|
Oritavancin 400 mg intravenous solution
|
$99.20 |
$105.60 |
$2,989.80 |
$3,311.06
|
|
Oropharyngeal biopsy 42800
|
$681.60 |
$720.00 |
$1,012.80 |
$2,443.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$74.40 |
$366.00 |
$366.00 |
$50.63
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$640.20 |
$698.40 |
$725.40 |
$174.40
|
|
Orthopantogram
|
$284.40 |
$325.20 |
$491.40 |
$241.50
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$421.00
|
|
Oscillation chest wall mechanical per session
|
$203.40 |
$316.80 |
$449.40 |
$196.70
|
|
Osmolality blood
|
$63.60 |
$129.60 |
$451.20 |
$69.55
|
|
Osmolality urine
|
$57.00 |
$121.20 |
$154.80 |
$65.50
|
|
Ost pch drain for barrier fl
|
$12.00 |
$12.00 |
$12.00 |
$11.45
|
|
Ost skn barr extnd >4 sq
|
$5.40 |
$5.40 |
$5.40 |
$1.01
|
|
Oth resp proc, group
|
$38.40 |
$70.20 |
$72.00 |
$126.00
|
|
Oth resp proc, indiv
|
$66.00 |
$79.80 |
$81.60 |
$83.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$85.80 |
$102.60 |
$175.20 |
$98.40
|
|
Ot re-evaluation patient/family
|
$138.00 |
$213.00 |
$272.40 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$251.40 |
$261.60 |
$302.40 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$251.40 |
$261.60 |
$302.40 |
$94.81
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$69.60 |
$125.40 |
$552.00 |
$76.52
|
|
Oxaliplatin 5 mg/ml desensitization
|
$58.80 |
$97.20 |
$19,417.80 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$7.35 |
$15.40 |
$69.60 |
$50.40
|
|
P-32 sod phosphate ther per mci
|
$618.60 |
$618.60 |
$618.60 |
$469.34
|
|
Pabpn1 gene detc abnor allel
|
$3,052.80 |
$3,052.80 |
$3,052.80 |
$225.42
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$29.40 |
$75.00 |
$1,179.00 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$28.20 |
$74.40 |
$4,243.20 |
$3,435.42
|
|
Palb2 gene known famil vrnt
|
$281.40 |
$281.40 |
$281.40 |
$496.86
|
|
Palifermin injection
|
$54.00 |
$54.00 |
$54.00 |
$5,464.63
|
|
Paliperidone 117 mg/0.75 ml inj
|
$34.00 |
$38.85 |
$5,211.60 |
$6,238.82
|
|
Palonosetron hcl
|
$332.40 |
$1,461.60 |
$3,325.80 |
$162.89
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$2,325.00 |
$2,828.80 |
$6,562.20 |
$122.00
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$364.20 |
$652.80 |
$3,062.40 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$34.20 |
$165.00 |
$201.00 |
$28.90
|
|
Papaverin hcl injection
|
$11.00 |
$61.20 |
$123.60 |
$78.75
|
|
Parathormone (pth) intact
|
$226.20 |
$385.80 |
$741.60 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$1,600.80 |
$1,600.80 |
$2,145.00 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,125.60 |
$1,125.60 |
$5,323.20 |
$1,125.60
|
|
Parathyroid planar img w/tomo spect
|
$1,750.80 |
$1,750.80 |
$2,145.00 |
$1,350.60
|
|
Parenteral 50% dextrose solu
|
$145.60 |
$228.60 |
$228.60 |
$145.60
|
|
Paricalcitol
|
$137.40 |
$268.80 |
$866.40 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$197.40 |
$305.40 |
$347.40 |
$245.67
|
|
Partial removal finger bone
|
$3,486.60 |
$3,711.00 |
$4,324.80 |
$2,134.33
|
|
Partial removal foot fascia
|
$3,958.20 |
$3,958.20 |
$3,958.20 |
$3,821.05
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$7,136.40 |
$7,136.40 |
$17,505.00 |
$4,921.76
|
|
Passy muir valve metal trach
|
$241.20 |
$304.20 |
$1,261.20 |
$275.75
|
|
Path clin consltj mod 21-40
|
$447.60 |
$447.60 |
$739.80 |
$202.78
|
|
Path clin consltj sf 5-20
|
$198.60 |
$198.60 |
$697.80 |
$97.14
|
|
Pathogen reduced plasma sing
|
$744.00 |
$744.00 |
$1,474.20 |
$344.50
|
|
Pca3/klk3 antigen
|
$918.00 |
$918.00 |
$918.00 |
$510.40
|
|
Pcv21 vaccine im
|
$189.60 |
$189.60 |
$252.80 |
$410.26
|
|
Pdgfra gene
|
$1,585.20 |
$1,680.60 |
$1,680.60 |
$717.23
|
|
Pdt dstr prmlg les phys/qhp
|
$777.00 |
$777.00 |
$969.00 |
$294.77
|
|
Pedicle enel/ntroral 15576
|
$3,955.80 |
$3,955.80 |
$3,955.80 |
$2,508.24
|
|
Pegaspargase injection
|
$19,415.40 |
$19,415.40 |
$19,415.40 |
$41,065.49
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$901.20 |
$2,401.80 |
$125,803.20 |
$11,216.31
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$1,329.00 |
$1,329.00 |
$1,333.80 |
$6,370.52
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$1,189.20 |
$1,189.60 |
$10,699.80 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$645.60 |
$684.60 |
$684.60 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,112.00 |
$2,238.60 |
$9,667.20 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$395.40 |
$395.40 |
$395.40 |
$4,120.37
|
|
Peg interferon alfa-2a/180
|
$4,833.00 |
$4,833.00 |
$4,833.00 |
$2,672.20
|
|
Pegloticase 8 mg/ml intravenous solution
|
$1,128.00 |
$1,128.00 |
$6,349.20 |
$49,135.11
|
|
Pegunigalsidase alfa-iwxj
|
$526.20 |
$526.20 |
$526.20 |
$2,146.13
|
|
Pelvic CT scan (with and without contrast)
|
$2,953.20 |
$3,394.80 |
$5,112.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,654.40 |
$3,054.00 |
$4,599.60 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,740.00 |
$1,950.00 |
$2,937.00 |
$1,333.20
|
|
Pelvic MRI (with and without contrast)
|
$5,810.40 |
$6,512.40 |
$9,808.20 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,502.00 |
$4,742.40 |
$8,004.00 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,682.80 |
$4,125.00 |
$6,214.20 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$550.80 |
$1,263.00 |
$1,671.00 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$186.60 |
$379.20 |
$519.60 |
$432.50
|
|
Pelvis X-ray (1 to 2 views)
|
$405.00 |
$456.60 |
$686.40 |
$282.00
|
|
Pelvis X-ray (complete, 4 or more views)
|
$405.00 |
$456.60 |
$686.40 |
$355.50
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$154.80 |
$199.20 |
$12,507.00 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$205.60 |
$2,483.40 |
$23,822.40 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$7.20 |
$251.40 |
$1,641.00 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$68.40 |
$225.60 |
$1,641.00 |
$824.70
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$16.20 |
$192.60 |
$598.20 |
$97.85
|
|
Penicillin g procaine inj
|
$5.40 |
$5.40 |
$5.40 |
$149.20
|
|
Penile injection
|
$619.20 |
$833.40 |
$1,095.60 |
$418.86
|
|
Penile rear tip xtnd 0.5cm
|
$15,121.80 |
$15,121.80 |
$27,688.80 |
$18,764.94
|
|
Penile vascular study
|
$1,077.60 |
$1,077.60 |
$1,179.60 |
$561.00
|
|
Penile vascular study
|
$526.80 |
$526.80 |
$526.80 |
$574.60
|
|
Pentamidine non-comp unit
|
$1,311.00 |
$1,311.00 |
$1,608.80 |
$294.39
|
|
Pentobarbital sodium inj
|
$63.60 |
$63.60 |
$7,574.40 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$6,720.00 |
$6,720.00 |
$10,857.00 |
$5,181.67
|
|
Perc cryo ablate renal tum
|
$44,842.80 |
$44,842.80 |
$59,707.20 |
$11,523.76
|
|
Perc d-e cor revasc chro add
|
$23,282.40 |
$23,282.40 |
$23,282.40 |
$13,103.00
|
|
Perc d-e cor revasc chro sin
|
$11,088.60 |
$17,506.20 |
$23,282.40 |
$18,435.36
|
|
Perc d-e cor revasc t cabg b
|
$11,088.60 |
$23,282.40 |
$23,537.40 |
$11,976.00
|
|
Perc d-e cor revasc t cabg s
|
$11,088.60 |
$17,505.00 |
$23,282.40 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$10,454.40 |
$23,282.40 |
$24,949.80 |
$12,449.00
|
|
Perc d-e cor stent ather s
|
$11,088.60 |
$18,556.80 |
$23,282.40 |
$18,545.83
|
|
Perc drug-el cor stent bran
|
$11,088.60 |
$23,282.40 |
$24,949.80 |
$11,667.75
|
|
Perc drug-el cor stent sing
|
$11,088.60 |
$17,925.60 |
$23,282.40 |
$16,258.50
|
|
Perc rf ablate renal tumor
|
$64,217.40 |
$64,217.40 |
$64,217.40 |
$7,243.60
|
|
Percut ablate liver rf
|
$8,648.40 |
$8,648.40 |
$8,648.40 |
$6,904.15
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$793.80 |
$1,422.60 |
$2,845.20 |
$332.84
|
|
Pericardial drain w/cath pq w/ct guid
|
$3,314.40 |
$3,568.20 |
$5,169.00 |
$2,440.31
|
|
Pericardiocentesis wwo imaging
|
$2,186.40 |
$2,440.80 |
$3,205.80 |
$2,418.99
|
|
Pericardiotomy/clot/for bod remove 33020
|
$8,025.60 |
$8,025.60 |
$8,025.60 |
$1,797.00
|
|
Peripheral vascular rehab
|
$224.40 |
$322.80 |
$409.20 |
$132.50
|
