|
MRA without cont, abd
|
$4.69 |
$4.69 |
$4.69 |
$1,764.03
|
|
MRI breast without cont bi
|
$7,008.85 |
$7,008.85 |
$7,008.85 |
$1,871.10
|
|
MRI breast w IV cont bi
|
$8,248.81 |
$8,248.81 |
$8,248.81 |
$1,875.95
|
|
MRI cardiac morph & func wo IV cont
|
$5,261.32 |
$5,261.32 |
$5,261.32 |
$1,367.88
|
|
MRI cardiac morph & func wwo IV cont
|
$8,540.84 |
$8,540.84 |
$8,540.84 |
$1,946.48
|
|
MRI cardiac morph & func wwo IV cont w/stress img
|
$6,452.88 |
$6,452.88 |
$6,452.88 |
$2,510.00
|
|
MRI compatible system
|
$9.00 |
$9.00 |
$9.00 |
$2,910.00
|
|
MRI guid ndl plc s&i
|
$5,568.98 |
$5,568.98 |
$5,568.98 |
$1,264.76
|
|
MRI without fol w/cont, breast
|
$8,280.06 |
$8,280.06 |
$8,280.06 |
$2,301.04
|
|
Mr safety implant&/fb assmt clin staff ea add 30
|
$319.05 |
$319.05 |
$319.05 |
$58.08
|
|
Mr sfty implt&/fb asmt stf 1
|
$159.53 |
$159.53 |
$159.53 |
$45.56
|
|
Mthfr gene analy common variants
|
$136.74 |
$136.74 |
$136.74 |
$180.48
|
|
Multiple sleep latency test
|
$12,166.85 |
$12,166.85 |
$12,166.85 |
$2,466.00
|
|
Mycobacteria dna amp probe
|
$1,949.38 |
$1,949.38 |
$1,949.38 |
$300.60
|
|
Myeloperoxidase ab multi step qualitative/semiquantitative
|
$1,137.28 |
$1,137.28 |
$1,137.28 |
$131.07
|
|
Myocrd img pet 1std rst/strs
|
$3.99 |
$3.99 |
$3.99 |
$3,627.73
|
|
Myocrd img pet mlt rst&strs
|
$3.99 |
$3.99 |
$3.99 |
$4,060.00
|
|
Neostigmine methylsulfate 1 mg/ml injection (wrapper)
|
$34.96 |
$34.96 |
$34.96 |
$60.38
|
|
Nesiritide injection
|
$9,928.49 |
$9,928.49 |
$9,928.49 |
$3,527.00
|
|
New Patient Office Visit (level 2)
|
$402.16 |
$402.16 |
$402.16 |
$151.45
|
|
New Patient Office Visit (level 3)
|
$476.46 |
$476.46 |
$476.46 |
$205.20
|
|
New Patient Office Visit (level 4)
|
$608.55 |
$608.55 |
$608.55 |
$289.60
|
|
New Patient Office Visit (level 5)
|
$681.67 |
$681.67 |
$681.67 |
$349.70
|
|
N.gonorrhoeae dna quant
|
$1,247.36 |
$1,247.36 |
$1,247.36 |
$47.12
|
|
Nm imaging bone/joint 3 phase study
|
$9,276.63 |
$9,276.63 |
$9,276.63 |
$1,708.85
|
|
Nm imaging bone/joint whole body
|
$8,696.74 |
$8,696.74 |
$8,696.74 |
$1,570.65
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$7,453.50 |
$7,453.50 |
$7,453.50 |
$1,397.69
|
|
Nm imaging gastric emptying study
|
$5,667.63 |
$5,667.63 |
$5,667.63 |
$1,340.40
|
|
Nm imaging gastrointestinal acute blood loss
|
$8,944.19 |
$8,944.19 |
$8,944.19 |
$1,197.47
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$8,346.42 |
$8,346.42 |
$8,346.42 |
$1,530.60
|
|
Nm imaging pulmonary ventilation/perfusion
|
$9,840.11 |
$9,840.11 |
$9,840.11 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$4,642.04 |
$4,642.04 |
$4,642.04 |
$1,091.00
|
|
Nm radiopharmaceutical therapy oral administration
|
$7,738.23 |
$7,738.23 |
$7,738.23 |
$1,057.20
|
|
Npsy fam hlth interv ea addl 15 min
|
$118.41 |
$118.41 |
$118.41 |
$86.33
|
|
Npsy grp hlth intrv ea addl 15 min
|
$102.04 |
$102.04 |
$102.04 |
$57.85
|
|
Npsy indiv hlth intrv ea addl 15 min
|
$119.67 |
$119.67 |
$119.67 |
$102.71
|
|
Nr lnr acclrtr tx max 5 sessions
|
$2.30 |
$2.30 |
$2.30 |
$7,421.70
|
|
Nuclear rx IV admin
|
$3,872.84 |
$3,872.84 |
$3,872.84 |
$814.80
|
|
Nuclear Stress Test (Heart)
|
$20,552.28 |
$20,552.28 |
$20,552.28 |
$3,804.45
|
|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$32,396.76 |
$32,396.76 |
$32,396.76 |
$14,865.31
|
|
Ob Ultrasound nuchal meas 1 gest
|
$624.75 |
$624.75 |
$624.75 |
$338.17
|
|
Olanzapine 10 mg intramuscular solution
|
$298.30 |
$298.30 |
$298.30 |
$109.58
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$497.44 |
$497.44 |
$497.44 |
$22.62
|
|
Opioids & opiate analogs 3/4
|
$1,735.95 |
$1,735.95 |
$1,735.95 |
$24.00
|
|
Organic acids total quant ea spec
|
$1,916.05 |
$1,916.05 |
$1,916.05 |
$151.36
|
|
Ortho shoe add full sole
|
$356.00 |
$356.00 |
$356.00 |
$116.50
|
|
Oscillation chest wall mechanical per session
|
$794.83 |
$794.83 |
$794.83 |
$195.00
|
|
Osmolality urine
|
$451.91 |
$451.91 |
$451.91 |
$65.65
|
|
Ostomy clamp, replacement
|
$10.00 |
$10.00 |
$10.00 |
$4.66
|
|
Ost pch drain for barrier fl
|
$13.00 |
$13.00 |
$13.00 |
$11.45
|
|
Ot evaluation high complexity patient/family
|
$867.94 |
$867.94 |
$867.94 |
$292.80
|
|
Ot evaluation low complexity patient/family
|
$326.47 |
$326.47 |
$326.47 |
$226.80
|
|
Ot evaluation moderate complexity patient/family
|
$402.44 |
$402.44 |
$402.44 |
$263.50
|
|
Ot re-evaluation patient/family
|
$373.36 |
$373.36 |
$373.36 |
$160.80
|
|
Oxaliplatin 5 mg/ml desensitization
|
$18,475.58 |
$18,475.58 |
$18,475.58 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$147.69 |
$147.69 |
$147.69 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$26.86 |
$26.86 |
$26.86 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$16,342.72 |
$16,342.72 |
$16,342.72 |
$3,420.45
|
|
Palivizumab 50 mg/0.5 ml inj
|
$44,949.10 |
$44,949.10 |
$44,949.10 |
$5,481.00
|
|
Palonosetron hcl
|
$6,555.81 |
$6,555.81 |
$6,555.81 |
$154.78
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$5,958.49 |
$5,958.49 |
$5,958.49 |
$129.80
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$39,734.73 |
$39,734.73 |
$39,734.73 |
$13,318.60
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$404.83 |
$404.83 |
$404.83 |
$27.16
|
|
Parathormone (pth) intact
|
$2,531.38 |
$2,531.38 |
$2,531.38 |
$201.50
|
|
Parathyrd planar w/spect&ct
|
$11,310.61 |
$11,310.61 |
$11,310.61 |
$1,555.00
|
|
Parathyroid planar imaging
|
$7,954.37 |
$7,954.37 |
$7,954.37 |
$1,073.82
|
|
Parathyroid planar img w/tomo spect
|
$9,767.06 |
$9,767.06 |
$9,767.06 |
$1,345.00
|
|
Pelvic control hip heavy dut
|
$980.00 |
$980.00 |
$980.00 |
$591.53
|
|
Pelvic & hip control thigh c
|
$4,102.00 |
$4,102.00 |
$4,102.00 |
$2,512.27
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$36,172.59 |
$36,172.59 |
$36,172.59 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$49,819.42 |
$49,819.42 |
$49,819.42 |
$6,202.54
|
|
Penile vascular study
|
$6,273.02 |
$6,273.02 |
$6,273.02 |
$585.20
|
|
Pentazocine injection
|
$755.14 |
$755.14 |
$755.14 |
$128.80
|
|
Pentobarbital sodium inj
|
$208.40 |
$208.40 |
$208.40 |
$2,047.85
|
|
Peri-proc device eval icd
|
$1,749.60 |
$1,749.60 |
$1,749.60 |
$192.40
|
|
Peri-proc device eval pm
|
$637.10 |
$637.10 |
$637.10 |
$156.00
|
|
Peritoneogram rs&i
|
$5,678.86 |
$5,678.86 |
$5,678.86 |
$689.15
|
|
Pet CT skull-mid thgh initial
|
$3.99 |
$3.99 |
$3.99 |
$4,711.20
|
|
Pet CT whole body initial
|
$3.99 |
$3.99 |
$3.99 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$3.99 |
$3.99 |
$3.99 |
$3,789.00
|
|
Pet image full body
|
$3.99 |
$3.99 |
$3.99 |
$5,070.50
|
|
Pet image ltd area
|
$3.99 |
$3.99 |
$3.99 |
$3,518.45
|
|
Pet image skull-thigh
|
$3.99 |
$3.99 |
$3.99 |
$4,278.00
|
|
Pet scan brain perf study
|
$3.99 |
$3.99 |
$3.99 |
$3,724.00
|
|
Ph body fluid
|
$330.18 |
$330.18 |
$330.18 |
$40.04
|
|
Phenobarbital therapeutic drug level
|
$1,364.08 |
$1,364.08 |
$1,364.08 |
$104.50
|
|
Phentolaine mesylate inj
|
$2,992.92 |
$2,992.92 |
$2,992.92 |
$1,028.40
|
|
Phosphorus 24 hour urine
|
$713.72 |
$713.72 |
$713.72 |
$41.58
|
|
Placental lactogen
|
$593.66 |
$593.66 |
$593.66 |
$163.28
|
|
Plasma cryoprecipitate reduced each unit
|
$376.49 |
$376.49 |
$376.49 |
$157.95
|
|
Platelet pheresis each unit
|
$4,327.35 |
$4,327.35 |
$4,327.35 |
$940.45
|
|
Platelets each unit
|
$368.87 |
$368.87 |
$368.87 |
$169.20
|
|
Plethysmography lung volumes/airway resistance
|
$11,947.66 |
$11,947.66 |
$11,947.66 |
$399.50
|
|
Polysom <6 yrs cpap/bilvl
|
$17,383.05 |
$17,383.05 |
$17,383.05 |
$3,398.50
|
|
Polysomnography sleep staging >=4 parameters age >=6 years w/cpap bipap
|
$17,383.05 |
$17,383.05 |
$17,383.05 |
$3,751.48
|
|
Postop app non-wgt bear dsg
|
$1,648.00 |
$1,648.00 |
$1,648.00 |
$896.02
|
|
Postop dress & 1 cast chg bk
|
$4,327.00 |
$4,327.00 |
$4,327.00 |
$2,711.11
|
|
Potassium 24 hour urine
|
$473.58 |
$473.58 |
$473.58 |
$50.70
|
|
Pouch drainable w barrier at
|
$39.00 |
$39.00 |
$39.00 |
$8.00
|
|
Pouch high output 2pc 50mm red
|
$51.00 |
$51.00 |
$51.00 |
$10.83
|
