|
Injection into brain canal
|
$41.78 |
$41.78 |
$41.78 |
$933.60
|
|
Injection of sinus tract
|
$529.78 |
$529.78 |
$529.78 |
$1,651.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$475.78 |
$475.78 |
$475.78 |
$1,496.00
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$296.48 |
$296.48 |
$296.48 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$565.95 |
$565.95 |
$565.95 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$326.53 |
$326.53 |
$326.53 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$640.07 |
$640.07 |
$640.07 |
$2,154.68
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$180.08 |
$180.08 |
$180.08 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$188.99 |
$188.99 |
$188.99 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$62.66 |
$62.66 |
$62.66 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$63.17 |
$63.17 |
$63.17 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$120.48 |
$120.48 |
$120.48 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$50.69 |
$50.69 |
$50.69 |
$141.60
|
|
Inj epidural sgl cerv-thor without img
|
$437.07 |
$437.07 |
$437.07 |
$1,366.20
|
|
Inj for mammo ductogram
|
$107.49 |
$107.49 |
$107.49 |
$433.50
|
|
Inj intralesional <= 7 lsn(s)
|
$69.28 |
$69.28 |
$69.28 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$31.33 |
$31.33 |
$31.33 |
$234.00
|
|
Inj mepivacaine hcl/10 ml
|
$14.14 |
$14.14 |
$14.14 |
$31.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$781.93 |
$781.93 |
$781.93 |
$1,522.56
|
|
Inj, pemivibart, 4500 mg
|
$10,808.83 |
$10,808.83 |
$10,808.83 |
$1,295.85
|
|
Inj proc ankle arthr
|
$152.06 |
$152.06 |
$152.06 |
$405.31
|
|
Inj proc elbow arthro
|
$130.67 |
$130.67 |
$130.67 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$151.30 |
$151.30 |
$151.30 |
$1,224.30
|
|
Inj prohance multipack
|
$1.16 |
$1.16 |
$1.16 |
$51.48
|
|
Inj retro urethrocysto
|
$206.31 |
$206.31 |
$206.31 |
$551.29
|
|
Inj, uzedy, 1 mg
|
$0.01 |
$0.01 |
$0.01 |
$11,643.18
|
|
Inj vancomycin (xellia) 10mg
|
$37.31 |
$37.31 |
$37.31 |
$86.90
|
|
Insert cath pleura with image
|
$959.21 |
$959.21 |
$959.21 |
$2,239.02
|
|
Insertion catheter bladder non indwelling
|
$48.91 |
$48.91 |
$48.91 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$69.54 |
$69.54 |
$69.54 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$640.32 |
$640.32 |
$640.32 |
$2,618.40
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$732.27 |
$732.27 |
$732.27 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,061.59 |
$1,061.59 |
$1,061.59 |
$2,527.91
|
|
Insitu hybridization auto
|
$108.00 |
$108.00 |
$108.00 |
$398.16
|
|
Insitu hybridization manual
|
$78.45 |
$78.45 |
$78.45 |
$407.11
|
|
In situ hybridization per specimen initial single probe stain
|
$54.00 |
$54.00 |
$54.00 |
$338.40
|
|
Insulin total
|
$20.64 |
$20.64 |
$20.64 |
$67.60
|
|
Integra meshed bil wound mat
|
$13,503.69 |
$13,503.69 |
$13,503.69 |
$13,503.69
|
|
Intens behave ther cardio dx
|
$16.05 |
$16.05 |
$16.05 |
$38.70
|
|
Interdiscal perq aspir dx
|
$1,124.25 |
$1,124.25 |
$1,124.25 |
$1,222.26
|
|
Intrinsic factor antibody
|
$30.57 |
$30.57 |
$30.57 |
$59.95
|
|
Intro long gi tube
|
$235.09 |
$235.09 |
$235.09 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$78.20 |
$78.20 |
$78.20 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$449.04 |
$449.04 |
$449.04 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$2.95 |
$2.95 |
$2.95 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$3.15 |
$3.15 |
$3.15 |
$182.21
|
|
Ip/obs cnsltj new/est low 45
|
$78.20 |
$78.20 |
$78.20 |
$225.55
|
|
Ip/obs cnsltj new/est mod 60
|
$105.20 |
$105.20 |
$105.20 |
$303.20
|
|
Ip/obs consltj new/est hi 80
|
$132.96 |
$132.96 |
$132.96 |
$365.60
|
|
Ip/obs consltj new/est sf 35
|
$51.96 |
$51.96 |
$51.96 |
$140.73
|
|
Iron
|
$24.97 |
$24.97 |
$24.97 |
$70.72
|
|
Iron binding capacity
|
$17.32 |
$17.32 |
$17.32 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$66.47 |
$66.47 |
$66.47 |
$73.22
|
|
Irrigation implantable venous access device for drug delivery systems
|
$52.47 |
$52.47 |
$52.47 |
$154.50
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$79.73 |
$79.73 |
$79.73 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$45.09 |
$45.09 |
$45.09 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$70.05 |
$70.05 |
$70.05 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$190.52 |
$190.52 |
$190.52 |
$460.85
|
|
Ivp w/nephrotomography
|
$326.02 |
$326.02 |
$326.02 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$205.29 |
$205.29 |
$205.29 |
$713.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$3.32 |
$3.32 |
$3.32 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$3.94 |
$3.94 |
$3.94 |
$29.52
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$209.62 |
$209.62 |
$209.62 |
$668.25
|
|
Kit lead specify 5-6-5
|
$3,005.46 |
$3,005.46 |
$3,005.46 |
$15,875.64
|
|
Knee MRI (with and without contrast)
|
$1,275.29 |
$1,275.29 |
$1,275.29 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,150.74 |
$1,150.74 |
$1,150.74 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,036.89 |
$1,036.89 |
$1,036.89 |
$2,181.10
|
|
Knee X-ray
|
$137.54 |
$137.54 |
$137.54 |
$443.90
|
|
Kras gene variants exon 2
|
$128.63 |
$128.63 |
$128.63 |
$495.00
|
|
Lactate dehydrogenase (ldh)
|
$24.46 |
$24.46 |
$24.46 |
$53.30
|
|
Lactic acid
|
$92.46 |
$92.46 |
$92.46 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$19.11 |
$19.11 |
$19.11 |
$88.40
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$446.75 |
$446.75 |
$446.75 |
$2,480.71
|
|
Lead acuity x4 spiral l 86cm
|
$1,375.38 |
$1,375.38 |
$1,375.38 |
$5,831.00
|
|
Lead capillary
|
$19.36 |
$19.36 |
$19.36 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$443.95 |
$443.95 |
$443.95 |
$3,844.75
|
|
Lead tachy durata sj4 58cm
|
$3,193.94 |
$3,193.94 |
$3,193.94 |
$6,696.00
|
|
Left compres band >=3" <5"/yd
|
$3.00 |
$3.00 |
$3.00 |
$5.20
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$384.60 |
$384.60 |
$384.60 |
$1,100.74
|
|
Lens, intraocular (new tech)
|
$30.57 |
$30.57 |
$30.57 |
$892.70
|
|
Levetiracetam therapeutic drug level
|
$6.12 |
$6.12 |
$6.12 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$37.31 |
$37.31 |
$37.31 |
$64.88
|
|
Ligation major artery chest
|
$747.04 |
$747.04 |
$747.04 |
$2,701.60
|
|
Ligation/major artery/extremity 37618
|
$490.81 |
$490.81 |
$490.81 |
$1,567.80
|
|
Lipase
|
$17.32 |
$17.32 |
$17.32 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$16.82 |
$16.82 |
$16.82 |
$55.90
|
|
Lithium therapeutic drug level
|
$18.60 |
$18.60 |
$18.60 |
$67.60
|
|
Liver Function Test
|
$29.55 |
$29.55 |
$29.55 |
$110.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$844.34 |
$844.34 |
$844.34 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$757.74 |
$757.74 |
$757.74 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$721.82 |
$721.82 |
$721.82 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,389.90 |
$1,389.90 |
$1,389.90 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,166.53 |
$1,166.53 |
$1,166.53 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,014.48 |
$1,014.48 |
$1,014.48 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$122.77 |
$122.77 |
$122.77 |
$344.00
|
|
Lumbar diskogram s&i
|
$937.56 |
$937.56 |
$937.56 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$68.52 |
$68.52 |
$68.52 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$98.32 |
$98.32 |
$98.32 |
$298.50
|
|
Magnesium
|
$19.36 |
$19.36 |
$19.36 |
$71.50
|
|
Magnetic image bone marrow
|
$919.98 |
$919.98 |
$919.98 |
$1,152.80
|