|
Nose (Nasal Bone) X-ray (complete)
|
$204.80 |
$204.80 |
$204.80 |
$274.65
|
|
Observation direct referral from physician office for admission
|
$210.40 |
$210.40 |
$210.40 |
$384.00
|
|
Observation per hour
|
$47.20 |
$47.20 |
$47.20 |
$82.50
|
|
Obstetrics panel
|
$303.20 |
$303.20 |
$303.20 |
$214.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$285.60 |
$285.60 |
$285.60 |
$357.00
|
|
Occupational Therapy Evaluation (high complexity)
|
$312.00 |
$312.00 |
$312.00 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$262.40 |
$262.40 |
$262.40 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$294.40 |
$294.40 |
$294.40 |
$263.90
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$3.06 |
$3.06 |
$3.06 |
$90.00
|
|
Olanzapine 10 mg intramuscular solution
|
$72.41 |
$72.41 |
$72.41 |
$109.62
|
|
Oncoprotein dcp
|
$156.80 |
$156.80 |
$156.80 |
$167.91
|
|
Ondansetron 4 mg s0119
|
$4.04 |
$4.04 |
$4.04 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$27.39 |
$27.39 |
$27.39 |
$22.62
|
|
Osmolality blood
|
$35.20 |
$35.20 |
$35.20 |
$70.85
|
|
Osmolality urine
|
$38.40 |
$38.40 |
$38.40 |
$65.52
|
|
Oth resp proc, group
|
$153.60 |
$153.60 |
$153.60 |
$126.00
|
|
Oth resp proc, indiv
|
$118.40 |
$118.40 |
$118.40 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$152.80 |
$152.80 |
$152.80 |
$97.80
|
|
Ot re-evaluation patient/family
|
$194.40 |
$194.40 |
$194.40 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$96.80 |
$96.80 |
$96.80 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$122.40 |
$122.40 |
$122.40 |
$93.12
|
|
Oxytocin 10 unit/ml injection solution
|
$26.65 |
$26.65 |
$26.65 |
$50.40
|
|
Paliperidone 117 mg/0.75 ml inj
|
$3,440.06 |
$3,440.06 |
$3,440.06 |
$6,238.82
|
|
Palonosetron hcl
|
$33.35 |
$33.35 |
$33.35 |
$163.00
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$27.71 |
$27.71 |
$27.71 |
$28.90
|
|
Parathormone (pth) intact
|
$212.00 |
$212.00 |
$212.00 |
$206.18
|
|
Partial removal of eye fluid
|
$2,403.20 |
$2,403.20 |
$2,403.20 |
$2,698.92
|
|
Pca3/klk3 antigen
|
$664.00 |
$664.00 |
$664.00 |
$510.40
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$4,800.69 |
$4,800.69 |
$4,800.69 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$2,502.00 |
$2,502.00 |
$2,502.00 |
$7,297.36
|
|
Pelvic CT scan (with and without contrast)
|
$2,460.00 |
$2,460.00 |
$2,460.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,152.80 |
$2,152.80 |
$2,152.80 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$3,784.00 |
$3,784.00 |
$3,784.00 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$2,567.20 |
$2,567.20 |
$2,567.20 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$548.80 |
$548.80 |
$548.80 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$512.80 |
$512.80 |
$512.80 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$220.00 |
$220.00 |
$220.00 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$400.80 |
$400.80 |
$400.80 |
$351.75
|
|
Pemivibart infusion
|
$783.20 |
$783.20 |
$783.20 |
$533.10
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$421.72 |
$421.72 |
$421.72 |
$824.70
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$244.80 |
$244.80 |
$244.80 |
$332.84
|
|
Ph body fluid
|
$34.40 |
$34.40 |
$34.40 |
$42.00
|
|
Phencyclidine (pcp)
|
$96.00 |
$96.00 |
$96.00 |
$96.39
|
|
Phenobarbital therapeutic drug level
|
$71.20 |
$71.20 |
$71.20 |
$105.00
|
|
Phenylephrine 10 mg/ml injection solution
|
$30.04 |
$30.04 |
$30.04 |
$62.98
|
|
Phenylep ketorolac opth soln
|
$592.00 |
$592.00 |
$592.00 |
$934.56
|
|
Phenytoin total therapeutic drug level
|
$82.40 |
$82.40 |
$82.40 |
$111.27
|
|
Phosphorus
|
$32.80 |
$32.80 |
$32.80 |
$49.20
|
|
Phosphorus 24 hour urine
|
$33.60 |
$33.60 |
$33.60 |
$42.25
|
|
Physical Therapy Evaluation (high complexity)
|
$312.00 |
$312.00 |
$312.00 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$262.40 |
$262.40 |
$262.40 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$294.40 |
$294.40 |
$294.40 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$181.60 |
$181.60 |
$181.60 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$94.70 |
$94.70 |
$94.70 |
$90.25
|
|
Pinworm exam
|
$29.60 |
$29.60 |
$29.60 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$32.95 |
$32.95 |
$32.95 |
$81.36
|
|
Place gastrostomy tube perc
|
$2,286.40 |
$2,286.40 |
$2,286.40 |
$2,289.60
|
|
Platelet aggregation each agent teg
|
$111.20 |
$111.20 |
$111.20 |
$148.98
|
|
Platelet automated
|
$31.20 |
$31.20 |
$31.20 |
$46.00
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,408.00 |
$1,408.00 |
$1,408.00 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$1,316.00 |
$1,316.00 |
$1,316.00 |
$1,284.80
|
|
Plethysmography lung volumes/airway resistance
|
$445.60 |
$445.60 |
$445.60 |
$408.05
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$105.60 |
$105.60 |
$105.60 |
$187.32
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,293.60 |
$4,293.60 |
$4,293.60 |
$3,790.61
|
|
Potassium 24 hour urine
|
$27.20 |
$27.20 |
$27.20 |
$51.17
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$92.00 |
$92.00 |
$92.00 |
$62.79
|
|
Potassium serum/plasma/whole blood
|
$36.80 |
$36.80 |
$36.80 |
$47.85
|
|
Pr application of long arm splint
|
$320.00 |
$320.00 |
$320.00 |
$332.75
|
|
Pr application splint static short arm
|
$285.60 |
$285.60 |
$285.60 |
$288.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$54.40 |
$54.40 |
$54.40 |
$48.00
|
|
Prealbumin
|
$59.20 |
$59.20 |
$59.20 |
$94.00
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$12.04 |
$12.04 |
$12.04 |
$13.87
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$554.40 |
$554.40 |
$554.40 |
$590.27
|
|
Pregnancy Ultrasound (first trimester)
|
$482.40 |
$482.40 |
$482.40 |
$539.37
|
|
Pregnancy Ultrasound (limited)
|
$505.60 |
$505.60 |
$505.60 |
$459.00
|
|
Pressure max expiratory/inspiratory
|
$150.40 |
$150.40 |
$150.40 |
$243.69
|
|
Pretreat rbc w chem/drugs reference
|
$51.20 |
$51.20 |
$51.20 |
$114.00
|
|
Pr incision & drainage abscess simple/single
|
$522.40 |
$522.40 |
$522.40 |
$467.85
|
|
Pr incision & drainage abscess vulva/perineal
|
$690.40 |
$690.40 |
$690.40 |
$543.84
|
|
Pr incision & removal foreign body subcutaneous tissues simple
|
$751.20 |
$751.20 |
$751.20 |
$592.62
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$3.36 |
$3.36 |
$3.36 |
$674.78
|
|
Procalcitonin
|
$96.00 |
$96.00 |
$96.00 |
$161.11
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$34.89 |
$34.89 |
$34.89 |
$38.48
|
|
Progesterone
|
$120.00 |
$120.00 |
$120.00 |
$116.00
|
|
Prolactin
|
$123.20 |
$123.20 |
$123.20 |
$123.50
|
|
Propofol infusion 10 mg/ml
|
$34.56 |
$34.56 |
$34.56 |
$73.36
|
|
Propranolol in ns IV syringe 0.1 mg/ml (neo/ped) - cnr
|
$27.52 |
$27.52 |
$27.52 |
$33.31
|
|
Protamine 10 mg/ml intravenous solution
|
$7.38 |
$7.38 |
$7.38 |
$56.70
|
|
Protein c activity
|
$83.20 |
$83.20 |
$83.20 |
$119.60
|
|
Protein electrophoretic fractionation & quantitation serum
|
$73.60 |
$73.60 |
$73.60 |
$84.00
|
|
Protein s total
|
$77.60 |
$77.60 |
$77.60 |
$85.10
|
|
Protein total 24 hour urine
|
$23.20 |
$23.20 |
$23.20 |
$52.50
|
|
Protein total body fluid
|
$52.00 |
$52.00 |
$52.00 |
$49.80
|
|
Protein total serum plasma whole blood
|
$33.60 |
$33.60 |
$33.60 |
$43.00
|
|
Prothrombin complex kcentra
|
$1,136.40 |
$1,136.40 |
$1,136.40 |
$6.98
|
|
Pr removal foreign body external auditory canal without anesthesia
|
$230.40 |
$230.40 |
$230.40 |
$252.00
|
|
Pr repair intermediate wounds scalp/axillae/trunk/extremities 2.6 - 7.5 cm
|
$828.00 |
$828.00 |
$828.00 |
$711.48
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb <= 2.5 cm
|
$355.20 |
$355.20 |
$355.20 |
$380.40
|
|
Pr repair sprfcl wd simple face/ears/eyelids/nose/lips/muc memb 2.6-5.0 cm
|
$321.60 |
$321.60 |
$321.60 |
$406.35
|