|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$338.65 |
$338.65 |
$338.65 |
$303.59
|
|
Initiation & management bipap/cpap initial day
|
$795.60 |
$795.60 |
$795.60 |
$608.40
|
|
Inj allopurinol sodium 1 mg
|
$8,033.93 |
$8,033.93 |
$8,033.93 |
$5,937.23
|
|
Inj calcitriol per 0.1 mcg
|
$9.25 |
$9.25 |
$9.25 |
$11.21
|
|
Inj. denosumab-bbdz, 1 mg
|
$3,655.90 |
$3,655.90 |
$3,655.90 |
$6,618.42
|
|
Injection carpal tunnel therapeutic (both sides)
|
$187.20 |
$187.20 |
$187.20 |
$441.60
|
|
Injection glatiramer acetate
|
$732.15 |
$732.15 |
$732.15 |
$458.43
|
|
Injection,onabotulinumtoxina
|
$1,311.76 |
$1,311.76 |
$1,311.76 |
$12.88
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$323.05 |
$323.05 |
$323.05 |
$1,017.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$150.80 |
$150.80 |
$150.80 |
$517.24
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$120.90 |
$120.90 |
$120.90 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$120.90 |
$120.90 |
$120.90 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$120.90 |
$120.90 |
$120.90 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$94.90 |
$94.90 |
$94.90 |
$130.19
|
|
Inj fluphenazine hcl 1.25 mg
|
$29.65 |
$29.65 |
$29.65 |
$29.65
|
|
Inj levocarnitine per 1 gm
|
$120.03 |
$120.03 |
$120.03 |
$87.51
|
|
Inj, levothyroxine, freskabi
|
$136.92 |
$136.92 |
$136.92 |
$244.63
|
|
Inj meropenem (wg crit care)
|
$92.62 |
$92.62 |
$92.62 |
$20.78
|
|
Inj multihance
|
$91.53 |
$91.53 |
$91.53 |
$86.40
|
|
Insertion catheter bladder non indwelling
|
$90.35 |
$90.35 |
$90.35 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$139.10 |
$139.10 |
$139.10 |
$245.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$439.40 |
$439.40 |
$439.40 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,309.75 |
$1,309.75 |
$1,309.75 |
$2,079.43
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,654.90 |
$1,654.90 |
$1,654.90 |
$5,423.04
|
|
Insitu hybridization auto
|
$310.05 |
$310.05 |
$310.05 |
$328.79
|
|
In situ hybridization per specimen each additional single probe stain
|
$241.15 |
$241.15 |
$241.15 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$245.05 |
$245.05 |
$245.05 |
$364.00
|
|
Insulin total
|
$58.50 |
$58.50 |
$58.50 |
$72.15
|
|
Intrinsic factor antibody
|
$61.10 |
$61.10 |
$61.10 |
$76.77
|
|
Intubation endotracheal emergency procedure
|
$453.70 |
$453.70 |
$453.70 |
$565.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$69.63 |
$69.63 |
$69.63 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$222.77 |
$222.77 |
$222.77 |
$145.52
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$83.85 |
$83.85 |
$83.85 |
$254.59
|
|
Iron
|
$40.30 |
$40.30 |
$40.30 |
$67.50
|
|
Iron binding capacity
|
$56.55 |
$56.55 |
$56.55 |
$55.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$200.51 |
$200.51 |
$200.51 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$116.35 |
$116.35 |
$116.35 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$93.60 |
$93.60 |
$93.60 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$153.40 |
$153.40 |
$153.40 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$153.40 |
$153.40 |
$153.40 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$153.40 |
$153.40 |
$153.40 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$153.40 |
$153.40 |
$153.40 |
$476.50
|
|
John cunningham antibody
|
$1,005.55 |
$1,005.55 |
$1,005.55 |
$39.65
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$77.35 |
$77.35 |
$77.35 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$9.29 |
$9.29 |
$9.29 |
$17.11
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$474.50 |
$474.50 |
$474.50 |
$618.54
|
|
Knee X-ray
|
$482.30 |
$482.30 |
$482.30 |
$387.20
|
|
Kras gene addl variants
|
$346.45 |
$346.45 |
$346.45 |
$366.56
|
|
Kras gene variants exon 2
|
$552.50 |
$552.50 |
$552.50 |
$495.00
|
|
Lab draw <3 yrs scalp vein 36405
|
$59.15 |
$59.15 |
$59.15 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$12.35 |
$12.35 |
$12.35 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$78.47 |
$78.47 |
$78.47 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$61.75 |
$61.75 |
$61.75 |
$50.55
|
|
Lactated ringers intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$46.35
|
|
Lactic acid
|
$195.65 |
$195.65 |
$195.65 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$83.20 |
$83.20 |
$83.20 |
$88.40
|
|
Laparo cholecystectomy/explr
|
$1,981.85 |
$1,981.85 |
$1,981.85 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$1,539.20 |
$1,539.20 |
$1,539.20 |
$6,870.89
|
|
Laparo partial colectomy 44204
|
$2,386.15 |
$2,386.15 |
$2,386.15 |
$3,790.40
|
|
Laparoscopy fundoplasty
|
$2,086.50 |
$2,086.50 |
$2,086.50 |
$11,191.12
|
|
Lap ing hernia repair init
|
$919.10 |
$919.10 |
$919.10 |
$6,457.82
|
|
Lead capillary
|
$61.75 |
$61.75 |
$61.75 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$877.50 |
$877.50 |
$877.50 |
$1,053.00
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$20,514.40 |
$20,514.40 |
$20,514.40 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,913.80 |
$12,913.80 |
$12,913.80 |
$4,308.91
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$12.01 |
$12.01 |
$12.01 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$63.05 |
$63.05 |
$63.05 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$19.45 |
$19.45 |
$19.45 |
$43.61
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$21.61 |
$21.61 |
$21.61 |
$25.89
|
|
Lidocaine therapeutic drug level
|
$78.65 |
$78.65 |
$78.65 |
$82.50
|
|
Ligation/biopsy of temporal artery 37609
|
$553.80 |
$553.80 |
$553.80 |
$3,679.25
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$140.79 |
$140.79 |
$140.79 |
$84.28
|
|
Lipase
|
$68.90 |
$68.90 |
$68.90 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$90.35 |
$90.35 |
$90.35 |
$90.60
|
|
Lipoprotein direct measurement hdl
|
$42.90 |
$42.90 |
$42.90 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$42.90 |
$42.90 |
$42.90 |
$61.60
|
|
Lithium therapeutic drug level
|
$62.40 |
$62.40 |
$62.40 |
$62.40
|
|
Liver Function Test
|
$89.05 |
$89.05 |
$89.05 |
$92.85
|
|
Liver hem/re-expl wnd/remove pack 47362
|
$2,028.65 |
$2,028.65 |
$2,028.65 |
$2,586.00
|
|
Locm 100-199mg/ml iodine,1ml
|
$123.66 |
$123.66 |
$123.66 |
$2.57
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$47.84 |
$47.84 |
$47.84 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,754.35 |
$1,754.35 |
$1,754.35 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,673.75 |
$1,673.75 |
$1,673.75 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,450.15 |
$1,450.15 |
$1,450.15 |
$1,450.15
|
|
Lower Back (Lumbar Spine) X-ray
|
$234.00 |
$234.00 |
$234.00 |
$328.23
|
|
L/s ratio fetal lung
|
$173.55 |
$173.55 |
$173.55 |
$173.55
|
|
Lung Function Test (Spirometry)
|
$233.35 |
$233.35 |
$233.35 |
$290.89
|
|
Macroscopic exam arthropod
|
$14.95 |
$14.95 |
$14.95 |
$38.50
|
|
Macroscopic exam parasite
|
$35.10 |
$35.10 |
$35.10 |
$35.98
|
|
Magnesium
|
$96.20 |
$96.20 |
$96.20 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$28.72 |
$28.72 |
$28.72 |
$39.81
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$70.85 |
$70.85 |
$70.85 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$83.85 |
$83.85 |
$83.85 |
$147.72
|
|
Marker biop eviva buckle ss
|
$91.00 |
$91.00 |
$91.00 |
$1,126.34
|
|
Mastoids complete
|
$218.40 |
$218.40 |
$218.40 |
$271.95
|
|
M.avium-intra dna dir prob
|
$70.85 |
$70.85 |
$70.85 |
$58.40
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$100.10 |
$100.10 |
$100.10 |
$76.70
|
|
Mayo aathr protein s free
|
$174.20 |
$174.20 |
$174.20 |
$139.23
|
|
Mayo activated protein c resistance assay
|
$100.10 |
$100.10 |
$100.10 |
$100.26
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$209.30 |
$209.30 |
$209.30 |
$172.80
|