|
Off/op consltj new/est sf 20
|
$150.40 |
$150.40 |
$194.40 |
|
|
Offset knee joint each
|
$162.01 |
$221.31 |
$221.31 |
|
|
Offset knee joint heavy duty
|
$231.50 |
$316.34 |
$316.34 |
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$1,535.79 |
$1,535.79 |
$1,535.79 |
|
|
Olanzapine 10 mg intramuscular solution
|
$33.94 |
$88.04 |
$121.07 |
|
|
Olanzapine long-acting inj
|
$1,396.40 |
$1,396.40 |
$1,396.40 |
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$1,037.04 |
$2,512.55 |
$2,734.96 |
|
|
Onco (ovar) five proteins
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
|
|
Ondansetron 4 mg s0119
|
$1.20 |
$1.20 |
$5.80 |
|
|
Ondansetron 8 mg disintegrating tablet
|
$2.53 |
$10.10 |
$22.32 |
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$22.67 |
$28.85 |
$69.28 |
|
|
Ophthalmic mitomycin
|
$201.70 |
$201.70 |
$201.70 |
|
|
Oph Ultrasound dx ant sgm Ultrasound uni/bi
|
$499.20 |
$499.20 |
$499.20 |
|
|
Oph Ultrasound dx quan a-scan only
|
$158.74 |
$238.34 |
$415.20 |
|
|
Opn ax/subcla art expos
|
$6,419.95 |
$6,419.95 |
$6,419.95 |
|
|
Opn ilac art expos cndt crtj
|
$1,384.49 |
$1,384.49 |
$2,423.90 |
|
|
Oral aprepitant
|
$134.24 |
$134.24 |
$513.94 |
|
|
Oral everolimus
|
$70.90 |
$70.90 |
$70.90 |
|
|
Oritavancin 400 mg intravenous solution
|
$1,039.68 |
$1,532.97 |
$1,532.97 |
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$36.69 |
$39.58 |
$59.33 |
|
|
Ortho dvc repair per 15 min
|
$24.25 |
$24.25 |
$24.25 |
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$310.73 |
$473.47 |
$552.38 |
|
|
Ortho elbow w/lock w/ft&adj
|
$720.27 |
$820.03 |
$956.70 |
|
|
Ortho ewhf rigd without jnt cstm w
|
$1,332.88 |
$2,102.50 |
$2,452.91 |
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$708.88 |
$1,227.02 |
$1,431.53 |
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$389.98 |
$526.45 |
$532.90 |
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$345.53 |
$526.70 |
$614.49 |
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$152.04 |
$178.13 |
$207.82 |
|
|
Ortho hnd without jnt w/fit&adj
|
$389.98 |
$456.77 |
$532.90 |
|
|
Orthopantogram
|
$138.54 |
$203.42 |
$370.40 |
|
|
Orthopedic shoe add rub insl
|
$62.72 |
$90.72 |
$90.72 |
|
|
Ortho shoe add full sole
|
$80.47 |
$109.93 |
$109.93 |
|
|
Ortho shoe add half sole
|
$50.34 |
$68.71 |
$68.71 |
|
|
Ortho shoe add leather insol
|
$46.26 |
$63.22 |
$63.22 |
|
|
Ortho shoe add march bar
|
$66.36 |
$90.66 |
$90.66 |
|
|
Ortho sidebar disconnect
|
$206.19 |
$281.68 |
$281.68 |
|
|
Orthosis lso rigd frm hyperex
|
$433.89 |
$729.41 |
$850.98 |
|
|
Orthovisc inj per dose
|
$783.04 |
$783.04 |
$783.04 |
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$513.02 |
$584.06 |
$681.41 |
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$1,211.11 |
$1,626.05 |
$1,897.06 |
|
|
Oscillation chest wall mechanical per session
|
$117.21 |
$161.34 |
$196.70 |
|
|
O shoe add felt w leath insl
|
$50.34 |
$68.71 |
$68.71 |
|
|
O shoe add horseshoe toe tap
|
$36.18 |
$49.45 |
$49.45 |
|
|
O shoe add instep extension
|
$134.90 |
$184.24 |
$184.24 |
|
|
O shoe add instep velcro clo
|
$102.65 |
$140.22 |
$140.22 |
|
|
O shoe add standard toe tap
|
$14.11 |
$19.38 |
$19.38 |
|
|
O shoe convert to sof counte
|
$84.56 |
$115.53 |
$115.53 |
|
|
Osmolality blood
|
$41.60 |
$55.78 |
$128.00 |
|
|
Osmolality urine
|
$46.40 |
$64.51 |
$128.00 |
|
|
Osteopath manip tx/5-6 body region 98927
|
$42.96 |
$42.96 |
$42.96 |
|
|
Osteopath manip tx/7-8 body region 98928
|
$42.96 |
$42.96 |
$42.96 |
|
|
Oth resp proc, group
|
$39.65 |
$66.91 |
$179.20 |
|
|
Oth resp proc, indiv
|
$48.72 |
$81.79 |
$136.00 |
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$65.46 |
$81.48 |
$134.40 |
|
|
Ot re-evaluation patient/family
|
$117.77 |
$146.61 |
$263.20 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$57.60 |
$81.48 |
$140.00 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$65.46 |
$103.20 |
$157.60 |
|
|
Outrigger
|
$82.82 |
$113.12 |
$113.12 |
|
|
Outrigger bil with vert extens
|
$277.20 |
$378.67 |
$378.67 |
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$41.47 |
$64.13 |
$218.77 |
|
|
Oxaliplatin 5 mg/ml desensitization
|
$119.53 |
$310.07 |
$1,184.23 |
|
|
Oxytocin 10 unit/ml injection solution
|
$25.04 |
$60.75 |
$160.43 |
|
|
P-32 chromic phos ther per mci
|
$415.78 |
$485.07 |
$485.07 |
|
|
P-32 sod phosphate ther per mci
|
$521.62 |
$608.55 |
$608.55 |
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$172.39 |
$448.24 |
$678.17 |
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,672.40 |
$2,476.41 |
$3,857.35 |
|
|
Paliperidone 117 mg/0.75 ml inj
|
$2,374.14 |
$5,277.29 |
$6,156.84 |
|
|
Palivizumab 50 mg/0.5 ml inj
|
$1,481.67 |
$3,055.32 |
$5,409.40 |
|
|
Palonosetron hcl
|
$55.26 |
$365.04 |
$411.13 |
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$32.24 |
$92.93 |
$114.84 |
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$3,323.36 |
$9,991.40 |
$11,482.89 |
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$25.87 |
$34.88 |
$62.00 |
|
|
Papaverin hcl injection
|
$41.05 |
$41.05 |
$51.30 |
|
|
Parathormone (pth) intact
|
$56.11 |
$58.85 |
$276.00 |
|
|
Parathyrd planar w/spect&ct
|
$1,171.20 |
$2,182.27 |
$3,795.79 |
|
|
Parathyroid planar imaging
|
$955.20 |
$1,785.46 |
$3,105.70 |
|
|
Parathyroid planar img w/tomo spect
|
$1,419.20 |
$2,100.80 |
$2,384.00 |
|
|
Paricalcitol
|
$47.09 |
$47.09 |
$76.83 |
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$72.74 |
$251.18 |
$282.40 |
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$5,355.20 |
$5,355.20 |
$5,355.20 |
|
|
Partial excision of lip
|
$4,968.80 |
$4,968.80 |
$4,968.80 |
|
|
Partial removal finger bone
|
$4,820.80 |
$4,820.80 |
$4,820.80 |
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$35.43 |
$5,811.90 |
$5,811.90 |
|
|
Part removal of metatarsal
|
$5,128.80 |
$5,128.80 |
$5,128.80 |
|
|
Passy muir valve metal trach
|
$116.54 |
$216.00 |
$289.60 |
|
|
Patten bottom
|
$506.46 |
$672.73 |
$672.73 |
|
|
Pca3/klk3 antigen
|
$662.40 |
$662.40 |
$662.40 |
|
|
Pcv21 vaccine im
|
$268.32 |
$410.26 |
$511.28 |
|
|
Pdgfra gene
|
$509.54 |
$509.54 |
$640.22 |
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$61.20 |
$71.40 |
$71.40 |
|
|
Ped crit care transport
|
$1,741.77 |
$1,741.77 |
$1,741.77 |
|
|
Ped crit care transport addl
|
$574.56 |
$574.56 |
$574.56 |
|
|
Pegaspargase injection
|
$31,063.74 |
$31,063.74 |
$31,063.74 |
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$3,920.00 |
$7,290.61 |
$7,418.74 |
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$1,745.35 |
$3,217.04 |
$3,881.49 |
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$2,678.00 |
$3,346.60 |
$6,359.36 |
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$4,177.60 |
$6,430.83 |
$6,736.15 |
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$1,339.85 |
$2,108.55 |
$2,722.79 |
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$826.05 |
$1,803.48 |
$1,803.48 |
|
|
Peg interferon alfa-2a/180
|
$1,075.96 |
$1,075.96 |
$1,075.96 |
|