|
Oil silicone ophth 8.5ml silikon 1000
|
$1,048.68 |
$1,048.68 |
$1,048.68 |
|
|
Olanzapine 10 mg intramuscular solution
|
$205.06 |
$205.06 |
$243.51 |
|
|
Olanzapine long-acting inj
|
$3,104.46 |
$3,104.46 |
$3,104.46 |
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$2,023.53 |
$2,023.53 |
$3,830.71 |
|
|
Oncology colon mrna
|
$2,132.80 |
$2,132.80 |
$2,132.80 |
|
|
Oncology colorectal scr
|
$1,633.60 |
$1,633.60 |
$1,633.60 |
|
|
Oncology gynecologic
|
$1,919.20 |
$1,919.20 |
$1,919.20 |
|
|
Oncology gynecologic
|
$562.40 |
$562.40 |
$562.40 |
|
|
Oncology tum unknown origin
|
$4,752.00 |
$4,752.00 |
$4,752.00 |
|
|
Ondansetron 4 mg s0119
|
$0.80 |
$0.80 |
$0.80 |
|
|
Ondansetron 8 mg disintegrating tablet
|
$10.08 |
$10.08 |
$45.82 |
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$67.70 |
$67.70 |
$114.66 |
|
|
Open tx rib 1-3 fx w/fix 21811
|
$871.20 |
$871.20 |
$871.20 |
|
|
Open tx rib 4-6 fx w/fix 21812
|
$1,056.00 |
$1,056.00 |
$1,056.00 |
|
|
Open tx rib 7+ fx w/fix 21813
|
$1,448.00 |
$1,448.00 |
$1,448.00 |
|
|
Opn tx orbit fx without impl 21406
|
$7,696.80 |
$7,696.80 |
$7,696.80 |
|
|
Optx carpl scphd fx int fixj
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
|
|
Optx clavicular fx w/int fix
|
$1,063.20 |
$1,063.20 |
$9,128.00 |
|
|
Optx lunate dislocation
|
$9,128.00 |
$9,128.00 |
$9,128.00 |
|
|
Optx medial ankle fx
|
$893.60 |
$893.60 |
$9,128.00 |
|
|
Optx mndblr/max alv ridge fx
|
$7,696.80 |
$7,696.80 |
$7,696.80 |
|
|
Optx prox humrl fx w/int fix
|
$1,303.20 |
$1,303.20 |
$18,806.40 |
|
|
Optx prx hmrl fx fix rpr rpl
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
|
|
Optx radial shaft fracture
|
$989.60 |
$989.60 |
$989.60 |
|
|
Optx rdl&uln shft fx rds&uln
|
$1,333.60 |
$1,333.60 |
$1,333.60 |
|
|
Optx ulnar shft fx int fixj
|
$924.00 |
$924.00 |
$9,128.00 |
|
|
Orchiopexy ingun/scrot appr
|
$5,104.80 |
$5,104.80 |
$5,104.80 |
|
|
Organic acids total quant ea spec
|
$68.80 |
$68.80 |
$68.80 |
|
|
Oropharyngeal biopsy 42800
|
$235.20 |
$235.20 |
$235.20 |
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$120.94 |
$120.94 |
$120.94 |
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$253.60 |
$253.60 |
$253.60 |
|
|
Ortho ewhf rigd without jnt cstm w
|
$320.00 |
$320.00 |
$320.00 |
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$476.80 |
$476.80 |
$476.80 |
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$220.80 |
$220.80 |
$220.80 |
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$268.00 |
$268.00 |
$268.00 |
|
|
Ortho hnd without jnt w/fit&adj
|
$196.00 |
$196.00 |
$196.00 |
|
|
Orthosis lso rigd frm hyperex
|
$991.80 |
$991.80 |
$991.80 |
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$271.20 |
$271.20 |
$271.20 |
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$731.20 |
$731.20 |
$731.20 |
|
|
Oscillation chest wall mechanical per session
|
$249.60 |
$249.60 |
$360.00 |
|
|
Osmolality blood
|
$80.00 |
$80.00 |
$147.20 |
|
|
Osmolality urine
|
$80.00 |
$80.00 |
$112.80 |
|
|
Osteochondral knee allograft
|
$2,016.80 |
$2,016.80 |
$2,016.80 |
|
|
Osteopath manip tx/5-6 body region 98927
|
$85.60 |
$85.60 |
$85.60 |
|
|
Osteopath manip tx/7-8 body region 98928
|
$104.80 |
$104.80 |
$104.80 |
|
|
Osteopath manip tx/9-10 body region98929
|
$125.60 |
$125.60 |
$125.60 |
|
|
Ot evaluation high complexity patient/family
|
$153.60 |
$153.60 |
$187.20 |
|
|
Ot evaluation low complexity patient/family
|
$119.20 |
$119.20 |
$154.40 |
|
|
Ot evaluation moderate complexity patient/family
|
$123.20 |
$123.20 |
$146.40 |
|
|
Oth resp proc, group
|
$66.40 |
$66.40 |
$66.40 |
|
|
Oth resp proc, indiv
|
$46.40 |
$46.40 |
$66.40 |
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$46.40 |
$46.40 |
$55.20 |
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$65.60 |
$65.60 |
$84.80 |
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$59.20 |
$59.20 |
$66.40 |
|
|
Otolaryngo binocular microscopy 92504
|
$43.20 |
$43.20 |
$43.20 |
|
|
Ot re-evaluation patient/family
|
$92.80 |
$92.80 |
$146.40 |
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$48.80 |
$48.80 |
$60.00 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$29.60 |
$29.60 |
$40.80 |
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$30.40 |
$30.40 |
$41.60 |
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$64.00 |
$64.00 |
$68.00 |
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$55.20 |
$55.20 |
$68.00 |
|
|
Ot training self care/home management direct contact each 15 minutes
|
$60.00 |
$60.00 |
$84.80 |
|
|
Ovarian cystectomy 58925
|
$1,136.00 |
$1,136.00 |
$1,136.00 |
|
|
Oxaliplatin 5 mg/ml desensitization
|
$366.28 |
$366.28 |
$366.28 |
|
|
Oxytocin 10 unit/ml injection solution
|
$77.18 |
$77.18 |
$77.18 |
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$29,760.00 |
$29,760.00 |
$29,760.00 |
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$212.46 |
$212.46 |
$468.24 |
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,911.73 |
$1,911.73 |
$1,911.73 |
|
|
Paliperidone 117 mg/0.75 ml inj
|
$12.00 |
$12.00 |
$5,776.94 |
|
|
Palivizumab 50 mg/0.5 ml inj
|
$1,664.80 |
$1,664.80 |
$1,664.80 |
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$97.17 |
$97.17 |
$238.38 |
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$82.18 |
$82.18 |
$82.18 |
|
|
Papaverin hcl injection
|
$211.93 |
$211.93 |
$211.93 |
|
|
Parathormone (pth) intact
|
$160.80 |
$160.80 |
$212.80 |
|
|
Parathyrd planar w/spect&ct
|
$2,122.40 |
$2,122.40 |
$2,122.40 |
|
|
Parathyroid planar img w/tomo spect
|
$1,016.00 |
$1,016.00 |
$1,016.00 |
|
|
Parial mast w/lymph removal 19302
|
$1,364.00 |
$1,364.00 |
$1,364.00 |
|
|
Paricalcitol
|
$78.62 |
$78.62 |
$78.62 |
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$107.20 |
$107.20 |
$249.60 |
|
|
Part hymenectomy/revi hymenal ring 56700
|
$304.80 |
$304.80 |
$4,075.20 |
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$865.60 |
$865.60 |
$865.60 |
|
|
Partial hip replacement
|
$1,664.00 |
$1,664.00 |
$1,664.00 |
|
|
Partial hysterectomy
|
$1,414.40 |
$1,414.40 |
$1,414.40 |
|
|
Partial removal finger bone
|
$1,980.00 |
$1,980.00 |
$1,980.00 |
|
|
Partial removal finger bone
|
$654.40 |
$654.40 |
$1,980.00 |
|
|
Partial removal foot fascia
|
$768.00 |
$768.00 |
$768.00 |
|
|
Partial removal of thyroid
|
$1,409.60 |
$1,409.60 |
$1,409.60 |
|
|
Partial removal of toe
|
$603.20 |
$603.20 |
$4,108.00 |
|
|
Partial thyroid excision
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$1,539.20 |
$1,539.20 |
$1,539.20 |
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$3,354.28 |
$3,354.28 |
$3,354.28 |
|
|
Passy muir valve metal trach
|
$288.58 |
$288.58 |
$288.58 |
|
|
Pdgfra gene
|
$1,009.60 |
$1,009.60 |
$1,009.60 |
|
|
Pdt dstr prmlg les phys/qhp
|
$326.40 |
$326.40 |
$326.40 |
|
|
Pedicle enel/ntroral 15576
|
$1,173.60 |
$1,173.60 |
$2,488.00 |
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$1,906.24 |
$1,906.24 |
$1,906.24 |
|
|
Pelvic CT scan (with and without contrast)
|
$1,828.80 |
$1,828.80 |
$3,385.60 |
|
|
Pelvic CT scan (with contrast)
|
$1,400.80 |
$1,400.80 |
$1,429.60 |
|
|
Pelvic CT scan (without contrast)
|
$1,148.80 |
$1,148.80 |
$1,332.80 |
|
|
Pelvic MRI (with and without contrast)
|
$2,183.20 |
$2,183.20 |
$3,043.20 |
|