|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$6,952.07 |
$6,952.07 |
$6,952.07 |
|
|
Iron
|
$40.30 |
$40.30 |
$74.75 |
|
|
Iron binding capacity
|
$31.20 |
$56.55 |
$77.35 |
|
|
Iron dextran 50 mg/ml injection solution
|
$29.58 |
$29.58 |
$30.22 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$196.31 |
$200.51 |
$200.54 |
|
|
Irradiation of blood product each unit reference
|
$84.50 |
$116.35 |
$130.00 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$93.60 |
$93.60 |
$128.05 |
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$10,544.98 |
$10,544.98 |
$10,544.98 |
|
|
Ivc venogram s&i
|
$2,594.80 |
$2,594.80 |
$2,594.80 |
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$153.40 |
$153.40 |
$190.45 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$153.40 |
$153.40 |
$206.70 |
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$153.40 |
$153.40 |
$190.45 |
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$153.40 |
$153.40 |
$190.45 |
|
|
Ivp w/nephrotomography
|
$883.35 |
$883.35 |
$885.95 |
|
|
Ivp w/wo kub w/wo tomography
|
$756.60 |
$756.60 |
$911.30 |
|
|
Ixabepilone 15 mg intravenous solution
|
$13,755.87 |
$13,755.87 |
$13,755.87 |
|
|
Jak2 targeted sequence analysis
|
$423.80 |
$423.80 |
$423.80 |
|
|
Jejunstmy tube plcmt
|
$2,951.78 |
$2,951.78 |
$2,951.78 |
|
|
John cunningham antibody
|
$1,005.55 |
$1,005.55 |
$1,898.00 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$75.40 |
$77.35 |
$91.00 |
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$8.62 |
$9.29 |
$20.16 |
|
|
Kidney endoscopy
|
$12,261.96 |
$12,261.96 |
$12,261.96 |
|
|
Kidney function study
|
$513.50 |
$513.50 |
$513.50 |
|
|
Kidney imaging morphology
|
$394.55 |
$394.55 |
$394.55 |
|
|
Kidney imag w/bld flow multi
|
$750.10 |
$750.10 |
$1,264.25 |
|
|
Kidney img w/bldflw sgl without rx
|
$1,132.95 |
$1,132.95 |
$1,401.20 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$474.50 |
$474.50 |
$627.90 |
|
|
Knee Arthroscopy (Cartilage Repair)
|
$4,729.29 |
$4,729.29 |
$4,729.29 |
|
|
Knee arthroscopy/drainage
|
$4,633.62 |
$4,633.62 |
$4,633.62 |
|
|
Knee Arthroscopy (Meniscus Repair)
|
$4,588.99 |
$4,588.99 |
$4,588.99 |
|
|
Knee arthroscopy/surgery
|
$6,202.61 |
$6,202.61 |
$6,202.61 |
|
|
Knee arthroscopy/surgery
|
$4,518.66 |
$4,518.66 |
$4,518.66 |
|
|
Knee arthroscopy/surgery
|
$4,535.82 |
$4,535.82 |
$4,535.82 |
|
|
Knee arthroscopy/surgery
|
$6,202.61 |
$6,202.61 |
$6,202.61 |
|
|
Knee arthroscopy/surgery
|
$4,623.79 |
$4,623.79 |
$4,623.79 |
|
|
Knee arthroscopy/surgery
|
$9,088.59 |
$9,088.59 |
$9,088.59 |
|
|
Knee arthroscopy/surgery
|
$4,617.73 |
$4,617.73 |
$4,617.73 |
|
|
Knee arthroscopy/surgery
|
$4,692.67 |
$4,692.67 |
$4,692.67 |
|
|
Knee arthroscopy/surgery
|
$10,608.30 |
$10,608.30 |
$10,608.30 |
|
|
Knee MRI (with and without contrast)
|
$2,653.30 |
$2,653.30 |
$4,697.55 |
|
|
Knee MRI (with contrast)
|
$2,106.00 |
$2,106.00 |
$2,265.90 |
|
|
Knee MRI (without contrast)
|
$2,048.15 |
$2,048.15 |
$3,174.60 |
|
|
Knee X-ray
|
$312.65 |
$388.05 |
$561.60 |
|
|
Kras gene addl variants
|
$320.45 |
$346.45 |
$346.45 |
|
|
Kras gene variants exon 2
|
$533.65 |
$552.50 |
$552.50 |
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$42.25 |
$42.25 |
$42.25 |
|
|
Lab draw <3 yrs scalp vein 36405
|
$59.15 |
$59.15 |
$70.20 |
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$7.15 |
$12.35 |
$12.35 |
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$50.58 |
$50.58 |
$78.47 |
|
|
Lactate dehydrogenase (ldh)
|
$21.45 |
$61.75 |
$61.75 |
|
|
Lactated ringers intravenous solution
|
$37.50 |
$37.50 |
$68.25 |
|
|
Lactic acid
|
$170.30 |
$195.65 |
$195.65 |
|
|
Lactoferrin fecal qualitative
|
$79.95 |
$83.20 |
$96.20 |
|
|
Lam facetec & foramot lumbar
|
$21,431.40 |
$21,431.40 |
$21,431.40 |
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$22,629.10 |
$22,629.10 |
$22,629.10 |
|
|
Laparo-asst vag hysterectomy
|
$10,987.16 |
$10,987.16 |
$10,987.16 |
|
|
Laparo cholecystectomy/explr
|
$1,981.85 |
$1,981.85 |
$1,981.85 |
|
|
Laparo cholecystectomy/graph
|
$1,427.40 |
$1,539.20 |
$10,625.96 |
|
|
Laparo new ureter/bladder
|
$22,777.85 |
$22,777.85 |
$22,777.85 |
|
|
Laparo partial colectomy 44204
|
$2,386.15 |
$2,386.15 |
$2,386.15 |
|
|
Laparo partial nephrectomy
|
$23,323.73 |
$23,323.73 |
$23,323.73 |
|
|
Laparo proc abdm/per/oment 49329
|
$7,429.57 |
$7,429.57 |
$7,429.57 |
|
|
Laparoscopic myomectomy
|
$9,261.13 |
$9,261.13 |
$9,261.13 |
|
|
Laparoscopy biopsy
|
$8,603.64 |
$8,603.64 |
$8,603.64 |
|
|
Laparoscopye procstom 43659
|
$16,338.06 |
$16,338.06 |
$16,338.06 |
|
|
Laparoscopy excise lesions
|
$11,313.76 |
$11,313.76 |
$11,313.76 |
|
|
Laparoscopy fundoplasty
|
$2,086.50 |
$2,086.50 |
$19,677.81 |
|
|
Laparoscopy gastrostomy
|
$6,903.31 |
$6,903.31 |
$6,903.31 |
|
|
Laparoscopy lymphadenectomy
|
$19,394.58 |
$19,394.58 |
$19,394.58 |
|
|
Laparoscopy lysis
|
$7,314.25 |
$7,314.25 |
$7,314.25 |
|
|
Laparoscopy pyeloplasty
|
$17,998.58 |
$17,998.58 |
$17,998.58 |
|
|
Laparoscopy remove adnexa
|
$8,777.57 |
$8,777.57 |
$8,777.57 |
|
|
Laparoscopy splenectomy
|
$21,255.22 |
$21,255.22 |
$21,255.22 |
|
|
Laparoscopy surg colpopexy
|
$24,113.30 |
$24,113.30 |
$24,113.30 |
|
|
Laparo urethral suspension
|
$27,973.19 |
$27,973.19 |
$27,973.19 |
|
|
Laparo-vag hyst incl t/o
|
$10,175.08 |
$10,175.08 |
$10,175.08 |
|
|
Laparo-vag hyst w/t/o compl
|
$10,192.43 |
$10,192.43 |
$10,192.43 |
|
|
Lap enterectomy 44202
|
$11,411.41 |
$11,411.41 |
$11,411.41 |
|
|
Lap enterolysis
|
$2,005.25 |
$2,005.25 |
$6,964.22 |
|
|
Lap ing hernia repair init
|
$919.10 |
$919.10 |
$14,323.48 |
|
|
Lap ing hernia repair recur
|
$1,406.60 |
$1,406.60 |
$14,912.23 |
|
|
Lap insert tunnel ip cath
|
$6,513.44 |
$6,513.44 |
$6,513.44 |
|
|
Lap paraesophag hern repair
|
$18,706.80 |
$18,706.80 |
$18,706.80 |
|
|
Lap paraesoph her rpr w/mesh
|
$22,760.26 |
$22,760.26 |
$22,760.26 |
|
|
Lap revision perm ip cath
|
$6,474.07 |
$6,474.07 |
$6,474.07 |
|
|
Lap rmvl gastr adj all parts
|
$7,179.54 |
$7,179.54 |
$7,179.54 |
|
|
Lap sleeve gastrectomy
|
$14,448.46 |
$14,448.46 |
$14,448.46 |
|
|
Laps surg prst8ect rpbic rad
|
$20,998.02 |
$20,998.02 |
$20,998.02 |
|
|
Lap w/omentopexy add-on 49326
|
$6,474.07 |
$6,474.07 |
$6,474.07 |
|
|
Laryngoscope w/vc inj
|
$3,377.63 |
$3,377.63 |
$3,377.63 |
|
|
Laryngoscop w/vc inj + scope
|
$3,937.28 |
$3,937.28 |
$3,937.28 |
|
|
Laryngoscopy w/biopsy
|
$4,906.91 |
$4,906.91 |
$4,906.91 |
|
|
Laryngoscopy w/bx & op scope
|
$3,777.52 |
$3,777.52 |
$3,777.52 |
|
|
Larynscop w/tumr exc + scope
|
$4,285.51 |
$4,285.51 |
$4,285.51 |
|
|
Laser surgery of prostate
|
$6,822.11 |
$6,822.11 |
$6,822.11 |
|
|
Lead capillary
|
$61.75 |
$61.75 |
$80.60 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$877.50 |
$877.50 |
$1,097.20 |
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$260.51 |
$260.51 |
$365.10 |
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$6,172.05 |
$20,514.40 |
$20,514.40 |
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$4,308.91 |
$12,913.80 |
$12,913.80 |
|