 |
$706.77 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$116.19 |
$116.19 |
$116.19 |
$97.85
|
|
Pentostatin 10 mg intravenous solution
|
$4,429.02 |
$4,429.02 |
$4,429.02 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$11,523.76
|
|
Perc rf ablate renal tumor
|
$1,018.14 |
$1,018.14 |
$1,018.14 |
$7,243.60
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$185.47 |
$185.47 |
$185.47 |
$332.84
|
|
Peripheral vascular rehab
|
$231.78 |
$231.78 |
$231.78 |
$132.50
|
|
Peroneal straps pair pre ots
|
$27.05 |
$27.05 |
$27.05 |
$36.90
|
|
Perp bk ptb thermopls direct
|
$2,502.75 |
$2,502.75 |
$2,502.75 |
$2,156.00
|