|
Protein electrophoretic fractionation & quantitation serum
|
$10.23 |
$10.23 |
$10.23 |
$84.00
|
|
Protein s total
|
$15.18 |
$15.18 |
$15.18 |
$83.52
|
|
Protein total 24 hour urine
|
$12.21 |
$12.21 |
$12.21 |
$52.50
|
|
Protein total body fluid
|
$12.21 |
$12.21 |
$12.21 |
$49.80
|
|
Protein total serum plasma whole blood
|
$11.55 |
$11.55 |
$11.55 |
$42.81
|
|
Prothrombin complex kcentra
|
$6.90 |
$6.90 |
$6.90 |
$7.40
|
|
Prothrombin time substitution plasma fractions each
|
$57.09 |
$57.09 |
$57.09 |
$41.50
|
|
PSA (Prostate) Test
|
$61.05 |
$61.05 |
$61.05 |
$107.50
|
|
Pt application of modality >=1 area electrical stimulation each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$87.45
|
|
Pt application of modality >=1 area iontophoresis each 15 minutes
|
$22.44 |
$22.44 |
$22.44 |
$102.05
|
|
Pt application of modality >=1 area ultrasound each 15 minutes
|
$11.22 |
$11.22 |
$11.22 |
$81.00
|
|
Pt application of modality traction mechanical
|
$11.88 |
$11.88 |
$11.88 |
$91.00
|
|
Pt evaluation high complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$292.80
|
|
Pt evaluation low complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$222.95
|
|
Pt evaluation moderate complexity patient/family
|
$60.06 |
$60.06 |
$60.06 |
$254.88
|
|
Pt re-evaluation patient/family
|
$25.74 |
$25.74 |
$25.74 |
$152.80
|
|
Pt repositioning canalith procedure(s) per day
|
$46.86 |
$46.86 |
$46.86 |
$118.00
|
|
Pt stimulation electrial unattended >= 1 area other than wound care part of therapy plan
|
$11.88 |
$11.88 |
$11.88 |
$81.48
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$87.50
|
|
Pt therapeutic procedure >=1 area massage each 15 minutes
|
$11.22 |
$11.22 |
$11.22 |
$79.30
|
|
Pt wheelchair management each 15 minutes
|
$16.50 |
$16.50 |
$16.50 |
$87.50
|
|
Pulmonary vent imaging
|
$321.42 |
$321.42 |
$321.42 |
$908.00
|
|
Puncture aspiration abscess/hematoma/bulla/cyst
|
$207.24 |
$207.24 |
$207.24 |
$520.80
|
|
Pyridoxine hcl 100 mg
|
$41.65 |
$41.65 |
$41.65 |
$48.70
|
|
Quant diff pulm perf and vent w/imaging
|
$580.80 |
$580.80 |
$580.80 |
$1,542.40
|
|
Quant diff pulm perf w/imaging
|
$580.80 |
$580.80 |
$580.80 |
$1,199.16
|
|
Rabies ig heat-treated human im/subq 90376
|
$1,017.95 |
$1,017.95 |
$1,017.95 |
$1,291.55
|
|
Rabies ig ht&sol human im/sc
|
$3,189.52 |
$3,189.52 |
$3,189.52 |
$2,756.77
|
|
Rabies immune globulin (pf) 300 unit/ml intramuscular solution
|
$3,770.01 |
$3,770.01 |
$3,770.01 |
$4,262.90
|
|
Radphm lcl tmr plnr bdy sgl day img
|
$670.56 |
$670.56 |
$670.56 |
$2,048.87
|
|
Radphm lcl tmr plnr bdy two day img
|
$670.56 |
$670.56 |
$670.56 |
$2,728.42
|
|
Radphm lcl tmr spect/ct 2+ areas/2+ days
|
$670.56 |
$670.56 |
$670.56 |
$2,495.00
|
|
Radphm lcl tomogr sgl area sgl day
|
$946.77 |
$946.77 |
$946.77 |
$2,177.00
|
|
Radphm lcl tumor plr sgl day
|
$202.29 |
$202.29 |
$202.29 |
$1,120.50
|
|
Ramucirumab 10 mg/ml intravenous solution
|
$8,439.23 |
$8,439.23 |
$8,439.23 |
$13,136.04
|
|
Rapid Strep Test
|
$37.95 |
$37.95 |
$37.95 |
$75.24
|
|
Rasburicase 1.5 mg intravenous solution
|
$6,224.84 |
$6,224.84 |
$6,224.84 |
$4,331.80
|
|
Ravulizumab-cwvz 100 mg/ml intravenous solution
|
$26,936.21 |
$26,936.21 |
$26,936.21 |
$41,926.70
|
|
Red blood cells frozen/deglycerolized/washed leukocytes reduced irradiated each unit
|
$298.32 |
$298.32 |
$298.32 |
$721.56
|
|
Red blood cells leukocytes reduced cmv negative irradiated each unit
|
$231.66 |
$231.66 |
$231.66 |
$577.71
|
|
Red blood cells leukocytes reduced each unit
|
$234.30 |
$234.30 |
$234.30 |
$441.00
|
|
Red blood cells leukocytes reduced irradiated each unit
|
$225.06 |
$225.06 |
$225.06 |
$528.45
|
|
Red blood cells washed each unit
|
$271.92 |
$271.92 |
$271.92 |
$572.46
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$479.64 |
$479.64 |
$479.64 |
$364.47
|
|
Remdesivir 100 mg intravenous powder for solution
|
$996.65 |
$996.65 |
$996.65 |
$1,524.70
|
|
Removal central venous device tunneled w/port/pump central/peripheral insertion
|
$795.96 |
$795.96 |
$795.96 |
$2,356.71
|
|
Removal devitalized tissue non-selective debridement without anesthesia per session
|
$101.31 |
$101.31 |
$101.31 |
$249.60
|
|
Renal function panel
|
$23.10 |
$23.10 |
$23.10 |
$113.52
|
|
Repair prosthesis per 15 min
|
$16.50 |
$16.50 |
$16.50 |
$16.50
|
|
Replace g/c tube perc
|
$463.98 |
$463.98 |
$463.98 |
$1,341.50
|
|
Replace picvad cath
|
$974.82 |
$974.82 |
$974.82 |
$3,724.63
|
|
Reptilase test
|
$34.98 |
$34.98 |
$34.98 |
$72.00
|
|
#resp virpnl dfa-adenovirus
|
$21.78 |
$21.78 |
$21.78 |
$45.80
|
|
#resp virpnl dfa-parainfluenza
|
$6.93 |
$6.93 |
$6.93 |
$35.20
|
|
Resp virus 6-11 targets
|
$79.20 |
$79.20 |
$79.20 |
$479.20
|
|
Resuscitation cardiopulmonary
|
$198.33 |
$198.33 |
$198.33 |
$764.40
|
|
Reticulocyte automated
|
$13.20 |
$13.20 |
$13.20 |
$52.57
|
|
Retifanlimab-dlwr 500 mg/20 ml intravenous solution
|
$16,580.57 |
$16,580.57 |
$16,580.57 |
$23,780.31
|
|
Rheumatoid factor quantitative
|
$18.81 |
$18.81 |
$18.81 |
$57.00
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$66.00 |
$66.00 |
$66.00 |
$243.11
|
|
Rho d immune globulin inj
|
$66.00 |
$66.00 |
$66.00 |
$217.71
|
|
Risankizumab-rzaa 60 mg/ml intravenous solution
|
$11,957.19 |
$11,957.19 |
$11,957.19 |
$30,071.50
|
|
Risperidone microspheres 12.5 mg/2 ml inj
|
$1,451.54 |
$1,451.54 |
$1,451.54 |
$2,429.37
|
|
Rituximab 10 mg/ml concentrate,intravenous
|
$5,283.11 |
$5,283.11 |
$5,283.11 |
$9,301.22
|
|
Rituximab 1,400 mg/11.7 ml (120 mg/ml)-hyaluronidase subcutaneous soln
|
$8,452.90 |
$8,452.90 |
$8,452.90 |
$15,057.18
|
|
Rituximab-abbs 10 mg/ml intravenous solution
|
$4,754.70 |
$4,754.70 |
$4,754.70 |
$5,343.99
|
|
Rituximab-arrx 10 mg/ml intravenous solution
|
$6,869.24 |
$6,869.24 |
$6,869.24 |
$6,287.16
|
|
Rituximab-pvvr 10 mg/ml intravenous solution
|
$6,869.24 |
$6,869.24 |
$6,869.24 |
$5,309.20
|
|
Romidepsin 10 mg/2 ml intravenous powder for solution
|
$3,292.06 |
$3,292.06 |
$3,292.06 |
$6,333.33
|
|
Romiplostim 125 mcg subcutaneous solution
|
$6,192.29 |
$6,192.29 |
$6,192.29 |
$8,950.11
|
|
Romosozumab-aqqg 105 mg/1.17 ml subcutaneous syringe (wrapper)
|
$1,478.29 |
$1,478.29 |
$1,478.29 |
$4,820.04
|
|
Ropivacaine 0.2 % epidural pca - 1 hour dose limit
|
$140.61 |
$140.61 |
$140.61 |
$188.50
|
|
Rotavirus antibody
|
$43.89 |
$43.89 |
$43.89 |
$125.01
|
|
Rp loclzj tum 2+area 1+d img
|
$264.00 |
$264.00 |
$264.00 |
$1,310.00
|
|
Rp loclzj tum spect w/ct 1
|
$946.77 |
$946.77 |
$946.77 |
$2,542.20
|
|
Rp loclzj tum spect w/ct 2
|
$748.11 |
$748.11 |
$748.11 |
$3,139.20
|
|
Rpl picc wo subq port/pump incl image guidnc w/s&i
|
$385.11 |
$385.11 |
$385.11 |
$2,173.60
|
|
Rsv assay w/optic
|
$37.95 |
$37.95 |
$37.95 |
$79.38
|
|
Rubella antibody igg
|
$20.13 |
$20.13 |
$20.13 |
$77.03
|
|
Rubeola antibody igg
|
$23.76 |
$23.76 |
$23.76 |
$80.00
|
|
Russell viper venom diluted
|
$37.62 |
$37.62 |
$37.62 |
$72.54
|
|
Sacituzumab govitecan-hziy 180 mg intravenous solution
|
$2,826.49 |
$2,826.49 |
$2,826.49 |
$5,174.32
|
|
Salivary gland imaging
|
$202.29 |
$202.29 |
$202.29 |
$585.00
|
|
Sargramostim injection
|
$278.36 |
$278.36 |
$278.36 |
$609.00
|
|
Sarscov coronavirus ag ia
|
$81.51 |
$81.51 |
$81.51 |
$59.25
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$120.78 |
$120.78 |
$120.78 |
$983.50
|
|
Scan duplex abd/pelvis/retroperitoneal limited
|
$81.18 |
$81.18 |
$81.18 |
$662.00
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$120.78 |
$120.78 |
$120.78 |
$750.20
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$64.35 |
$64.35 |
$64.35 |
$583.00
|
|
Scan duplex extremity veins unilateral/limited study
|
$143.88 |
$143.88 |
$143.88 |
$721.60
|
|
Scan duplex lower extremity arteries complete bilateral
|
$286.77 |
$286.77 |
$286.77 |
$985.20
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$143.88 |
$143.88 |
$143.88 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$143.88 |
$143.88 |
$143.88 |
$595.35
|
|
Screening Mammogram
|
$77.22 |
$77.22 |
$77.22 |
$312.55
|
|
Screening prostate cancer PSA
|
$61.05 |
$61.05 |
$61.05 |
$100.63
|
|
Screw cortex 2.0 x 10mm
|
$8,407.99 |
$8,407.99 |
$8,407.99 |
$29,055.00
|
|
Sc ther infusion reset pump
|
$36.30 |
$36.30 |
$36.30 |
$140.15
|
|
Sedimentation rate erythrocyte automated
|
$8.91 |
$8.91 |
$8.91 |
$42.00
|
|
Sewho erbs palsey design abd
|
$328.02 |
$328.02 |
$328.02 |
$988.40
|
|
Shoulder MRI (with and without contrast)
|
$895.95 |
$895.95 |
$895.95 |
$2,713.80
|