|
New Patient Office Visit (level 5)
|
$1,170.40 |
$1,170.40 |
$1,170.40 |
$355.80
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$232.59 |
$232.59 |
$232.59 |
$251.32
|
|
Nintedanib 150 mg capsule
|
$1.20 |
$1.20 |
$1.20 |
$262.93
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$12,313.22 |
$12,313.22 |
$12,313.22 |
$14,820.18
|
|
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution
|
$23,656.16 |
$23,656.16 |
$23,656.16 |
$41,635.10
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$1,818.40 |
$1,818.40 |
$1,818.40 |
$1,397.69
|
|
Nm imaging gastrointestinal acute blood loss
|
$1,569.60 |
$1,569.60 |
$1,569.60 |
$1,207.59
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,577.60 |
$1,577.60 |
$1,577.60 |
$1,541.32
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,950.40 |
$1,950.40 |
$1,950.40 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$1,091.00
|
|
No pt prsnt train add 15
|
$63.20 |
$63.20 |
$63.20 |
$47.60
|
|
No pt prsnt train initial 30
|
$127.20 |
$127.20 |
$127.20 |
$61.33
|
|
Nose (Nasal Bone) X-ray (complete)
|
$184.00 |
$184.00 |
$184.00 |
$274.65
|
|
Nr lnr acclrtr tx max 5 sessions
|
$11,344.80 |
$11,344.80 |
$11,344.80 |
$6,930.00
|
|
Nuclear Stress Test (Heart)
|
$3,340.48 |
$3,340.48 |
$3,340.48 |
$3,859.98
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$13,279.36 |
$13,279.36 |
$13,279.36 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$76.00 |
$76.00 |
$76.00 |
$384.00
|
|
Observation per hour
|
$76.00 |
$76.00 |
$76.00 |
$82.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$489.60 |
$489.60 |
$489.60 |
$357.00
|
|
Ob Ultrasound nuchal meas add-on
|
$340.80 |
$340.80 |
$340.80 |
$249.60
|
|
Occupational Therapy Evaluation (high complexity)
|
$266.40 |
$266.40 |
$266.40 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$240.80 |
$240.80 |
$240.80 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$248.00 |
$248.00 |
$248.00 |
$263.90
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$31,130.40 |
$31,130.40 |
$31,130.40 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$60.90 |
$60.90 |
$60.90 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$10,210.18 |
$10,210.18 |
$10,210.18 |
$12,080.43
|
|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$1,571.80 |
$1,571.80 |
$1,571.80 |
$2,224.00
|
|
Olanzapine 10 mg intramuscular solution
|
$73.99 |
$73.99 |
$73.99 |
$109.62
|
|
Ondansetron 4 mg s0119
|
$1.20 |
$1.20 |
$1.20 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$60.55 |
$60.55 |
$60.55 |
$22.62
|
|
Orthopantogram
|
$295.20 |
$295.20 |
$295.20 |
$241.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$129.60 |
$129.60 |
$129.60 |
$97.80
|
|
Ot re-evaluation patient/family
|
$135.20 |
$135.20 |
$135.20 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$57.60 |
$57.60 |
$57.60 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$103.20 |
$103.20 |
$103.20 |
$93.12
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$64.13 |
$64.13 |
$64.13 |
$76.52
|
|
Oxaliplatin 5 mg/ml desensitization
|
$310.72 |
$310.72 |
$310.72 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$160.43 |
$160.43 |
$160.43 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$448.24 |
$448.24 |
$448.24 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$3,857.35 |
$3,857.35 |
$3,857.35 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$5,118.15 |
$5,118.15 |
$5,118.15 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$2,959.65 |
$2,959.65 |
$2,959.65 |
$5,580.28
|
|
Palonosetron hcl
|
$67.28 |
$67.28 |
$67.28 |
$163.00
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$83.12 |
$83.12 |
$83.12 |
$123.55
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$10,925.44 |
$10,925.44 |
$10,925.44 |
$13,051.61
|
|
Parathyrd planar w/spect&ct
|
$1,716.00 |
$1,716.00 |
$1,716.00 |
$1,574.40
|
|
Parathyroid planar img w/tomo spect
|
$1,464.80 |
$1,464.80 |
$1,464.80 |
$1,374.75
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$241.60 |
$241.60 |
$241.60 |
$245.67
|
|
Pcv21 vaccine im
|
$410.26 |
$410.26 |
$410.26 |
$410.26
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$7,290.61 |
$7,290.61 |
$7,290.61 |
$11,216.31
|
|
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
|
$2,678.00 |
$2,678.00 |
$2,678.00 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$6,616.16 |
$6,616.16 |
$6,616.16 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,075.76 |
$2,075.76 |
$2,075.76 |
$4,133.25
|
|
Pelvic CT scan (with and without contrast)
|
$2,484.00 |
$2,484.00 |
$2,484.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,348.80 |
$2,348.80 |
$2,348.80 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,992.80 |
$1,992.80 |
$1,992.80 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,841.73 |
$3,841.73 |
$3,841.73 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$2,604.80 |
$2,604.80 |
$2,604.80 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$767.20 |
$767.20 |
$767.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$574.40 |
$574.40 |
$574.40 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$280.80 |
$280.80 |
$280.80 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$276.80 |
$276.80 |
$276.80 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$9,183.62 |
$9,183.62 |
$9,183.62 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$6,467.09 |
$6,467.09 |
$6,467.09 |
$7,089.13
|
|
Pemivibart infusion
|
$783.20 |
$783.20 |
$783.20 |
$533.10
|
|
Peng benzathine/procaine inj
|
$420.80 |
$420.80 |
$420.80 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$321.32 |
$321.32 |
$321.32 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$63.56 |
$63.56 |
$63.56 |
$97.85
|
|
Pentamidine non-comp unit
|
$125.84 |
$125.84 |
$125.84 |
$294.39
|
|
Peripheral vascular rehab
|
$112.00 |
$112.00 |
$112.00 |
$132.50
|
|
Pertuzumab 30 mg/ml desensitization
|
$10,549.12 |
$10,549.12 |
$10,549.12 |
$14,272.91
|
|
Pet CT skull-mid thgh initial
|
$6,522.60 |
$6,522.60 |
$6,522.60 |
$4,707.00
|
|
Pet CT whole body initial
|
$6,666.40 |
$6,666.40 |
$6,666.40 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$5,952.80 |
$5,952.80 |
$5,952.80 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$5,569.60 |
$5,569.60 |
$5,569.60 |
$4,349.76
|
|
Pfc sigma fem post aug sz3 8mm
|
$12,651.20 |
$12,651.20 |
$12,651.20 |
$39,920.50
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$74.40 |
$74.40 |
$74.40 |
$114.56
|
|
Phentolaine mesylate inj
|
$787.20 |
$787.20 |
$787.20 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$61.12 |
$61.12 |
$61.12 |
$62.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$60.83 |
$60.83 |
$60.83 |
$10.80
|
|
Phlebotomy therapeutic
|
$216.00 |
$216.00 |
$216.00 |
$231.40
|
|
Physical Therapy Evaluation (high complexity)
|
$241.60 |
$241.60 |
$241.60 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$219.20 |
$219.20 |
$219.20 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$225.60 |
$225.60 |
$225.60 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$135.20 |
$135.20 |
$135.20 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$81.41 |
$81.41 |
$81.41 |
$90.25
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$67.32 |
$67.32 |
$67.32 |
$81.36
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,908.00 |
$1,908.00 |
$1,908.00 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$365.60 |
$365.60 |
$365.60 |
$1,332.43
|
|
Platelet pheresis each unit
|
$1,306.40 |
$1,306.40 |
$1,306.40 |
$1,012.80
|
|
Platelet pheresis irr ea
|
$1,463.20 |
$1,463.20 |
$1,463.20 |
$1,108.52
|
|
Platelets each unit
|
$219.20 |
$219.20 |
$219.20 |
$169.29
|
|
Platelets leukocytes reduced each unit
|
$214.40 |
$214.40 |
$214.40 |
$315.25
|
|
Platelets leukocytes reduced irradiated each unit
|
$303.20 |
$303.20 |
$303.20 |
$411.20
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,763.20 |
$1,763.20 |
$1,763.20 |
$1,284.80
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$2,578.40 |
$2,578.40 |
$2,578.40 |
$5,087.15
|
|
Plethysmography lung volumes/airway resistance
|
$302.40 |
$302.40 |
$302.40 |
$408.05
|
|
Plmt access bil tree sm bwl
|
$418.40 |
$418.40 |
$418.40 |
$4,679.40
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,364.80 |
$4,364.80 |
$4,364.80 |
$3,790.61
|