|
Ophthalmic mitomycin
|
$775.44 |
$775.44 |
$775.44 |
$775.44
|
|
Oral aprepitant
|
$286.55 |
$286.55 |
$286.55 |
$410.20
|
|
Oral busulfan
|
$29.52 |
$29.52 |
$29.52 |
$176.80
|
|
Oral everolimus
|
$720.08 |
$720.08 |
$720.08 |
$33.34
|
|
Organic acids total quant ea spec
|
$295.20 |
$295.20 |
$295.20 |
$151.36
|
|
Oritavancin 400 mg intravenous solution
|
$2,298.41 |
$2,298.41 |
$2,298.41 |
$3,082.73
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$50.63 |
$50.63 |
$50.63 |
$50.63
|
|
Ortho elbow w/lock w/ft&adj
|
$169.72 |
$169.72 |
$169.72 |
$536.90
|
|
Ortho ewh rgd without jnt cstm w/fit&adj
|
$1,097.19 |
$1,097.19 |
$1,097.19 |
$708.88
|
|
Orthosis lso rigd frm hyperex
|
$873.43 |
$873.43 |
$873.43 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$609.50 |
$609.50 |
$609.50 |
$420.76
|
|
Oscillation chest wall mechanical per session
|
$155.55 |
$155.55 |
$155.55 |
$195.00
|
|
Osmolality blood
|
$188.70 |
$188.70 |
$188.70 |
$67.60
|
|
Osmolality urine
|
$188.70 |
$188.70 |
$188.70 |
$65.00
|
|
Ostomy clamp, replacement
|
$2.79 |
$2.79 |
$2.79 |
$4.66
|
|
Ostomy irrigation set
|
$41.58 |
$41.58 |
$41.58 |
$41.58
|
|
Ost pch drain for barrier fl
|
$11.45 |
$11.45 |
$11.45 |
$11.45
|
|
Ost pch drain w bar & filter
|
$2.92 |
$2.92 |
$2.92 |
$7.39
|
|
Ost skn barr extnd >4 sq
|
$1.01 |
$1.01 |
$1.01 |
$5.40
|
|
Ost urine pch w b/bltin conv
|
$2.90 |
$2.90 |
$2.90 |
$2.90
|
|
Ot evaluation high complexity patient/family
|
$508.20 |
$508.20 |
$508.20 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$508.20 |
$508.20 |
$508.20 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$508.20 |
$508.20 |
$508.20 |
$263.50
|
|
Oth resp proc, group
|
$79.95 |
$79.95 |
$79.95 |
$123.05
|
|
Oth resp proc, indiv
|
$76.80 |
$76.80 |
$76.80 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$134.70 |
$134.70 |
$134.70 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$128.10 |
$128.10 |
$128.10 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$115.20 |
$115.20 |
$115.20 |
$105.00
|
|
Ot re-evaluation patient/family
|
$508.20 |
$508.20 |
$508.20 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$117.45 |
$117.45 |
$117.45 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$123.90 |
$123.90 |
$123.90 |
$87.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$123.90 |
$123.90 |
$123.90 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$113.70 |
$113.70 |
$113.70 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$111.60 |
$111.60 |
$111.60 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$76.52 |
$76.52 |
$76.52 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$432.00 |
$432.00 |
$432.00 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$94.05 |
$94.05 |
$94.05 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$216.00 |
$216.00 |
$216.00 |
$216.00
|
|
Pad repl cerv collr univ adult
|
$192.01 |
$192.01 |
$192.01 |
$192.01
|
|
Palingen or palingen xplus
|
$656.01 |
$656.01 |
$656.01 |
$656.01
|
|
Palingen or promatrx
|
$691.88 |
$691.88 |
$691.88 |
$691.88
|
|
Paliperidone 117 mg/0.75 ml inj
|
$6,887.83 |
$6,887.83 |
$6,887.83 |
$6,238.82
|
|
Palonosetron hcl
|
$432.00 |
$432.00 |
$432.00 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$202.09 |
$202.09 |
$202.09 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$13,051.61 |
$13,051.61 |
$13,051.61 |
$13,051.61
|
|
Papaverin hcl injection
|
$52.18 |
$52.18 |
$52.18 |
$77.05
|
|
Parathormone (pth) intact
|
$273.30 |
$273.30 |
$273.30 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$2,634.30 |
$2,634.30 |
$2,634.30 |
$1,574.40
|
|
Parathyroid planar imaging
|
$1,132.80 |
$1,132.80 |
$1,132.80 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$1,883.70 |
$1,883.70 |
$1,883.70 |
$1,350.60
|
|
Paricalcitol
|
$41.45 |
$41.45 |
$41.45 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$235.35 |
$235.35 |
$235.35 |
$245.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$6,448.80 |
$6,448.80 |
$6,448.80 |
$4,921.76
|
|
Passy muir valve metal trach
|
$275.75 |
$275.75 |
$275.75 |
$275.75
|
|
Paste skin barrier .5oz adapt
|
$5.73 |
$5.73 |
$5.73 |
$5.73
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$61.50 |
$61.50 |
$61.50 |
$49.45
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$12,707.63 |
$12,707.63 |
$12,707.63 |
$11,216.31
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$4,133.25 |
$4,133.25 |
$4,133.25 |
$4,133.25
|
|
Pegloticase 8 mg/ml intravenous solution
|
$56,690.57 |
$56,690.57 |
$56,690.57 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$2,612.85 |
$2,612.85 |
$2,612.85 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,612.85 |
$2,612.85 |
$2,612.85 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$2,081.55 |
$2,081.55 |
$2,081.55 |
$1,363.11
|
|
Pelvic & hip control thigh c
|
$2,637.58 |
$2,637.58 |
$2,637.58 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$3,482.70 |
$3,482.70 |
$3,482.70 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$2,997.75 |
$2,997.75 |
$2,997.75 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$2,830.05 |
$2,830.05 |
$2,830.05 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$861.45 |
$861.45 |
$861.45 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$383.10 |
$383.10 |
$383.10 |
$430.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$11,003.90 |
$11,003.90 |
$11,003.90 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$8,005.14 |
$8,005.14 |
$8,005.14 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$477.40 |
$477.40 |
$477.40 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,124.96 |
$1,124.96 |
$1,124.96 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$88.57 |
$88.57 |
$88.57 |
$101.34
|
|
Penicillin g procaine inj
|
$180.77 |
$180.77 |
$180.77 |
$147.96
|
|
Penile injection
|
$386.70 |
$386.70 |
$386.70 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$18,349.50 |
$18,349.50 |
$18,349.50 |
$18,764.94
|
|
Pentobarbital sodium inj
|
$4,655.07 |
$4,655.07 |
$4,655.07 |
$2,205.38
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$231.43 |
$231.43 |
$231.43 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$2,976.90 |
$2,976.90 |
$2,976.90 |
$2,251.20
|
|
Peripheral vascular rehab
|
$108.15 |
$108.15 |
$108.15 |
$132.50
|
|
Perit-vens shunt pat tst
|
$1,076.40 |
$1,076.40 |
$1,076.40 |
$758.37
|
|
Permanent tear duct plug
|
$241.08 |
$241.08 |
$241.08 |
$291.00
|
|
Perphenazine 4mg oral
|
$1.84 |
$1.84 |
$1.84 |
$2.58
|
|
Perq dev breast 1st strtctc
|
$490.20 |
$490.20 |
$490.20 |
$1,456.00
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$507.60 |
$507.60 |
$507.60 |
$625.93
|
|
Pertuzumab 30 mg/ml desensitization
|
$12,923.02 |
$12,923.02 |
$12,923.02 |
$13,666.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$49,800.00 |
$49,800.00 |
$49,800.00 |
$38,834.22
|
|
Ph body fluid
|
$83.55 |
$83.55 |
$83.55 |
$41.28
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$160.05 |
$160.05 |
$160.05 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$350.85 |
$350.85 |
$350.85 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,940.25 |
$1,940.25 |
$1,940.25 |
$1,028.40
|
|
Phenylephrine 10 mg/ml injection solution
|
$100.62 |
$100.62 |
$100.62 |
$67.89
|
|
Phenylep ketorolac opth soln
|
$934.56 |
$934.56 |
$934.56 |
$934.56
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$6.00 |
$6.00 |
$6.00 |
$10.80
|
|
Phenytoin total therapeutic drug level
|
$294.90 |
$294.90 |
$294.90 |
$110.88
|
|
Phlebotomy therapeutic
|
$167.70 |
$167.70 |
$167.70 |
$231.66
|
|
Phosphorus
|
$160.50 |
$160.50 |
$160.50 |
$48.80
|
|
Phosphorus 24 hour urine
|
$39.60 |
$39.60 |
$39.60 |
$41.51
|
|
Phys blood bank serv reactj
|
$239.55 |
$239.55 |
$239.55 |
$207.50
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$31.16 |
$31.16 |
$31.16 |
$87.50
|