|
Ot re-evaluation patient/family
|
$97.20 |
$97.20 |
$97.20 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$101.40 |
$101.40 |
$101.40 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$101.40 |
$101.40 |
$101.40 |
$93.12
|
|
Oxaliplatin 5 mg/ml desensitization
|
$1,965.00 |
$1,965.00 |
$1,965.00 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$29.00 |
$29.00 |
$29.00 |
$50.40
|
|
P-32 chromic phos ther per mci
|
$1,084.20 |
$1,084.20 |
$1,084.20 |
$290.64
|
|
P-32 sod phosphate ther per mci
|
$222.60 |
$222.60 |
$222.60 |
$469.34
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$300.60 |
$300.60 |
$300.60 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$6,166.20 |
$6,166.20 |
$6,166.20 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$9,557.40 |
$9,557.40 |
$9,557.40 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$6,940.20 |
$6,940.20 |
$6,940.20 |
$5,580.28
|
|
Palonosetron hcl
|
$378.60 |
$378.60 |
$378.60 |
$163.00
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$200.00 |
$200.00 |
$200.00 |
$123.55
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$30.80 |
$30.80 |
$30.80 |
$28.90
|
|
Papaverin hcl injection
|
$264.80 |
$264.80 |
$264.80 |
$78.75
|
|
Parathormone (pth) intact
|
$188.40 |
$188.40 |
$188.40 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$2,233.80 |
$2,233.80 |
$2,233.80 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,859.40 |
$1,859.40 |
$1,859.40 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$1,859.40 |
$1,859.40 |
$1,859.40 |
$1,374.75
|
|
Parenteral 50% dextrose solu
|
$130.40 |
$130.40 |
$130.40 |
$145.60
|
|
Paricalcitol
|
$28.20 |
$28.20 |
$28.20 |
$47.15
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$5,607.60 |
$5,607.60 |
$5,607.60 |
$4,921.76
|
|
Passy muir valve metal trach
|
$289.80 |
$289.80 |
$289.80 |
$275.75
|
|
Path clin consltj sf 5-20
|
$188.40 |
$188.40 |
$188.40 |
$97.14
|
|
Pcv21 vaccine im
|
$252.80 |
$252.80 |
$252.80 |
$410.26
|
|
Pegaspargase injection
|
$62,371.80 |
$62,371.80 |
$62,371.80 |
$41,065.49
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$18,128.40 |
$18,128.40 |
$18,128.40 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$1,035.20 |
$1,035.20 |
$1,035.20 |
$4,133.25
|
|
Pegloticase 8 mg/ml intravenous solution
|
$94,586.40 |
$94,586.40 |
$94,586.40 |
$49,135.11
|
|
Pegunigalsidase alfa-iwxj
|
$548.00 |
$548.00 |
$548.00 |
$2,146.13
|
|
Pelvic CT scan (with and without contrast)
|
$2,533.80 |
$2,533.80 |
$2,533.80 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,902.00 |
$1,902.00 |
$1,902.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,313.40 |
$1,313.40 |
$1,313.40 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$4,010.40 |
$4,010.40 |
$4,010.40 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,051.00 |
$3,051.00 |
$3,051.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,514.00 |
$2,514.00 |
$2,514.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$732.00 |
$732.00 |
$732.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$718.80 |
$718.80 |
$718.80 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$511.20 |
$511.20 |
$511.20 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$509.40 |
$509.40 |
$509.40 |
$351.75
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$21,534.00 |
$21,534.00 |
$21,534.00 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$15,666.00 |
$15,666.00 |
$15,666.00 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$581.40 |
$581.40 |
$581.40 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,494.00 |
$1,494.00 |
$1,494.00 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$136.80 |
$136.80 |
$136.80 |
$97.85
|
|
Penile vascular study
|
$669.60 |
$669.60 |
$669.60 |
$561.00
|
|
Pentobarbital sodium inj
|
$115.20 |
$115.20 |
$115.20 |
$2,205.38
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$1,066.20 |
$1,066.20 |
$1,066.20 |
$332.84
|
|
Perq dev breast 1st strtctc
|
$1,793.40 |
$1,793.40 |
$1,793.40 |
$1,456.00
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$1,759.80 |
$1,759.80 |
$1,759.80 |
$625.93
|
|
Pertuzumab 30 mg/ml desensitization
|
$22,539.60 |
$22,539.60 |
$22,539.60 |
$14,272.91
|
|
Pfc sigma fem post aug sz3 8mm
|
$19,378.20 |
$19,378.20 |
$19,378.20 |
$39,920.50
|
|
Ph body fluid
|
$39.60 |
$39.60 |
$39.60 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$128.80 |
$128.80 |
$128.80 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$163.80 |
$163.80 |
$163.80 |
$105.00
|
|
Phentolaine mesylate inj
|
$1,968.60 |
$1,968.60 |
$1,968.60 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$0.60 |
$0.60 |
$0.60 |
$62.98
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$15.00 |
$15.00 |
$15.00 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$114.00 |
$114.00 |
$114.00 |
$111.27
|
|
Phlebotomy therapeutic
|
$193.20 |
$193.20 |
$193.20 |
$231.40
|
|
Phosphorus
|
$262.80 |
$262.80 |
$262.80 |
$49.20
|
|
Phosphorus 24 hour urine
|
$262.80 |
$262.80 |
$262.80 |
$42.25
|
|
Phys blood bank serv reactj
|
$398.40 |
$398.40 |
$398.40 |
$207.50
|
|
Physical Therapy Evaluation (high complexity)
|
$197.40 |
$197.40 |
$197.40 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$197.40 |
$197.40 |
$197.40 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$197.40 |
$197.40 |
$197.40 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$97.20 |
$97.20 |
$97.20 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$220.80 |
$220.80 |
$220.80 |
$90.25
|
|
Pinworm examinations
|
$48.00 |
$48.00 |
$48.00 |
$5.70
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$114.00 |
$114.00 |
$114.00 |
$81.36
|
|
Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides)
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,141.20 |
$1,141.20 |
$1,141.20 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$946.80 |
$946.80 |
$946.80 |
$1,332.43
|
|
Place po breast cath for rad
|
$595.80 |
$595.80 |
$595.80 |
$10,741.80
|
|
Platelet aggregation each agent teg
|
$385.80 |
$385.80 |
$385.80 |
$148.98
|
|
Platelet automated
|
$35.40 |
$35.40 |
$35.40 |
$46.00
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$4,062.00 |
$4,062.00 |
$4,062.00 |
$1,532.70
|
|
Platelets pheresis leukocytes reduced each unit
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$1,162.50
|
|
Platelets pheresis leukocytes reduced irradiated each unit
|
$2,893.20 |
$2,893.20 |
$2,893.20 |
$1,284.80
|
|
Platelets pheresis pathogen-reduced each unit
|
$1,791.00 |
$1,791.00 |
$1,791.00 |
$1,005.65
|
|
Plc pq device breast ea addl lesion stereo guide
|
$1,619.40 |
$1,619.40 |
$1,619.40 |
$685.00
|
|
Plc pq device breast ea addl lesion Ultrasound guide
|
$946.80 |
$946.80 |
$946.80 |
$754.00
|
|
Plethysmography lung volumes/airway resistance
|
$234.00 |
$234.00 |
$234.00 |
$408.05
|
|
Pms2 gene dup/delet variants
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$407.27
|
|
Pms2 gene full seq analysis
|
$1,194.60 |
$1,194.60 |
$1,194.60 |
$1,002.60
|
|
#pnh-flow cytometry interp
|
$656.40 |
$656.40 |
$656.40 |
$123.75
|
|
Pn soln nos 10 grams lipids
|
$190.20 |
$190.20 |
$190.20 |
$96.00
|
|
Poct blood gases ph pco2 po2 arterial calculated o2
|
$268.20 |
$268.20 |
$268.20 |
$187.32
|
|
Polatuzumab vedotin-piiq 140 mg intravenous solution
|
$36,544.20 |
$36,544.20 |
$36,544.20 |
$35,781.91
|
|
Positioner proc acufex leg acs
|
$42.60 |
$42.60 |
$42.60 |
$79.80
|
|
Potassium 24 hour urine
|
$52.20 |
$52.20 |
$52.20 |
$51.17
|
|
Potassium chloride 10 meq/100ml in sterile water intravenous piggyback
|
$61.80 |
$61.80 |
$61.80 |
$62.79
|
|
Potassium serum/plasma/whole blood
|
$39.60 |
$39.60 |
$39.60 |
$47.85
|
|
Pq dr cath chg w cont s&i
|
$1,347.00 |
$1,347.00 |
$1,347.00 |
$720.00
|
|
Pq thr inj ext pse
|
$730.80 |
$730.80 |
$730.80 |
$781.62
|
|
Pralidoxime 1 gram solution for injection
|
$399.60 |
$399.60 |
$399.60 |
$292.00
|
|
Pr amput fgr/thumb prim/sec any joint/phal sgl incl neurectomies w dir clsr
|
$6,141.00 |
$6,141.00 |
$6,141.00 |
$3,738.90
|
|
Pr application of long arm splint
|
$471.00 |
$471.00 |
$471.00 |
$332.75
|
|
Pr application splint static short arm
|
$471.00 |
$471.00 |
$471.00 |
$288.00
|
|
Pr counseling smoke/tobacco intermediate greater 3 - 10 minutes
|
$31.20 |
$31.20 |
$31.20 |
$48.00
|
