|
Neck (Cervical Spine) CT scan (without contrast)
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$1,470.00
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$3,840.00 |
$3,840.00 |
$3,840.00 |
$2,869.75
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$3,092.00 |
$3,092.00 |
$3,092.00 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,809.60 |
$2,809.60 |
$2,809.60 |
$2,042.95
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$319.20 |
$319.20 |
$319.20 |
$333.83
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$467.20 |
$467.20 |
$467.20 |
$463.80
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$767.20 |
$767.20 |
$767.20 |
$508.50
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,706.40 |
$3,706.40 |
$3,706.40 |
$2,659.98
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$2,885.60 |
$2,885.60 |
$2,885.60 |
$2,109.10
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,673.60 |
$2,673.60 |
$2,673.60 |
$1,806.75
|
|
Neck Soft Tissue CT Scan (with and without contrast)
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$1,940.00
|
|
Neck Soft Tissue CT Scan (with contrast)
|
$2,027.20 |
$2,027.20 |
$2,027.20 |
$1,603.55
|
|
Neck Soft Tissue CT Scan (without contrast)
|
$1,901.60 |
$1,901.60 |
$1,901.60 |
$1,312.00
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$24.38 |
$24.38 |
$24.38 |
$60.16
|
|
New Patient Office Visit (level 3)
|
$186.40 |
$186.40 |
$186.40 |
$211.00
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$124.40 |
$124.40 |
$124.40 |
$251.32
|
|
Nintedanib 150 mg capsule
|
$4.86 |
$4.86 |
$4.86 |
$262.93
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$2,049.60 |
$2,049.60 |
$2,049.60 |
$1,541.32
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,948.00 |
$1,948.00 |
$1,948.00 |
$1,590.00
|
|
No pt prsnt train add 15
|
$67.20 |
$67.20 |
$67.20 |
$47.60
|
|
No pt prsnt train initial 30
|
$136.00 |
$136.00 |
$136.00 |
$61.33
|
|
Nose (Nasal Bone) X-ray (complete)
|
$385.60 |
$385.60 |
$385.60 |
$274.65
|
|
Nuclear Stress Test (Heart)
|
$4,100.80 |
$4,100.80 |
$4,100.80 |
$3,859.98
|
|
Observation direct referral from physician office for admission
|
$212.00 |
$212.00 |
$212.00 |
$384.00
|
|
Observation per hour
|
$52.80 |
$52.80 |
$52.80 |
$82.50
|
|
Occupational Therapy Evaluation (high complexity)
|
$228.00 |
$228.00 |
$228.00 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$178.40 |
$178.40 |
$178.40 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$200.00 |
$200.00 |
$200.00 |
$263.90
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$20,417.00 |
$20,417.00 |
$20,417.00 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$24.92 |
$24.92 |
$24.92 |
$90.00
|
|
Olanzapine 10 mg intramuscular solution
|
$33.94 |
$33.94 |
$33.94 |
$109.62
|
|
Ondansetron 4 mg s0119
|
$2.86 |
$2.86 |
$2.86 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$24.35 |
$24.35 |
$24.35 |
$22.62
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$36.69 |
$36.69 |
$36.69 |
$50.63
|
|
Osmolality blood
|
$53.60 |
$53.60 |
$53.60 |
$70.85
|
|
Osmolality urine
|
$50.40 |
$50.40 |
$50.40 |
$65.52
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$100.80 |
$100.80 |
$100.80 |
$97.80
|
|
Ot re-evaluation patient/family
|
$232.00 |
$232.00 |
$232.00 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$97.60 |
$97.60 |
$97.60 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$122.40 |
$122.40 |
$122.40 |
$93.12
|
|
Oxytocin 10 unit/ml injection solution
|
$25.04 |
$25.04 |
$25.04 |
$50.40
|
|
Paliperidone 117 mg/0.75 ml inj
|
$4,101.77 |
$4,101.77 |
$4,101.77 |
$6,238.82
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$32.24 |
$32.24 |
$32.24 |
$123.55
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$25.87 |
$25.87 |
$25.87 |
$28.90
|
|
Parathormone (pth) intact
|
$111.20 |
$111.20 |
$111.20 |
$206.18
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$264.00 |
$264.00 |
$264.00 |
$245.67
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$3,920.00 |
$3,920.00 |
$3,920.00 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$2,809.27 |
$2,809.27 |
$2,809.27 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$2,858.24 |
$2,858.24 |
$2,858.24 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$4,972.60 |
$4,972.60 |
$4,972.60 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$1,882.92 |
$1,882.92 |
$1,882.92 |
$4,133.25
|
|
Pelvic CT scan (with and without contrast)
|
$2,530.40 |
$2,530.40 |
$2,530.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,115.20 |
$2,115.20 |
$2,115.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,703.20 |
$1,703.20 |
$1,703.20 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,416.80 |
$3,416.80 |
$3,416.80 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,568.80 |
$3,568.80 |
$3,568.80 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,810.40 |
$2,810.40 |
$2,810.40 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$776.80 |
$776.80 |
$776.80 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$716.80 |
$716.80 |
$716.80 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$310.40 |
$310.40 |
$310.40 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$400.80 |
$400.80 |
$400.80 |
$351.75
|
|
Pemivibart infusion
|
$783.20 |
$783.20 |
$783.20 |
$533.10
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$457.17 |
$457.17 |
$457.17 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$58.25 |
$58.25 |
$58.25 |
$97.85
|
|
Pentamidine non-comp unit
|
$136.40 |
$136.40 |
$136.40 |
$294.39
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$597.95 |
$597.95 |
$597.95 |
$332.84
|
|
Peripheral vascular rehab
|
$154.40 |
$154.40 |
$154.40 |
$132.50
|
|
Ph body fluid
|
$9.60 |
$9.60 |
$9.60 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$32.32 |
$32.32 |
$32.32 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$94.40 |
$94.40 |
$94.40 |
$105.00
|
|
Phenylephrine 10 mg/ml injection solution
|
$38.16 |
$38.16 |
$38.16 |
$62.98
|
|
Phenytoin total therapeutic drug level
|
$99.20 |
$99.20 |
$99.20 |
$111.27
|
|
Phlebotomy therapeutic
|
$264.00 |
$264.00 |
$264.00 |
$231.40
|
|
Phosphorus
|
$49.60 |
$49.60 |
$49.60 |
$49.20
|
|
Phosphorus 24 hour urine
|
$24.80 |
$24.80 |
$24.80 |
$42.25
|
|
Physical Therapy Evaluation (high complexity)
|
$228.00 |
$228.00 |
$228.00 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$193.60 |
$193.60 |
$193.60 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$200.00 |
$200.00 |
$200.00 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$219.20 |
$219.20 |
$219.20 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$69.59 |
$69.59 |
$69.59 |
$90.25
|
|
Pinworm exam
|
$20.00 |
$20.00 |
$20.00 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$27.42 |
$27.42 |
$27.42 |
$81.36
|
|
Platelet automated
|
$42.40 |
$42.40 |
$42.40 |
$46.00
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,537.60 |
$1,537.60 |
$1,537.60 |
$1,162.50
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$179.20 |
$179.20 |
$179.20 |
$187.32
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,322.40 |
$4,322.40 |
$4,322.40 |
$3,790.61
|
|
Potassium 24 hour urine
|
$23.20 |
$23.20 |
$23.20 |
$51.17
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$71.20 |
$71.20 |
$71.20 |
$62.79
|
|
Potassium serum/plasma/whole blood
|
$45.60 |
$45.60 |
$45.60 |
$47.85
|
|
Pralidoxime 1 gram solution for injection
|
$160.43 |
$160.43 |
$160.43 |
$292.00
|
|
Pr application of long arm splint
|
$266.40 |
$266.40 |
$266.40 |
$332.75
|
|
Pr application splint static short arm
|
$196.00 |
$196.00 |
$196.00 |
$288.00
|
|
Prealbumin
|
$87.20 |
$87.20 |
$87.20 |
$94.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$14.64 |
$14.64 |
$14.64 |
$13.87
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$764.80 |
$764.80 |
$764.80 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$680.00 |
$680.00 |
$680.00 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$546.40 |
$546.40 |
$546.40 |
$459.00
|
|
Pr evaluation psychiatric diagnostic w/medical services
|
$340.80 |
$340.80 |
$340.80 |
$313.30
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$455.20 |
$455.20 |
$455.20 |
$779.35
|
|
Pr incision & drainage abscess simple/single
|
$537.60 |
$537.60 |
$537.60 |
$467.85
|