|
Nm imaging bone/joint whole body
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,570.65
|
|
Nm imaging cardiac blood pooling planar single study at rest or stress
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,401.00
|
|
Nm imaging gastric emptying study
|
$1,340.40 |
$1,340.40 |
$1,340.40 |
$1,357.00
|
|
Nm imaging gastrointestinal acute blood loss
|
$985.80 |
$985.80 |
$985.80 |
$1,211.60
|
|
Nm imaging hepatobiliary system w/pharmacologic intervention
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,612.00
|
|
Nm imaging kidney morphology vascular flow/function single study w/pharmacological intervention
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,550.95
|
|
Nm imaging pulmonary ventilation/perfusion
|
$1,460.40 |
$1,460.40 |
$1,460.40 |
$1,590.00
|
|
Nm imaging thyroid single/multiple uptake(s) quantitative measurement(s)
|
$900.00 |
$900.00 |
$900.00 |
$1,091.00
|
|
Nps surg dilat eust tube uni
|
$4,114.80 |
$4,114.80 |
$4,114.80 |
$6,966.64
|
|
Nras gene variants exon 2&3
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$621.00
|
|
Nsl/sins ndsc surg max sins
|
$3,157.20 |
$3,157.20 |
$3,157.20 |
$5,695.20
|
|
Nsl/sins ndsc surg sphn sins
|
$4,833.00 |
$4,833.00 |
$4,833.00 |
$4,881.00
|
|
Nsl/sinus ndsc cryoabltj pnn
|
$180.00 |
$180.00 |
$180.00 |
$6,695.65
|
|
Nuclear Stress Test (Heart)
|
$1,185.60 |
$1,185.60 |
$1,185.60 |
$3,809.00
|
|
Nushield 1 square cm
|
$817.69 |
$817.69 |
$817.69 |
$937.50
|
|
Observation direct referral from physician office for admission
|
$413.40 |
$413.40 |
$413.40 |
$387.00
|
|
Observation/inpatient hospital care hi severity 99236
|
$220.80 |
$220.80 |
$220.80 |
$390.40
|
|
Observation/inpatient hospital care low severity 99234
|
$139.80 |
$139.80 |
$139.80 |
$239.20
|
|
Observation/inpatient hospital care mod severity 99235
|
$184.80 |
$184.80 |
$184.80 |
$303.20
|
|
Observation per hour
|
$87.00 |
$87.00 |
$87.00 |
$80.73
|
|
Obtaining screen pap smear
|
$43.80 |
$43.80 |
$43.80 |
$37.22
|
|
Ocrelizumab 30 mg/ml intravenous solution
|
$54,177.00 |
$54,177.00 |
$54,177.00 |
$41,294.43
|
|
Octreotide acetate 100 mcg/ml injection (wrapper)
|
$801.00 |
$801.00 |
$801.00 |
$90.00
|
|
Octreotide,microspheres ER 20 mg intramuscular susp, extended release
|
$13,606.80 |
$13,606.80 |
$13,606.80 |
$12,080.43
|
|
Off/op cnsltj new/est low 30
|
$75.00 |
$75.00 |
$75.00 |
$183.00
|
|
Off/op consltj new/est hi 55
|
$120.00 |
$120.00 |
$120.00 |
$339.30
|
|
Olanzapine 10 mg intramuscular solution
|
$121.20 |
$121.20 |
$121.20 |
$109.62
|
|
Omalizumab 150 mg/ml subcutaneous syringe (wrapper)
|
$3,617.40 |
$3,617.40 |
$3,617.40 |
$4,595.01
|
|
Ondansetron 8 mg disintegrating tablet
|
$4.80 |
$4.80 |
$4.80 |
$9.00
|
|
Ondansetron hcl (pf) 2 mg/ml injection (wrapper)
|
$17.40 |
$17.40 |
$17.40 |
$22.75
|
|
Open thrombectomy of av fistula without revision 36831
|
$995.40 |
$995.40 |
$995.40 |
$6,396.89
|
|
Opn impltj crnl nrv nea&pg
|
$1,258.80 |
$1,258.80 |
$1,258.80 |
$35,498.40
|
|
Opn mpltj hpglsl nstm ary pg
|
$1,174.80 |
$1,174.80 |
$1,174.80 |
$36,076.18
|
|
Oral aprepitant
|
$694.80 |
$694.80 |
$694.80 |
$410.20
|
|
Oritavancin 1,200 mg intravenous solution
|
$17,931.60 |
$17,931.60 |
$17,931.60 |
$11,017.26
|
|
Oropharyngeal biopsy 42800
|
$190.20 |
$190.20 |
$190.20 |
$2,133.48
|
|
Orphenadrine citrate 30 mg/ml injection solution
|
$53.40 |
$53.40 |
$53.40 |
$50.63
|
|
Orthovisc inj per dose
|
$1,672.20 |
$1,672.20 |
$1,672.20 |
$537.58
|
|
Oscillation chest wall mechanical per session
|
$133.80 |
$133.80 |
$133.80 |
$195.00
|
|
Osmolality blood
|
$163.20 |
$163.20 |
$163.20 |
$69.55
|
|
Osmolality urine
|
$114.00 |
$114.00 |
$114.00 |
$66.13
|
|
Ot evaluation high complexity patient/family
|
$337.80 |
$337.80 |
$337.80 |
$292.00
|
|
Ot evaluation low complexity patient/family
|
$337.80 |
$337.80 |
$337.80 |
$229.45
|
|
Ot evaluation moderate complexity patient/family
|
$337.80 |
$337.80 |
$337.80 |
$263.50
|
|
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes
|
$179.40 |
$179.40 |
$179.40 |
$98.40
|
|
Ot manual therpy techniques >=1 region each 15 minutes
|
$147.00 |
$147.00 |
$147.00 |
$105.00
|
|
Otolaryngo binocular microscopy 92504
|
$37.80 |
$37.80 |
$37.80 |
$60.80
|
|
Ot re-evaluation patient/family
|
$249.00 |
$249.00 |
$249.00 |
$158.40
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$207.00 |
$207.00 |
$207.00 |
$99.00
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$234.60 |
$234.60 |
$234.60 |
$97.80
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$186.00 |
$186.00 |
$186.00 |
$100.65
|
|
Ot training self care/home management direct contact each 15 minutes
|
$202.80 |
$202.80 |
$202.80 |
$93.60
|
|
Oxaliplatin 5 mg/ml desensitization
|
$667.20 |
$667.20 |
$667.20 |
$347.26
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$334.20 |
$334.20 |
$334.20 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$5,716.20 |
$5,716.20 |
$5,716.20 |
$3,420.45
|
|
Paliperidone 117 mg/0.75 ml inj
|
$8,341.20 |
$8,341.20 |
$8,341.20 |
$6,238.82
|
|
Palonosetron hcl
|
$1,510.80 |
$1,510.80 |
$1,510.80 |
$162.89
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$120.60 |
$120.60 |
$120.60 |
$129.80
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$15,835.80 |
$15,835.80 |
$15,835.80 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$11.40 |
$11.40 |
$11.40 |
$28.90
|
|
Papaverin hcl injection
|
$165.30 |
$165.30 |
$165.30 |
$76.06
|
|
Parathormone (pth) intact
|
$583.20 |
$583.20 |
$583.20 |
$204.00
|
|
Parathyroid planar imaging
|
$791.40 |
$791.40 |
$791.40 |
$1,132.80
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$43.20 |
$43.20 |
$43.20 |
$245.67
|
|
Partial hysterectomy
|
$1,980.60 |
$1,980.60 |
$1,980.60 |
$2,400.00
|
|
Partial removal of lip
|
$882.00 |
$882.00 |
$882.00 |
$3,276.00
|
|
Partial removal of thyroid
|
$1,673.40 |
$1,673.40 |
$1,673.40 |
$6,376.26
|
|
Partial removal of thyroid
|
$2,091.60 |
$2,091.60 |
$2,091.60 |
$5,741.00
|
|
Partial thyroid excision
|
$1,865.40 |
$1,865.40 |
$1,865.40 |
$6,311.00
|
|
Pedicle enel/ntroral 15576
|
$1,514.40 |
$1,514.40 |
$1,514.40 |
$2,501.10
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$19,804.20 |
$19,804.20 |
$19,804.20 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$13,920.00 |
$13,920.00 |
$13,920.00 |
$7,265.37
|
|
Pegfilgrastim-jmdb 6 mg/0.6 ml subcutaneous syringe
|
$16,902.60 |
$16,902.60 |
$16,902.60 |
$4,133.25
|
|
Pegloticase 8 mg/ml intravenous solution
|
$68,089.80 |
$68,089.80 |
$68,089.80 |
$49,585.09
|
|
Pelvic CT scan (with and without contrast)
|
$2,918.40 |
$2,918.40 |
$2,918.40 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$2,554.20 |
$2,554.20 |
$2,554.20 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$1,841.40 |
$1,841.40 |
$1,841.40 |
$1,357.52
|
|
Pelvic MRI (with and without contrast)
|
$3,243.60 |
$3,243.60 |
$3,243.60 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,243.60 |
$3,243.60 |
$3,243.60 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$3,060.60 |
$3,060.60 |
$3,060.60 |
$1,916.50
|
|
Pelvic Ultrasound (complete)
|
$778.80 |
$778.80 |
$778.80 |
$652.50
|
|
Pelvic Ultrasound (limited)
|
$194.40 |
$194.40 |
$194.40 |
$435.09
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$15,735.00 |
$15,735.00 |
$15,735.00 |
$11,589.18
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$11,278.20 |
$11,278.20 |
$11,278.20 |
$6,582.76
|
|
Peng benzathine/procaine inj
|
$37.20 |
$37.20 |
$37.20 |
$397.04
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$1,013.40 |
$1,013.40 |
$1,013.40 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$169.80 |
$169.80 |
$169.80 |
$97.85
|
|
Perc d-e cor revasc t cabg b
|
$18,577.20 |
$18,577.20 |
$18,577.20 |
$12,091.30
|
|
Perc d-e cor revasc t cabg s
|
$18,577.20 |
$18,577.20 |
$18,577.20 |
$16,047.20
|
|
Perc drug-el cor stent bran
|
$18,577.20 |
$18,577.20 |
$18,577.20 |
$11,974.50
|
|
Perc drug-el cor stent sing
|
$18,577.20 |
$18,577.20 |
$18,577.20 |
$16,258.50
|
|
Perflutren lipid microspheres 1.1 mg/ml intravenous suspension
|
$299.40 |
$299.40 |
$299.40 |
$321.71
|
|
Pericardiocentesis wwo imaging
|
$299.40 |
$299.40 |
$299.40 |
$2,276.64
|
|
Pertuzumab 30 mg/ml desensitization
|
$16,712.40 |
$16,712.40 |
$16,712.40 |
$13,666.00
|
|
Pet CT skull-mid thgh initial
|
$5,751.00 |
$5,751.00 |
$5,751.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$5,751.00 |
$5,751.00 |
$5,751.00 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$1,876.80 |
$1,876.80 |
$1,876.80 |
$3,926.00
|
|
Pet image w/ct lmtd
|
$4,471.20 |
$4,471.20 |
$4,471.20 |
$4,409.00
|
|
Pfc sigma fem post aug sz3 8mm
|
$15,681.96 |
$15,681.96 |
$15,681.96 |
$37,204.82
|
|
Ph body fluid
|
$155.40 |
$155.40 |
$155.40 |
$40.04
|
