|
Offset knee joint each
|
$196.00 |
$196.00 |
$196.00 |
$221.31
|
|
Olanzapine 10 mg intramuscular solution
|
$101.83 |
$101.83 |
$101.83 |
$109.58
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$828.90 |
$828.90 |
$828.90 |
$4,595.01
|
|
Oncoprotein her-2/neu
|
$456.25 |
$456.25 |
$913.82 |
$219.00
|
|
Oprelvekin injection
|
$862.51 |
$862.51 |
$862.51 |
$848.31
|
|
Oral everolimus
|
$10.97 |
$10.97 |
$10.97 |
$33.34
|
|
Oral hiv-1/hiv-2 screen
|
$173.25 |
$173.25 |
$376.52 |
$38.58
|
|
Organic acids total quant ea spec
|
$692.75 |
$692.75 |
$1,383.90 |
$151.36
|
|
Oritavancin 400 mg intravenous solution
|
$3,311.06 |
$3,311.06 |
$3,311.06 |
$3,082.73
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$84.17 |
$84.17 |
$96.50 |
$50.63
|
|
Orthopantogram
|
$711.00 |
$711.00 |
$711.00 |
$241.50
|
|
Ortho shoe add full sole
|
$770.00 |
$770.00 |
$770.00 |
$109.93
|
|
Osmolality blood
|
$115.75 |
$115.75 |
$392.90 |
$67.60
|
|
Ostomy clamp, replacement
|
$3.00 |
$3.00 |
$3.00 |
$4.66
|
|
Ost urine pch w b/bltin conv
|
$66.00 |
$66.00 |
$66.00 |
$2.90
|
|
Ot evaluation high complexity patient/family
|
$967.93 |
$967.93 |
$967.93 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$967.93 |
$967.93 |
$967.93 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$967.93 |
$967.93 |
$967.93 |
$263.50
|
|
Ot re-evaluation patient/family
|
$612.27 |
$612.27 |
$612.27 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$203.25 |
$203.25 |
$203.25 |
$101.38
|
|
Oxaliplatin 5 mg/ml desensitization
|
$6.30 |
$6.30 |
$6.30 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$85.75 |
$85.75 |
$123.75 |
$50.40
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$3,194.24 |
$3,194.24 |
$3,194.24 |
$3,435.42
|
|
Palonosetron hcl
|
$280.61 |
$280.61 |
$280.61 |
$170.48
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$2,905.60 |
$2,905.60 |
$2,905.60 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$85.95 |
$85.95 |
$85.95 |
$29.31
|
|
Papaverin hcl injection
|
$99.35 |
$99.35 |
$131.25 |
$77.05
|
|
Parathormone (pth) intact
|
$842.50 |
$842.50 |
$1,689.56 |
$204.87
|
|
Parathyroid planar imaging
|
$1,796.50 |
$1,796.50 |
$1,796.50 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$5,591.50 |
$5,591.50 |
$21,659.92 |
$1,350.60
|
|
Paricalcitol
|
$110.25 |
$110.25 |
$110.25 |
$47.15
|
|
Pegaspargase injection
|
$71,192.14 |
$71,192.14 |
$71,192.14 |
$39,780.27
|
|
Peg interferon alfa-2a/180
|
$3,289.23 |
$3,289.23 |
$3,289.23 |
$3,289.23
|
|
Pelvic control pelvic sling
|
$5,143.00 |
$5,143.00 |
$5,143.00 |
$912.18
|
|
Pelvic CT scan (with and without contrast)
|
$6,853.50 |
$6,853.50 |
$6,853.50 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$6,853.50 |
$6,853.50 |
$6,853.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$6,853.50 |
$6,853.50 |
$6,853.50 |
$1,363.11
|
|
Pelvic Ultrasound (complete)
|
$1,709.00 |
$1,709.00 |
$1,709.00 |
$643.80
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$9,460.15 |
$9,460.15 |
$9,460.15 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$125.70 |
$125.70 |
$125.70 |
$375.32
|
|
Penile vascular study
|
$1,953.26 |
$1,953.26 |
$1,953.26 |
$574.60
|
|
Pentamidine 300 mg solution for injection
|
$237.61 |
$237.61 |
$237.61 |
$453.61
|
|
Pentamidine non-comp unit
|
$126.17 |
$126.17 |
$126.17 |
$294.39
|
|
Pentazocine injection
|
$94.75 |
$94.75 |
$122.50 |
$128.80
|
|
Pentobarbital sodium inj
|
$196.50 |
$196.50 |
$196.50 |
$2,205.38
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$303.52 |
$303.52 |
$303.52 |
$321.71
|
|
Perit-vens shunt pat tst
|
$4,101.45 |
$4,101.45 |
$4,101.45 |
$758.37
|
|
Perphenazine 4mg oral
|
$2.50 |
$2.50 |
$2.50 |
$2.58
|
|
Perq transcath cls aortic
|
$60,710.66 |
$60,710.66 |
$60,710.66 |
$22,633.26
|
|
Pertuzumab 30 mg/ml desensitization
|
$22,178.38 |
$22,178.38 |
$22,178.38 |
$13,666.00
|
|
Phencyclidine (pcp)
|
$195.12 |
$195.12 |
$195.12 |
$96.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$156.72 |
$156.72 |
$156.72 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$438.25 |
$438.25 |
$879.94 |
$104.50
|
|
Phentolaine mesylate inj
|
$174.00 |
$174.00 |
$1,436.76 |
$1,028.40
|
|
Phenytoin total therapeutic drug level
|
$130.25 |
$130.25 |
$535.17 |
$110.88
|
|
Phosphorus
|
$123.50 |
$123.50 |
$245.93 |
$48.80
|
|
Phosphorus 24 hour urine
|
$145.25 |
$145.25 |
$288.73 |
$41.51
|
|
Phys blood bank serv reactj
|
$180.87 |
$180.87 |
$180.87 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$95.33 |
$95.33 |
$95.33 |
$87.50
|
|
Piflu f-18, dia 1 millicurie
|
$2,086.69 |
$2,086.69 |
$2,086.69 |
$1,035.81
|
|
Pinworm exam
|
$171.50 |
$171.50 |
$345.86 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$25.45 |
$25.45 |
$25.45 |
$83.03
|
|
Plasma cryoprecipitate reduced each unit
|
$409.65 |
$409.65 |
$409.65 |
$157.95
|
|
Platelet automated
|
$41.50 |
$41.50 |
$858.28 |
$45.60
|
|
Platelet pheresis each unit
|
$3,090.64 |
$3,090.64 |
$3,090.64 |
$961.70
|
|
Platelet pheresis irr ea
|
$3,094.25 |
$3,094.25 |
$3,094.25 |
$1,082.25
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,465.81 |
$2,465.81 |
$2,465.81 |
$1,278.55
|
|
Plerixafor injection
|
$23,662.98 |
$23,662.98 |
$23,662.98 |
$16,079.30
|
|
Plethysmography lung volumes/airway resistance
|
$1,309.21 |
$1,309.21 |
$1,309.21 |
$405.00
|
|
Pm device progr eval dual
|
$326.40 |
$326.40 |
$326.40 |
$148.00
|
|
Pm device progr eval multi
|
$326.40 |
$326.40 |
$326.40 |
$139.00
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$18,497.33 |
$18,497.33 |
$18,497.33 |
$3,751.48
|
|
Postop app non-wgt bear dsg
|
$5,375.00 |
$5,375.00 |
$5,375.00 |
$977.13
|
|
Potassium 24 hour urine
|
$194.75 |
$194.75 |
$392.90 |
$50.40
|
|
Potassium serum/plasma/whole blood
|
$48.25 |
$48.25 |
$345.86 |
$46.75
|
|
Pouch ostmy nb pouchkin ctf
|
$148.00 |
$148.00 |
$148.00 |
$1.55
|
|
Pouch uros new (both sides) 2.75in clr
|
$24.00 |
$24.00 |
$24.00 |
$15.80
|
|
Pq biliary strict dil s&i
|
$29,500.51 |
$29,500.51 |
$29,500.51 |
$1,097.60
|
|
Pralatrexate injection
|
$13,125.00 |
$13,125.00 |
$13,125.00 |
$21,919.03
|
|
Pralidoxime 1 gram solution for injection
|
$271.00 |
$271.00 |
$271.00 |
$271.00
|
|
Pr application of long arm splint
|
$1,332.53 |
$1,332.53 |
$1,332.53 |
$329.00
|
|
Pr application splint static short arm
|
$907.33 |
$907.33 |
$907.33 |
$287.70
|
|
Prealbumin
|
$460.00 |
$460.00 |
$922.28 |
$93.36
|
|
Pregnancy associated plasma protein-a
|
$488.50 |
$488.50 |
$1,056.60 |
$71.28
|
|
Pre-tibial shell molded to p
|
$4,222.00 |
$4,222.00 |
$4,222.00 |
$708.74
|
|
Pretreatment serum by diff red cell adsorption patient rbc/known phenotype each adsorption ref
|
$421.32 |
$421.32 |
$421.32 |
$152.85
|
|
Pretreat rbc absorption reference
|
$393.72 |
$393.72 |
$393.72 |
$150.00
|
|
Pretreat rbc density gradient separation reference
|
$642.73 |
$642.73 |
$642.73 |
$174.00
|
|
Pretreat rbc w chem/drugs reference
|
$344.69 |
$344.69 |
$344.69 |
$112.20
|
|
Pretreat rbc w enzyme reference
|
$717.37 |
$717.37 |
$717.37 |
$167.05
|
|
Prgrmg dev eval impltbl sys
|
$285.43 |
$285.43 |
$285.43 |
$130.00
|
|
Prgrmg dev eval scrms ip
|
$326.40 |
$326.40 |
$326.40 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$550.75 |
$550.75 |
$550.75 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$550.75 |
$550.75 |
$550.75 |
$205.40
|
|
Prgr stim/pace a/iv drug
|
$19,928.17 |
$19,928.17 |
$19,928.17 |
$4,601.35
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$21.00 |
$21.00 |
$143.38 |
$670.00
|
|
Procalcitonin
|
$534.50 |
$534.50 |
$1,168.17 |
$161.11
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$84.13 |
$84.13 |
$84.25 |
$36.72
|
|
Prochlorperazine maleate 5 mg tablet
|
$2.02 |
$2.02 |
$2.02 |
$1.50
|
|
Progesterone
|
$514.00 |
$514.00 |
$1,035.44 |
$115.64
|
