|
Obstetrics panel
|
$190.00 |
$190.00 |
$190.00 |
$214.50
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$47,087.40 |
$47,087.40 |
$47,087.40 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$9.20 |
$9.20 |
$9.20 |
$90.00
|
|
Olanzapine 10 mg intramuscular solution
|
$46.20 |
$46.20 |
$46.20 |
$109.58
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$13.20 |
$13.20 |
$13.20 |
$22.62
|
|
Organic acids total quant ea spec
|
$118.40 |
$118.40 |
$118.40 |
$151.36
|
|
Ortho dvc repair per 15 min
|
$158.40 |
$158.40 |
$158.40 |
$53.43
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$157.60 |
$157.60 |
$157.60 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$148.00 |
$148.00 |
$148.00 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$283.20 |
$283.20 |
$283.20 |
$310.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$454.40 |
$454.40 |
$454.40 |
$420.76
|
|
Oscillation chest wall mechanical per session
|
$612.80 |
$612.80 |
$612.80 |
$195.00
|
|
Osmolality blood
|
$33.60 |
$33.60 |
$33.60 |
$67.60
|
|
Osmolality urine
|
$34.40 |
$34.40 |
$34.40 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$576.00 |
$576.00 |
$576.00 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$335.20 |
$335.20 |
$335.20 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$440.00 |
$440.00 |
$440.00 |
$263.50
|
|
Oth resp proc, group
|
$288.80 |
$288.80 |
$288.80 |
$123.05
|
|
Oth resp proc, indiv
|
$140.00 |
$140.00 |
$140.00 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$84.00 |
$84.00 |
$84.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$156.00 |
$156.00 |
$156.00 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$140.00 |
$140.00 |
$140.00 |
$105.00
|
|
Ot re-evaluation patient/family
|
$206.40 |
$206.40 |
$206.40 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$187.20 |
$187.20 |
$187.20 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$162.40 |
$162.40 |
$162.40 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$162.40 |
$162.40 |
$162.40 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$160.00 |
$160.00 |
$160.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$170.40 |
$170.40 |
$170.40 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$162.40 |
$162.40 |
$162.40 |
$94.25
|
|
Oxytocin 10 unit/ml injection solution
|
$6.00 |
$6.00 |
$6.00 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$225.60 |
$225.60 |
$225.60 |
$216.00
|
|
Palonosetron hcl
|
$56.20 |
$56.20 |
$56.20 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$47.60 |
$47.60 |
$47.60 |
$128.07
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$21.40 |
$21.40 |
$21.40 |
$29.31
|
|
Papaverin hcl injection
|
$50.60 |
$50.60 |
$50.60 |
$77.05
|
|
Parathormone (pth) intact
|
$248.80 |
$248.80 |
$248.80 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$2,225.60 |
$2,225.60 |
$2,225.60 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$1,129.91
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$479.20 |
$479.20 |
$479.20 |
$245.00
|
|
Passy muir valve metal trach
|
$136.80 |
$136.80 |
$136.80 |
$275.75
|
|
Pelvic CT scan (with contrast)
|
$475.50 |
$475.50 |
$475.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$281.00 |
$281.00 |
$281.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$706.00 |
$706.00 |
$706.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$639.00 |
$639.00 |
$639.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$455.50 |
$455.50 |
$455.50 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$517.60 |
$517.60 |
$517.60 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$468.00 |
$468.00 |
$468.00 |
$430.00
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$57.20 |
$57.20 |
$57.20 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$979.60 |
$979.60 |
$979.60 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$49.80 |
$49.80 |
$49.80 |
$101.34
|
|
Penile injection
|
$490.40 |
$490.40 |
$490.40 |
$418.00
|
|
Perc cryo ablate renal tum
|
$13,924.80 |
$13,924.80 |
$13,924.80 |
$11,458.04
|
|
Perc d-e cor revasc chro sin
|
$35,649.60 |
$35,649.60 |
$35,649.60 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$9,396.00 |
$9,396.00 |
$9,396.00 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$23,046.40 |
$23,046.40 |
$23,046.40 |
$16,047.20
|
|
Perc drug-el cor stent bran
|
$8,457.60 |
$8,457.60 |
$8,457.60 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$19,388.00 |
$19,388.00 |
$19,388.00 |
$16,258.50
|
|
Percut ablate liver rf
|
$22,308.00 |
$22,308.00 |
$22,308.00 |
$6,904.15
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$400.00 |
$400.00 |
$400.00 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$2,207.20 |
$2,207.20 |
$2,207.20 |
$2,251.20
|
|
Perq dev breast 1st strtctc
|
$699.20 |
$699.20 |
$699.20 |
$1,456.00
|
|
Pet CT skull-mid thgh initial
|
$6,880.00 |
$6,880.00 |
$6,880.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$6,880.00 |
$6,880.00 |
$6,880.00 |
$4,850.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$8,448.00 |
$8,448.00 |
$8,448.00 |
$38,834.22
|
|
Ph body fluid
|
$15.20 |
$15.20 |
$15.20 |
$41.28
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$39.60 |
$39.60 |
$39.60 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$64.00 |
$64.00 |
$64.00 |
$104.50
|
|
Phentolaine mesylate inj
|
$796.40 |
$796.40 |
$796.40 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$13.00 |
$13.00 |
$13.00 |
$67.89
|
|
Phenytoin total therapeutic drug level
|
$55.20 |
$55.20 |
$55.20 |
$110.88
|
|
Phlebotomy therapeutic
|
$110.00 |
$110.00 |
$110.00 |
$231.66
|
|
Phosphorus
|
$15.00 |
$15.00 |
$15.00 |
$48.80
|
|
Phosphorus 24 hour urine
|
$24.00 |
$24.00 |
$24.00 |
$41.51
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$139.80 |
$139.80 |
$139.80 |
$87.50
|
|
Piflu f-18, dia 1 millicurie
|
$1,686.40 |
$1,686.40 |
$1,686.40 |
$1,035.81
|
|
Pin caspar distraction 12mm
|
$9,504.00 |
$9,504.00 |
$9,504.00 |
$11,925.00
|
|
Pinworm exam
|
$17.60 |
$17.60 |
$17.60 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$37.00 |
$37.00 |
$37.00 |
$83.03
|
|
Place gastrostomy tube perc
|
$3,048.80 |
$3,048.80 |
$3,048.80 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,616.80 |
$1,616.80 |
$1,616.80 |
$1,517.21
|
|
Placement nephrostomy catheter (both sides)
|
$3,552.80 |
$3,552.80 |
$3,552.80 |
$3,873.65
|
|
Placement occlusive device venous/arterial access site post procedure
|
$196.80 |
$196.80 |
$196.80 |
$571.45
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$13,369.60 |
$13,369.60 |
$13,369.60 |
$13,964.50
|
|
Place non-slctv cath thoracic arta
|
$5,274.40 |
$5,274.40 |
$5,274.40 |
$5,053.33
|
|
Platelet aggregation each agent teg
|
$151.20 |
$151.20 |
$151.20 |
$148.80
|
|
Platelet automated
|
$64.80 |
$64.80 |
$64.80 |
$45.60
|
|
Platelets leukocytes reduced each unit
|
$565.60 |
$565.60 |
$565.60 |
$302.25
|
|
Platelets leukocytes reduced irradiated each unit
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$411.20
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,944.00 |
$2,944.00 |
$2,944.00 |
$1,139.20
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$3,188.00 |
$3,188.00 |
$3,188.00 |
$1,278.55
|
|
Plcmnt biliary drainage cath w/img ext
|
$5,962.40 |
$5,962.40 |
$5,962.40 |
$4,482.60
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$8,096.80 |
$8,096.80 |
$8,096.80 |
$5,074.68
|
|
Plcmt sft tiss loc pq w/img 1st lsn
|
$1,201.60 |
$1,201.60 |
$1,201.60 |
$1,230.00
|
|
Plcmt sft tiss loc pq w/img ea addl lsn
|
$600.80 |
$600.80 |
$600.80 |
$751.30
|
|
Plethysmography lung volumes/airway resistance
|
$1,119.20 |
$1,119.20 |
$1,119.20 |
$405.00
|
|
Plmt biliary drainage cath
|
$6,028.00 |
$6,028.00 |
$6,028.00 |
$4,762.80
|
|
Plmt nephroureteral catheter
|
$3,511.20 |
$3,511.20 |
$3,511.20 |
$4,081.37
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$129.60 |
$129.60 |
$129.60 |
$187.32
|
|
Polysom <6 yrs cpap/bilvl
|
$5,560.00 |
$5,560.00 |
$5,560.00 |
$3,494.55
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$4,164.80 |
$4,164.80 |
$4,164.80 |
$3,751.48
|
