|
Pelvic CT scan (with and without contrast)
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,424.40 |
$1,424.40 |
$1,424.40 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$876.00 |
$876.00 |
$876.00 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$394.20 |
$394.20 |
$394.20 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$394.20 |
$394.20 |
$394.20 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$262.80 |
$262.80 |
$262.80 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$262.80 |
$262.80 |
$262.80 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$850.20 |
$850.20 |
$850.20 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$2,425.80 |
$2,425.80 |
$2,425.80 |
$7,089.13
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$96.00 |
$96.00 |
$96.00 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$30.00 |
$30.00 |
$30.00 |
$97.85
|
|
Penile injection
|
$403.80 |
$403.80 |
$403.80 |
$424.60
|
|
Penile vascular study
|
$199.80 |
$199.80 |
$199.80 |
$561.00
|
|
Pentamidine non-comp unit
|
$99.60 |
$99.60 |
$99.60 |
$294.39
|
|
Pentobarbital sodium inj
|
$42.00 |
$42.00 |
$42.00 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$1,609.20 |
$1,609.20 |
$1,609.20 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$20,125.80 |
$20,125.80 |
$20,125.80 |
$11,523.76
|
|
Perc d-e cor revasc chro add
|
$402.60 |
$402.60 |
$402.60 |
$13,103.00
|
|
Perc d-e cor revasc chro sin
|
$24,161.40 |
$24,161.40 |
$24,161.40 |
$18,435.36
|
|
Perc d-e cor revasc t cabg b
|
$9,788.40 |
$9,788.40 |
$9,788.40 |
$11,976.00
|
|
Perc d-e cor revasc t cabg s
|
$15,411.00 |
$15,411.00 |
$15,411.00 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$9,788.40 |
$9,788.40 |
$9,788.40 |
$12,449.00
|
|
Perc d-e cor stent ather s
|
$24,161.40 |
$24,161.40 |
$24,161.40 |
$18,545.83
|
|
Perc drug-el cor stent bran
|
$9,788.40 |
$9,788.40 |
$9,788.40 |
$11,667.75
|
|
Perc drug-el cor stent sing
|
$15,411.00 |
$15,411.00 |
$15,411.00 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$17,216.40 |
$17,216.40 |
$17,216.40 |
$7,243.60
|
|
Percut ablate liver rf
|
$7,327.20 |
$7,327.20 |
$7,327.20 |
$6,904.15
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$104.40 |
$104.40 |
$104.40 |
$332.84
|
|
Pericardiocentesis wwo imaging
|
$2,473.20 |
$2,473.20 |
$2,473.20 |
$2,375.00
|
|
Perit-vens shunt pat tst
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$752.49
|
|
Perphenazine 4mg oral
|
$0.60 |
$0.60 |
$0.60 |
$2.58
|
|
Perq clsr tcat l atr apndge
|
$5,606.40 |
$5,606.40 |
$5,606.40 |
$9,309.08
|
|
Perq dev breast 1st mr guide
|
$2,153.40 |
$2,153.40 |
$2,153.40 |
$1,768.20
|
|
Perq dev breast 1st strtctc
|
$924.60 |
$924.60 |
$924.60 |
$1,456.00
|
|
Perq plmt bile duct stent
|
$14,191.20 |
$14,191.20 |
$14,191.20 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$7,327.20 |
$7,327.20 |
$7,327.20 |
$7,020.00
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$978.00 |
$978.00 |
$978.00 |
$625.93
|
|
Perq transcath closure each
|
$4,354.20 |
$4,354.20 |
$4,354.20 |
$9,204.00
|
|
Perq transcath cls aortic
|
$46,970.40 |
$46,970.40 |
$46,970.40 |
$22,633.26
|
|
Perq transcath cls mitral
|
$46,970.40 |
$46,970.40 |
$46,970.40 |
$23,617.60
|
|
Perq transcath septal reduxn
|
$5,606.40 |
$5,606.40 |
$5,606.40 |
$8,999.20
|
|
Pertuzumab 30 mg/ml desensitization
|
$279.60 |
$279.60 |
$279.60 |
$14,272.91
|
|
Pertuzu, trastuzu, 10 mg
|
$523.20 |
$523.20 |
$523.20 |
$27,858.08
|
|
Pet CT skull-mid thgh initial
|
$5,639.40 |
$5,639.40 |
$5,639.40 |
$4,707.00
|
|
Pet CT whole body initial
|
$5,639.40 |
$5,639.40 |
$5,639.40 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$5,639.40 |
$5,639.40 |
$5,639.40 |
$4,060.00
|
|
Pet image w/ct lmtd
|
$5,639.40 |
$5,639.40 |
$5,639.40 |
$4,349.76
|
|
Pet not otherwise specified
|
$1,300.80 |
$1,300.80 |
$1,300.80 |
$1,070.40
|
|
Pet scan brain perf study
|
$7,048.20 |
$7,048.20 |
$7,048.20 |
$3,832.80
|
|
Ph body fluid
|
$19.20 |
$19.20 |
$19.20 |
$42.00
|
|
Phencyclidine (pcp)
|
$74.40 |
$74.40 |
$74.40 |
$96.39
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$40.80 |
$40.80 |
$40.80 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$110.40 |
$110.40 |
$110.40 |
$105.00
|
|
Phentolaine mesylate inj
|
$293.40 |
$293.40 |
$293.40 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$2.40 |
$2.40 |
$2.40 |
$62.98
|
|
Phenytoin total therapeutic drug level
|
$94.80 |
$94.80 |
$94.80 |
$111.27
|
|
Phlebotomy therapeutic
|
$231.00 |
$231.00 |
$231.00 |
$231.40
|
|
Phosphorus
|
$24.00 |
$24.00 |
$24.00 |
$49.20
|
|
Phosphorus 24 hour urine
|
$29.40 |
$29.40 |
$29.40 |
$42.25
|
|
Physical Therapy Evaluation (high complexity)
|
$363.00 |
$363.00 |
$363.00 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$226.80 |
$226.80 |
$226.80 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$303.60 |
$303.60 |
$303.60 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$139.20 |
$139.20 |
$139.20 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$29.40 |
$29.40 |
$29.40 |
$90.25
|
|
Piflu f-18, dia 1 millicurie
|
$1,252.20 |
$1,252.20 |
$1,252.20 |
$1,038.40
|
|
Pinworm exam
|
$238.80 |
$238.80 |
$238.80 |
$39.62
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$9.00 |
$9.00 |
$9.00 |
$81.36
|
|
Place cath xtrnl carotid
|
$4,005.60 |
$4,005.60 |
$4,005.60 |
$4,202.90
|
|
Place duod/jej tube perc
|
$7,209.00 |
$7,209.00 |
$7,209.00 |
$2,562.75
|
|
Place endorectal app
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$1,260.56
|
|
Place gastrostomy tube perc
|
$7,713.60 |
$7,713.60 |
$7,713.60 |
$2,289.60
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$924.60 |
$924.60 |
$924.60 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,930.80 |
$1,930.80 |
$1,930.80 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,162.20 |
$1,162.20 |
$1,162.20 |
$1,332.43
|
|
Placement nephrostomy catheter (both sides)
|
$5,191.20 |
$5,191.20 |
$5,191.20 |
$3,933.00
|
|
Placement occlusive device venous/arterial access site post procedure
|
$2,304.60 |
$2,304.60 |
$2,304.60 |
$572.00
|
|
Placement stent(s) intravascular transcatheter artery initial
|
$21,745.20 |
$21,745.20 |
$21,745.20 |
$13,879.25
|
|
Place non-slctv cath thoracic arta
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$5,271.46
|
|
Place slctv cath carotd art uni
|
$10,450.20 |
$10,450.20 |
$10,450.20 |
$10,150.40
|
|
Place slctv cath carotid/inom art excrn uni
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$6,498.00
|
|
Place slctv cath carotid/inom art intcrn uni
|
$10,450.20 |
$10,450.20 |
$10,450.20 |
$9,074.00
|
|
Place slctv cath subclavian art
|
$6,300.60 |
$6,300.60 |
$6,300.60 |
$6,325.00
|
|
Place slctv cath vertebral art uni
|
$10,450.20 |
$10,450.20 |
$10,450.20 |
$9,090.00
|
|
Plasma cryoprecipitate reduced each unit
|
$130.80 |
$130.80 |
$130.80 |
$163.04
|
|
Platelet aggregation each agent teg
|
$126.00 |
$126.00 |
$126.00 |
$148.98
|
|
Platelet automated
|
$22.80 |
$22.80 |
$22.80 |
$46.00
|
|
Platelet pheresis irr ea
|
$991.80 |
$991.80 |
$991.80 |
$1,108.52
|
|
Platelets each unit
|
$154.80 |
$154.80 |
$154.80 |
$169.29
|
|
Platelets irradiated ea unit
|
$199.80 |
$199.80 |
$199.80 |
$259.70
|
|
Platelets leukocytes reduced each unit
|
$181.80 |
$181.80 |
$181.80 |
$315.25
|
|
Platelets leukocytes reduced irradiated each unit
|
$310.20 |
$310.20 |
$310.20 |
$411.20
|
|
Platelets pheresis leukocytes reduced each unit
|
$715.80 |
$715.80 |
$715.80 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$908.40 |
$908.40 |
$908.40 |
$1,284.80
|
|
Plcmnt biliary drainage cath w/img ext
|
$7,503.60 |
$7,503.60 |
$7,503.60 |
$4,642.20
|
|
Plcmnt stent transcath ctrl dialysis seg add-on
|
$16,133.40 |
$16,133.40 |
$16,133.40 |
$6,927.20
|
|
Plcmnt ureteral stent pq w/img exstng trct
|
$7,729.80 |
$7,729.80 |
$7,729.80 |
$5,087.15
|
|
Plcmnt ureteral stent pq w/img new w/cath
|
$7,729.80 |
$7,729.80 |
$7,729.80 |
$5,589.75
|
