|
Ot re-evaluation patient/family
|
$52.00 |
$52.00 |
$52.00 |
$160.80
|
|
Ot therapeutic activities direct patient contact each 15 minutes
|
$255.00 |
$255.00 |
$255.00 |
$101.38
|
|
Ot therapeutic interventions cognitive skills direct patient contact each additional 15 minutes
|
$43.00 |
$43.00 |
$43.00 |
$87.00
|
|
Ot therapeutic interventions cognitive skills direct patient contact initial 15 minutes
|
$45.50 |
$45.50 |
$45.50 |
$91.80
|
|
Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes
|
$262.00 |
$262.00 |
$262.00 |
$98.15
|
|
Ot therapeutic procedure neuromuscular reeducate each 15 minutes
|
$344.00 |
$344.00 |
$344.00 |
$101.23
|
|
Ot training self care/home management direct contact each 15 minutes
|
$222.00 |
$222.00 |
$222.00 |
$94.25
|
|
Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr
|
$2.00 |
$2.00 |
$2.00 |
$83.08
|
|
Oxaliplatin 5 mg/ml desensitization
|
$36.39 |
$36.39 |
$36.39 |
$370.75
|
|
Oxytocin 10 unit/ml injection solution
|
$12.90 |
$12.90 |
$12.90 |
$50.40
|
|
Paclitaxel 6 mg/ml concentrate,intravenous
|
$125.58 |
$125.58 |
$125.58 |
$216.00
|
|
Paclitaxel protein-bound 100 mg intravenous suspension
|
$8,748.32 |
$8,748.32 |
$8,748.32 |
$3,435.42
|
|
Paliperidone 117 mg/0.75 ml inj
|
$32.00 |
$32.00 |
$32.00 |
$6,238.82
|
|
Palivizumab 50 mg/0.5 ml inj
|
$4,096.50 |
$4,096.50 |
$4,096.50 |
$5,569.20
|
|
Palonosetron hcl
|
$40.50 |
$40.50 |
$40.50 |
$170.48
|
|
Pamidronate 30 mg/10 ml (3 mg/ml) intravenous solution
|
$36.59 |
$36.59 |
$36.59 |
$128.07
|
|
Panitumumab 20 mg/ml intravenous solution (wrapper)
|
$19,977.96 |
$19,977.96 |
$19,977.96 |
$13,051.61
|
|
Pantoprazole in ns IV syringe 0.8 mg/ml (neo/ped) - cnr
|
$20.03 |
$20.03 |
$20.03 |
$29.31
|
|
Parathormone (pth) intact
|
$270.50 |
$270.50 |
$270.50 |
$204.87
|
|
Parathyrd planar w/spect&ct
|
$807.00 |
$807.00 |
$807.00 |
$1,574.40
|
|
Parathyroid autotransplantation 60512
|
$5,659.67 |
$5,659.67 |
$5,659.67 |
$4,080.85
|
|
Parathyroid planar imaging
|
$864.50 |
$864.50 |
$864.50 |
$1,129.91
|
|
Paring/cutting benign hyperkeratotic lesion single
|
$381.50 |
$381.50 |
$381.50 |
$245.00
|
|
Part hymenectomy/revi hymenal ring 56700
|
$3,780.00 |
$3,780.00 |
$3,780.00 |
$3,762.53
|
|
Partial exc bone humerus
|
$5,494.00 |
$5,494.00 |
$5,494.00 |
$3,839.54
|
|
Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah)
|
$7,598.50 |
$7,598.50 |
$7,598.50 |
$4,914.00
|
|
Partial removal finger bone
|
$3,964.92 |
$3,964.92 |
$3,964.92 |
$2,049.27
|
|
Partial removal foot fascia
|
$3,955.63 |
$3,955.63 |
$3,955.63 |
$3,762.00
|
|
Partial removal of eye fluid
|
$1,620.50 |
$1,620.50 |
$1,620.50 |
$2,698.92
|
|
Partial removal of fibula
|
$5,803.00 |
$5,803.00 |
$5,803.00 |
$3,786.00
|
|
Partial removal of hand bone
|
$3,050.33 |
$3,050.33 |
$3,050.33 |
$3,839.54
|
|
Partial removal of thyroid
|
$18,649.50 |
$18,649.50 |
$18,649.50 |
$6,457.82
|
|
Partial removal of thyroid
|
$16,979.00 |
$16,979.00 |
$16,979.00 |
$5,855.00
|
|
Partial removal of ulna
|
$8,369.50 |
$8,369.50 |
$8,369.50 |
$3,839.54
|
|
Particle matristem matrix 1000mg micron-q4118-cost per mg
|
$2,054.82 |
$2,054.82 |
$2,054.82 |
$4,921.76
|
|
Part removal of metatarsal
|
$3,799.50 |
$3,799.50 |
$3,799.50 |
$3,134.00
|
|
Part removal of metatarsal 28112
|
$12,096.00 |
$12,096.00 |
$12,096.00 |
$3,839.54
|
|
Pca3/klk3 antigen
|
$552.00 |
$552.00 |
$552.00 |
$510.40
|
|
Pcv21 vaccine im
|
$222.50 |
$222.50 |
$222.50 |
$410.26
|
|
Pdgfra gene
|
$597.00 |
$597.00 |
$597.00 |
$717.23
|
|
Pdt dstr prmlg les phys/qhp
|
$229.00 |
$229.00 |
$229.00 |
$294.77
|
|
Pegfilgrastim 6 mg/0.6 ml (deliverable) wearable subcutaneous injector
|
$9,522.59 |
$9,522.59 |
$9,522.59 |
$11,216.31
|
|
Pegfilgrastim-cbqv 6 mg/0.6 ml subcutaneous syringe
|
$7,265.37 |
$7,265.37 |
$7,265.37 |
$7,297.36
|
|
Pegloticase 8 mg/ml intravenous solution
|
$40,845.92 |
$40,845.92 |
$40,845.92 |
$49,135.11
|
|
Pelvic CT scan (with and without contrast)
|
$1,916.50 |
$1,916.50 |
$1,916.50 |
$1,890.36
|
|
Pelvic CT scan (with contrast)
|
$1,916.50 |
$1,916.50 |
$1,916.50 |
$1,608.98
|
|
Pelvic CT scan (without contrast)
|
$927.00 |
$927.00 |
$927.00 |
$1,363.11
|
|
Pelvic MRI (with and without contrast)
|
$3,091.00 |
$3,091.00 |
$3,091.00 |
$2,860.00
|
|
Pelvic MRI (with contrast)
|
$3,092.50 |
$3,092.50 |
$3,092.50 |
$2,210.00
|
|
Pelvic MRI (without contrast)
|
$1,877.50 |
$1,877.50 |
$1,877.50 |
$1,902.00
|
|
Pelvic Ultrasound (complete)
|
$711.50 |
$711.50 |
$711.50 |
$643.80
|
|
Pelvic Ultrasound (limited)
|
$475.50 |
$475.50 |
$475.50 |
$430.00
|
|
Pembrolizumab 25 mg/ml intravenous solution
|
$23,590.88 |
$23,590.88 |
$23,590.88 |
$12,385.22
|
|
Pemetrexed disodium 100 mg intravenous powder for solution
|
$199.35 |
$199.35 |
$199.35 |
$7,089.13
|
|
Peng benzathine/procaine inj
|
$42.00 |
$42.00 |
$42.00 |
$375.32
|
|
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe
|
$630.37 |
$630.37 |
$630.37 |
$826.47
|
|
Penicillin g potassium in ns IV syringe 100,000 units/ml (neo/ped) - cnr
|
$9.72 |
$9.72 |
$9.72 |
$101.34
|
|
Penile injection
|
$4,203.33 |
$4,203.33 |
$4,203.33 |
$418.00
|
|
Penile rear tip xtnd 0.5cm
|
$7,390.50 |
$7,390.50 |
$7,390.50 |
$18,764.94
|
|
Penis plastic surgery
|
$10,425.50 |
$10,425.50 |
$10,425.50 |
$4,081.37
|
|
Perc d-e cor revasc chro add
|
$10,332.00 |
$10,332.00 |
$10,332.00 |
$12,886.61
|
|
Perc d-e cor revasc chro sin
|
$34,785.50 |
$34,785.50 |
$34,785.50 |
$18,808.65
|
|
Perc d-e cor revasc t cabg b
|
$24,648.50 |
$24,648.50 |
$24,648.50 |
$11,088.63
|
|
Perc d-e cor revasc t cabg s
|
$24,649.00 |
$24,649.00 |
$24,649.00 |
$16,047.20
|
|
Perc d-e cor stent ather br
|
$10,332.00 |
$10,332.00 |
$10,332.00 |
$12,191.74
|
|
Perc d-e cor stent ather s
|
$9,867.00 |
$9,867.00 |
$9,867.00 |
$18,700.50
|
|
Perc drug-el cor stent bran
|
$10,332.00 |
$10,332.00 |
$10,332.00 |
$11,515.20
|
|
Perc drug-el cor stent sing
|
$22,822.00 |
$22,822.00 |
$22,822.00 |
$16,258.50
|
|
Pericardiocentesis wwo imaging
|
$2,010.00 |
$2,010.00 |
$2,010.00 |
$2,251.20
|
|
Peri-implt capslc brst compl
|
$21,990.50 |
$21,990.50 |
$21,990.50 |
$3,986.00
|
|
Perineoplasty rpr per nonob
|
$8,870.00 |
$8,870.00 |
$8,870.00 |
$3,522.35
|
|
Peri-proc device eval icd
|
$124.00 |
$124.00 |
$124.00 |
$192.40
|
|
Peri-proc device eval pm
|
$117.50 |
$117.50 |
$117.50 |
$159.90
|
|
Perit-vens shunt pat tst
|
$944.00 |
$944.00 |
$944.00 |
$758.37
|
|
Perq clsr tcat l atr apndge
|
$9,871.50 |
$9,871.50 |
$9,871.50 |
$9,509.53
|
|
Perq dev breast 1st strtctc
|
$3,288.50 |
$3,288.50 |
$3,288.50 |
$1,456.00
|
|
Perq nl/pl lithotrp cplx>2cm
|
$15,530.50 |
$15,530.50 |
$15,530.50 |
$10,114.58
|
|
Perq nl/pl lithotrp smpl<2cm
|
$11,105.67 |
$11,105.67 |
$11,105.67 |
$9,442.38
|
|
Perq rplcmt g-tube req revsn gstrst trk
|
$191.50 |
$191.50 |
$191.50 |
$625.93
|
|
Perq transcath cls aortic
|
$9,903.00 |
$9,903.00 |
$9,903.00 |
$22,633.26
|
|
Perq transcath septal reduxn
|
$5,187.50 |
$5,187.50 |
$5,187.50 |
$8,605.90
|
|
Pertussis ag if
|
$76.50 |
$76.50 |
$76.50 |
$69.05
|
|
Pertuzumab 30 mg/ml desensitization
|
$13,053.58 |
$13,053.58 |
$13,053.58 |
$13,666.00
|
|
Pet CT skull-mid thgh initial
|
$4,083.00 |
$4,083.00 |
$4,083.00 |
$4,707.00
|
|
Pet CT whole body initial
|
$3,960.50 |
$3,960.50 |
$3,960.50 |
$4,850.00
|
|
Pet fdg brain metoblic eval sb
|
$5,517.50 |
$5,517.50 |
$5,517.50 |
$4,060.00
|
|
Pet image full body
|
$1,490.50 |
$1,490.50 |
$1,490.50 |
$5,070.50
|
|
Pet image ltd area
|
$1,199.50 |
$1,199.50 |
$1,199.50 |
$3,677.40
|
|
Pet image skull-thigh
|
$3,980.50 |
$3,980.50 |
$3,980.50 |
$4,256.70
|
|
Pet image w/ct lmtd
|
$3,647.50 |
$3,647.50 |
$3,647.50 |
$4,305.60
|
|
Pfc sigma fem post aug sz3 8mm
|
$9,429.04 |
$9,429.04 |
$9,429.04 |
$38,834.22
|
|
Pharmacologic management w/psytx
|
$68.00 |
$68.00 |
$68.00 |
$78.96
|
|
Ph body fluid
|
$71.50 |
$71.50 |
$71.50 |
$41.28
|
|
Phencyclidine (pcp)
|
$86.50 |
$86.50 |
$86.50 |
$96.00
|
|
Phenobarbital in ns IV syringe 10 mg/ml (neonate) - cnr
|
$110.09 |
$110.09 |
$110.09 |
$112.72
|
|
Phenobarbital therapeutic drug level
|
$52.00 |
$52.00 |
$52.00 |
$104.50
|
|
Phenylephrine 10 mg/ml injection solution
|
$146.42 |
$146.42 |
$146.42 |
$67.89
|
|
Phenytoin total therapeutic drug level
|
$85.00 |
$85.00 |
$85.00 |
$110.88
|
|
Phlebotomy therapeutic
|
$242.00 |
$242.00 |
$242.00 |
$231.66
|
|
Phleb veins 1 extrm 10-20 stab
|
$17,107.50 |
$17,107.50 |
$17,107.50 |
$4,599.65
|