|
Oil silicone ophth 8.5ml silikon 1000
|
$5,199.00 |
$5,199.00 |
$5,199.00 |
$1,220.80
|
|
Olanzapine 10 mg intramuscular solution
|
$373.18 |
$373.18 |
$373.18 |
$109.58
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$8,483.10 |
$8,483.10 |
$8,483.10 |
$4,595.01
|
|
Oncoprotein dcp
|
$193.20 |
$193.20 |
$193.20 |
$161.60
|
|
Ondansetron 8 mg disintegrating tablet
|
$19.40 |
$19.40 |
$19.40 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$22.62
|
|
Open bx/exc inguinofem nodes
|
$17,992.58 |
$17,992.58 |
$17,992.58 |
$4,992.00
|
|
Open periprosthetic breast capsule 19370
|
$41,591.62 |
$41,591.62 |
$41,591.62 |
$4,520.16
|
|
Ophthalmic mitomycin
|
$2,502.60 |
$2,502.60 |
$2,502.60 |
$775.44
|
|
Opn impltj crnl nrv nea&pg
|
$259,416.47 |
$259,416.47 |
$259,416.47 |
$35,498.40
|
|
Opn impltj nea sacral nerve
|
$95,752.73 |
$95,752.73 |
$95,752.73 |
$7,766.27
|
|
Optx clavicular fx w/int fix
|
$30,199.09 |
$30,199.09 |
$30,199.09 |
$9,013.88
|
|
Optx prox humrl fx w/int fix
|
$48,037.40 |
$48,037.40 |
$48,037.40 |
$13,938.00
|
|
Optx radial shaft fracture
|
$39,480.55 |
$39,480.55 |
$39,480.55 |
$5,301.66
|
|
Optx ulnar shft fx int fixj
|
$25,321.87 |
$25,321.87 |
$25,321.87 |
$8,453.60
|
|
Oral aprepitant
|
$2,439.23 |
$2,439.23 |
$2,439.23 |
$410.20
|
|
Oritavancin 400 mg intravenous solution
|
$6,686.27 |
$6,686.27 |
$6,686.27 |
$3,082.73
|
|
Ortho dvc repair per 15 min
|
$1,169.78 |
$1,169.78 |
$1,169.78 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$1,231.90 |
$1,231.90 |
$1,231.90 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$2,906.24 |
$2,906.24 |
$2,906.24 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$5,470.28 |
$5,470.28 |
$5,470.28 |
$1,288.00
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$1,155.37 |
$1,155.37 |
$1,155.37 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$1,370.35 |
$1,370.35 |
$1,370.35 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$450.49 |
$450.49 |
$450.49 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$1,155.37 |
$1,155.37 |
$1,155.37 |
$231.00
|
|
Orthopedic shoe add rub insl
|
$137.05 |
$137.05 |
$137.05 |
$70.40
|
|
Ortho shoe add leather insol
|
$137.05 |
$137.05 |
$137.05 |
$63.22
|
|
Ortho shoe add march bar
|
$196.63 |
$196.63 |
$196.63 |
$90.66
|
|
Orthosis lso rigd frm hyperex
|
$2,589.10 |
$2,589.10 |
$2,589.10 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$1,519.67 |
$1,519.67 |
$1,519.67 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$4,230.64 |
$4,230.64 |
$4,230.64 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$168.60 |
$168.60 |
$168.60 |
$195.00
|
|
O shoe add horseshoe toe tap
|
$107.20 |
$107.20 |
$107.20 |
$49.45
|
|
O shoe add instep extension
|
$399.55 |
$399.55 |
$399.55 |
$201.67
|
|
O shoe add instep velcro clo
|
$304.04 |
$304.04 |
$304.04 |
$140.22
|
|
O shoe add standard toe tap
|
$41.90 |
$41.90 |
$41.90 |
$19.38
|
|
O shoe convert to sof counte
|
$250.43 |
$250.43 |
$250.43 |
$115.53
|
|
Osmolality blood
|
$45.00 |
$45.00 |
$45.00 |
$67.60
|
|
Osmolality urine
|
$111.00 |
$111.00 |
$111.00 |
$65.00
|
|
Osteopath manip tx/5-6 body region 98927
|
$52.20 |
$52.20 |
$52.20 |
$68.25
|
|
Osteopath manip tx/7-8 body region 98928
|
$49.20 |
$49.20 |
$49.20 |
$84.22
|
|
Osteopath manip tx/9-10 body region98929
|
$52.20 |
$52.20 |
$52.20 |
$92.42
|
|
Ot evaluation high complexity patient/family
|
$351.00 |
$351.00 |
$351.00 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$356.40 |
$356.40 |
$356.40 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$349.80 |
$349.80 |
$349.80 |
$263.50
|
|
Oth resp proc, group
|
$331.20 |
$331.20 |
$331.20 |
$123.05
|
|
Oth resp proc, indiv
|
$73.80 |
$73.80 |
$73.80 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$36.00 |
$36.00 |
$36.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$107.40 |
$107.40 |
$107.40 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$141.00 |
$141.00 |
$141.00 |
$105.00
|
|
Ot re-evaluation patient/family
|
$160.80 |
$160.80 |
$160.80 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$168.60 |
$168.60 |
$168.60 |
$101.38
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$210.00 |
$210.00 |
$210.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$285.00 |
$285.00 |
$285.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$235.80 |
$235.80 |
$235.80 |
$94.25
|
|
Outrigger
|
$245.29 |
$245.29 |
$245.29 |
$123.81
|
|
Outrigger bil with vert extens
|
$821.08 |
$821.08 |
$821.08 |
$378.67
|
|
Oxytocin 10 unit/ml injection solution
|
$231.53 |
$231.53 |
$231.53 |
$50.40
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$129,715.05 |
$129,715.05 |
$129,715.05 |
$47,880.00
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$414.97 |
$414.97 |
$414.97 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$9,195.95 |
$9,195.95 |
$9,195.95 |
$3,435.42
|
|
Palingen or palingen xplus
|
$30,206.19 |
$30,206.19 |
$30,206.19 |
$656.01
|
|
Paliperidone 117 mg/0.75 ml inj
|
$10,279.01 |
$10,279.01 |
$10,279.01 |
$6,238.82
|
|
Palonosetron hcl
|
$103.68 |
$103.68 |
$103.68 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$304.96 |
$304.96 |
$304.96 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$42,175.21 |
$42,175.21 |
$42,175.21 |
$13,051.61
|
|
Papaverin hcl injection
|
$195.67 |
$195.67 |
$195.67 |
$77.05
|
|
Parathormone (pth) intact
|
$232.20 |
$232.20 |
$232.20 |
$204.87
|
|
Parathyroid autotransplantation 60512
|
$23,313.47 |
$23,313.47 |
$23,313.47 |
$4,080.85
|
|
Parathyroid planar imaging
|
$1,595.40 |
$1,595.40 |
$1,595.40 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$861.00 |
$861.00 |
$861.00 |
$1,350.60
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$190.80 |
$190.80 |
$190.80 |
$245.00
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$58,812.22 |
$58,812.22 |
$58,812.22 |
$4,914.00
|
|
Partial removal finger bone
|
$1,195.80 |
$1,195.80 |
$1,195.80 |
$2,049.27
|
|
Partial removal of eye fluid
|
$26,348.99 |
$26,348.99 |
$26,348.99 |
$2,698.92
|
|
Partial removal of thyroid
|
$31,817.21 |
$31,817.21 |
$31,817.21 |
$6,457.82
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$22,771.62 |
$22,771.62 |
$22,771.62 |
$4,921.76
|
|
Part removal of metatarsal
|
$14,156.50 |
$14,156.50 |
$14,156.50 |
$3,795.71
|
|
Part removal of metatarsal 28112
|
$68,019.31 |
$68,019.31 |
$68,019.31 |
$3,839.54
|
|
Passy muir valve metal trach
|
$2,087.35 |
$2,087.35 |
$2,087.35 |
$275.75
|
|
Patten bottom
|
$1,500.22 |
$1,500.22 |
$1,500.22 |
$672.73
|
|
Pcv21 vaccine im
|
$582.60 |
$582.60 |
$582.60 |
$410.26
|
|
Pdgfra gene
|
$1,090.20 |
$1,090.20 |
$1,090.20 |
$717.23
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$107.20 |
$107.20 |
$107.20 |
$49.45
|
|
Pegaspargase injection
|
$80,445.45 |
$80,445.45 |
$80,445.45 |
$39,780.27
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$36,967.63 |
$36,967.63 |
$36,967.63 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$24,048.00 |
$24,048.00 |
$24,048.00 |
$7,297.36
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$12,024.01 |
$12,024.01 |
$12,024.01 |
$4,133.25
|
|
Pegfilgrastim-pbbk 6 mg/0.6 ml subcutaneous syringe
|
$14,400.01 |
$14,400.01 |
$14,400.01 |
$4,067.80
|
|
Pegloticase 8 mg/ml intravenous solution
|
$92,228.97 |
$92,228.97 |
$92,228.97 |
$49,135.11
|
|
Pelv band/spread bar thigh c
|
$2,219.04 |
$2,219.04 |
$2,219.04 |
$802.87
|
|
Pelvic control band & belt b
|
$1,472.98 |
$1,472.98 |
$1,472.98 |
$566.16
|
|
Pelvic control band & belt u
|
$1,085.35 |
$1,085.35 |
$1,085.35 |
$500.58
|
|
Pelvic control hip heavy dut
|
$1,171.91 |
$1,171.91 |
$1,171.91 |
$591.53
|
|
Pelvic control pelvic sling
|
$2,034.26 |
$2,034.26 |
$2,034.26 |
$912.18
|
|
Pelvic CT scan (with and without contrast)
|
$3,156.60 |
$3,156.60 |
$3,156.60 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,887.80 |
$2,887.80 |
$2,887.80 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,810.20 |
$1,810.20 |
$1,810.20 |
$1,363.11
|
|
Pelvic & hip control thigh c
|
$4,977.21 |
$4,977.21 |
$4,977.21 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$3,834.60 |
$3,834.60 |
$3,834.60 |
$2,860.00
|
