|
Nm imaging gastrointestinal acute blood loss
|
$1,837.20 |
$1,837.20 |
$1,837.20 |
$1,264.90
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$3,134.88 |
$3,134.88 |
$3,134.88 |
$1,774.30
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$5,570.79 |
$5,570.79 |
$5,570.79 |
$1,574.40
|
|
Nm imaging pulmonary ventilation/perfusion
|
$7,404.13 |
$7,404.13 |
$7,404.13 |
$1,574.40
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$2,806.06 |
$2,806.06 |
$2,806.06 |
$1,186.03
|
|
Nuclear Stress Test (Heart)
|
$7,136.16 |
$7,136.16 |
$7,136.16 |
$3,921.45
|
|
Olanzapine 10 mg intramuscular solution
|
$258.07 |
$258.07 |
$258.07 |
$120.17
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$8,704.09 |
$8,704.09 |
$8,704.09 |
$4,595.01
|
|
Onco (ovar) two proteins
|
$1,740.96 |
$1,740.96 |
$1,740.96 |
$260.50
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$68.21 |
$68.21 |
$68.21 |
$56.42
|
|
Osmolality blood
|
$219.24 |
$219.24 |
$219.24 |
$67.60
|
|
Osmolality urine
|
$1,097.71 |
$1,097.71 |
$1,097.71 |
$65.65
|
|
Ot evaluation high complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$303.05
|
|
Ot evaluation low complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$238.00
|
|
Ot evaluation moderate complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$270.58
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$227.02 |
$227.02 |
$227.02 |
$107.32
|
|
Ot re-evaluation patient/family
|
$526.38 |
$526.38 |
$526.38 |
$174.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$215.99 |
$215.99 |
$215.99 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$215.99 |
$215.99 |
$215.99 |
$91.80
|
|
Oxytocin 10 unit/ml injection solution
|
$87.75 |
$87.75 |
$87.75 |
$48.29
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$9,808.48 |
$9,808.48 |
$9,808.48 |
$3,656.90
|
|
Palivizumab 50 mg/0.5 ml inj
|
$15,130.72 |
$15,130.72 |
$15,130.72 |
$5,156.88
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$94.77 |
$94.77 |
$94.77 |
$35.43
|
|
Parathormone (pth) intact
|
$952.56 |
$952.56 |
$952.56 |
$200.23
|
|
Parathyroid planar img w/tomo spect
|
$2,806.06 |
$2,806.06 |
$2,806.06 |
$1,398.75
|
|
Passy muir valve metal trach
|
$2,356.00 |
$2,356.00 |
$2,356.00 |
$242.47
|
|
Pelvic CT scan (with and without contrast)
|
$6,267.89 |
$6,267.89 |
$6,267.89 |
$1,918.15
|
|
Pelvic CT scan (with contrast)
|
$5,155.57 |
$5,155.57 |
$5,155.57 |
$1,669.00
|
|
Pelvic CT scan (without contrast)
|
$4,185.82 |
$4,185.82 |
$4,185.82 |
$1,332.80
|
|
Pelvic MRI (with and without contrast)
|
$11,123.29 |
$11,123.29 |
$11,123.29 |
$2,744.64
|
|
Pelvic MRI (without contrast)
|
$6,198.54 |
$6,198.54 |
$6,198.54 |
$1,879.15
|
|
Pelvic Ultrasound (complete)
|
$1,275.19 |
$1,275.19 |
$1,275.19 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$1,295.40 |
$1,295.40 |
$1,295.40 |
$445.00
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$19,969.18 |
$19,969.18 |
$19,969.18 |
$4,181.29
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$1,295.34 |
$1,295.34 |
$1,295.34 |
$321.71
|
|
Ph body fluid
|
$84.92 |
$84.92 |
$84.92 |
$39.20
|
|
Phenobarbital therapeutic drug level
|
$1,022.12 |
$1,022.12 |
$1,022.12 |
$104.50
|
|
Phentolaine mesylate inj
|
$413.75 |
$413.75 |
$413.75 |
$1,028.40
|
|
Phenytoin total therapeutic drug level
|
$625.55 |
$625.55 |
$625.55 |
$111.27
|
|
Phosphorus
|
$245.43 |
$245.43 |
$245.43 |
$47.81
|
|
Phys blood bank serv reactj
|
$1,405.78 |
$1,405.78 |
$1,405.78 |
$219.94
|
|
Platelet automated
|
$211.39 |
$211.39 |
$211.39 |
$44.00
|
|
Potassium 24 hour urine
|
$177.34 |
$177.34 |
$177.34 |
$50.00
|
|
Potassium serum/plasma/whole blood
|
$177.34 |
$177.34 |
$177.34 |
$44.64
|
|
Pq dr cath chg w cont s&i
|
$1,021.38 |
$1,021.38 |
$1,021.38 |
$711.36
|
|
Pralidoxime 1 gram solution for injection
|
$595.40 |
$595.40 |
$595.40 |
$297.18
|
|
Prealbumin
|
$266.77 |
$266.77 |
$266.77 |
$87.20
|
|
Prednisolone sodium phosphate 15 mg/5 ml (3 mg/ml) oral solution
|
$33.37 |
$33.37 |
$33.37 |
$13.32
|
|
Pregnancy Ultrasound (complete, after first trimester)
|
$2,378.78 |
$2,378.78 |
$2,378.78 |
$592.71
|
|
Pregnancy Ultrasound (first trimester)
|
$1,131.35 |
$1,131.35 |
$1,131.35 |
$541.45
|
|
Pressure max expiratory/inspiratory
|
$43.09 |
$43.09 |
$43.09 |
$253.00
|
|
Procainamide 100 mg/ml injection (wrapper)
|
$693.28 |
$693.28 |
$693.28 |
$546.07
|
|
Procalcitonin
|
$693.65 |
$693.65 |
$693.65 |
$144.10
|
|
Prochlorperazine edisylate 10 mg/2 ml (5 mg/ml) injection solution
|
$167.56 |
$167.56 |
$167.56 |
$44.76
|
|
Progesterone
|
$836.57 |
$836.57 |
$836.57 |
$105.00
|
|
Prolactin
|
$961.52 |
$961.52 |
$961.52 |
$127.50
|
|
Protamine 10 mg/ml intravenous solution
|
$1,765.80 |
$1,765.80 |
$1,765.80 |
$60.98
|
|
Protein electrophoretic fractionation & quantitation serum
|
$676.06 |
$676.06 |
$676.06 |
$85.20
|
|
Protein total 24 hour urine
|
$665.23 |
$665.23 |
$665.23 |
$52.50
|
|
Protein total serum plasma whole blood
|
$477.39 |
$477.39 |
$477.39 |
$42.81
|
|
PSA (Prostate) Test
|
$749.40 |
$749.40 |
$749.40 |
$109.35
|
|
Pt evaluation high complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$297.00
|
|
Pt evaluation low complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$226.00
|
|
Pt evaluation moderate complexity patient/family
|
$881.96 |
$881.96 |
$881.96 |
$263.90
|
|
Pt re-evaluation patient/family
|
$526.38 |
$526.38 |
$526.38 |
$157.30
|
|
Pt repositioning canalith procedure(s) per day
|
$227.02 |
$227.02 |
$227.02 |
$123.92
|
|
Pt therapeutic procedure >=1 area gait training each 15 minutes
|
$219.67 |
$219.67 |
$219.67 |
$85.68
|
|
Pulse ox multiple
|
$139.08 |
$139.08 |
$139.08 |
$194.33
|
|
Pulse ox single
|
$85.08 |
$85.08 |
$85.08 |
$88.63
|
|
Pyridoxine hcl 100 mg
|
$77.86 |
$77.86 |
$77.86 |
$43.51
|
|
Quest t3 uptake
|
$251.00 |
$251.00 |
$251.00 |
$56.10
|
|
Rabies ig heat-treated human im/subq 90376
|
$3,792.98 |
$3,792.98 |
$3,792.98 |
$1,059.01
|
|
Radphm lcl tomogr sgl area sgl day
|
$4,281.37 |
$4,281.37 |
$4,281.37 |
$2,377.65
|
|
Rasburicase 1.5 mg intravenous solution
|
$4,684.22 |
$4,684.22 |
$4,684.22 |
$2,789.64
|
|
Regadenoson 0.4 mg/5 ml intravenous syringe
|
$1,979.35 |
$1,979.35 |
$1,979.35 |
$468.96
|
|
Remdesivir 100 mg intravenous powder for solution
|
$2,188.07 |
$2,188.07 |
$2,188.07 |
$1,560.00
|
|
Renal function panel
|
$1,074.15 |
$1,074.15 |
$1,074.15 |
$110.10
|
|
Reticulocyte direct measurement automated
|
$334.76 |
$334.76 |
$334.76 |
$33.57
|
|
Rheumatoid factor quantitative
|
$125.34 |
$125.34 |
$125.34 |
$58.00
|
|
Rho(d) immune globulin 1,500 unit (300 mcg)/2 ml injection syringe
|
$880.87 |
$880.87 |
$880.87 |
$243.11
|
|
Rifampin in ns IV syringe 3 mg/ml (neo/ped) - cnr
|
$2,005.30 |
$2,005.30 |
$2,005.30 |
$462.44
|
|
Russell viper venom diluted
|
$757.25 |
$757.25 |
$757.25 |
$70.16
|
|
Sarscov coronavirus ag ia
|
$37.42 |
$37.42 |
$37.42 |
$60.40
|
|
Scan duplex abd/pelvis/retroperitoneal complete
|
$2,296.80 |
$2,296.80 |
$2,296.80 |
$1,012.55
|
|
Scan duplex aorta/ivc/iliac or bypass grafts complete
|
$2,504.64 |
$2,504.64 |
$2,504.64 |
$815.66
|
|
Scan duplex aorta/ivc/iliac unilateral/limited
|
$1,247.00 |
$1,247.00 |
$1,247.00 |
$509.35
|
|
Scan duplex extracranial arteries unilateral/limited study
|
$1,277.22 |
$1,277.22 |
$1,277.22 |
$589.60
|
|
Scan duplex extremity veins unilateral/limited study
|
$1,808.99 |
$1,808.99 |
$1,808.99 |
$759.20
|
|
Scan duplex lower extremity arteries complete bilateral
|
$1,999.31 |
$1,999.31 |
$1,999.31 |
$1,006.85
|
|
Scan duplex lower extremity arteries unilateral/limited study left
|
$2,177.60 |
$2,177.60 |
$2,177.60 |
$660.00
|
|
Scan duplex upper extremity arteries unilateral/limited study left
|
$2,304.69 |
$2,304.69 |
$2,304.69 |
$601.70
|
|
Screening prostate cancer PSA
|
$749.36 |
$749.36 |
$749.36 |
$100.80
|
|
Sedimentation rate erythrocyte automated
|
$353.01 |
$353.01 |
$353.01 |
$44.20
|
|
Sevelamer carbonate 800 mg tablet
|
$28.54 |
$28.54 |
$28.54 |
$7.14
|
|
Sevelamer carbonate pdr 20mg
|
$61.55 |
$61.55 |
$61.55 |
$21.42
|
|
Sickling rbc
|
$448.96 |
$448.96 |
$448.96 |
$53.55
|
|
Sildenafil citrate, 25 mg
|
$122.72 |
$122.72 |
$122.72 |
$4.87
|
|
Sincalide 5 mcg solution for injection
|
$5,959.90 |
$5,959.90 |
$5,959.90 |
$354.67
|
|
Sinus CT scan (with contrast)
|
$5,170.92 |
$5,170.92 |
$5,170.92 |
$1,519.50
|
|
Sinus CT scan (without contrast)
|
$4,106.87 |
$4,106.87 |
$4,106.87 |
$1,279.50
|