|
Onco (ovar) five proteins
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$986.70
|
|
Ondansetron 8 mg disintegrating tablet
|
$9.30 |
$9.30 |
$9.30 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$9.00 |
$9.00 |
$9.00 |
$22.62
|
|
One-way allow prorated trip
|
$5.40 |
$5.40 |
$5.40 |
$18.57
|
|
Optx clavicular fx w/int fix
|
$27,236.49 |
$27,236.49 |
$27,236.49 |
$9,013.88
|
|
Organic acids total quant ea spec
|
$97.20 |
$97.20 |
$97.20 |
$151.36
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$47.52 |
$47.52 |
$47.52 |
$50.63
|
|
Ortho dvc repair per 15 min
|
$645.69 |
$645.69 |
$645.69 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$679.99 |
$679.99 |
$679.99 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$1,604.18 |
$1,604.18 |
$1,604.18 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$3,019.48 |
$3,019.48 |
$3,019.48 |
$1,288.00
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$637.74 |
$637.74 |
$637.74 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$756.41 |
$756.41 |
$756.41 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$248.66 |
$248.66 |
$248.66 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$637.74 |
$637.74 |
$637.74 |
$231.00
|
|
Orthopedic shoe add rub insl
|
$75.65 |
$75.65 |
$75.65 |
$70.40
|
|
Ortho shoe add leather insol
|
$75.65 |
$75.65 |
$75.65 |
$63.22
|
|
Ortho shoe add march bar
|
$108.53 |
$108.53 |
$108.53 |
$90.66
|
|
Orthosis lso rigd frm hyperex
|
$1,429.13 |
$1,429.13 |
$1,429.13 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$838.82 |
$838.82 |
$838.82 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$2,335.22 |
$2,335.22 |
$2,335.22 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$265.80 |
$265.80 |
$265.80 |
$195.00
|
|
O shoe add horseshoe toe tap
|
$59.17 |
$59.17 |
$59.17 |
$49.45
|
|
O shoe add instep extension
|
$220.54 |
$220.54 |
$220.54 |
$201.67
|
|
O shoe add instep velcro clo
|
$167.82 |
$167.82 |
$167.82 |
$140.22
|
|
O shoe add standard toe tap
|
$23.13 |
$23.13 |
$23.13 |
$19.38
|
|
O shoe convert to sof counte
|
$138.23 |
$138.23 |
$138.23 |
$115.53
|
|
Osmolality blood
|
$37.80 |
$37.80 |
$37.80 |
$67.60
|
|
Osmolality urine
|
$54.00 |
$54.00 |
$54.00 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$193.80 |
$193.80 |
$193.80 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$147.60 |
$147.60 |
$147.60 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$170.40 |
$170.40 |
$170.40 |
$263.50
|
|
Oth resp proc, group
|
$88.80 |
$88.80 |
$88.80 |
$123.05
|
|
Oth resp proc, indiv
|
$124.80 |
$124.80 |
$124.80 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$57.60 |
$57.60 |
$57.60 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$89.40 |
$89.40 |
$89.40 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$70.20 |
$70.20 |
$70.20 |
$105.00
|
|
Ot re-evaluation patient/family
|
$97.80 |
$97.80 |
$97.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$73.20 |
$73.20 |
$73.20 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$51.00 |
$51.00 |
$51.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$39.00 |
$39.00 |
$39.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$79.20 |
$79.20 |
$79.20 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$64.80 |
$64.80 |
$64.80 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$64.80 |
$64.80 |
$64.80 |
$94.25
|
|
Outrigger
|
$135.40 |
$135.40 |
$135.40 |
$123.81
|
|
Outrigger bil with vert extens
|
$453.22 |
$453.22 |
$453.22 |
$378.67
|
|
Oxaliplatin 5 mg/ml desensitization
|
$119.28 |
$119.28 |
$119.28 |
$370.75
|
|
Pabpn1 gene detc abnor allel
|
$417.60 |
$417.60 |
$417.60 |
$225.42
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$71,600.02 |
$71,600.02 |
$71,600.02 |
$47,880.00
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$99.42 |
$99.42 |
$99.42 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$4,711.74 |
$4,711.74 |
$4,711.74 |
$3,435.42
|
|
Palb2 gene full gene seq
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$672.50
|
|
Palingen or palingen xplus
|
$16,673.19 |
$16,673.19 |
$16,673.19 |
$656.01
|
|
Palonosetron hcl
|
$90.00 |
$90.00 |
$90.00 |
$170.48
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$21,609.42 |
$21,609.42 |
$21,609.42 |
$13,051.61
|
|
Parathormone (pth) intact
|
$129.60 |
$129.60 |
$129.60 |
$204.87
|
|
Parathyroid planar imaging
|
$1,264.80 |
$1,264.80 |
$1,264.80 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,350.60 |
$1,350.60 |
$1,350.60 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$135.00 |
$135.00 |
$135.00 |
$245.00
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$32,978.80 |
$32,978.80 |
$32,978.80 |
$4,914.00
|
|
Partial removal finger bone
|
$2,692.80 |
$2,692.80 |
$2,692.80 |
$2,049.27
|
|
Partial removal leg bone(s)
|
$375.00 |
$375.00 |
$375.00 |
$4,315.20
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$12,569.46 |
$12,569.46 |
$12,569.46 |
$4,921.76
|
|
Passy muir valve metal trach
|
$1,152.17 |
$1,152.17 |
$1,152.17 |
$275.75
|
|
Patten bottom
|
$828.09 |
$828.09 |
$828.09 |
$672.73
|
|
Pca3/klk3 antigen
|
$1,855.20 |
$1,855.20 |
$1,855.20 |
$510.40
|
|
Pcv21 vaccine im
|
$582.60 |
$582.60 |
$582.60 |
$410.26
|
|
Pdgfra gene
|
$1,855.20 |
$1,855.20 |
$1,855.20 |
$717.23
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$59.17 |
$59.17 |
$59.17 |
$49.45
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$15,287.70 |
$15,287.70 |
$15,287.70 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$9,944.88 |
$9,944.88 |
$9,944.88 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,972.44 |
$4,972.44 |
$4,972.44 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$5,955.06 |
$5,955.06 |
$5,955.06 |
$4,067.80
|
|
Pelv band/spread bar thigh c
|
$1,224.86 |
$1,224.86 |
$1,224.86 |
$802.87
|
|
Pelvic control band & belt b
|
$813.05 |
$813.05 |
$813.05 |
$566.16
|
|
Pelvic control band & belt u
|
$599.09 |
$599.09 |
$599.09 |
$500.58
|
|
Pelvic control hip heavy dut
|
$646.87 |
$646.87 |
$646.87 |
$591.53
|
|
Pelvic control pelvic sling
|
$1,122.87 |
$1,122.87 |
$1,122.87 |
$912.18
|
|
Pelvic CT scan (with and without contrast)
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,708.20 |
$1,708.20 |
$1,708.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,008.60 |
$1,008.60 |
$1,008.60 |
$1,363.11
|
|
Pelvic & hip control thigh c
|
$2,747.32 |
$2,747.32 |
$2,747.32 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$5,301.60 |
$5,301.60 |
$5,301.60 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,073.20 |
$3,073.20 |
$3,073.20 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,137.80 |
$2,137.80 |
$2,137.80 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$645.00 |
$645.00 |
$645.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$696.60 |
$696.60 |
$696.60 |
$430.00
|
|
Pelv & thor control gluteal
|
$358.06 |
$358.06 |
$358.06 |
$299.21
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$17,938.80 |
$17,938.80 |
$17,938.80 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$12,056.28 |
$12,056.28 |
$12,056.28 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$879.06 |
$879.06 |
$879.06 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$50.40 |
$50.40 |
$50.40 |
$101.34
|
|
Penile rear tip xtnd 0.5cm
|
$34,035.92 |
$34,035.92 |
$34,035.92 |
$18,764.94
|
|
Pericardiotomy/clot/for bod remove 33020
|
$1,696.80 |
$1,696.80 |
$1,696.80 |
$1,797.00
|
|
Peri-proc device eval icd
|
$37.20 |
$37.20 |
$37.20 |
$192.40
|
|
Permanent tear duct plug
|
$330.02 |
$330.02 |
$330.02 |
$291.00
|
|
Peroneal straps pair pre ots
|
$44.22 |
$44.22 |
$44.22 |
$36.90
|
|
Perq dev breast 1st strtctc
|
$1,477.20 |
$1,477.20 |
$1,477.20 |
$1,456.00
|
|
Pertussis ag if
|
$70.80 |
$70.80 |
$70.80 |
$69.05
|
|
Pertuzumab 30 mg/ml desensitization
|
$20,338.74 |
$20,338.74 |
$20,338.74 |
$13,666.00
|
