|
Pertuzumab 30 mg/ml desensitization
|
$5,346.55 |
$5,346.55 |
$5,346.55 |
$14,272.91
|
|
Pertuzu, trastuzu, 10 mg
|
$8,951.00 |
$8,951.00 |
$8,951.00 |
$27,858.08
|
|
Pet CT skull-mid thgh initial
|
$4,492.00 |
$4,492.00 |
$4,492.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$4,492.00 |
$4,492.00 |
$4,492.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,492.00 |
$4,492.00 |
$4,492.00 |
$4,060.00
|
|
Pet scan brain perf study
|
$3,445.60 |
$3,445.60 |
$3,445.60 |
$3,724.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$52,536.00 |
$52,536.00 |
$52,536.00 |
$40,252.07
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$94.13 |
$94.13 |
$94.13 |
$112.72
|
|
Phentolaine mesylate inj
|
$792.44 |
$792.44 |
$792.44 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$70.37 |
$70.37 |
$70.37 |
$62.98
|
|
Phenylep ketorolac opth soln
|
$471.87 |
$471.87 |
$471.87 |
$934.56
|
|
Phlebotomy therapeutic
|
$271.20 |
$271.20 |
$271.20 |
$231.87
|
|
Phleb veins 1 extrm 10-20 stab
|
$8,209.60 |
$8,209.60 |
$8,209.60 |
$4,810.00
|
|
Phleb veins 1 extrm >20 stab
|
$8,209.60 |
$8,209.60 |
$8,209.60 |
$4,516.05
|
|
Physical Therapy Evaluation (high complexity)
|
$295.20 |
$295.20 |
$295.20 |
$297.00
|
|
Physical Therapy Evaluation (low complexity)
|
$252.80 |
$252.80 |
$252.80 |
$224.95
|
|
Physical Therapy Evaluation (moderate complexity)
|
$272.00 |
$272.00 |
$272.00 |
$257.34
|
|
Physical Therapy Re-Evaluation
|
$173.60 |
$173.60 |
$173.60 |
$155.00
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$91.54 |
$91.54 |
$91.54 |
$89.82
|
|
Piflu f-18, dia 1 millicurie
|
$872.00 |
$872.00 |
$872.00 |
$1,038.40
|
|
Pillow shldr abduc inflat univ
|
$367.08 |
$367.08 |
$367.08 |
$537.66
|
|
Pin caspar distraction 12mm
|
$35,129.60 |
$35,129.60 |
$35,129.60 |
$11,672.88
|
|
Pinch graft 1/mlt c> sm ulcer tip/oth area 2cm 15050
|
$957.60 |
$957.60 |
$957.60 |
$1,116.00
|
|
Pin finger fracture each
|
$5,111.20 |
$5,111.20 |
$5,111.20 |
$4,192.86
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$205.80 |
$205.80 |
$205.80 |
$81.36
|
|
Place cath intracranial art
|
$7,125.60 |
$7,125.60 |
$7,125.60 |
$3,775.95
|
|
Place cath xtrnl carotid
|
$7,339.20 |
$7,339.20 |
$7,339.20 |
$4,202.90
|
|
Place duod/jej tube perc
|
$2,763.20 |
$2,763.20 |
$2,763.20 |
$2,562.75
|
|
Place gastrostomy tube perc
|
$2,581.60 |
$2,581.60 |
$2,581.60 |
$2,308.95
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,772.80 |
$1,772.80 |
$1,772.80 |
$1,494.36
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,345.60 |
$1,345.60 |
$1,345.60 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,985.60 |
$1,985.60 |
$1,985.60 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$4,953.60 |
$4,953.60 |
$4,953.60 |
$3,946.56
|
|
Placement occlusive device venous/arterial access site post procedure
|
$945.60 |
$945.60 |
$945.60 |
$571.45
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$17,932.80 |
$17,932.80 |
$17,932.80 |
$13,879.25
|
|
Place non-slctv cath thoracic arta
|
$8,304.80 |
$8,304.80 |
$8,304.80 |
$5,274.33
|
|
Place slctv cath carotd art uni
|
$10,576.80 |
$10,576.80 |
$10,576.80 |
$10,150.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$7,237.60 |
$7,237.60 |
$7,237.60 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$7,748.00 |
$7,748.00 |
$7,748.00 |
$9,074.00
|
|
Place slctv cath subclavian art
|
$10,005.60 |
$10,005.60 |
$10,005.60 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$11,411.20 |
$11,411.20 |
$11,411.20 |
$9,200.62
|
|
Platelet pheresis each unit
|
$1,695.20 |
$1,695.20 |
$1,695.20 |
$1,015.50
|
|
Platelet pheresis irr ea
|
$2,027.20 |
$2,027.20 |
$2,027.20 |
$1,108.52
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$2,933.72 |
$2,933.72 |
$2,933.72 |
$1,532.70
|
|
Platelets leukocytes reduced irradiated each unit
|
$642.40 |
$642.40 |
$642.40 |
$411.20
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,968.32 |
$1,968.32 |
$1,968.32 |
$1,162.85
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,518.91 |
$2,518.91 |
$2,518.91 |
$1,288.20
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,571.33 |
$1,571.33 |
$1,571.33 |
$1,007.82
|
|
Plcmnt biliary drainage cath w/img ext
|
$7,006.40 |
$7,006.40 |
$7,006.40 |
$4,650.08
|
|
Plcmnt stent transcath ctrl dialysis seg add-on
|
$18,169.60 |
$18,169.60 |
$18,169.60 |
$6,927.20
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$6,915.20 |
$6,915.20 |
$6,915.20 |
$5,087.15
|
|
Plcmnt ureteral stent pq w/img new w/cath
|
$7,172.00 |
$7,172.00 |
$7,172.00 |
$5,590.00
|
|
Plcmt dlyd xtn pros 1st vsl
|
$15,894.40 |
$15,894.40 |
$15,894.40 |
$3,793.50
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$1,259.20 |
$1,259.20 |
$1,259.20 |
$1,230.00
|
|
Plcmt sft tiss loc pq w/img ea addl lsn
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$759.55
|
|
Plcmt xtn pros evasc rpr per vsl
|
$4,280.00 |
$4,280.00 |
$4,280.00 |
$3,473.00
|
|
Plc pq device breast ea addl lesion MRI guide
|
$1,714.40 |
$1,714.40 |
$1,714.40 |
$1,421.06
|
|
Plc pq device breast ea addl lesion stereo guide
|
$1,437.60 |
$1,437.60 |
$1,437.60 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$1,345.60 |
$1,345.60 |
$1,345.60 |
$758.52
|
|
Plethysmography lung volumes/airway resistance
|
$436.00 |
$436.00 |
$436.00 |
$411.51
|
|
Plmt access bil tree sm bwl
|
$5,416.80 |
$5,416.80 |
$5,416.80 |
$4,683.65
|
|
Plmt biliary drainage cath
|
$7,162.40 |
$7,162.40 |
$7,162.40 |
$4,762.80
|
|
Plmt nephroureteral catheter
|
$5,344.00 |
$5,344.00 |
$5,344.00 |
$4,170.03
|
|
Plmt ureteral stent prq
|
$6,915.20 |
$6,915.20 |
$6,915.20 |
$5,151.51
|
|
Pm device progr eval dual
|
$91.20 |
$91.20 |
$91.20 |
$148.65
|
|
Pm device progr eval multi
|
$92.80 |
$92.80 |
$92.80 |
$139.10
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$16,000.03 |
$16,000.03 |
$16,000.03 |
$35,781.91
|
|
Polysom <6 yrs cpap/bilvl
|
$3,770.40 |
$3,770.40 |
$3,770.40 |
$3,514.50
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$3,952.00 |
$3,952.00 |
$3,952.00 |
$3,785.10
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$105.92 |
$105.92 |
$105.92 |
$61.80
|
|
Pq biliary strict dil s&i
|
$1,561.60 |
$1,561.60 |
$1,561.60 |
$1,102.53
|
|
Pq dr cath chg w cont s&i
|
$479.20 |
$479.20 |
$479.20 |
$721.71
|
|
Pq kyphplsty 1 bdy lumb w/img
|
$11,984.80 |
$11,984.80 |
$11,984.80 |
$10,195.00
|
|
Pq thr inj ext pse
|
$1,552.00 |
$1,552.00 |
$1,552.00 |
$786.66
|
|
Pq vrtbrplst 1 bdy inj crv-thr/lmb-scr w/img addl
|
$3,958.40 |
$3,958.40 |
$3,958.40 |
$2,975.00
|
|
Pq vrtbrplst 1 bdy inj crv-thr w/img ini
|
$5,879.20 |
$5,879.20 |
$5,879.20 |
$4,664.99
|
|
Pq vrtbrplst 1 bdy inj lmb-scr w/img ini
|
$5,344.00 |
$5,344.00 |
$5,344.00 |
$4,811.54
|
|
Pralatrexate injection
|
$14,055.04 |
$14,055.04 |
$14,055.04 |
$20,353.38
|
|
Pralidoxime 1 gram solution for injection
|
$160.43 |
$160.43 |
$160.43 |
$292.00
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$4,847.20 |
$4,847.20 |
$4,847.20 |
$3,738.90
|
|
Pr application of long arm splint
|
$272.00 |
$272.00 |
$272.00 |
$334.08
|
|
Pr application splint static short arm
|
$239.20 |
$239.20 |
$239.20 |
$288.51
|
|
Pr biopsy skin punch single lesion
|
$436.00 |
$436.00 |
$436.00 |
$458.25
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$56.80 |
$56.80 |
$56.80 |
$48.00
|
|
Prcrd drg 0-5yr or w/anomly
|
$2,196.80 |
$2,196.80 |
$2,196.80 |
$2,157.55
|
|
Prcrd drg 6+yr without anomly
|
$2,835.20 |
$2,835.20 |
$2,835.20 |
$2,253.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$3.40 |
$3.40 |
$3.40 |
$13.80
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$640.80 |
$640.80 |
$640.80 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$560.80 |
$560.80 |
$560.80 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$410.40 |
$410.40 |
$410.40 |
$459.00
|
|
Pressure velocity wire add ves
|
$870.40 |
$870.40 |
$870.40 |
$1,618.20
|
|
Pr excision benign lesion scalp/neck/hands/feet/genitalia <= 0.5 cm
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$1,917.33
|
|
Pr excision benign lesion trunk/arms/legs 3.1 - 4.0 cm
|
$2,472.00 |
$2,472.00 |
$2,472.00 |
$2,271.01
|
|
Pr excision nail/nail matrix partial/complete permanent removal
|
$640.80 |
$640.80 |
$640.80 |
$780.60
|
|
Prgrmg dev eval pm/ldls pm
|
$78.40 |
$78.40 |
$78.40 |
$139.10
|
|
Prgrmg dev eval scrms ip
|
$76.80 |
$76.80 |
$76.80 |
$139.10
|
|
Prgrmg eval implantable dfb
|
$94.40 |
$94.40 |
$94.40 |
$157.00
|
|
Prgrmg eval implantable dfb
|
$162.40 |
$162.40 |
$162.40 |
$181.35
|
|
Prgrmg eval implantable dfb
|
$124.00 |
$124.00 |
$124.00 |
$206.05
|
|
Prgr stim/pace a/iv drug
|
$11,396.00 |
$11,396.00 |
$11,396.00 |
$4,540.00
|
