|
Nr lnr acclrtr tx max 5 sessions
|
$6,205.80 |
$6,205.80 |
$6,205.80 |
$6,930.00
|
|
Ntsty modul rad tx dlvr cplx
|
$2,570.40 |
$2,570.40 |
$2,570.40 |
$2,494.40
|
|
Ntsty modul rad tx dlvr smpl
|
$2,393.40 |
$2,393.40 |
$2,393.40 |
$2,165.29
|
|
Nuclear rx intra-arterial
|
$666.00 |
$666.00 |
$666.00 |
$765.00
|
|
Nuclear rx IV admin
|
$2,610.00 |
$2,610.00 |
$2,610.00 |
$863.20
|
|
Nuclear Stress Test (Heart)
|
$4,206.60 |
$4,206.60 |
$4,206.60 |
$3,858.20
|
|
Nudt15 gene common variants
|
$472.80 |
$472.80 |
$472.80 |
$304.50
|
|
Nushield 1 square cm
|
$312.00 |
$312.00 |
$312.00 |
$914.95
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$300.60 |
$300.60 |
$300.60 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$117.00 |
$117.00 |
$117.00 |
$385.00
|
|
Observation per hour
|
$176.40 |
$176.40 |
$176.40 |
$82.55
|
|
Obstetrical care 59410
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$2,112.80
|
|
Obstetric panel inc HIV tstg
|
$351.60 |
$351.60 |
$351.60 |
$271.00
|
|
Obtaining screen pap smear
|
$13.80 |
$13.80 |
$13.80 |
$38.50
|
|
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 |
$264.55
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$220.80 |
$220.80 |
$220.80 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$1,886.40 |
$1,886.40 |
$1,886.40 |
$12,080.43
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$1,824.80 |
$1,824.80 |
$1,824.80 |
$1,220.80
|
|
Olanzapine 10 mg intramuscular solution
|
$12.80 |
$12.80 |
$12.80 |
$109.62
|
|
Oncoprotein dcp
|
$861.60 |
$861.60 |
$861.60 |
$171.25
|
|
Ondansetron 4 mg s0119
|
$136.80 |
$136.80 |
$136.80 |
$2.52
|
|
Ondansetron 8 mg disintegrating tablet
|
$25.20 |
$25.20 |
$25.20 |
$9.93
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$27.40 |
$27.40 |
$27.40 |
$22.62
|
|
Optx clavicular fx w/int fix
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$8,453.60
|
|
Optx gr hmrl tbrs fx int fix
|
$7,589.40 |
$7,589.40 |
$7,589.40 |
$7,157.53
|
|
Optx medial ankle fx
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$6,653.00
|
|
Optx post ankle fx
|
$6,855.00 |
$6,855.00 |
$6,855.00 |
$5,886.74
|
|
Optx prox humrl fx w/int fix
|
$6,347.40 |
$6,347.40 |
$6,347.40 |
$13,780.53
|
|
Optx radial shaft fracture
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$5,419.00
|
|
Optx rad/uln dislc aqt/chrnc
|
$4,493.40 |
$4,493.40 |
$4,493.40 |
$5,886.74
|
|
Optx rdl shft fx&cltx rad/ul
|
$6,347.40 |
$6,347.40 |
$6,347.40 |
$7,386.73
|
|
Optx rdl&uln shft fx rds&uln
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$7,807.24
|
|
Optx rdl&uln shft fx rds/uln
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$6,665.84
|
|
Optx scapular fx w/int fixj
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$7,906.00
|
|
Optx ulnar shft fx int fixj
|
$5,152.80 |
$5,152.80 |
$5,152.80 |
$8,453.60
|
|
Optx ulnar styloid fracture
|
$6,492.00 |
$6,492.00 |
$6,492.00 |
$5,295.25
|
|
Oral aprepitant
|
$1,012.80 |
$1,012.80 |
$1,012.80 |
$410.20
|
|
Oral everolimus
|
$1,152.00 |
$1,152.00 |
$1,152.00 |
$30.30
|
|
Organic acids total quant ea spec
|
$277.20 |
$277.20 |
$277.20 |
$152.50
|
|
Oritavancin 400 mg intravenous solution
|
$447.20 |
$447.20 |
$447.20 |
$3,311.06
|
|
Oropharyngeal biopsy 42800
|
$836.40 |
$836.40 |
$836.40 |
$2,443.00
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$61.00 |
$61.00 |
$61.00 |
$50.63
|
|
Orthovisc inj per dose
|
$903.60 |
$903.60 |
$903.60 |
$537.58
|
|
Oscillation chest wall mechanical per session
|
$128.40 |
$128.40 |
$128.40 |
$196.70
|
|
Osmolality blood
|
$111.00 |
$111.00 |
$111.00 |
$69.55
|
|
Osmolality urine
|
$108.00 |
$108.00 |
$108.00 |
$65.50
|
|
Osteopath manip tx/5-6 body region 98927
|
$19.20 |
$19.20 |
$19.20 |
$67.84
|
|
Osteopath manip tx/7-8 body region 98928
|
$19.20 |
$19.20 |
$19.20 |
$83.27
|
|
Osteopath manip tx/9-10 body region98929
|
$19.20 |
$19.20 |
$19.20 |
$89.00
|
|
Ost pch for bar w flange/flt
|
$4.20 |
$4.20 |
$4.20 |
$5.91
|
|
Oth resp proc, group
|
$391.80 |
$391.80 |
$391.80 |
$126.00
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$150.60 |
$150.60 |
$150.60 |
$98.40
|
|
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
|
$106.20 |
$106.20 |
$106.20 |
$88.54
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$106.20 |
$106.20 |
$106.20 |
$94.81
|
|
Oxaliplatin 5 mg/ml desensitization
|
$13.20 |
$13.20 |
$13.20 |
$348.69
|
|
Oxytocin 10 unit/ml injection solution
|
$29.00 |
$29.00 |
$29.00 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$2.40 |
$2.40 |
$2.40 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$61.80 |
$61.80 |
$61.80 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$54.40 |
$54.40 |
$54.40 |
$6,238.82
|
|
Palonosetron hcl
|
$378.60 |
$378.60 |
$378.60 |
$162.89
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$450.00 |
$450.00 |
$450.00 |
$122.00
|
|
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
|
$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 |
$1,125.60
|
|
Parenteral 50% dextrose solu
|
$130.40 |
$130.40 |
$130.40 |
$145.60
|
|
Paricalcitol
|
$26.40 |
$26.40 |
$26.40 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$230.40 |
$230.40 |
$230.40 |
$245.67
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$5,397.60 |
$5,397.60 |
$5,397.60 |
$4,914.00
|
|
Partial removal finger bone
|
$5,465.40 |
$5,465.40 |
$5,465.40 |
$2,134.33
|
|
Partial removal of foot bone
|
$5,397.60 |
$5,397.60 |
$5,397.60 |
$3,839.54
|
|
Partial removal of toe
|
$5,397.60 |
$5,397.60 |
$5,397.60 |
$3,674.58
|
|
Part removal of metatarsal
|
$5,397.60 |
$5,397.60 |
$5,397.60 |
$3,821.05
|
|
Passy muir valve metal trach
|
$289.80 |
$289.80 |
$289.80 |
$275.75
|
|
Path clin consltj mod 21-40
|
$431.40 |
$431.40 |
$431.40 |
$202.78
|
|
Path clin consltj sf 5-20
|
$190.20 |
$190.20 |
$190.20 |
$97.14
|
|
Pcv21 vaccine im
|
$252.80 |
$252.80 |
$252.80 |
$410.26
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$12,717.60 |
$12,717.60 |
$12,717.60 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$2,015.20 |
$2,015.20 |
$2,015.20 |
$7,297.36
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$645.60 |
$645.60 |
$645.60 |
$4,300.20
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$2,014.80 |
$2,014.80 |
$2,014.80 |
$4,133.25
|
|
Pegloticase 8 mg/ml intravenous solution
|
$11,823.60 |
$11,823.60 |
$11,823.60 |
$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 |
$1,333.20
|
|
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 |
$432.50
|
|
Pelvis X-ray (1 to 2 views)
|
$511.20 |
$511.20 |
$511.20 |
$282.00
|
|
Pelvis X-ray (complete, 4 or more views)
|
$509.40 |
$509.40 |
$509.40 |
$355.50
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$287.20 |
$287.20 |
$287.20 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$3,134.40 |
$3,134.40 |
$3,134.40 |
$7,089.13
|
