|
Oil silicone ophth 8.5ml silikon 1000
|
$2,624.22 |
$2,624.22 |
$2,624.22 |
$1,195.75
|
|
Olanzapine 10 mg intramuscular solution
|
$126.66 |
$126.66 |
$126.66 |
$109.58
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$12,724.74 |
$12,724.74 |
$12,724.74 |
$4,781.43
|
|
Oncoprotein her-2/neu
|
$383.40 |
$383.40 |
$383.40 |
$161.60
|
|
Ondansetron 8 mg disintegrating tablet
|
$3.00 |
$3.00 |
$3.00 |
$8.40
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$6.00 |
$6.00 |
$6.00 |
$22.62
|
|
Opn mpltj hpglsl nstm ary pg
|
$91,960.25 |
$91,960.25 |
$91,960.25 |
$36,076.18
|
|
Optx clavicular fx w/int fix
|
$31,690.07 |
$31,690.07 |
$31,690.07 |
$8,819.16
|
|
Oral aprepitant
|
$489.12 |
$489.12 |
$489.12 |
$410.20
|
|
Organic acids total quant ea spec
|
$114.60 |
$114.60 |
$114.60 |
$151.36
|
|
Oritavancin 1,200 mg intravenous solution
|
$24,080.04 |
$24,080.04 |
$24,080.04 |
$11,017.26
|
|
Oritavancin 400 mg intravenous solution
|
$5,014.74 |
$5,014.74 |
$5,014.74 |
$3,186.36
|
|
Ortho dvc repair per 15 min
|
$590.45 |
$590.45 |
$590.45 |
$44.80
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$621.81 |
$621.81 |
$621.81 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$1,466.94 |
$1,466.94 |
$1,466.94 |
$504.00
|
|
Ortho ewhf rigd without jnt cstm w
|
$2,761.15 |
$2,761.15 |
$2,761.15 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$457.80 |
$457.80 |
$457.80 |
$714.59
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$583.18 |
$583.18 |
$583.18 |
$213.39
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$691.69 |
$691.69 |
$691.69 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$227.39 |
$227.39 |
$227.39 |
$162.99
|
|
Ortho hnd without jnt w/fit&adj
|
$583.18 |
$583.18 |
$583.18 |
$225.00
|
|
Orthopedic shoe add rub insl
|
$69.17 |
$69.17 |
$69.17 |
$70.18
|
|
Ortho shoe add leather insol
|
$69.17 |
$69.17 |
$69.17 |
$69.17
|
|
Ortho shoe add march bar
|
$99.25 |
$99.25 |
$99.25 |
$99.25
|
|
Orthosis lso rigd frm hyperex
|
$1,306.86 |
$1,306.86 |
$1,306.86 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$767.06 |
$767.06 |
$767.06 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$2,135.43 |
$2,135.43 |
$2,135.43 |
$645.00
|
|
Oscillation chest wall mechanical per session
|
$426.00 |
$426.00 |
$426.00 |
$195.00
|
|
O shoe add horseshoe toe tap
|
$54.11 |
$54.11 |
$54.11 |
$54.11
|
|
O shoe add instep extension
|
$201.67 |
$201.67 |
$201.67 |
$201.67
|
|
O shoe add instep velcro clo
|
$153.46 |
$153.46 |
$153.46 |
$153.46
|
|
O shoe add standard toe tap
|
$21.15 |
$21.15 |
$21.15 |
$21.15
|
|
O shoe convert to sof counte
|
$126.41 |
$126.41 |
$126.41 |
$126.41
|
|
Osmolality blood
|
$90.00 |
$90.00 |
$90.00 |
$69.55
|
|
Osmolality urine
|
$64.20 |
$64.20 |
$64.20 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$213.00 |
$213.00 |
$213.00 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$191.40 |
$191.40 |
$191.40 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$180.60 |
$180.60 |
$180.60 |
$263.50
|
|
Other immunoelectrophoresis
|
$33.60 |
$33.60 |
$33.60 |
$107.52
|
|
Oth resp proc, group
|
$274.80 |
$274.80 |
$274.80 |
$127.40
|
|
Oth resp proc, indiv
|
$109.20 |
$109.20 |
$109.20 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$81.00 |
$81.00 |
$81.00 |
$98.62
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$71.40 |
$71.40 |
$71.40 |
$104.50
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$66.60 |
$66.60 |
$66.60 |
$105.00
|
|
Ot re-evaluation patient/family
|
$88.80 |
$88.80 |
$88.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$55.80 |
$55.80 |
$55.80 |
$98.90
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$113.40 |
$113.40 |
$113.40 |
$86.65
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$113.40 |
$113.40 |
$113.40 |
$91.20
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$63.60 |
$63.60 |
$63.60 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$66.00 |
$66.00 |
$66.00 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$80.40 |
$80.40 |
$80.40 |
$93.60
|
|
Outrigger
|
$123.81 |
$123.81 |
$123.81 |
$123.81
|
|
Outrigger bil with vert extens
|
$414.44 |
$414.44 |
$414.44 |
$414.44
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$65,474.29 |
$65,474.29 |
$65,474.29 |
$47,880.00
|
|
Palb2 gene full gene seq
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$649.44
|
|
Palingen or palingen xplus
|
$15,246.72 |
$15,246.72 |
$15,246.72 |
$656.01
|
|
Paliperidone 117 mg/0.75 ml inj
|
$7,709.28 |
$7,709.28 |
$7,709.28 |
$6,272.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$145.62 |
$145.62 |
$145.62 |
$129.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$22.92 |
$22.92 |
$22.92 |
$27.16
|
|
Parathormone (pth) intact
|
$280.80 |
$280.80 |
$280.80 |
$201.50
|
|
Parathyrd planar w/spect&ct
|
$962.40 |
$962.40 |
$962.40 |
$1,555.00
|
|
Parathyroid planar imaging
|
$496.20 |
$496.20 |
$496.20 |
$1,073.82
|
|
Parathyroid planar img w/tomo spect
|
$962.40 |
$962.40 |
$962.40 |
$1,345.00
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$285.60 |
$285.60 |
$285.60 |
$242.88
|
|
Partial removal finger bone
|
$3,034.80 |
$3,034.80 |
$3,034.80 |
$1,964.00
|
|
Partial removal of thyroid
|
$24,006.20 |
$24,006.20 |
$24,006.20 |
$6,376.26
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$11,494.09 |
$11,494.09 |
$11,494.09 |
$4,706.31
|
|
Passy muir valve metal trach
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$275.75
|
|
Path clin consltj sf 5-20
|
$133.80 |
$133.80 |
$133.80 |
$82.15
|
|
Patten bottom
|
$757.24 |
$757.24 |
$757.24 |
$757.24
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$54.11 |
$54.11 |
$54.11 |
$44.97
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$27,725.76 |
$27,725.76 |
$27,725.76 |
$11,216.31
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$9,018.06 |
$9,018.06 |
$9,018.06 |
$4,133.25
|
|
Pelv band/spread bar thigh c
|
$1,120.07 |
$1,120.07 |
$1,120.07 |
$802.87
|
|
Pelvic control band & belt b
|
$743.50 |
$743.50 |
$743.50 |
$743.50
|
|
Pelvic control band & belt u
|
$547.83 |
$547.83 |
$547.83 |
$547.83
|
|
Pelvic control hip heavy dut
|
$591.53 |
$591.53 |
$591.53 |
$591.53
|
|
Pelvic control pelvic sling
|
$1,026.80 |
$1,026.80 |
$1,026.80 |
$1,026.80
|
|
Pelvic CT scan (with and without contrast)
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$1,899.75
|
|
Pelvic CT scan (with contrast)
|
$1,265.40 |
$1,265.40 |
$1,265.40 |
$1,635.62
|
|
Pelvic CT scan (without contrast)
|
$1,068.00 |
$1,068.00 |
$1,068.00 |
$1,366.50
|
|
Pelvic & hip control thigh c
|
$2,512.27 |
$2,512.27 |
$2,512.27 |
$2,512.27
|
|
Pelvic Ultrasound (complete)
|
$732.60 |
$732.60 |
$732.60 |
$650.40
|
|
Pelvic Ultrasound (limited)
|
$122.40 |
$122.40 |
$122.40 |
$430.00
|
|
Pelv & thor control gluteal
|
$327.43 |
$327.43 |
$327.43 |
$327.43
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$20,619.30 |
$20,619.30 |
$20,619.30 |
$6,202.54
|
|
Peng benzathine/procaine inj
|
$1,050.30 |
$1,050.30 |
$1,050.30 |
$338.23
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,594.26 |
$1,594.26 |
$1,594.26 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$57.42 |
$57.42 |
$57.42 |
$97.85
|
|
Penile rear tip xtnd 0.5cm
|
$31,123.99 |
$31,123.99 |
$31,123.99 |
$18,349.50
|
|
Pentamidine non-comp unit
|
$406.08 |
$406.08 |
$406.08 |
$279.76
|
|
Perc cryo ablate renal tum
|
$8,894.40 |
$8,894.40 |
$8,894.40 |
$11,458.04
|
|
Permanent tear duct plug
|
$301.79 |
$301.79 |
$301.79 |
$262.41
|
|
Peroneal straps pair pre ots
|
$40.44 |
$40.44 |
$40.44 |
$40.44
|
|
Perq dev breast 1st mr guide
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$1,871.40 |
$1,871.40 |
$1,871.40 |
$1,456.00
|
|
Perq nl/pl lithotrp cplx>2cm
|
$39,858.48 |
$39,858.48 |
$39,858.48 |
$10,114.58
|
|
Perq nl/pl lithotrp smpl<2cm
|
$36,476.65 |
$36,476.65 |
$36,476.65 |
$8,748.48
|
|
Perq plmt bile duct stent
|
$12,962.40 |
$12,962.40 |
$12,962.40 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$10,801.20 |
$10,801.20 |
$10,801.20 |
$6,870.89
|
