|
Injection radioactive tracer sentinel node (both sides)
|
$58.61 |
$58.61 |
$58.61 |
$685.44
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$174.87 |
$174.87 |
$174.87 |
$1,685.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$55.10 |
$55.10 |
$55.10 |
$145.60
|
|
Inj epidural sgl lumb-sacral without img
|
$148.54 |
$148.54 |
$148.54 |
$1,450.84
|
|
Inj intralesional <= 7 lsn(s)
|
$37.21 |
$37.21 |
$37.21 |
$235.13
|
|
Inj proc myelogram lumbar
|
$361.08 |
$361.08 |
$361.08 |
$838.30
|
|
Inj proc sialogram
|
$73.70 |
$73.70 |
$73.70 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$3.31 |
$3.31 |
$3.31 |
$349.45
|
|
Inj retro urethrocysto
|
$183.32 |
$183.32 |
$183.32 |
$447.74
|
|
Inj, rimabotulinumtoxinb
|
$20.81 |
$20.81 |
$20.81 |
$714.24
|
|
Ins cerv dilator (sep proc)
|
$345.01 |
$345.01 |
$345.01 |
$490.73
|
|
Insertion catheter bladder non indwelling
|
$90.69 |
$90.69 |
$90.69 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$673.06 |
$673.06 |
$673.06 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$651.41 |
$651.41 |
$651.41 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$782.28 |
$782.28 |
$782.28 |
$2,453.83
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$414.01 |
$414.01 |
$414.01 |
$5,236.80
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$413.07 |
$413.07 |
$413.07 |
$4,997.60
|
|
Insitu hybridization auto
|
$453.39 |
$453.39 |
$453.39 |
$377.37
|
|
Insitu hybridization (fish)
|
$307.62 |
$307.62 |
$307.62 |
$481.00
|
|
Insitu hybridization manual
|
$453.39 |
$453.39 |
$453.39 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$77.35 |
$77.35 |
$77.35 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$217.17 |
$217.17 |
$217.17 |
$338.40
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$845.26 |
$845.26 |
$845.26 |
$1,690.00
|
|
Insulin total
|
$31.98 |
$31.98 |
$31.98 |
$66.64
|
|
Intestinal stricturoplasty
|
$1,910.70 |
$1,910.70 |
$1,910.70 |
$2,351.50
|
|
Int hrhc lig 1 hroid without img
|
$409.30 |
$409.30 |
$409.30 |
$3,491.25
|
|
Int hrhc lig 2+hroid without img
|
$461.58 |
$461.58 |
$461.58 |
$3,245.23
|
|
Intrapul surf admin endo tube
|
$80.18 |
$80.18 |
$80.18 |
$220.80
|
|
Intrinsic factor antibody
|
$31.27 |
$31.27 |
$31.27 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$403.10 |
$403.10 |
$403.10 |
$601.28
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.30 |
$0.30 |
$0.30 |
$279.10
|
|
Iron
|
$116.69 |
$116.69 |
$116.69 |
$75.00
|
|
Iron binding capacity
|
$15.15 |
$15.15 |
$15.15 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$110.96 |
$110.96 |
$110.96 |
$146.11
|
|
IV Fluids (each additional hour)
|
$53.35 |
$53.35 |
$53.35 |
$133.90
|
|
IV Fluids (first hour)
|
$330.37 |
$330.37 |
$330.37 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$121.75 |
$121.75 |
$121.75 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$140.22 |
$140.22 |
$140.22 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$64.98 |
$64.98 |
$64.98 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$398.77 |
$398.77 |
$398.77 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$74.05 |
$74.05 |
$74.05 |
$167.50
|
|
IV Push Injection (first drug)
|
$265.76 |
$265.76 |
$265.76 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$606.00 |
$606.00 |
$606.00 |
$713.40
|
|
Jak2 targeted sequence analysis
|
$644.40 |
$644.40 |
$644.40 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$369.01 |
$369.01 |
$369.01 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$278.85 |
$278.85 |
$278.85 |
$362.05
|
|
John cunningham antibody
|
$767.44 |
$767.44 |
$767.44 |
$78.00
|
|
Ketamine and metabolite screen - quest
|
$81.35 |
$81.35 |
$81.35 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$34.22 |
$34.22 |
$34.22 |
$58.56
|
|
Kidney img w/bldflw sgl without rx
|
$81.02 |
$81.02 |
$81.02 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$768.69 |
$768.69 |
$768.69 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$483.99 |
$483.99 |
$483.99 |
$490.75
|
|
Kit gene analys d816 variant
|
$434.62 |
$434.62 |
$434.62 |
$374.61
|
|
Kit lead specify 5-6-5
|
$14,456.20 |
$14,456.20 |
$14,456.20 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,482.25 |
$1,482.25 |
$1,482.25 |
$1,635.87
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$3,357.75 |
$3,357.75 |
$3,357.75 |
$2,254.50
|
|
Knee MRI (with and without contrast)
|
$3,118.81 |
$3,118.81 |
$3,118.81 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,598.90 |
$2,598.90 |
$2,598.90 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,079.00 |
$2,079.00 |
$2,079.00 |
$2,130.88
|
|
Knee X-ray
|
$437.28 |
$437.28 |
$437.28 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$313.63 |
$313.63 |
$313.63 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$382.54 |
$382.54 |
$382.54 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$298.17 |
$298.17 |
$298.17 |
$251.20
|
|
Kras gene addl variants
|
$672.22 |
$672.22 |
$672.22 |
$387.20
|
|
Kras gene variants exon 2
|
$672.22 |
$672.22 |
$672.22 |
$536.20
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$33.08 |
$33.08 |
$33.08 |
$109.20
|
|
Lactate dehydrogenase (ldh)
|
$31.42 |
$31.42 |
$31.42 |
$55.50
|
|
Lactic acid
|
$49.37 |
$49.37 |
$49.37 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$54.98 |
$54.98 |
$54.98 |
$82.16
|
|
Lactoferrin fecal quant
|
$114.44 |
$114.44 |
$114.44 |
$108.93
|
|
Laparo cholecystectomy/explr
|
$1,380.50 |
$1,380.50 |
$1,380.50 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$887.83 |
$887.83 |
$887.83 |
$8,346.00
|
|
Laparoscopy remove adnexa
|
$300.97 |
$300.97 |
$300.97 |
$8,782.80
|
|
Lap ing hernia repair init
|
$796.93 |
$796.93 |
$796.93 |
$9,605.51
|
|
Lap ing hernia repair recur
|
$1,038.08 |
$1,038.08 |
$1,038.08 |
$6,870.89
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$704.48 |
$704.48 |
$704.48 |
$740.40
|
|
Lb with mastopexy 15839
|
$902.91 |
$902.91 |
$902.91 |
$3,722.04
|
|
Lead acuity x4 spiral l 86cm
|
$16,865.20 |
$16,865.20 |
$16,865.20 |
$5,460.00
|
|
Lead capillary
|
$44.32 |
$44.32 |
$44.32 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$16,865.20 |
$16,865.20 |
$16,865.20 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$10,842.70 |
$10,842.70 |
$10,842.70 |
$8,202.66
|
|
Leg Artery Ultrasound (complete, both legs)
|
$718.79 |
$718.79 |
$718.79 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,035.25 |
$1,035.25 |
$1,035.25 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$827.97 |
$827.97 |
$827.97 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$752.50 |
$752.50 |
$752.50 |
$1,092.58
|
|
Lens, intraocular (new tech)
|
$1,245.09 |
$1,245.09 |
$1,245.09 |
$589.05
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,256.87 |
$2,256.87 |
$2,256.87 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$2,256.87 |
$2,256.87 |
$2,256.87 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$996.53 |
$996.53 |
$996.53 |
$377.71
|
|
Levetiracetam therapeutic drug level
|
$35.34 |
$35.34 |
$35.34 |
$88.92
|
|
Liberta rc ipg
|
$48,182.20 |
$48,182.20 |
$48,182.20 |
$39,189.70
|
|
Lidocaine therapeutic drug level
|
$25.25 |
$25.25 |
$25.25 |
$87.45
|
|
Lifileucel til/dose 7.5b-72b snij
|
$2,538,266.72 |
$2,538,266.72 |
$2,538,266.72 |
$30,744.64
|
|
Ligate/strip long leg vein
|
$872.76 |
$872.76 |
$872.76 |
$3,724.63
|
|
Ligate/strip short leg vein
|
$778.09 |
$778.09 |
$778.09 |
$3,724.63
|
|
Ligation/biopsy of temporal artery 37609
|
$378.68 |
$378.68 |
$378.68 |
$3,322.80
|
|
Lipase
|
$32.54 |
$32.54 |
$32.54 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$57.22 |
$57.22 |
$57.22 |
$87.00
|
|
Lipoprotein blood quant
|
$57.78 |
$57.78 |
$57.78 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$35.90 |
$35.90 |
$35.90 |
$57.50
|