|
MRI chest without contrast
|
$583.77 |
$583.77 |
$583.77 |
$1,818.00
|
|
MRI chest without & w/contrast
|
$833.58 |
$833.58 |
$833.58 |
$2,652.73
|
|
MRI chest w IV cont
|
$586.41 |
$586.41 |
$586.41 |
$2,210.00
|
|
MRI guid ndl plc s&i
|
$504.24 |
$504.24 |
$504.24 |
$1,267.50
|
|
MRI loex nonjt w IV cont
|
$586.41 |
$586.41 |
$586.41 |
$2,092.50
|
|
MRI lower extremity other than joint without contrast (both sides)
|
$586.41 |
$586.41 |
$586.41 |
$2,104.85
|
|
MRI lower extremity other than joint without & w/contrast (both sides)
|
$895.95 |
$895.95 |
$895.95 |
$2,753.50
|
|
MRI orbit/face/neck without contrast
|
$583.77 |
$583.77 |
$583.77 |
$1,883.25
|
|
MRI orbit/face/neck without & w/contrast
|
$833.58 |
$833.58 |
$833.58 |
$2,812.50
|
|
MRI orbit fac&nck w IV cont
|
$598.62 |
$598.62 |
$598.62 |
$2,176.20
|
|
MRI tmj
|
$598.62 |
$598.62 |
$598.62 |
$1,736.28
|
|
MRI upper extremity other than joint without contrast (both sides)
|
$511.83 |
$511.83 |
$511.83 |
$1,951.95
|
|
MRI upper extremity other than joint without & w/contrast (both sides)
|
$895.95 |
$895.95 |
$895.95 |
$2,637.60
|
|
MRI upper extremity w/dye
|
$586.41 |
$586.41 |
$586.41 |
$2,021.30
|
|
MRI without fol w/cont, breast
|
$795.63 |
$795.63 |
$795.63 |
$2,449.20
|
|
MRI without fol w/cont, brst, un
|
$530.64 |
$530.64 |
$530.64 |
$1,720.40
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$74.91 |
$74.91 |
$74.91 |
$49.60
|
|
Mr sfty implt&/fb asmt stf 1
|
$74.91 |
$74.91 |
$74.91 |
$45.00
|
|
Mr spectroscopy
|
$504.24 |
$504.24 |
$504.24 |
$1,340.00
|
|
Mthfr gene analy common variants
|
$114.51 |
$114.51 |
$114.51 |
$184.00
|
|
M.tuberculo dna dir probe
|
$66.66 |
$66.66 |
$66.66 |
$58.40
|
|
Mumps antibody igg
|
$11.88 |
$11.88 |
$11.88 |
$77.35
|
|
Mycophenolate mofetil 250 mg capsule
|
$2.62 |
$2.62 |
$2.62 |
$10.79
|
|
Mycophenolic acid
|
$5.38 |
$5.38 |
$5.38 |
$12.84
|
|
Mycoplasma antibody igm
|
$45.21 |
$45.21 |
$45.21 |
$76.59
|
|
Myd88 gene p.leu265pro vrnt
|
$252.45 |
$252.45 |
$252.45 |
$397.50
|
|
Myelography via inj w/s&i 2+ regions
|
$510.18 |
$510.18 |
$510.18 |
$2,193.60
|
|
Myelography via inj w/s&i cervical
|
$396.33 |
$396.33 |
$396.33 |
$1,745.94
|
|
Myelography via inj w/s&i lumbosacral
|
$396.33 |
$396.33 |
$396.33 |
$1,843.92
|
|
Myelography via inj w/s&i thoracic
|
$396.33 |
$396.33 |
$396.33 |
$1,738.08
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$68.31 |
$68.31 |
$68.31 |
$135.50
|
|
Natalizumab 300 mg/15 ml intravenous solution
|
$9,985.93 |
$9,985.93 |
$9,985.93 |
$16,254.52
|
|
Natriuretic peptide
|
$112.86 |
$112.86 |
$112.86 |
$176.15
|
|
Natural killer cells total count
|
$33.99 |
$33.99 |
$33.99 |
$132.63
|
|
Ndl insj without njx 1 or 2 musc
|
$8.25 |
$8.25 |
$8.25 |
$39.20
|
|
Ndl insj without njx 3+ musc
|
$8.25 |
$8.25 |
$8.25 |
$45.00
|
|
Neck (Cervical Spine) CT scan (with and without contrast)
|
$897.93 |
$897.93 |
$897.93 |
$2,030.60
|
|
Neck (Cervical Spine) CT scan (with contrast)
|
$598.62 |
$598.62 |
$598.62 |
$1,708.20
|
|
Neck (Cervical Spine) CT scan (without contrast)
|
$598.62 |
$598.62 |
$598.62 |
$1,498.90
|
|
Neck (Cervical Spine) MRI (with and without contrast)
|
$953.70 |
$953.70 |
$953.70 |
$2,855.40
|
|
Neck (Cervical Spine) MRI (with contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,301.53
|
|
Neck (Cervical Spine) MRI (without contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,003.30
|
|
Neck MRA (blood vessel MRI, with and without contrast)
|
$576.51 |
$576.51 |
$576.51 |
$2,650.00
|
|
Neck MRA (blood vessel MRI, with contrast)
|
$384.12 |
$384.12 |
$384.12 |
$2,055.58
|
|
Neck MRA (blood vessel MRI, without contrast)
|
$352.77 |
$352.77 |
$352.77 |
$1,790.58
|
|
Nelarabine injection
|
$1,409.43 |
$1,409.43 |
$1,409.43 |
$975.00
|
|
Nivolumab 10 mg/ml intravenous solution (wrapper)
|
$8,933.11 |
$8,933.11 |
$8,933.11 |
$14,820.18
|
|
Nivolumab 240 mg-relatlimab-rmbw 80 mg/20 ml intravenous solution
|
$17,344.16 |
$17,344.16 |
$17,344.16 |
$41,635.10
|
|
Nm imaging bone/joint 3 phase study
|
$369.93 |
$369.93 |
$369.93 |
$1,676.35
|
|
Nm imaging bone/joint whole body
|
$309.54 |
$309.54 |
$309.54 |
$1,570.65
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$321.75 |
$321.75 |
$321.75 |
$1,382.40
|
|
Nm imaging gastric emptying study
|
$319.11 |
$319.11 |
$319.11 |
$1,340.15
|
|
Nm imaging gastrointestinal acute blood loss
|
$246.18 |
$246.18 |
$246.18 |
$1,200.00
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$441.21 |
$441.21 |
$441.21 |
$1,612.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$274.56 |
$274.56 |
$274.56 |
$1,517.10
|
|
Nm imaging pulmonary ventilation/perfusion
|
$557.37 |
$557.37 |
$557.37 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$215.49 |
$215.49 |
$215.49 |
$1,079.00
|
|
Npm1 gene
|
$204.60 |
$204.60 |
$204.60 |
$457.50
|
|
Nuclear Stress Test (Heart)
|
$744.81 |
$744.81 |
$744.81 |
$3,804.45
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$9,686.21 |
$9,686.21 |
$9,686.21 |
$14,865.31
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$23,213.65 |
$23,213.65 |
$23,213.65 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$19.68 |
$19.68 |
$19.68 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$7,774.14 |
$7,774.14 |
$7,774.14 |
$12,080.43
|
|
Ofatumumab 20 mg/ml intravenous solution (wrapper)
|
$6,785.74 |
$6,785.74 |
$6,785.74 |
$2,224.00
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$1,592.63 |
$1,592.63 |
$1,592.63 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$12.25 |
$12.25 |
$12.25 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$5.53 |
$5.53 |
$5.53 |
$22.62
|
|
Oral everolimus
|
$6.62 |
$6.62 |
$6.62 |
$33.34
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$36.08 |
$36.08 |
$36.08 |
$50.63
|
|
Ortho dvc repair per 15 min
|
$16.50 |
$16.50 |
$16.50 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$110.22 |
$110.22 |
$110.22 |
$279.81
|
|
Ortho ewhf rigd without jnt cstm w
|
$489.72 |
$489.72 |
$489.72 |
$1,288.00
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$303.27 |
$303.27 |
$303.27 |
$708.88
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$103.62 |
$103.62 |
$103.62 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$122.76 |
$122.76 |
$122.76 |
$310.00
|
|
Ortho hnd without jnt w/fit&adj
|
$103.62 |
$103.62 |
$103.62 |
$231.00
|
|
Orthosis lso rigd frm hyperex
|
$1,153.35 |
$1,153.35 |
$1,153.35 |
$816.00
|
|
Orthovisc inj per dose
|
$537.58 |
$537.58 |
$537.58 |
$537.58
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$127.71 |
$127.71 |
$127.71 |
$420.76
|
|
Osmolality blood
|
$22.11 |
$22.11 |
$22.11 |
$67.60
|
|
Osmolality urine
|
$22.77 |
$22.77 |
$22.77 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$263.50
|
|
Oth resp proc, group
|
$36.63 |
$36.63 |
$36.63 |
$123.05
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$22.44 |
$22.44 |
$22.44 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$105.00
|
|
Ot re-evaluation patient/family
|
$25.74 |
$25.74 |
$25.74 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$45.16 |
$45.16 |
$45.16 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$222.01 |
$222.01 |
$222.01 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$15.43 |
$15.43 |
$15.43 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$164.89 |
$164.89 |
$164.89 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$1,843.25 |
$1,843.25 |
$1,843.25 |
$3,435.42
|