|
Ot evaluation low complexity patient/family
|
$98.55 |
$98.55 |
$98.55 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$131.40 |
$131.40 |
$131.40 |
$270.58
|
|
Other immunoelectrophoresis
|
$42.75 |
$42.75 |
$42.75 |
$46.40
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$24.60 |
$24.60 |
$24.60 |
$100.75
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$41.25 |
$41.25 |
$41.25 |
$107.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$54.15 |
$54.15 |
$54.15 |
$107.32
|
|
Ot re-evaluation patient/family
|
$98.55 |
$98.55 |
$98.55 |
$174.00
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$56.25 |
$56.25 |
$56.25 |
$100.20
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$25.95 |
$25.95 |
$25.95 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$27.30 |
$27.30 |
$27.30 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$42.90 |
$42.90 |
$42.90 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$36.15 |
$36.15 |
$36.15 |
$100.10
|
|
Ot training self care/home management direct contact each 15 minutes
|
$41.85 |
$41.85 |
$41.85 |
$93.75
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$780.84 |
$780.84 |
$780.84 |
$50.50
|
|
Oxaliplatin 5 mg/ml desensitization
|
$460.76 |
$460.76 |
$460.76 |
$364.29
|
|
Oxytocin 10 unit/ml injection solution
|
$62.73 |
$62.73 |
$62.73 |
$45.86
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$37,800.00 |
$37,800.00 |
$37,800.00 |
$44,654.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$105.64 |
$105.64 |
$105.64 |
$231.46
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$4,782.25 |
$4,782.25 |
$4,782.25 |
$4,014.63
|
|
Palonosetron hcl
|
$138.82 |
$138.82 |
$138.82 |
$372.41
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$9.38 |
$9.38 |
$9.38 |
$146.80
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$435.42 |
$435.42 |
$435.42 |
$44.25
|
|
Papaverin hcl injection
|
$718.55 |
$718.55 |
$718.55 |
$76.40
|
|
Parathormone (pth) intact
|
$99.15 |
$99.15 |
$99.15 |
$200.23
|
|
Parathyroid planar imaging
|
$528.19 |
$528.19 |
$528.19 |
$1,166.00
|
|
Parathyroid planar img w/tomo spect
|
$422.55 |
$422.55 |
$422.55 |
$1,398.75
|
|
Paricalcitol
|
$867.60 |
$867.60 |
$867.60 |
$47.38
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$113.70 |
$113.70 |
$113.70 |
$270.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$1,804.54 |
$1,804.54 |
$1,804.54 |
$4,418.62
|
|
Passy muir valve metal trach
|
$451.71 |
$451.71 |
$451.71 |
$241.20
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$12.13 |
$12.13 |
$12.13 |
$14.70
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$36,040.45 |
$36,040.45 |
$36,040.45 |
$12,556.80
|
|
Pegfilgrastim-apgf 6 mg/0.6 ml subcutaneous syringe
|
$22,702.20 |
$22,702.20 |
$22,702.20 |
$7,670.65
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$24,148.20 |
$24,148.20 |
$24,148.20 |
$8,382.81
|
|
Pegfilgrastim-fpgk 6 mg/0.6 ml subcutaneous syringe
|
$24,872.65 |
$24,872.65 |
$24,872.65 |
$2,735.46
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$24,148.20 |
$24,148.20 |
$24,148.20 |
$5,908.68
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$14,460.00 |
$14,460.00 |
$14,460.00 |
$1,194.98
|
|
Pelvic CT scan (with and without contrast)
|
$1,636.50 |
$1,636.50 |
$1,636.50 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$1,482.30 |
$1,482.30 |
$1,482.30 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$856.80 |
$856.80 |
$856.80 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$1,584.45 |
$1,584.45 |
$1,584.45 |
$2,744.64
|
|
Pelvic MRI (with contrast)
|
$1,267.50 |
$1,267.50 |
$1,267.50 |
$2,087.21
|
|
Pelvic MRI (without contrast)
|
$1,077.45 |
$1,077.45 |
$1,077.45 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$605.55 |
$605.55 |
$605.55 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$282.45 |
$282.45 |
$282.45 |
$445.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$20,467.46 |
$20,467.46 |
$20,467.46 |
$16,340.69
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$11,973.75 |
$11,973.75 |
$11,973.75 |
$4,181.29
|
|
Peng benzathine/procaine inj
|
$363.50 |
$363.50 |
$363.50 |
$258.72
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$437.38 |
$437.38 |
$437.38 |
$643.59
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$121.99 |
$121.99 |
$121.99 |
$100.50
|
|
Penicillin g procaine inj
|
$160.16 |
$160.16 |
$160.16 |
$40.94
|
|
Penile injection
|
$79.88 |
$79.88 |
$79.88 |
$418.00
|
|
Perc d-e cor revasc chro add
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$12,250.08
|
|
Perc d-e cor revasc chro sin
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$19,992.17
|
|
Perc d-e cor revasc t cabg b
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$12,287.00
|
|
Perc d-e cor revasc t cabg s
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$15,337.30
|
|
Perc d-e cor stent ather br
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$12,199.20
|
|
Perc d-e cor stent ather s
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$19,892.81
|
|
Perc drug-el cor stent bran
|
$7,561.20 |
$7,561.20 |
$7,561.20 |
$11,667.75
|
|
Perc drug-el cor stent sing
|
$7,561.13 |
$7,561.13 |
$7,561.13 |
$14,070.70
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$412.98 |
$412.98 |
$412.98 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$220.50 |
$220.50 |
$220.50 |
$2,573.60
|
|
Peripheral vascular rehab
|
$28.16 |
$28.16 |
$28.16 |
$128.69
|
|
Peri-proc device eval icd
|
$344.10 |
$344.10 |
$344.10 |
$220.35
|
|
Perit-vens shunt pat tst
|
$199.95 |
$199.95 |
$199.95 |
$695.40
|
|
Perphenazine 4mg oral
|
$0.73 |
$0.73 |
$0.73 |
$9.93
|
|
Perq clsr tcat l atr apndge
|
$7,454.44 |
$7,454.44 |
$7,454.44 |
$12,032.67
|
|
Perq dev breast 1st mr guide
|
$393.90 |
$393.90 |
$393.90 |
$2,032.24
|
|
Perq dev breast 1st strtctc
|
$725.55 |
$725.55 |
$725.55 |
$1,548.60
|
|
Perq plmt bile duct stent
|
$2,324.10 |
$2,324.10 |
$2,324.10 |
$6,904.15
|
|
Perq plmt bile duct stent
|
$2,324.10 |
$2,324.10 |
$2,324.10 |
$6,457.82
|
|
Perq plmt bile duct stent
|
$2,324.10 |
$2,324.10 |
$2,324.10 |
$7,082.99
|
|
Perqt bx lung/mediastinum 32405
|
$531.60 |
$531.60 |
$531.60 |
$1,770.60
|
|
Pertussis ag if
|
$61.80 |
$61.80 |
$61.80 |
$49.00
|
|
Pertuzumab 30 mg/ml desensitization
|
$1,370.85 |
$1,370.85 |
$1,370.85 |
$18,443.20
|
|
Pet CT skull-mid thgh initial
|
$1,764.15 |
$1,764.15 |
$1,764.15 |
$4,854.75
|
|
Pet CT whole body initial
|
$1,817.10 |
$1,817.10 |
$1,817.10 |
$5,017.50
|
|
Pet fdg brain metoblic eval sb
|
$1,109.70 |
$1,109.70 |
$1,109.70 |
$3,559.05
|
|
Pet image w/ct lmtd
|
$1,023.30 |
$1,023.30 |
$1,023.30 |
$4,422.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$23,112.97 |
$23,112.97 |
$23,112.97 |
$34,848.45
|
|
Ph body fluid
|
$26.07 |
$26.07 |
$26.07 |
$39.20
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$75.73 |
$75.73 |
$75.73 |
$123.17
|
|
Phenobarbital therapeutic drug level
|
$63.90 |
$63.90 |
$63.90 |
$104.50
|
|
Phentolaine mesylate inj
|
$1,474.92 |
$1,474.92 |
$1,474.92 |
$1,011.98
|
|
Phenylephrine 10 mg/ml injection solution
|
$520.56 |
$520.56 |
$520.56 |
$58.49
|
|
Phenytoin in ns IV syringe 5 mg/ml (neo/ped) - cnr
|
$58.13 |
$58.13 |
$58.13 |
$23.37
|
|
Phenytoin total therapeutic drug level
|
$62.58 |
$62.58 |
$62.58 |
$111.27
|
|
Phlebotomy therapeutic
|
$60.00 |
$60.00 |
$60.00 |
$249.00
|
|
Phosphorus
|
$33.51 |
$33.51 |
$33.51 |
$47.81
|
|
Phosphorus 24 hour urine
|
$26.93 |
$26.93 |
$26.93 |
$42.81
|
|
Phys blood bank serv authrj
|
$23.40 |
$23.40 |
$23.40 |
$97.60
|
|
Phys blood bank serv reactj
|
$22.80 |
$22.80 |
$22.80 |
$219.94
|
|
Phys blood bank serv xmatch
|
$11.71 |
$11.71 |
$11.71 |
$56.08
|
|
Phytonadione (vitamin k1) 10 mg/ml injection solution
|
$169.94 |
$169.94 |
$169.94 |
$86.36
|
|
Pin caspar distraction 12mm
|
$17,298.54 |
$17,298.54 |
$17,298.54 |
$9,784.88
|
|
Pinworm exam
|
$21.75 |
$21.75 |
$21.75 |
$39.75
|
|
Piperacillin-tazobactam 3.375 gram intravenous solution
|
$662.27 |
$662.27 |
$662.27 |
$95.01
|
|
Place cath intracranial art
|
$2,103.45 |
$2,103.45 |
$2,103.45 |
$3,799.90
|
|
Place cath xtrnl carotid
|
$636.15 |
$636.15 |
$636.15 |
$4,202.65
|
|
Place duod/jej tube perc
|
$755.55 |
$755.55 |
$755.55 |
$2,588.00
|