|
Ot evaluation low complexity patient/family
|
$338.40 |
$338.40 |
$338.40 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$398.40 |
$398.40 |
$398.40 |
$263.50
|
|
Other immunoelectrophoresis
|
$374.40 |
$374.40 |
$374.40 |
$107.52
|
|
Oth resp proc, group
|
$220.80 |
$220.80 |
$220.80 |
$123.05
|
|
Oth resp proc, indiv
|
$433.20 |
$433.20 |
$433.20 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$127.20 |
$127.20 |
$127.20 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$194.40 |
$194.40 |
$194.40 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$167.40 |
$167.40 |
$167.40 |
$105.00
|
|
Ot re-evaluation patient/family
|
$189.00 |
$189.00 |
$189.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$172.80 |
$172.80 |
$172.80 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$42.00 |
$42.00 |
$42.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$42.00 |
$42.00 |
$42.00 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$181.20 |
$181.20 |
$181.20 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$167.40 |
$167.40 |
$167.40 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$167.40 |
$167.40 |
$167.40 |
$94.25
|
|
Outrigger
|
$123.81 |
$123.81 |
$123.81 |
$123.81
|
|
Outrigger bil with vert extens
|
$414.44 |
$414.44 |
$414.44 |
$378.67
|
|
Oxaliplatin 5 mg/ml desensitization
|
$75.00 |
$75.00 |
$75.00 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$50.04 |
$50.04 |
$50.04 |
$50.04
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$65,474.29 |
$65,474.29 |
$65,474.29 |
$47,880.00
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$111.60 |
$111.60 |
$111.60 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$6,097.02 |
$6,097.02 |
$6,097.02 |
$3,435.42
|
|
Palingen or palingen xplus
|
$15,246.72 |
$15,246.72 |
$15,246.72 |
$656.01
|
|
Paliperidone 117 mg/0.75 ml inj
|
$6,713.52 |
$6,713.52 |
$6,713.52 |
$6,238.82
|
|
Palonosetron hcl
|
$75.00 |
$75.00 |
$75.00 |
$168.43
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$62.82 |
$62.82 |
$62.82 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$6,739.38 |
$6,739.38 |
$6,739.38 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$21.30 |
$21.30 |
$21.30 |
$28.70
|
|
Papaverin hcl injection
|
$90.12 |
$90.12 |
$90.12 |
$76.40
|
|
Parathormone (pth) intact
|
$314.40 |
$314.40 |
$314.40 |
$201.50
|
|
Parathyrd planar w/spect&ct
|
$947.40 |
$947.40 |
$947.40 |
$1,574.40
|
|
Parathyroid planar imaging
|
$817.20 |
$817.20 |
$817.20 |
$1,126.25
|
|
Parathyroid planar img w/tomo spect
|
$888.60 |
$888.60 |
$888.60 |
$1,350.00
|
|
Paricalcitol
|
$65.94 |
$65.94 |
$65.94 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$366.00 |
$366.00 |
$366.00 |
$245.00
|
|
Partial removal finger bone
|
$5,843.46 |
$5,843.46 |
$5,843.46 |
$2,049.27
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$11,494.09 |
$11,494.09 |
$11,494.09 |
$4,921.76
|
|
Passy muir valve metal trach
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$275.75
|
|
Patten bottom
|
$757.24 |
$757.24 |
$757.24 |
$672.73
|
|
Pca3/klk3 antigen
|
$873.00 |
$873.00 |
$873.00 |
$510.40
|
|
Pdgfra gene
|
$873.00 |
$873.00 |
$873.00 |
$717.23
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$54.11 |
$54.11 |
$54.11 |
$49.45
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$24,144.48 |
$24,144.48 |
$24,144.48 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$15,706.38 |
$15,706.38 |
$15,706.38 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$7,853.22 |
$7,853.22 |
$7,853.22 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$9,405.06 |
$9,405.06 |
$9,405.06 |
$4,067.80
|
|
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 |
$566.16
|
|
Pelvic control band & belt u
|
$547.83 |
$547.83 |
$547.83 |
$500.58
|
|
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 |
$781.87
|
|
Pelvic CT scan (with and without contrast)
|
$1,842.60 |
$1,842.60 |
$1,842.60 |
$1,887.84
|
|
Pelvic CT scan (with contrast)
|
$1,700.40 |
$1,700.40 |
$1,700.40 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,512.00 |
$1,512.00 |
$1,512.00 |
$1,362.00
|
|
Pelvic & hip control thigh c
|
$2,512.27 |
$2,512.27 |
$2,512.27 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$3,306.60 |
$3,306.60 |
$3,306.60 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,856.00 |
$2,856.00 |
$2,856.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,605.20 |
$2,605.20 |
$2,605.20 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$1,032.00 |
$1,032.00 |
$1,032.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$417.60 |
$417.60 |
$417.60 |
$430.00
|
|
Pelv & thor control gluteal
|
$327.43 |
$327.43 |
$327.43 |
$299.21
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$22,378.38 |
$22,378.38 |
$22,378.38 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$201.24 |
$201.24 |
$201.24 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$914.64 |
$914.64 |
$914.64 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,388.34 |
$1,388.34 |
$1,388.34 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$221.34 |
$221.34 |
$221.34 |
$101.34
|
|
Penile rear tip xtnd 0.5cm
|
$31,123.99 |
$31,123.99 |
$31,123.99 |
$18,764.94
|
|
Pentamidine 300 mg solution for injection
|
$726.00 |
$726.00 |
$726.00 |
$453.61
|
|
Pentamidine non-comp unit
|
$726.00 |
$726.00 |
$726.00 |
$294.39
|
|
Perc rf ablate renal tumor
|
$4,675.80 |
$4,675.80 |
$4,675.80 |
$7,243.60
|
|
Percut ablate liver rf
|
$5,268.60 |
$5,268.60 |
$5,268.60 |
$6,904.15
|
|
Perit-vens shunt pat tst
|
$1,090.80 |
$1,090.80 |
$1,090.80 |
$752.49
|
|
Permanent tear duct plug
|
$301.79 |
$301.79 |
$301.79 |
$291.00
|
|
Peroneal straps pair pre ots
|
$40.44 |
$40.44 |
$40.44 |
$36.90
|
|
Pertussis ag if
|
$128.40 |
$128.40 |
$128.40 |
$69.05
|
|
Pertuzumab 30 mg/ml desensitization
|
$25,372.26 |
$25,372.26 |
$25,372.26 |
$13,666.00
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$252.05 |
$252.05 |
$252.05 |
$141.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$112,395.34 |
$112,395.34 |
$112,395.34 |
$38,883.60
|
|
Ph1 assmt&mgmt nqhp 11-20
|
$52.80 |
$52.80 |
$52.80 |
$60.80
|
|
Ph1 assmt&mgmt nqhp 21-30
|
$78.00 |
$78.00 |
$78.00 |
$91.50
|
|
Ph1 assmt&mgmt nqhp 5-10
|
$27.00 |
$27.00 |
$27.00 |
$33.30
|
|
Ph body fluid
|
$95.40 |
$95.40 |
$95.40 |
$41.28
|
|
Phencyclidine (pcp)
|
$78.00 |
$78.00 |
$78.00 |
$95.55
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$95.70 |
$95.70 |
$95.70 |
$112.16
|
|
Phenobarbital therapeutic drug level
|
$157.80 |
$157.80 |
$157.80 |
$104.25
|
|
Phenylephrine 10 mg/ml injection solution
|
$7.50 |
$7.50 |
$7.50 |
$67.89
|
|
Phenylep ketorolac opth soln
|
$2,053.20 |
$2,053.20 |
$2,053.20 |
$934.56
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$7.50 |
$7.50 |
$7.50 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$129.00 |
$129.00 |
$129.00 |
$110.88
|
|
Phlebotomy therapeutic
|
$196.80 |
$196.80 |
$196.80 |
$231.66
|
|
Phosphorus
|
$57.00 |
$57.00 |
$57.00 |
$47.81
|
|
Phosphorus 24 hour urine
|
$76.80 |
$76.80 |
$76.80 |
$40.95
|
|
Phys blood bank serv reactj
|
$129.00 |
$129.00 |
$129.00 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$42.66 |
$42.66 |
$42.66 |
$87.50
|
|
Pik3ca gene trgt seq alys
|
$463.20 |
$463.20 |
$463.20 |
$463.20
|
|
Pillow shldr abduc inflat univ
|
$1,717.48 |
$1,717.48 |
$1,717.48 |
$543.52
|
|
Pin caspar distraction 12mm
|
$24,142.82 |
$24,142.82 |
$24,142.82 |
$11,925.00
|
|
Pinworm exam
|
$30.00 |
$30.00 |
$30.00 |
$39.67
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$29.88 |
$29.88 |
$29.88 |
$83.03
|
|
Place gastrostomy tube perc
|
$1,564.20 |
$1,564.20 |
$1,564.20 |
$2,289.60
|
