|
Passy muir valve metal trach
|
$289.80 |
$289.80 |
$289.80 |
$275.75
|
|
Path clin consltj mod 21-40
|
$431.40 |
$431.40 |
$431.40 |
$202.78
|
|
Path clin consltj sf 5-20
|
$503.40 |
$503.40 |
$503.40 |
$97.14
|
|
Pcv21 vaccine im
|
$252.80 |
$252.80 |
$252.80 |
$410.26
|
|
Pdgfra gene
|
$1,648.80 |
$1,648.80 |
$1,648.80 |
$717.23
|
|
Pegaspargase injection
|
$12,652.20 |
$12,652.20 |
$12,652.20 |
$41,065.49
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$1,153.80 |
$1,153.80 |
$1,153.80 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$1,308.60 |
$1,308.60 |
$1,308.60 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$10,014.00 |
$10,014.00 |
$10,014.00 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$645.60 |
$645.60 |
$645.60 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,014.80 |
$2,014.80 |
$2,014.80 |
$4,133.25
|
|
Pegunigalsidase alfa-iwxj
|
$548.00 |
$548.00 |
$548.00 |
$2,146.13
|
|
Pelvic CT scan (with and without contrast)
|
$1,627.20 |
$1,627.20 |
$1,627.20 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,357.20 |
$1,357.20 |
$1,357.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,192.80 |
$1,192.80 |
$1,192.80 |
$1,333.20
|
|
Pelvic MRI (with and without contrast)
|
$2,604.00 |
$2,604.00 |
$2,604.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$1,699.20 |
$1,699.20 |
$1,699.20 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$1,699.20 |
$1,699.20 |
$1,699.20 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$589.80 |
$589.80 |
$589.80 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$436.80 |
$436.80 |
$436.80 |
$432.50
|
|
Pelvis X-ray (1 to 2 views)
|
$151.20 |
$151.20 |
$151.20 |
$282.00
|
|
Pelvis X-ray (complete, 4 or more views)
|
$187.80 |
$187.80 |
$187.80 |
$355.50
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$13,809.00 |
$13,809.00 |
$13,809.00 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$1,827.60 |
$1,827.60 |
$1,827.60 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$373.80 |
$373.80 |
$373.80 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$128.40 |
$128.40 |
$128.40 |
$97.85
|
|
Penile injection
|
$970.20 |
$970.20 |
$970.20 |
$418.86
|
|
Pentamidine non-comp unit
|
$498.40 |
$498.40 |
$498.40 |
$294.39
|
|
Perc cryo ablate renal tum
|
$17,461.80 |
$17,461.80 |
$17,461.80 |
$11,523.76
|
|
Perc d-e cor revasc chro sin
|
$10,182.60 |
$10,182.60 |
$10,182.60 |
$18,435.36
|
|
Perc d-e cor revasc t cabg b
|
$9,616.80 |
$9,616.80 |
$9,616.80 |
$11,976.00
|
|
Perc d-e cor revasc t cabg s
|
$10,182.60 |
$10,182.60 |
$10,182.60 |
$16,047.20
|
|
Perc d-e cor stent ather s
|
$10,520.40 |
$10,520.40 |
$10,520.40 |
$18,545.83
|
|
Perc drug-el cor stent bran
|
$9,616.80 |
$9,616.80 |
$9,616.80 |
$11,667.75
|
|
Perc drug-el cor stent sing
|
$10,182.60 |
$10,182.60 |
$10,182.60 |
$16,258.50
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$1,221.60 |
$1,221.60 |
$1,221.60 |
$332.84
|
|
Pericardiocentesis wwo imaging
|
$2,823.60 |
$2,823.60 |
$2,823.60 |
$2,418.99
|
|
Peripheral vascular rehab
|
$398.40 |
$398.40 |
$398.40 |
$132.50
|
|
Perq art m-thrombect &/nfs
|
$3,630.60 |
$3,630.60 |
$3,630.60 |
$7,559.55
|
|
Pertuzumab 30 mg/ml desensitization
|
$10,054.80 |
$10,054.80 |
$10,054.80 |
$14,272.91
|
|
Pertuzu, trastuzu, 10 mg
|
$327.60 |
$327.60 |
$327.60 |
$27,858.08
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$677.40 |
$677.40 |
$677.40 |
$141.60
|
|
Pet CT skull-mid thgh initial
|
$5,901.60 |
$5,901.60 |
$5,901.60 |
$4,707.00
|
|
Pet CT whole body initial
|
$6,894.60 |
$6,894.60 |
$6,894.60 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$4,077.60 |
$4,077.60 |
$4,077.60 |
$4,060.00
|
|
Pet image full body
|
$13,379.40 |
$13,379.40 |
$13,379.40 |
$5,148.14
|
|
Pet image ltd area
|
$10,294.80 |
$10,294.80 |
$10,294.80 |
$3,809.11
|
|
Pet image skull-thigh
|
$9,348.60 |
$9,348.60 |
$9,348.60 |
$4,589.00
|
|
Pet image w/ct lmtd
|
$4,341.60 |
$4,341.60 |
$4,341.60 |
$4,349.76
|
|
Pfc sigma fem post aug sz3 8mm
|
$19,252.20 |
$19,252.20 |
$19,252.20 |
$40,252.07
|
|
Ph body fluid
|
$93.60 |
$93.60 |
$93.60 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$45.20 |
$45.20 |
$45.20 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$148.80 |
$148.80 |
$148.80 |
$104.80
|
|
Phentolaine mesylate inj
|
$383.20 |
$383.20 |
$383.20 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$0.05 |
$0.05 |
$0.05 |
$62.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$406.20 |
$406.20 |
$406.20 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$180.60 |
$180.60 |
$180.60 |
$111.20
|
|
Phlebotomy therapeutic
|
$261.00 |
$261.00 |
$261.00 |
$231.87
|
|
Phosphorus
|
$61.80 |
$61.80 |
$61.80 |
$48.96
|
|
Phosphorus 24 hour urine
|
$30.60 |
$30.60 |
$30.60 |
$42.25
|
|
Phys blood bank serv reactj
|
$398.40 |
$398.40 |
$398.40 |
$207.50
|
|
Physical Therapy Evaluation (high complexity)
|
$216.00 |
$216.00 |
$216.00 |
$297.00
|
|
Physical Therapy Evaluation (low complexity)
|
$216.00 |
$216.00 |
$216.00 |
$224.95
|
|
Physical Therapy Evaluation (moderate complexity)
|
$216.00 |
$216.00 |
$216.00 |
$257.34
|
|
Physical Therapy Re-Evaluation
|
$113.40 |
$113.40 |
$113.40 |
$155.00
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$20.40 |
$20.40 |
$20.40 |
$89.82
|
|
Piflu f-18, dia 1 millicurie
|
$1,119.00 |
$1,119.00 |
$1,119.00 |
$1,038.40
|
|
Pin caspar distraction 12mm
|
$6,332.40 |
$6,332.40 |
$6,332.40 |
$11,672.88
|
|
Pinworm exam
|
$45.00 |
$45.00 |
$45.00 |
$39.00
|
|
Pinworm examinations
|
$69.60 |
$69.60 |
$69.60 |
$5.70
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$88.80 |
$88.80 |
$88.80 |
$81.36
|
|
Place cath xtrnl carotid
|
$6,011.40 |
$6,011.40 |
$6,011.40 |
$4,202.90
|
|
Place duod/jej tube perc
|
$4,937.40 |
$4,937.40 |
$4,937.40 |
$2,562.75
|
|
Place gastrostomy tube perc
|
$4,149.00 |
$4,149.00 |
$4,149.00 |
$2,308.95
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,150.20 |
$1,150.20 |
$1,150.20 |
$1,494.36
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$670.80 |
$670.80 |
$670.80 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$1,623.60 |
$1,623.60 |
$1,623.60 |
$3,946.56
|
|
Placement occlusive device venous/arterial access site post procedure
|
$759.00 |
$759.00 |
$759.00 |
$571.45
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$10,473.00 |
$10,473.00 |
$10,473.00 |
$13,879.25
|
|
Place non-slctv cath thoracic arta
|
$4,316.40 |
$4,316.40 |
$4,316.40 |
$5,274.33
|
|
Place slctv cath carotd art uni
|
$8,871.60 |
$8,871.60 |
$8,871.60 |
$10,150.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$6,202.80 |
$6,202.80 |
$6,202.80 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$8,171.40 |
$8,171.40 |
$8,171.40 |
$9,074.00
|
|
Place slctv cath subclavian art
|
$8,111.40 |
$8,111.40 |
$8,111.40 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$9,040.80 |
$9,040.80 |
$9,040.80 |
$9,200.62
|
|
Plasma cryoprecipitate reduced each unit
|
$189.00 |
$189.00 |
$189.00 |
$163.04
|
|
Platelet aggregation each agent teg
|
$120.00 |
$120.00 |
$120.00 |
$148.98
|
|
Platelet automated
|
$64.80 |
$64.80 |
$64.80 |
$45.76
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$1,556.40 |
$1,556.40 |
$1,556.40 |
$1,532.70
|
|
Platelets pheresis leukocytes reduced each unit
|
$1,444.20 |
$1,444.20 |
$1,444.20 |
$1,162.85
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,482.80 |
$2,482.80 |
$2,482.80 |
$1,288.20
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,405.80 |
$1,405.80 |
$1,405.80 |
$1,007.82
|
|
Plcmnt biliary drainage cath w/img ext
|
$4,482.60 |
$4,482.60 |
$4,482.60 |
$4,650.08
|
|
Plcmnt stent transcath ctrl dialysis seg add-on
|
$5,382.00 |
$5,382.00 |
$5,382.00 |
$6,927.20
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$4,641.60 |
$4,641.60 |
$4,641.60 |
$5,087.15
|
|
Plcmt dlyd xtn pros 1st vsl
|
$2,843.40 |
$2,843.40 |
$2,843.40 |
$3,793.50
|
|
Plcmt xtn pros evasc rpr per vsl
|
$1,302.00 |
$1,302.00 |
$1,302.00 |
$3,473.00
|
|
Plc pq device breast ea addl lesion stereo guide
|
$1,588.20 |
$1,588.20 |
$1,588.20 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$592.20 |
$592.20 |
$592.20 |
$758.52
|
