|
MRI upper extremity w/dye
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$2,061.15
|
|
MRI without fol w/cont, breast
|
$3,543.00 |
$3,543.00 |
$3,543.00 |
$2,550.00
|
|
MRI without fol w/cont, brst, un
|
$4,459.80 |
$4,459.80 |
$4,459.80 |
$1,779.08
|
|
Mr safety determination physician/other qhp
|
$160.20 |
$160.20 |
$160.20 |
$160.20
|
|
Mr safety implant elec prepj
|
$166.80 |
$166.80 |
$166.80 |
$170.13
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$18.60 |
$18.60 |
$18.60 |
$55.00
|
|
Mr sfty implt&/fb asmt stf 1
|
$44.40 |
$44.40 |
$44.40 |
$46.20
|
|
Mr sfty med physics xm cstmz
|
$439.80 |
$439.80 |
$439.80 |
$439.80
|
|
Msh2 gene dup/delete variant
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$403.20
|
|
Msh2 gene full seq
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$764.00
|
|
Msh6 gene dup/delete variant
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$476.00
|
|
Msh6 gene full seq
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$1,130.35
|
|
Mthfr gene analy common variants
|
$275.40 |
$275.40 |
$275.40 |
$184.00
|
|
Mucopolysaccharides
|
$280.80 |
$280.80 |
$280.80 |
$178.36
|
|
Mumps antibody igg
|
$285.60 |
$285.60 |
$285.60 |
$78.00
|
|
Mycophenolate mofetil 250 mg capsule
|
$120.00 |
$120.00 |
$120.00 |
$10.79
|
|
Mycoplasma antibody igm
|
$581.40 |
$581.40 |
$581.40 |
$77.35
|
|
Myd88 gene p.leu265pro vrnt
|
$282.00 |
$282.00 |
$282.00 |
$416.00
|
|
Myelogphy 2/> spine regions
|
$4,064.40 |
$4,064.40 |
$4,064.40 |
$1,494.22
|
|
Myelography l-s spine
|
$3,447.00 |
$3,447.00 |
$3,447.00 |
$1,334.09
|
|
Myelography neck spine
|
$3,476.40 |
$3,476.40 |
$3,476.40 |
$1,241.50
|
|
Myelography thoracic spine
|
$2,874.60 |
$2,874.60 |
$2,874.60 |
$1,255.00
|
|
Myelography via inj w/s&i 2+ regions
|
$4,064.40 |
$4,064.40 |
$4,064.40 |
$2,267.34
|
|
Myelography via inj w/s&i cervical
|
$3,476.40 |
$3,476.40 |
$3,476.40 |
$1,760.85
|
|
Myelography via inj w/s&i lumbosacral
|
$3,447.00 |
$3,447.00 |
$3,447.00 |
$1,850.00
|
|
Myelography via inj w/s&i thoracic
|
$2,874.60 |
$2,874.60 |
$2,874.60 |
$1,742.95
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$273.00 |
$273.00 |
$273.00 |
$130.80
|
|
Nafcillin 2 gram solution for injection
|
$1.80 |
$1.80 |
$1.80 |
$84.00
|
|
Nalbuphine 10 mg/ml injection solution
|
$16.20 |
$16.20 |
$16.20 |
$38.00
|
|
Naltrexone, depot form
|
$7,275.00 |
$7,275.00 |
$7,275.00 |
$3,249.40
|
|
Nasopharyngoscopy w/endoscope
|
$365.40 |
$365.40 |
$365.40 |
$293.58
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$28,621.80 |
$28,621.80 |
$28,621.80 |
$16,254.52
|
|
Natriuretic peptide
|
$342.00 |
$342.00 |
$342.00 |
$176.15
|
|
Natural killer cells total count
|
$112.80 |
$112.80 |
$112.80 |
$135.00
|
|
Ndl emg musc 1 xtr/non-limb
|
$205.80 |
$205.80 |
$205.80 |
$228.50
|
|
Nebulizer Breathing Treatment
|
$286.80 |
$286.80 |
$286.80 |
$203.49
|
|
Neck Airway (Soft Tissue) X-ray
|
$285.60 |
$285.60 |
$285.60 |
$237.43
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$3,574.80 |
$3,574.80 |
$3,574.80 |
$2,032.54
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$3,176.40 |
$3,176.40 |
$3,176.40 |
$1,717.80
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$2,108.40 |
$2,108.40 |
$2,108.40 |
$1,470.00
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$3,867.60 |
$3,867.60 |
$3,867.60 |
$2,869.75
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$2,941.20 |
$2,941.20 |
$2,941.20 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$2,424.00 |
$2,424.00 |
$2,424.00 |
$2,042.95
|
|
Neck (Cervical Spine) X-ray (2 to 3 views)
|
$637.20 |
$637.20 |
$637.20 |
$333.83
|
|
Neck (Cervical Spine) X-ray (4 to 5 views)
|
$526.20 |
$526.20 |
$526.20 |
$463.80
|
|
Neck (Cervical Spine) X-ray (6 or more views)
|
$679.20 |
$679.20 |
$679.20 |
$508.50
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$3,826.20 |
$3,826.20 |
$3,826.20 |
$2,659.98
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$3,207.00 |
$3,207.00 |
$3,207.00 |
$2,109.10
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$2,366.40 |
$2,366.40 |
$2,366.40 |
$1,806.75
|
|
Neck Soft Tissue CT Scan (with and without contrast)
|
$3,145.80 |
$3,145.80 |
$3,145.80 |
$1,940.00
|
|
Neck Soft Tissue CT Scan (with contrast)
|
$2,511.00 |
$2,511.00 |
$2,511.00 |
$1,603.55
|
|
Neck Soft Tissue CT Scan (without contrast)
|
$2,061.60 |
$2,061.60 |
$2,061.60 |
$1,312.00
|
|
Neg pres wound ther drsg set
|
$1,625.40 |
$1,625.40 |
$1,625.40 |
$676.00
|
|
Neisseria meningitidis
|
$139.80 |
$139.80 |
$139.80 |
$75.00
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$175.20 |
$175.20 |
$175.20 |
$60.16
|
|
Nicardipine 25 mg/10 ml intravenous solution
|
$3.00 |
$3.00 |
$3.00 |
$251.32
|
|
Nitroglycerin 50 mg/250 ml (200 mcg/ml) in 5 % dextrose intravenous
|
$4.00 |
$4.00 |
$4.00 |
$74.56
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$12,144.00 |
$12,144.00 |
$12,144.00 |
$14,820.18
|
|
Njx interlaminar crv/thrc
|
$3,015.60 |
$3,015.60 |
$3,015.60 |
$1,622.32
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$1,651.20 |
$1,651.20 |
$1,651.20 |
$1,397.69
|
|
Nm imaging gastrointestinal acute blood loss
|
$1,691.40 |
$1,691.40 |
$1,691.40 |
$1,207.59
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,658.40 |
$1,658.40 |
$1,658.40 |
$1,541.32
|
|
Nm imaging pulmonary ventilation/perfusion
|
$2,217.00 |
$2,217.00 |
$2,217.00 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$1,091.00
|
|
Nm radiopharmaceutical therapy oral administration
|
$944.40 |
$944.40 |
$944.40 |
$1,024.56
|
|
Non-card vasc flow imaging
|
$417.60 |
$417.60 |
$417.60 |
$608.56
|
|
Nose (Nasal Bone) X-ray (complete)
|
$262.20 |
$262.20 |
$262.20 |
$274.65
|
|
Npm1 gene
|
$1,905.60 |
$1,905.60 |
$1,905.60 |
$457.50
|
|
Nuclear exam of tear flow
|
$637.20 |
$637.20 |
$637.20 |
$648.04
|
|
Nuclear rx intracav admin
|
$3,139.20 |
$3,139.20 |
$3,139.20 |
$776.97
|
|
Nuclear rx IV admin
|
$2,610.00 |
$2,610.00 |
$2,610.00 |
$864.50
|
|
Nuclear Stress Test (Heart)
|
$4,206.60 |
$4,206.60 |
$4,206.60 |
$3,859.98
|
|
Nudt15 gene common variants
|
$450.00 |
$450.00 |
$450.00 |
$304.50
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$898.20 |
$898.20 |
$898.20 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$117.00 |
$117.00 |
$117.00 |
$384.00
|
|
Observation per hour
|
$176.40 |
$176.40 |
$176.40 |
$82.50
|
|
Obstetric panel inc HIV tstg
|
$351.60 |
$351.60 |
$351.60 |
$263.65
|
|
Obstetrics panel
|
$228.00 |
$228.00 |
$228.00 |
$214.50
|
|
Ob Ultrasound nuchal meas 1 gest
|
$519.60 |
$519.60 |
$519.60 |
$357.00
|
|
Occupational Therapy Evaluation (high complexity)
|
$197.40 |
$197.40 |
$197.40 |
$297.00
|
|
Occupational Therapy Evaluation (low complexity)
|
$197.40 |
$197.40 |
$197.40 |
$232.40
|
|
Occupational Therapy Evaluation (moderate complexity)
|
$197.40 |
$197.40 |
$197.40 |
$263.90
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$220.80 |
$220.80 |
$220.80 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$28,302.00 |
$28,302.00 |
$28,302.00 |
$12,080.43
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$2,292.60 |
$2,292.60 |
$2,292.60 |
$1,220.80
|
|
Olanzapine 10 mg intramuscular solution
|
$12.80 |
$12.80 |
$12.80 |
$109.62
|
|
Ondansetron 4 mg s0119
|
$136.80 |
$136.80 |
$136.80 |
$2.52
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$27.40 |
$27.40 |
$27.40 |
$22.62
|
|
Ophthalmic mitomycin
|
$1,663.20 |
$1,663.20 |
$1,663.20 |
$775.44
|
|
Oral aprepitant
|
$1,583.40 |
$1,583.40 |
$1,583.40 |
$410.20
|
|
Oral busulfan
|
$24.60 |
$24.60 |
$24.60 |
$176.80
|
|
Oral everolimus
|
$115.20 |
$115.20 |
$115.20 |
$30.30
|
|
Organic acids total quant ea spec
|
$277.20 |
$277.20 |
$277.20 |
$152.50
|
|
Oritavancin 400 mg intravenous solution
|
$13,431.00 |
$13,431.00 |
$13,431.00 |
$3,311.06
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$61.00 |
$61.00 |
$61.00 |
$50.63
|
|
Oscillation chest wall mechanical per session
|
$128.40 |
$128.40 |
$128.40 |
$196.30
|
|
Osmolality blood
|
$111.00 |
$111.00 |
$111.00 |
$70.85
|
|
Osmolality urine
|
$361.20 |
$361.20 |
$361.20 |
$65.52
|
|
Other immunoelectrophoresis
|
$132.60 |
$132.60 |
$132.60 |
$107.52
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$82.80 |
$82.80 |
$82.80 |
$97.80
|
