|
Nm imaging bone/joint whole body
|
$1,678.95 |
$1,678.95 |
$1,678.95 |
$1,736.40
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$2,313.35 |
$2,313.35 |
$2,313.35 |
$1,428.50
|
|
Nm imaging gastric emptying study
|
$2,689.70 |
$2,689.70 |
$2,689.70 |
$1,431.75
|
|
Nm imaging gastrointestinal acute blood loss
|
$3,013.40 |
$3,013.40 |
$3,013.40 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$2,859.35 |
$2,859.35 |
$2,859.35 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,962.35 |
$1,962.35 |
$1,962.35 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,893.45 |
$1,893.45 |
$1,893.45 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$2,011.10 |
$2,011.10 |
$2,011.10 |
$1,186.03
|
|
Nm radiopharmaceutical therapy oral administration
|
$2,201.55 |
$2,201.55 |
$2,201.55 |
$1,020.34
|
|
Non-card vasc flow imaging
|
$1,626.30 |
$1,626.30 |
$1,626.30 |
$608.56
|
|
Noninv pace analysis
|
$778.05 |
$778.05 |
$778.05 |
$761.60
|
|
Noonan spectrum disorders
|
$3,450.85 |
$3,450.85 |
$3,450.85 |
$2,357.96
|
|
Npm1 gene
|
$902.20 |
$902.20 |
$902.20 |
$430.95
|
|
Nras gene variants exon 2&3
|
$794.30 |
$794.30 |
$794.30 |
$554.45
|
|
Nr lnr acclrtr tx max 5 sessions
|
$5,177.25 |
$5,177.25 |
$5,177.25 |
$7,875.40
|
|
Ntrk translocation analysis
|
$2,813.20 |
$2,813.20 |
$2,813.20 |
$727.74
|
|
Ntsty modul rad tx dlvr cplx
|
$4,248.40 |
$4,248.40 |
$4,248.40 |
$2,590.00
|
|
Ntsty modul rad tx dlvr smpl
|
$4,248.40 |
$4,248.40 |
$4,248.40 |
$2,364.96
|
|
Nuclear rx intra-arterial
|
$1,777.10 |
$1,777.10 |
$1,777.10 |
$761.95
|
|
Nuclear rx IV admin
|
$2,193.75 |
$2,193.75 |
$2,193.75 |
$866.71
|
|
Nuclear Stress Test (Heart)
|
$3,829.15 |
$3,829.15 |
$3,829.15 |
$3,921.45
|
|
Nushield 1 square cm
|
$526.44 |
$526.44 |
$526.44 |
$2,342.13
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$24,320.50 |
$24,320.50 |
$24,320.50 |
$14,996.94
|
|
Observation direct referral from physician office for admission
|
$163.80 |
$163.80 |
$163.80 |
$411.10
|
|
Observation per hour
|
$71.50 |
$71.50 |
$71.50 |
$79.30
|
|
Obstetrics panel
|
$169.65 |
$169.65 |
$169.65 |
$204.80
|
|
Ob Ultrasound nuchal meas 1 gest
|
$648.70 |
$648.70 |
$648.70 |
$331.29
|
|
Ob Ultrasound nuchal meas add-on
|
$503.10 |
$503.10 |
$503.10 |
$243.29
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$55,706.88 |
$55,706.88 |
$55,706.88 |
$54,942.65
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$344.34 |
$344.34 |
$344.34 |
$73.13
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$21,711.85 |
$21,711.85 |
$21,711.85 |
$14,506.60
|
|
Olanzapine 10 mg intramuscular solution
|
$63.54 |
$63.54 |
$63.54 |
$122.78
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$4,797.94 |
$4,797.94 |
$4,797.94 |
$4,797.94
|
|
Oncoprotein dcp
|
$390.00 |
$390.00 |
$390.00 |
$167.75
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$22.62 |
$22.62 |
$22.62 |
$34.32
|
|
Open tenotomy tendon flexor foot single or multiple 28230
|
$2,015.00 |
$2,015.00 |
$2,015.00 |
$2,180.80
|
|
Opn impltj crnl nrv nea&pg
|
$30,989.40 |
$30,989.40 |
$30,989.40 |
$33,303.98
|
|
Oral aprepitant
|
$82.71 |
$82.71 |
$82.71 |
$374.43
|
|
Oral everolimus
|
$9.78 |
$9.78 |
$9.78 |
$33.34
|
|
Organic acids total quant ea spec
|
$638.95 |
$638.95 |
$638.95 |
$151.36
|
|
Oritavancin 400 mg intravenous solution
|
$3,513.35 |
$3,513.35 |
$3,513.35 |
$3,513.35
|
|
Oropharyngeal biopsy 42800
|
$637.65 |
$637.65 |
$637.65 |
$1,855.10
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$69.02 |
$69.02 |
$69.02 |
$65.07
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$563.04 |
$563.04 |
$563.04 |
$284.85
|
|
Ortho elbow w/lock w/ft&adj
|
$949.15 |
$949.15 |
$949.15 |
$717.62
|
|
Ortho ewhf rigd without jnt cstm w
|
$2,495.75 |
$2,495.75 |
$2,495.75 |
$782.70
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$1,458.18 |
$1,458.18 |
$1,458.18 |
$801.60
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$526.44 |
$526.44 |
$526.44 |
$213.39
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$656.22 |
$656.22 |
$656.22 |
$389.25
|
|
Ortho hnd without jnt w/fit&adj
|
$526.44 |
$526.44 |
$526.44 |
$240.24
|
|
Orthopantogram
|
$308.10 |
$308.10 |
$308.10 |
$219.22
|
|
Orthosis lso rigd frm hyperex
|
$841.90 |
$841.90 |
$841.90 |
$920.03
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$692.82 |
$692.82 |
$692.82 |
$269.58
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$1,931.38 |
$1,931.38 |
$1,931.38 |
$532.80
|
|
Oscillation chest wall mechanical per session
|
$128.05 |
$128.05 |
$128.05 |
$221.34
|
|
Osmolality blood
|
$61.75 |
$61.75 |
$61.75 |
$67.60
|
|
Osmolality urine
|
$61.75 |
$61.75 |
$61.75 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$287.95 |
$287.95 |
$287.95 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$258.05 |
$258.05 |
$258.05 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$280.15 |
$280.15 |
$280.15 |
$270.58
|
|
Oth resp proc, group
|
$176.15 |
$176.15 |
$176.15 |
$154.00
|
|
Oth resp proc, indiv
|
$60.45 |
$60.45 |
$60.45 |
$87.45
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$249.60 |
$249.60 |
$249.60 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$202.15 |
$202.15 |
$202.15 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$81.90 |
$81.90 |
$81.90 |
$107.32
|
|
Ot re-evaluation patient/family
|
$175.50 |
$175.50 |
$175.50 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$96.85 |
$96.85 |
$96.85 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$143.00 |
$143.00 |
$143.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$143.00 |
$143.00 |
$143.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$89.70 |
$89.70 |
$89.70 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$94.25 |
$94.25 |
$94.25 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$96.85 |
$96.85 |
$96.85 |
$93.75
|
|
Oxaliplatin 5 mg/ml desensitization
|
$153.63 |
$153.63 |
$153.63 |
$364.29
|
|
Oxytocin 10 unit/ml injection solution
|
$22.65 |
$22.65 |
$22.65 |
$45.86
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$147.03 |
$147.03 |
$147.03 |
$231.46
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$2,172.10 |
$2,172.10 |
$2,172.10 |
$4,014.63
|
|
Palb2 gene known famil vrnt
|
$1,437.15 |
$1,437.15 |
$1,437.15 |
$398.20
|
|
Paliperidone 117 mg/0.75 ml inj
|
$11,107.72 |
$11,107.72 |
$11,107.72 |
$6,493.54
|
|
Palonosetron hcl
|
$27.14 |
$27.14 |
$27.14 |
$372.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$105.98 |
$105.98 |
$105.98 |
$146.80
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$0.42 |
$0.42 |
$0.42 |
$18,554.59
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$29.60 |
$29.60 |
$29.60 |
$44.25
|
|
Papaverin hcl injection
|
$71.50 |
$71.50 |
$71.50 |
$76.40
|
|
Parathormone (pth) intact
|
$157.30 |
$157.30 |
$157.30 |
$200.23
|
|
Parathyrd planar w/spect&ct
|
$2,340.65 |
$2,340.65 |
$2,340.65 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,666.60 |
$1,666.60 |
$1,666.60 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$2,083.90 |
$2,083.90 |
$2,083.90 |
$1,398.75
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$91.65 |
$91.65 |
$91.65 |
$270.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$4,839.77 |
$4,839.77 |
$4,839.77 |
$4,418.62
|
|
Part removal of metatarsal
|
$546.00 |
$546.00 |
$546.00 |
$2,942.23
|
|
Passy muir valve metal trach
|
$145.09 |
$145.09 |
$145.09 |
$241.20
|
|
Pdgfra gene
|
$1,296.75 |
$1,296.75 |
$1,296.75 |
$659.20
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$16.86 |
$16.86 |
$16.86 |
$14.70
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$10,005.45 |
$10,005.45 |
$10,005.45 |
$12,556.80
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$5,495.20 |
$5,495.20 |
$5,495.20 |
$7,670.65
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$10,794.65 |
$10,794.65 |
$10,794.65 |
$8,382.81
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,458.74 |
$4,458.74 |
$4,458.74 |
$5,908.68
|
|
Pegloticase 8 mg/ml intravenous solution
|
$10,584.86 |
$10,584.86 |
$10,584.86 |
$41,940.84
|
|
Pelvic CT scan (with and without contrast)
|
$2,484.30 |
$2,484.30 |
$2,484.30 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$2,258.10 |
$2,258.10 |
$2,258.10 |
$1,669.00
|
