|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$3,315.07 |
$3,315.07 |
$3,315.07 |
$12,080.43
|
|
Olanzapine 10 mg intramuscular solution
|
$57.67 |
$57.67 |
$57.67 |
$109.58
|
|
Onc brst mrna 70 cnt 31 gene
|
$2,614.00 |
$2,614.00 |
$2,614.00 |
$4,260.30
|
|
Ondansetron 8 mg disintegrating tablet
|
$1.88 |
$1.88 |
$1.88 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$25.50 |
$25.50 |
$25.50 |
$22.62
|
|
Opioids & opiate analogs 3/4
|
$64.20 |
$64.20 |
$64.20 |
$24.00
|
|
Opn ilac art expos cndt crtj
|
$472.00 |
$472.00 |
$472.00 |
$1,169.29
|
|
Oral aprepitant
|
$58.91 |
$58.91 |
$58.91 |
$410.20
|
|
Oral everolimus
|
$7.33 |
$7.33 |
$7.33 |
$33.34
|
|
Organic acids total quant ea spec
|
$159.00 |
$159.00 |
$159.00 |
$151.36
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$20.53 |
$20.53 |
$20.53 |
$50.63
|
|
Oscillation chest wall mechanical per session
|
$68.60 |
$68.60 |
$68.60 |
$195.00
|
|
Osmolality blood
|
$37.40 |
$37.40 |
$37.40 |
$67.60
|
|
Osmolality urine
|
$37.40 |
$37.40 |
$37.40 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$175.60 |
$175.60 |
$175.60 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$175.60 |
$175.60 |
$175.60 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$175.60 |
$175.60 |
$175.60 |
$263.50
|
|
Oth resp proc, group
|
$21.60 |
$21.60 |
$21.60 |
$123.05
|
|
Oth resp proc, indiv
|
$16.20 |
$16.20 |
$16.20 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$38.20 |
$38.20 |
$38.20 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$46.80 |
$46.80 |
$46.80 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$46.80 |
$46.80 |
$46.80 |
$105.00
|
|
Ot re-evaluation patient/family
|
$87.80 |
$87.80 |
$87.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$50.20 |
$50.20 |
$50.20 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$27.60 |
$27.60 |
$27.60 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$82.80 |
$82.80 |
$82.80 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$50.20 |
$50.20 |
$50.20 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$46.80 |
$46.80 |
$46.80 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$44.80 |
$44.80 |
$44.80 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$154.09 |
$154.09 |
$154.09 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$396.02 |
$396.02 |
$396.02 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$74.92 |
$74.92 |
$74.92 |
$50.40
|
|
P-32 sod phosphate ther per mci
|
$228.95 |
$228.95 |
$228.95 |
$469.34
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$71.76 |
$71.76 |
$71.76 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$799.85 |
$799.85 |
$799.85 |
$3,435.42
|
|
Palingen or promatrx
|
$415.00 |
$415.00 |
$415.00 |
$691.88
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$148.71 |
$148.71 |
$148.71 |
$128.07
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$8.84 |
$8.84 |
$8.84 |
$29.31
|
|
Papaverin hcl injection
|
$57.46 |
$57.46 |
$57.46 |
$77.05
|
|
Parathormone (pth) intact
|
$92.60 |
$92.60 |
$92.60 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$377.60 |
$377.60 |
$377.60 |
$1,574.40
|
|
Parathyroid planar imaging
|
$373.80 |
$373.80 |
$373.80 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$298.40 |
$298.40 |
$298.40 |
$1,350.60
|
|
Paricalcitol
|
$11.11 |
$11.11 |
$11.11 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$47.20 |
$47.20 |
$47.20 |
$245.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$2.80 |
$2.80 |
$2.80 |
$4,921.76
|
|
Pelvic CT scan (with and without contrast)
|
$900.80 |
$900.80 |
$900.80 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$718.00 |
$718.00 |
$718.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$613.20 |
$613.20 |
$613.20 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$1,434.80 |
$1,434.80 |
$1,434.80 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$748.80 |
$748.80 |
$748.80 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$254.20 |
$254.20 |
$254.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$127.80 |
$127.80 |
$127.80 |
$430.00
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$2,376.09 |
$2,376.09 |
$2,376.09 |
$7,089.13
|
|
Pemivibart infusion
|
$280.80 |
$280.80 |
$280.80 |
$533.10
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$161.94 |
$161.94 |
$161.94 |
$101.34
|
|
Penile injection
|
$62.80 |
$62.80 |
$62.80 |
$418.00
|
|
Pentobarbital sodium inj
|
$5,203.75 |
$5,203.75 |
$5,203.75 |
$2,205.38
|
|
Perc cryo ablate renal tum
|
$2,334.20 |
$2,334.20 |
$2,334.20 |
$11,458.04
|
|
Perc d-e cor revasc chro add
|
$10,560.60 |
$10,560.60 |
$10,560.60 |
$12,886.61
|
|
Perc d-e cor revasc chro sin
|
$10,819.60 |
$10,819.60 |
$10,819.60 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$10,560.60 |
$10,560.60 |
$10,560.60 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$10,819.60 |
$10,819.60 |
$10,819.60 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$12,449.00 |
$12,449.00 |
$12,449.00 |
$12,191.74
|
|
Perc d-e cor stent ather s
|
$12,817.80 |
$12,817.80 |
$12,817.80 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$10,058.00 |
$10,058.00 |
$10,058.00 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$10,304.60 |
$10,304.60 |
$10,304.60 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$2,218.20 |
$2,218.20 |
$2,218.20 |
$7,243.60
|
|
Percut ablate liver rf
|
$2,602.40 |
$2,602.40 |
$2,602.40 |
$6,904.15
|
|
Pericardial drain w/cath pq w/ct guid
|
$499.60 |
$499.60 |
$499.60 |
$2,513.20
|
|
Pericardiocentesis wwo imaging
|
$619.60 |
$619.60 |
$619.60 |
$2,251.20
|
|
Peri-proc device eval icd
|
$28.20 |
$28.20 |
$28.20 |
$192.40
|
|
Peri-proc device eval pm
|
$28.20 |
$28.20 |
$28.20 |
$159.90
|
|
Peritoneal cath sub q resv per
|
$2,983.00 |
$2,983.00 |
$2,983.00 |
$5,625.74
|
|
Peritoneogram rs&i
|
$228.40 |
$228.40 |
$228.40 |
$695.89
|
|
Perit-vens shunt pat tst
|
$183.60 |
$183.60 |
$183.60 |
$758.37
|
|
Perq art m-thrombect &/nfs
|
$3,614.40 |
$3,614.40 |
$3,614.40 |
$7,559.55
|
|
Perq clsr tcat l atr apndge
|
$6,579.80 |
$6,579.80 |
$6,579.80 |
$9,509.53
|
|
Perq dev breast 1st strtctc
|
$524.20 |
$524.20 |
$524.20 |
$1,456.00
|
|
Perq p-art revsc 1 abnor bi
|
$10,030.00 |
$10,030.00 |
$10,030.00 |
$17,321.20
|
|
Perq p-art revsc 1 abnor uni
|
$6,198.20 |
$6,198.20 |
$6,198.20 |
$21,321.00
|
|
Perq p-art revsc 1 nm nt bi
|
$6,198.20 |
$6,198.20 |
$6,198.20 |
$15,873.70
|
|
Perq p-art revsc 1 nm nt uni
|
$6,198.20 |
$6,198.20 |
$6,198.20 |
$17,321.20
|
|
Perq p-art revsc each addl
|
$3,099.40 |
$3,099.40 |
$3,099.40 |
$8,627.68
|
|
Perq plmt bile duct stent
|
$1,890.60 |
$1,890.60 |
$1,890.60 |
$6,870.89
|
|
Perq plmt bile duct stent
|
$1,890.60 |
$1,890.60 |
$1,890.60 |
$6,738.60
|
|
Perq plmt bile duct stent
|
$1,890.60 |
$1,890.60 |
$1,890.60 |
$6,904.15
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$183.60 |
$183.60 |
$183.60 |
$625.93
|
|
Perqt bx lung/mediastinum 32405
|
$303.20 |
$303.20 |
$303.20 |
$1,617.64
|
|
Perq transcath closure each
|
$70.80 |
$70.80 |
$70.80 |
$9,204.00
|
|
Perq transcath closure pda
|
$6,908.40 |
$6,908.40 |
$6,908.40 |
$18,408.00
|
|
Perq transcath septal reduxn
|
$6,738.80 |
$6,738.80 |
$6,738.80 |
$8,605.90
|
|
Pertussis ag if
|
$32.40 |
$32.40 |
$32.40 |
$69.05
|
|
Pet CT skull-mid thgh initial
|
$2,472.20 |
$2,472.20 |
$2,472.20 |
$4,707.00
|
|
Pet CT whole body initial
|
$2,472.20 |
$2,472.20 |
$2,472.20 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$4,060.00
|
|
Pet image skull-thigh
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$4,256.70
|
|
Pet not otherwise specified
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$1,070.40
|
|
Pfc sigma fem post aug sz3 8mm
|
$1,259.00 |
$1,259.00 |
$1,259.00 |
$38,834.22
|
|
Ph body fluid
|
$28.20 |
$28.20 |
$28.20 |
$41.28
|