|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$1,175.38 |
$1,175.38 |
$1,175.38 |
$4,595.01
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$9.10 |
$9.10 |
$9.10 |
$22.62
|
|
Ophthalmic mitomycin
|
$44.58 |
$44.58 |
$44.58 |
$775.44
|
|
Orchiectomy partial
|
$1,358.71 |
$1,358.71 |
$1,358.71 |
$4,081.37
|
|
Organic acids total quant ea spec
|
$213.31 |
$213.31 |
$213.31 |
$151.36
|
|
Oritavancin 400 mg intravenous solution
|
$828.32 |
$828.32 |
$828.32 |
$3,082.73
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$5.62 |
$5.62 |
$5.62 |
$50.63
|
|
Oscillation chest wall mechanical per session
|
$268.09 |
$268.09 |
$268.09 |
$195.00
|
|
Osmolality blood
|
$132.80 |
$132.80 |
$132.80 |
$67.60
|
|
Osmolality urine
|
$119.52 |
$119.52 |
$119.52 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$205.84 |
$205.84 |
$205.84 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$136.12 |
$136.12 |
$136.12 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$171.81 |
$171.81 |
$171.81 |
$263.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$71.38 |
$71.38 |
$71.38 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$83.83 |
$83.83 |
$83.83 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$86.32 |
$86.32 |
$86.32 |
$105.00
|
|
Ot re-evaluation patient/family
|
$136.12 |
$136.12 |
$136.12 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$85.49 |
$85.49 |
$85.49 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$130.31 |
$130.31 |
$130.31 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$130.31 |
$130.31 |
$130.31 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$129.48 |
$129.48 |
$129.48 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$89.64 |
$89.64 |
$89.64 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$84.66 |
$84.66 |
$84.66 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$83.50 |
$83.50 |
$83.50 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$17.76 |
$17.76 |
$17.76 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$2.74 |
$2.74 |
$2.74 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$2.55 |
$2.55 |
$2.55 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,199.45 |
$1,199.45 |
$1,199.45 |
$3,435.42
|
|
Palivizumab 50 mg/0.5 ml inj
|
$5,405.89 |
$5,405.89 |
$5,405.89 |
$5,569.20
|
|
Palonosetron hcl
|
$3.45 |
$3.45 |
$3.45 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$41.49 |
$41.49 |
$41.49 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$290.18 |
$290.18 |
$290.18 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$3.86 |
$3.86 |
$3.86 |
$29.31
|
|
Papaverin hcl injection
|
$15.72 |
$15.72 |
$15.72 |
$77.05
|
|
Parathormone (pth) intact
|
$244.02 |
$244.02 |
$244.02 |
$204.87
|
|
Parathyroid planar imaging
|
$1,318.87 |
$1,318.87 |
$1,318.87 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,346.26 |
$1,346.26 |
$1,346.26 |
$1,350.60
|
|
Parial mast w/lymph removal 19302
|
$2,030.18 |
$2,030.18 |
$2,030.18 |
$5,509.55
|
|
Paricalcitol
|
$7.93 |
$7.93 |
$7.93 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$185.92 |
$185.92 |
$185.92 |
$245.00
|
|
Partial removal finger bone
|
$2,049.27 |
$2,049.27 |
$2,049.27 |
$2,049.27
|
|
Partial removal of thyroid
|
$1,609.37 |
$1,609.37 |
$1,609.37 |
$6,457.82
|
|
Partial removal of thyroid
|
$2,138.91 |
$2,138.91 |
$2,138.91 |
$5,855.00
|
|
Partial removal of toe
|
$2,049.27 |
$2,049.27 |
$2,049.27 |
$3,674.58
|
|
Partial thyroid excision
|
$1,605.22 |
$1,605.22 |
$1,605.22 |
$6,457.82
|
|
Partial thyroid lobect w/contratlat stot lobec 60212
|
$2,292.46 |
$2,292.46 |
$2,292.46 |
$6,376.26
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$7,235.64 |
$7,235.64 |
$7,235.64 |
$4,921.76
|
|
Part removal of metatarsal
|
$1,362.86 |
$1,362.86 |
$1,362.86 |
$3,134.00
|
|
Passy muir valve metal trach
|
$61.09 |
$61.09 |
$61.09 |
$275.75
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$6,187.35 |
$6,187.35 |
$6,187.35 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$4,396.33 |
$4,396.33 |
$4,396.33 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,134.14 |
$2,134.14 |
$2,134.14 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$2,020.97 |
$2,020.97 |
$2,020.97 |
$4,067.80
|
|
Pegloticase 8 mg/ml intravenous solution
|
$18,759.66 |
$18,759.66 |
$18,759.66 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$3,040.29 |
$3,040.29 |
$3,040.29 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,642.72 |
$2,642.72 |
$2,642.72 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,985.36 |
$1,985.36 |
$1,985.36 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$2,947.33 |
$2,947.33 |
$2,947.33 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,771.37 |
$2,771.37 |
$2,771.37 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,363.01 |
$2,363.01 |
$2,363.01 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$761.94 |
$761.94 |
$761.94 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$472.27 |
$472.27 |
$472.27 |
$430.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$1,223.78 |
$1,223.78 |
$1,223.78 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$3,069.12 |
$3,069.12 |
$3,069.12 |
$7,089.13
|
|
Pemivibart infusion
|
$544.48 |
$544.48 |
$544.48 |
$533.10
|
|
Peng benzathine/procaine inj
|
$92.27 |
$92.27 |
$92.27 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$147.03 |
$147.03 |
$147.03 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$41.75 |
$41.75 |
$41.75 |
$101.34
|
|
Penile rear tip xtnd 0.5cm
|
$8,293.20 |
$8,293.20 |
$8,293.20 |
$18,764.94
|
|
Pentobarbital sodium inj
|
$27.30 |
$27.30 |
$27.30 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$1,930.08 |
$1,930.08 |
$1,930.08 |
$5,181.67
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$33.20 |
$33.20 |
$33.20 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$636.61 |
$636.61 |
$636.61 |
$2,251.20
|
|
Peripheral vascular rehab
|
$175.96 |
$175.96 |
$175.96 |
$132.50
|
|
Perq dev breast 1st mr guide
|
$1,561.23 |
$1,561.23 |
$1,561.23 |
$1,837.20
|
|
Perq dev breast 1st strtctc
|
$3,306.72 |
$3,306.72 |
$3,306.72 |
$1,456.00
|
|
Pertussis ag if
|
$86.32 |
$86.32 |
$86.32 |
$69.05
|
|
Pertuzumab 30 mg/ml desensitization
|
$402.95 |
$402.95 |
$402.95 |
$13,666.00
|
|
Pet CT skull-mid thgh initial
|
$7,909.90 |
$7,909.90 |
$7,909.90 |
$4,707.00
|
|
Pet CT whole body initial
|
$7,356.29 |
$7,356.29 |
$7,356.29 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,520.18 |
$4,520.18 |
$4,520.18 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$5,379.23 |
$5,379.23 |
$5,379.23 |
$4,305.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$41,010.30 |
$41,010.30 |
$41,010.30 |
$38,834.22
|
|
Ph body fluid
|
$35.69 |
$35.69 |
$35.69 |
$41.28
|
|
Phencyclidine (pcp)
|
$105.41 |
$105.41 |
$105.41 |
$96.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$41.76 |
$41.76 |
$41.76 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$43.99 |
$43.99 |
$43.99 |
$104.50
|
|
Phentolaine mesylate inj
|
$353.35 |
$353.35 |
$353.35 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$3.53 |
$3.53 |
$3.53 |
$67.89
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$1.32 |
$1.32 |
$1.32 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$46.48 |
$46.48 |
$46.48 |
$110.88
|
|
Phlebotomy therapeutic
|
$307.93 |
$307.93 |
$307.93 |
$231.66
|
|
Phosphorus
|
$54.78 |
$54.78 |
$54.78 |
$48.80
|
|
Phosphorus 24 hour urine
|
$63.08 |
$63.08 |
$63.08 |
$41.51
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$36.34 |
$36.34 |
$36.34 |
$87.50
|
|
Piflu f-18, dia 1 millicurie
|
$1,229.23 |
$1,229.23 |
$1,229.23 |
$1,035.81
|
|
Pin caspar distraction 12mm
|
$14,581.44 |
$14,581.44 |
$14,581.44 |
$11,925.00
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$1,373.65 |
$1,373.65 |
$1,373.65 |
$1,116.00
|
|
Pinworm exam
|
$64.74 |
$64.74 |
$64.74 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$90.35 |
$90.35 |
$90.35 |
$83.03
|