|
Nuclear Stress Test (Heart)
|
$2,927.20 |
$2,927.20 |
$2,927.20 |
$3,859.98
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$11,796.27 |
$11,796.27 |
$11,796.27 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$225.60 |
$225.60 |
$225.60 |
$384.00
|
|
Observation per hour
|
$64.00 |
$64.00 |
$64.00 |
$82.50
|
|
Obstetric panel inc HIV tstg
|
$521.60 |
$521.60 |
$521.60 |
$263.65
|
|
Occupational Therapy Evaluation (high complexity)
|
$292.80 |
$292.80 |
$292.80 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$256.80 |
$256.80 |
$256.80 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$280.00 |
$280.00 |
$280.00 |
$263.90
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$26,156.43 |
$26,156.43 |
$26,156.43 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$44.54 |
$44.54 |
$44.54 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$4,938.55 |
$4,938.55 |
$4,938.55 |
$12,080.43
|
|
Olanzapine 10 mg intramuscular solution
|
$102.56 |
$102.56 |
$102.56 |
$109.62
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$2,512.55 |
$2,512.55 |
$2,512.55 |
$4,595.01
|
|
Onco (ovar) five proteins
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$986.70
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$35.81 |
$35.81 |
$35.81 |
$22.62
|
|
Orthopantogram
|
$370.40 |
$370.40 |
$370.40 |
$241.50
|
|
Osmolality blood
|
$64.00 |
$64.00 |
$64.00 |
$70.85
|
|
Osmolality urine
|
$80.80 |
$80.80 |
$80.80 |
$65.52
|
|
Oth resp proc, group
|
$100.00 |
$100.00 |
$100.00 |
$126.00
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$124.80 |
$124.80 |
$124.80 |
$97.80
|
|
Ot re-evaluation patient/family
|
$184.80 |
$184.80 |
$184.80 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$132.00 |
$132.00 |
$132.00 |
$93.12
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$41.47 |
$41.47 |
$41.47 |
$76.52
|
|
Oxaliplatin 5 mg/ml desensitization
|
$485.65 |
$485.65 |
$485.65 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$66.40 |
$66.40 |
$66.40 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$338.78 |
$338.78 |
$338.78 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$2,200.24 |
$2,200.24 |
$2,200.24 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$5,404.63 |
$5,404.63 |
$5,404.63 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$5,078.52 |
$5,078.52 |
$5,078.52 |
$5,580.28
|
|
Palonosetron hcl
|
$147.68 |
$147.68 |
$147.68 |
$163.00
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$81.28 |
$81.28 |
$81.28 |
$123.55
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$9,991.40 |
$9,991.40 |
$9,991.40 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$37.35 |
$37.35 |
$37.35 |
$28.90
|
|
Parathormone (pth) intact
|
$246.40 |
$246.40 |
$246.40 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$1,664.80 |
$1,664.80 |
$1,664.80 |
$1,574.40
|
|
Parathyroid planar imaging
|
$955.20 |
$955.20 |
$955.20 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$1,419.20 |
$1,419.20 |
$1,419.20 |
$1,374.75
|
|
Passy muir valve metal trach
|
$172.80 |
$172.80 |
$172.80 |
$275.75
|
|
Pcv21 vaccine im
|
$511.28 |
$511.28 |
$511.28 |
$410.26
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$7,418.74 |
$7,418.74 |
$7,418.74 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$3,881.49 |
$3,881.49 |
$3,881.49 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,401.21 |
$4,401.21 |
$4,401.21 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$6,430.83 |
$6,430.83 |
$6,430.83 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,722.79 |
$2,722.79 |
$2,722.79 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$1,803.48 |
$1,803.48 |
$1,803.48 |
$4,120.37
|
|
Pelvic CT scan (with and without contrast)
|
$2,576.00 |
$2,576.00 |
$2,576.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,211.20 |
$2,211.20 |
$2,211.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,737.60 |
$1,737.60 |
$1,737.60 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,714.40 |
$3,714.40 |
$3,714.40 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,708.00 |
$3,708.00 |
$3,708.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,677.60 |
$2,677.60 |
$2,677.60 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$650.40 |
$650.40 |
$650.40 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$418.40 |
$418.40 |
$418.40 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$313.60 |
$313.60 |
$313.60 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$334.40 |
$334.40 |
$334.40 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$8,552.04 |
$8,552.04 |
$8,552.04 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$4,523.88 |
$4,523.88 |
$4,523.88 |
$7,089.13
|
|
Pemivibart infusion
|
$790.40 |
$790.40 |
$790.40 |
$533.10
|
|
Peng benzathine/procaine inj
|
$82.63 |
$82.63 |
$82.63 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$228.57 |
$228.57 |
$228.57 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$68.90 |
$68.90 |
$68.90 |
$97.85
|
|
Pentamidine non-comp unit
|
$164.00 |
$164.00 |
$164.00 |
$294.39
|
|
Pentostatin 10 mg intravenous solution
|
$2,428.08 |
$2,428.08 |
$2,428.08 |
$5,181.67
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$185.88 |
$185.88 |
$185.88 |
$332.84
|
|
Pericardiocentesis wwo imaging
|
$2,640.80 |
$2,640.80 |
$2,640.80 |
$2,375.00
|
|
Peripheral vascular rehab
|
$161.60 |
$161.60 |
$161.60 |
$132.50
|
|
Perq dev breast 1st strtctc
|
$1,859.20 |
$1,859.20 |
$1,859.20 |
$1,456.00
|
|
Pertuzumab 30 mg/ml desensitization
|
$7,444.76 |
$7,444.76 |
$7,444.76 |
$14,272.91
|
|
Pfc sigma fem post aug sz3 8mm
|
$10,719.20 |
$10,719.20 |
$10,719.20 |
$39,920.50
|
|
Ph body fluid
|
$34.40 |
$34.40 |
$34.40 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$112.10 |
$112.10 |
$112.10 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$104.80 |
$104.80 |
$104.80 |
$105.00
|
|
Phenylephrine 10 mg/ml injection solution
|
$35.27 |
$35.27 |
$35.27 |
$62.98
|
|
Phenytoin total therapeutic drug level
|
$152.80 |
$152.80 |
$152.80 |
$111.27
|
|
Phlebotomy therapeutic
|
$253.60 |
$253.60 |
$253.60 |
$231.40
|
|
Phleb veins 1 extrm 10-20 stab
|
$6,159.20 |
$6,159.20 |
$6,159.20 |
$4,810.00
|
|
Phosphorus
|
$48.80 |
$48.80 |
$48.80 |
$49.20
|
|
Phosphorus 24 hour urine
|
$62.40 |
$62.40 |
$62.40 |
$42.25
|
|
Phys blood bank serv authrj
|
$237.60 |
$237.60 |
$237.60 |
$102.55
|
|
Physical Therapy Evaluation (high complexity)
|
$292.80 |
$292.80 |
$292.80 |
$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
|
$184.80 |
$184.80 |
$184.80 |
$154.80
|
|
Pik3ca gene trgt seq alys
|
$2,050.40 |
$2,050.40 |
$2,050.40 |
$463.20
|
|
Pinworm exam
|
$28.00 |
$28.00 |
$28.00 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$113.52 |
$113.52 |
$113.52 |
$81.36
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$476.00 |
$476.00 |
$476.00 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,672.00 |
$1,672.00 |
$1,672.00 |
$1,332.43
|
|
Platelet aggregation each agent teg
|
$108.00 |
$108.00 |
$108.00 |
$148.98
|
|
Platelet automated
|
$49.60 |
$49.60 |
$49.60 |
$46.00
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$2,237.60 |
$2,237.60 |
$2,237.60 |
$1,532.70
|
|
Platelets leukocytes reduced each unit
|
$407.20 |
$407.20 |
$407.20 |
$315.25
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,260.00 |
$1,260.00 |
$1,260.00 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,513.60 |
$1,513.60 |
$1,513.60 |
$1,284.80
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$1,745.60 |
$1,745.60 |
$1,745.60 |
$1,230.00
|
|
Plcmt sft tiss loc pq w/img ea addl lsn
|
$901.60 |
$901.60 |
$901.60 |
$759.55
|
|
Plc pq device breast ea addl lesion stereo guide
|
$908.80 |
$908.80 |
$908.80 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$754.00
|