|
Interdiscal perq aspir dx
|
$6,627.96 |
$6,627.96 |
$6,627.96 |
$1,222.26
|
|
Interrog evl pm/ldls pm ip
|
$175.95 |
$175.95 |
$175.95 |
$127.20
|
|
Int hrhc lig 1 hroid without img
|
$5,818.08 |
$5,818.08 |
$5,818.08 |
$3,245.23
|
|
Intranasal biopsy 30100
|
$3,144.15 |
$3,144.15 |
$3,144.15 |
$1,850.94
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,034.79 |
$1,034.79 |
$1,034.79 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$343.74 |
$343.74 |
$343.74 |
$239.52
|
|
Intrinsic factor antibody
|
$48.20 |
$48.20 |
$48.20 |
$59.95
|
|
Intro cath dialysis circuit
|
$1,587.63 |
$1,587.63 |
$1,587.63 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$5,594.19 |
$5,594.19 |
$5,594.19 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$11,337.81 |
$11,337.81 |
$11,337.81 |
$15,625.00
|
|
Intro catheter aorta
|
$435.54 |
$435.54 |
$435.54 |
$1,861.61
|
|
Intro cath svc/ivc
|
$1,168.92 |
$1,168.92 |
$1,168.92 |
$1,350.75
|
|
Intro long gi tube
|
$5,381.01 |
$5,381.01 |
$5,381.01 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$1,490.73 |
$1,490.73 |
$1,490.73 |
$477.85
|
|
Intro windpipe wire/tube
|
$3,145.68 |
$3,145.68 |
$3,145.68 |
$2,316.30
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$6,984.45 |
$6,984.45 |
$6,984.45 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$4,935.78 |
$4,935.78 |
$4,935.78 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$1,773.78 |
$1,773.78 |
$1,773.78 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$153.03 |
$153.03 |
$153.03 |
$147.60
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$112.91 |
$112.91 |
$112.91 |
$148.28
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$82,783.25 |
$82,783.25 |
$82,783.25 |
$52,277.70
|
|
Ipratropium bromide non-comp
|
$5.61 |
$5.61 |
$5.61 |
$5.28
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$507.20 |
$507.20 |
$507.20 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,139.59 |
$9,139.59 |
$9,139.59 |
$5,317.81
|
|
Iron
|
$94.86 |
$94.86 |
$94.86 |
$70.72
|
|
Iron binding capacity
|
$100.47 |
$100.47 |
$100.47 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$84.15 |
$84.15 |
$84.15 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$105.83 |
$105.83 |
$105.83 |
$163.28
|
|
Irrigation implantable venous access device for drug delivery systems
|
$347.31 |
$347.31 |
$347.31 |
$154.50
|
|
Ivc venogram s&i
|
$6,609.60 |
$6,609.60 |
$6,609.60 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$385.56 |
$385.56 |
$385.56 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$385.56 |
$385.56 |
$385.56 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$382.50 |
$382.50 |
$382.50 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,226.04 |
$1,226.04 |
$1,226.04 |
$460.85
|
|
IV inj ra drug dx study
|
$655.35 |
$655.35 |
$655.35 |
$560.00
|
|
Ivp w/nephrotomography
|
$2,838.66 |
$2,838.66 |
$2,838.66 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$1,828.86 |
$1,828.86 |
$1,828.86 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$199.92 |
$199.92 |
$199.92 |
$378.30
|
|
John cunningham antibody
|
$770.65 |
$770.65 |
$770.65 |
$48.57
|
|
Ketamine and metabolite screen - quest
|
$5.56 |
$5.56 |
$5.56 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$61.20 |
$61.20 |
$61.20 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$29.52
|
|
Kidney function study
|
$1,346.91 |
$1,346.91 |
$1,346.91 |
$549.70
|
|
Kidney imag w/bld flow multi
|
$2,318.97 |
$2,318.97 |
$2,318.97 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,612.11 |
$1,612.11 |
$1,612.11 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,696.77 |
$1,696.77 |
$1,696.77 |
$668.25
|
|
Kit cath f 8f w/glv + wipe ster
|
$9.80 |
$9.80 |
$9.80 |
$8.68
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,256.17 |
$6,256.17 |
$6,256.17 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$17,518.50 |
$17,518.50 |
$17,518.50 |
$31,352.76
|
|
Kit ipg optimizer smart
|
$29,702.40 |
$29,702.40 |
$29,702.40 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$21,898.13 |
$21,898.13 |
$21,898.13 |
$15,875.64
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,061.68 |
$2,061.68 |
$2,061.68 |
$1,391.79
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$4,063.54 |
$4,063.54 |
$4,063.54 |
$3,877.17
|
|
Kit sound processor cochlear osia 2
|
$7,004.52 |
$7,004.52 |
$7,004.52 |
$10,472.03
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,693.58 |
$2,693.58 |
$2,693.58 |
$2,306.56
|
|
Knee MRI (with and without contrast)
|
$9,004.56 |
$9,004.56 |
$9,004.56 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$4,864.38 |
$4,864.38 |
$4,864.38 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,988.20 |
$3,988.20 |
$3,988.20 |
$2,181.10
|
|
Knee X-ray
|
$1,026.12 |
$1,026.12 |
$1,026.12 |
$443.90
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$223.89 |
$223.89 |
$223.89 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$98.94 |
$98.94 |
$98.94 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$39.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$132.74 |
$132.74 |
$132.74 |
$172.80
|
|
Lactate dehydrogenase (ldh)
|
$88.23 |
$88.23 |
$88.23 |
$53.30
|
|
Lactated ringers intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$48.00
|
|
Lactic acid
|
$156.57 |
$156.57 |
$156.57 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$74.46 |
$74.46 |
$74.46 |
$88.40
|
|
Lactoferrin fecal quant
|
$95.88 |
$95.88 |
$95.88 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$21,487.67 |
$21,487.67 |
$21,487.67 |
$19,124.00
|
|
Laparo cholecystectomy/graph
|
$10,257.12 |
$10,257.12 |
$10,257.12 |
$7,220.90
|
|
Laparoscopy remove adnexa
|
$9,451.83 |
$9,451.83 |
$9,451.83 |
$6,904.15
|
|
Largsc w/removal lesion
|
$4,250.85 |
$4,250.85 |
$4,250.85 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$575.79 |
$575.79 |
$575.79 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$2,438.82 |
$2,438.82 |
$2,438.82 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$2,438.82 |
$2,438.82 |
$2,438.82 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$2,438.82 |
$2,438.82 |
$2,438.82 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$575.79 |
$575.79 |
$575.79 |
$660.10
|
|
Lateral canthopexy
|
$5,598.78 |
$5,598.78 |
$5,598.78 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$5,083.17 |
$5,083.17 |
$5,083.17 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$3,540.52 |
$3,540.52 |
$3,540.52 |
$5,831.00
|
|
Lead capillary
|
$52.02 |
$52.02 |
$52.02 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$3,854.16 |
$3,854.16 |
$3,854.16 |
$3,844.75
|
|
Lead tachy durata sj4 58cm
|
$4,044.30 |
$4,044.30 |
$4,044.30 |
$6,696.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,286.22 |
$1,286.22 |
$1,286.22 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,684.41 |
$2,684.41 |
$2,684.41 |
$1,489.57
|
|
Lens iol ant bicnvx 24.0 multi
|
$2,684.41 |
$2,684.41 |
$2,684.41 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$348.97 |
$348.97 |
$348.97 |
$201.11
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$363.70 |
$363.70 |
$363.70 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,982.84 |
$2,982.84 |
$2,982.84 |
$4,250.55
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$11,458.07 |
$11,458.07 |
$11,458.07 |
$6,694.24
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$153.61 |
$153.61 |
$153.61 |
$82.84
|
|
Levetiracetam therapeutic drug level
|
$33.28 |
$33.28 |
$33.28 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$145.35 |
$145.35 |
$145.35 |
$62.72
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$248.30 |
$248.30 |
$248.30 |
$397.50
|
|
Liberta rc ipg
|
$26,271.91 |
$26,271.91 |
$26,271.91 |
$39,840.21
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$38.00
|
|
Lidocaine therapeutic drug level
|
$50.97 |
$50.97 |
$50.97 |
$83.85
|
|
Ligation/biopsy of temporal artery 37609
|
$3,395.58 |
$3,395.58 |
$3,395.58 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$5,057.67 |
$5,057.67 |
$5,057.67 |
$1,567.80
|
|
Ligation major artery neck
|
$4,544.61 |
$4,544.61 |
$4,544.61 |
$3,724.63
|