|
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
|
$335.20 |
$335.20 |
$335.20 |
$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
|
$155.20 |
$155.20 |
$155.20 |
$196.30
|
|
Osmolality blood
|
$134.40 |
$134.40 |
$134.40 |
$70.85
|
|
Osmolality urine
|
$436.80 |
$436.80 |
$436.80 |
$65.52
|
|
Oth resp proc, group
|
$473.60 |
$473.60 |
$473.60 |
$126.00
|
|
Ot re-evaluation patient/family
|
$117.60 |
$117.60 |
$117.60 |
$160.80
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$128.80 |
$128.80 |
$128.80 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$128.80 |
$128.80 |
$128.80 |
$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
|
$1,311.20 |
$1,311.20 |
$1,311.20 |
$290.64
|
|
P-32 sod phosphate ther per mci
|
$268.80 |
$268.80 |
$268.80 |
$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
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$550.80 |
$550.80 |
$550.80 |
$13,051.61
|
|
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
|
$228.00 |
$228.00 |
$228.00 |
$206.18
|
|
Parathyrd planar w/spect&ct
|
$2,701.60 |
$2,701.60 |
$2,701.60 |
$1,574.40
|
|
Parathyroid planar imaging
|
$2,248.00 |
$2,248.00 |
$2,248.00 |
$1,126.00
|
|
Parathyroid planar img w/tomo spect
|
$2,248.00 |
$2,248.00 |
$2,248.00 |
$1,374.75
|
|
Parenteral 50% dextrose solu
|
$130.40 |
$130.40 |
$130.40 |
$145.60
|
|
Paricalcitol
|
$28.20 |
$28.20 |
$28.20 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$29.20 |
$29.20 |
$29.20 |
$245.67
|
|
Partial removal finger bone
|
$6,609.60 |
$6,609.60 |
$6,609.60 |
$2,134.33
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$6,781.60 |
$6,781.60 |
$6,781.60 |
$4,921.76
|
|
Passy muir valve metal trach
|
$350.40 |
$350.40 |
$350.40 |
$275.75
|
|
Path clin consltj sf 5-20
|
$228.00 |
$228.00 |
$228.00 |
$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 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$1,069.80 |
$1,069.80 |
$1,069.80 |
$11,216.31
|
|
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
|
$7,964.40 |
$7,964.40 |
$7,964.40 |
$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)
|
$3,064.00 |
$3,064.00 |
$3,064.00 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,588.80 |
$1,588.80 |
$1,588.80 |
$1,335.34
|
|
Pelvic MRI (with and without contrast)
|
$4,850.40 |
$4,850.40 |
$4,850.40 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,689.60 |
$3,689.60 |
$3,689.60 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,040.00 |
$3,040.00 |
$3,040.00 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$885.60 |
$885.60 |
$885.60 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$869.60 |
$869.60 |
$869.60 |
$430.80
|
|
Pelvis X-ray (1 to 2 views)
|
$617.60 |
$617.60 |
$617.60 |
$281.82
|
|
Pelvis X-ray (complete, 4 or more views)
|
$616.00 |
$616.00 |
$616.00 |
$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 rear tip xtnd 0.5cm
|
$31,936.00 |
$31,936.00 |
$31,936.00 |
$18,764.94
|
|
Penile vascular study
|
$809.60 |
$809.60 |
$809.60 |
$561.00
|
|
Pentobarbital sodium inj
|
$115.20 |
$115.20 |
$115.20 |
$2,205.38
|
|
Pentostatin 10 mg intravenous solution
|
$10,218.00 |
$10,218.00 |
$10,218.00 |
$5,181.67
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$1,066.20 |
$1,066.20 |
$1,066.20 |
$332.84
|
|
Pericardiocentesis wwo imaging
|
$2,977.60 |
$2,977.60 |
$2,977.60 |
$2,375.00
|
|
Perq dev breast 1st strtctc
|
$2,168.80 |
$2,168.80 |
$2,168.80 |
$1,456.00
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$2,128.00 |
$2,128.00 |
$2,128.00 |
$625.93
|
|
Pertuzumab 30 mg/ml desensitization
|
$22,539.60 |
$22,539.60 |
$22,539.60 |
$14,272.91
|
|
Pertuzu, trastuzu, 10 mg
|
$324.60 |
$324.60 |
$324.60 |
$27,858.08
|
|
Pessary 3.5 in 7 vag sil rng fold
|
$903.20 |
$903.20 |
$903.20 |
$141.60
|
|
Pessary reusable rub anytype
|
$122.40 |
$122.40 |
$122.40 |
$57.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$22,916.00 |
$22,916.00 |
$22,916.00 |
$39,920.50
|
|
Ph body fluid
|
$63.20 |
$63.20 |
$63.20 |
$42.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$128.80 |
$128.80 |
$128.80 |
$114.56
|
|
Phenobarbital therapeutic drug level
|
$198.40 |
$198.40 |
$198.40 |
$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
|
$137.60 |
$137.60 |
$137.60 |
$111.27
|
|
Phlebotomy therapeutic
|
$233.60 |
$233.60 |
$233.60 |
$231.40
|
|
Phone e/m phys/qhp 11-20 min
|
$46.20 |
$46.20 |
$46.20 |
$174.75
|
|
Phone e/m phys/qhp 21-30 min
|
$68.40 |
$68.40 |
$68.40 |
$187.00
|
|
Phone e/m phys/qhp 5-10 min
|
$24.00 |
$24.00 |
$24.00 |
$93.75
|
|
Phosphorus
|
$85.60 |
$85.60 |
$85.60 |
$49.20
|
|
Phosphorus 24 hour urine
|
$90.40 |
$90.40 |
$90.40 |
$42.25
|
|
Phys blood bank serv reactj
|
$481.60 |
$481.60 |
$481.60 |
$207.50
|
|
Physical Therapy Evaluation (high complexity)
|
$238.40 |
$238.40 |
$238.40 |
$294.00
|
|
Physical Therapy Evaluation (low complexity)
|
$238.40 |
$238.40 |
$238.40 |
$223.92
|
|
Physical Therapy Evaluation (moderate complexity)
|
$238.40 |
$238.40 |
$238.40 |
$256.20
|
|
Physical Therapy Re-Evaluation
|
$117.60 |
$117.60 |
$117.60 |
$154.80
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$220.80 |
$220.80 |
$220.80 |
$90.25
|
|
Pinworm exam
|
$54.60 |
$54.60 |
$54.60 |
$39.62
|
|
Pinworm examinations
|
$58.00 |
$58.00 |
$58.00 |
$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)
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$1,485.90
|
|
Placement localization device(s) breast percutaneous mammographic guide ea addl lesion left
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$795.00
|
|
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides)
|
$1,144.80 |
$1,144.80 |
$1,144.80 |
$1,332.43
|
|
Place po breast cath for rad
|
$720.80 |
$720.80 |
$720.80 |
$10,741.80
|
|
Platelet aggregation each agent teg
|
$466.40 |
$466.40 |
$466.40 |
$148.98
|
|
Platelet automated
|
$42.80 |
$42.80 |
$42.80 |
$46.00
|
|
Platelets hla matched leukocytes reduced apheresis/pheresis each unit
|
$4,912.80 |
$4,912.80 |
$4,912.80 |
$1,532.70
|
