|
Obinutuzumab 1,000 mg/40 ml intravenous solution
|
$4,968.16 |
$4,968.16 |
$4,968.16 |
$14,865.31
|
|
Observation direct referral from physician office for admission
|
$570.90 |
$570.90 |
$570.90 |
$384.00
|
|
Observation per hour
|
$40.20 |
$40.20 |
$40.20 |
$81.22
|
|
Obstetrics panel
|
$94.20 |
$94.20 |
$94.20 |
$214.50
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$90.00 |
$90.00 |
$90.00 |
$90.00
|
|
Offset knee joint each
|
$245.72 |
$245.72 |
$245.72 |
$221.31
|
|
Offset knee joint heavy duty
|
$351.18 |
$351.18 |
$351.18 |
$271.15
|
|
Oil silicone ophth 8.5ml silikon 1000
|
$2,662.50 |
$2,662.50 |
$2,662.50 |
$1,220.80
|
|
Olanzapine 10 mg intramuscular solution
|
$177.12 |
$177.12 |
$177.12 |
$109.58
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$6,671.60 |
$6,671.60 |
$6,671.60 |
$4,595.01
|
|
Oncoprotein dcp
|
$96.60 |
$96.60 |
$96.60 |
$161.60
|
|
Ondansetron 8 mg disintegrating tablet
|
$6.00 |
$6.00 |
$6.00 |
$9.30
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$22.62
|
|
Open bx/exc inguinofem nodes
|
$17,485.89 |
$17,485.89 |
$17,485.89 |
$4,992.00
|
|
Opn mpltj hpglsl nstm ary pg
|
$90,872.19 |
$90,872.19 |
$90,872.19 |
$36,076.18
|
|
Opn tx dprsd zygomatic arch
|
$12,827.11 |
$12,827.11 |
$12,827.11 |
$5,419.00
|
|
Optx clavicular fx w/int fix
|
$25,810.31 |
$25,810.31 |
$25,810.31 |
$9,013.88
|
|
Optx prox humrl fx w/int fix
|
$32,738.75 |
$32,738.75 |
$32,738.75 |
$13,938.00
|
|
Oral aprepitant
|
$2,539.90 |
$2,539.90 |
$2,539.90 |
$410.20
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$153.50 |
$153.50 |
$153.50 |
$50.63
|
|
Ortho dvc repair per 15 min
|
$599.06 |
$599.06 |
$599.06 |
$53.43
|
|
Ortho elbow without jnt cstm w/fit&adj
|
$630.88 |
$630.88 |
$630.88 |
$279.81
|
|
Ortho elbow w/lock w/ft&adj
|
$1,488.34 |
$1,488.34 |
$1,488.34 |
$536.90
|
|
Ortho ewhf rigd without jnt cstm w
|
$2,801.43 |
$2,801.43 |
$2,801.43 |
$1,288.00
|
|
Ortho hnd/fngr without jnt cstm w/fit&adj
|
$591.69 |
$591.69 |
$591.69 |
$238.34
|
|
Ortho hnd/fngr w/jnt cstm w/fit&adj
|
$701.78 |
$701.78 |
$701.78 |
$310.00
|
|
Ortho hnd metcrpl fx prefb w/fit&adj
|
$230.71 |
$230.71 |
$230.71 |
$174.40
|
|
Ortho hnd without jnt w/fit&adj
|
$591.69 |
$591.69 |
$591.69 |
$231.00
|
|
Orthopedic shoe add rub insl
|
$70.18 |
$70.18 |
$70.18 |
$70.40
|
|
Ortho shoe add leather insol
|
$70.18 |
$70.18 |
$70.18 |
$63.22
|
|
Ortho shoe add march bar
|
$100.69 |
$100.69 |
$100.69 |
$90.66
|
|
Orthosis lso rigd frm hyperex
|
$1,325.92 |
$1,325.92 |
$1,325.92 |
$816.00
|
|
Ortho whf rigd without jnt cstm w/fit&adj
|
$778.25 |
$778.25 |
$778.25 |
$420.76
|
|
Ortho wrst/hnd w/jnt cstm w/fit&adj
|
$2,166.58 |
$2,166.58 |
$2,166.58 |
$718.40
|
|
Oscillation chest wall mechanical per session
|
$84.30 |
$84.30 |
$84.30 |
$195.00
|
|
O shoe add horseshoe toe tap
|
$54.90 |
$54.90 |
$54.90 |
$49.45
|
|
O shoe add instep extension
|
$204.61 |
$204.61 |
$204.61 |
$201.67
|
|
O shoe add instep velcro clo
|
$155.70 |
$155.70 |
$155.70 |
$140.22
|
|
O shoe add standard toe tap
|
$21.46 |
$21.46 |
$21.46 |
$19.38
|
|
O shoe convert to sof counte
|
$128.25 |
$128.25 |
$128.25 |
$115.53
|
|
Osmolality blood
|
$22.50 |
$22.50 |
$22.50 |
$67.60
|
|
Osmolality urine
|
$55.50 |
$55.50 |
$55.50 |
$65.00
|
|
Ot evaluation high complexity patient/family
|
$253.80 |
$253.80 |
$253.80 |
$297.00
|
|
Ot evaluation low complexity patient/family
|
$253.80 |
$253.80 |
$253.80 |
$231.60
|
|
Ot evaluation moderate complexity patient/family
|
$253.80 |
$253.80 |
$253.80 |
$263.50
|
|
Oth resp proc, indiv
|
$26.10 |
$26.10 |
$26.10 |
$82.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$18.00 |
$18.00 |
$18.00 |
$98.40
|
|
Ot management/training orthotic(s) upper/lower extremities and/or trunk each 15 minutes
|
$227.40 |
$227.40 |
$227.40 |
$105.00
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$192.90 |
$192.90 |
$192.90 |
$105.00
|
|
Ot re-evaluation patient/family
|
$224.40 |
$224.40 |
$224.40 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$249.00 |
$249.00 |
$249.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$77.70 |
$77.70 |
$77.70 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$55.80 |
$55.80 |
$55.80 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$382.50 |
$382.50 |
$382.50 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$216.90 |
$216.90 |
$216.90 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$192.90 |
$192.90 |
$192.90 |
$94.25
|
|
Outrigger
|
$125.62 |
$125.62 |
$125.62 |
$123.81
|
|
Outrigger bil with vert extens
|
$420.49 |
$420.49 |
$420.49 |
$378.67
|
|
Oxaliplatin 5 mg/ml desensitization
|
$220.80 |
$220.80 |
$220.80 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$196.80 |
$196.80 |
$196.80 |
$50.40
|
|
Pacemaker leadless 19.5f 32.2mm ra
|
$66,429.37 |
$66,429.37 |
$66,429.37 |
$47,880.00
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$552.00 |
$552.00 |
$552.00 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$8,721.94 |
$8,721.94 |
$8,721.94 |
$3,435.42
|
|
Palingen or palingen xplus
|
$15,469.12 |
$15,469.12 |
$15,469.12 |
$656.01
|
|
Paliperidone 117 mg/0.75 ml inj
|
$8,084.02 |
$8,084.02 |
$8,084.02 |
$6,238.82
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$317.54 |
$317.54 |
$317.54 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$40,001.23 |
$40,001.23 |
$40,001.23 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$49.94 |
$49.94 |
$49.94 |
$29.31
|
|
Papaverin hcl injection
|
$203.74 |
$203.74 |
$203.74 |
$77.05
|
|
Parathormone (pth) intact
|
$236.40 |
$236.40 |
$236.40 |
$204.87
|
|
Parathyroid planar imaging
|
$1,277.70 |
$1,277.70 |
$1,277.70 |
$1,129.91
|
|
Parathyroid planar img w/tomo spect
|
$430.50 |
$430.50 |
$430.50 |
$1,350.60
|
|
Paricalcitol
|
$98.40 |
$98.40 |
$98.40 |
$47.15
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$61.20 |
$61.20 |
$61.20 |
$245.00
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$19,706.24 |
$19,706.24 |
$19,706.24 |
$4,914.00
|
|
Partial removal finger bone
|
$597.90 |
$597.90 |
$597.90 |
$2,049.27
|
|
Partial removal of thyroid
|
$30,316.76 |
$30,316.76 |
$30,316.76 |
$6,457.82
|
|
Partial removal of thyroid
|
$32,654.96 |
$32,654.96 |
$32,654.96 |
$5,855.00
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$11,661.75 |
$11,661.75 |
$11,661.75 |
$4,921.76
|
|
Part removal of metatarsal
|
$10,258.70 |
$10,258.70 |
$10,258.70 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$15,382.01 |
$15,382.01 |
$15,382.01 |
$3,839.54
|
|
Passy muir valve metal trach
|
$1,068.97 |
$1,068.97 |
$1,068.97 |
$275.75
|
|
Patten bottom
|
$768.29 |
$768.29 |
$768.29 |
$672.73
|
|
Pdgfra gene
|
$545.10 |
$545.10 |
$545.10 |
$717.23
|
|
Pd hl 3.5in 4d med rbr mld 6432
|
$54.90 |
$54.90 |
$54.90 |
$49.45
|
|
Pegaspargase injection
|
$80,445.45 |
$80,445.45 |
$80,445.45 |
$39,780.27
|
|
Pelv band/spread bar thigh c
|
$1,136.41 |
$1,136.41 |
$1,136.41 |
$802.87
|
|
Pelvic control band & belt b
|
$754.34 |
$754.34 |
$754.34 |
$566.16
|
|
Pelvic control band & belt u
|
$555.82 |
$555.82 |
$555.82 |
$500.58
|
|
Pelvic control hip heavy dut
|
$600.15 |
$600.15 |
$600.15 |
$591.53
|
|
Pelvic control pelvic sling
|
$1,041.78 |
$1,041.78 |
$1,041.78 |
$912.18
|
|
Pelvic CT scan (with and without contrast)
|
$3,764.40 |
$3,764.40 |
$3,764.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$3,523.80 |
$3,523.80 |
$3,523.80 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$2,671.20 |
$2,671.20 |
$2,671.20 |
$1,363.11
|
|
Pelvic & hip control thigh c
|
$2,548.92 |
$2,548.92 |
$2,548.92 |
$2,512.27
|
|
Pelvic MRI (with and without contrast)
|
$6,279.30 |
$6,279.30 |
$6,279.30 |
$2,860.00
|
|
Pelvic MRI (without contrast)
|
$3,948.30 |
$3,948.30 |
$3,948.30 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$1,297.50 |
$1,297.50 |
$1,297.50 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$649.50 |
$649.50 |
$649.50 |
$430.00
|
|
Pelv & thor control gluteal
|
$332.20 |
$332.20 |
$332.20 |
$299.21
|