|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$624.75 |
$624.75 |
$624.75 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$205.53 |
$205.53 |
$205.53 |
$141.60
|
|
Injection treatment of eye
|
$2,863.65 |
$2,863.65 |
$2,863.65 |
$2,698.92
|
|
Inject sacroiliac joint
|
$267.24 |
$267.24 |
$267.24 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$792.03 |
$792.03 |
$792.03 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,170.45 |
$1,170.45 |
$1,170.45 |
$1,450.84
|
|
Inj for ext venography
|
$860.88 |
$860.88 |
$860.88 |
$737.55
|
|
Inj intralesional <= 7 lsn(s)
|
$221.85 |
$221.85 |
$221.85 |
$241.74
|
|
Inj, levothyroxine, freskabi
|
$250.28 |
$250.28 |
$250.28 |
$303.45
|
|
Inj pantoprazole(hikma) 40mg
|
$84.15 |
$84.15 |
$84.15 |
$33.52
|
|
Inj testosterone cypionate
|
$42.89 |
$42.89 |
$42.89 |
$82.58
|
|
Ins cerv dilator (sep proc)
|
$359.04 |
$359.04 |
$359.04 |
$544.00
|
|
Insert and remove bone pin
|
$3,657.72 |
$3,657.72 |
$3,657.72 |
$4,335.60
|
|
Insert cath pleura with image
|
$1,828.35 |
$1,828.35 |
$1,828.35 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,139.96 |
$2,139.96 |
$2,139.96 |
$2,212.00
|
|
Insert drug delivery implant
|
$537.03 |
$537.03 |
$537.03 |
$285.80
|
|
Insert intrauterine device iud
|
$213.69 |
$213.69 |
$213.69 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$447.78 |
$447.78 |
$447.78 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$555.90 |
$555.90 |
$555.90 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,352.85 |
$4,352.85 |
$4,352.85 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$4,050.93 |
$4,050.93 |
$4,050.93 |
$2,549.95
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,013.19 |
$4,013.19 |
$4,013.19 |
$2,618.40
|
|
Insertion of catheter vein
|
$1,441.77 |
$1,441.77 |
$1,441.77 |
$1,749.80
|
|
Insertion of heart electrode 33211
|
$8,326.26 |
$8,326.26 |
$8,326.26 |
$9,090.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,264.51 |
$3,264.51 |
$3,264.51 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,264.51 |
$3,264.51 |
$3,264.51 |
$2,527.91
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$8,326.26 |
$8,326.26 |
$8,326.26 |
$7,572.47
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,660.78 |
$3,660.78 |
$3,660.78 |
$5,470.54
|
|
Insertion ureth cath
|
$1,892.10 |
$1,892.10 |
$1,892.10 |
$2,424.12
|
|
Insert pessary/other device
|
$351.39 |
$351.39 |
$351.39 |
$278.90
|
|
Insert prost urethral stent
|
$2,279.70 |
$2,279.70 |
$2,279.70 |
$2,424.12
|
|
Insert swan-ganz cath
|
$1,517.76 |
$1,517.76 |
$1,517.76 |
$2,164.52
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$710.94 |
$710.94 |
$710.94 |
$1,483.95
|
|
Inst fibrinolysis agent ini day
|
$997.05 |
$997.05 |
$997.05 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$997.05 |
$997.05 |
$997.05 |
$898.12
|
|
Ins tun cv cath wo subq prt/pm
|
$6,316.35 |
$6,316.35 |
$6,316.35 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$3,660.78 |
$3,660.78 |
$3,660.78 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$3,612.84 |
$3,612.84 |
$3,612.84 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$710.94 |
$710.94 |
$710.94 |
$1,074.68
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$8,670.07 |
$8,670.07 |
$8,670.07 |
$9,970.16
|
|
Integra meshed bil wound mat
|
$24,127.41 |
$24,127.41 |
$24,127.41 |
$25,450.30
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$2,713.20 |
$2,713.20 |
$2,713.20 |
$2,908.50
|
|
Interdental fixation
|
$1,705.95 |
$1,705.95 |
$1,705.95 |
$2,133.48
|
|
Interrog evl pm/ldls pm ip
|
$121.38 |
$121.38 |
$121.38 |
$127.20
|
|
Int hrhc lig 1 hroid without img
|
$3,157.41 |
$3,157.41 |
$3,157.41 |
$3,245.23
|
|
Intranasal biopsy 30100
|
$1,705.95 |
$1,705.95 |
$1,705.95 |
$1,850.94
|
|
Intraoral i+d tongue/floor lingual 41000
|
$561.51 |
$561.51 |
$561.51 |
$1,182.15
|
|
Intro long gi tube
|
$1,014.39 |
$1,014.39 |
$1,014.39 |
$1,036.00
|
|
Intro windpipe wire/tube
|
$1,630.47 |
$1,630.47 |
$1,630.47 |
$2,316.30
|
|
Intubation endotracheal emergency procedure
|
$284.07 |
$284.07 |
$284.07 |
$617.60
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$5,619.23 |
$5,619.23 |
$5,619.23 |
$182.21
|
|
Ipratropium bromide non-comp
|
$5.61 |
$5.61 |
$5.61 |
$4.77
|
|
Iron
|
$53.04 |
$53.04 |
$53.04 |
$70.72
|
|
Iron binding capacity
|
$58.14 |
$58.14 |
$58.14 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$169.30
|
|
Irrigation implantable venous access device for drug delivery systems
|
$102.00 |
$102.00 |
$102.00 |
$154.50
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$205.53 |
$205.53 |
$205.53 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$141.78 |
$141.78 |
$141.78 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$597.72 |
$597.72 |
$597.72 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$699.72 |
$699.72 |
$699.72 |
$460.85
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$67.32 |
$67.32 |
$67.32 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$29.52
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$467.16 |
$467.16 |
$467.16 |
$668.25
|
|
Kit cath f 8f w/glv + wipe ster
|
$7.37 |
$7.37 |
$7.37 |
$8.68
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$7,191.00 |
$7,191.00 |
$7,191.00 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$20,655.00 |
$20,655.00 |
$20,655.00 |
$31,352.76
|
|
Kit ipg optimizer smart
|
$34,476.00 |
$34,476.00 |
$34,476.00 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$25,818.75 |
$25,818.75 |
$25,818.75 |
$15,875.64
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,574.37 |
$1,574.37 |
$1,574.37 |
$1,391.79
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$4,396.62 |
$4,396.62 |
$4,396.62 |
$234.08
|
|
Kit sound processor cochlear osia 2
|
$8,359.31 |
$8,359.31 |
$8,359.31 |
$10,653.60
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,087.65 |
$2,087.65 |
$2,087.65 |
$2,306.56
|
|
Knee Arthroscopy (Cartilage Repair)
|
$982.26 |
$982.26 |
$982.26 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$856.80 |
$856.80 |
$856.80 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,034.28 |
$1,034.28 |
$1,034.28 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,044.48 |
$1,044.48 |
$1,044.48 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$783.36 |
$783.36 |
$783.36 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,042.44 |
$1,042.44 |
$1,042.44 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$890.97 |
$890.97 |
$890.97 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,098.03 |
$1,098.03 |
$1,098.03 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,619.25 |
$1,619.25 |
$1,619.25 |
$4,137.60
|
|
Knee arthroscopy/surgery
|
$1,541.22 |
$1,541.22 |
$1,541.22 |
$7,807.24
|
|
Knee MRI (with and without contrast)
|
$2,993.70 |
$2,993.70 |
$2,993.70 |
$2,950.00
|
|
Knee MRI (without contrast)
|
$1,788.57 |
$1,788.57 |
$1,788.57 |
$2,181.10
|
|
Knee X-ray
|
$479.91 |
$479.91 |
$479.91 |
$443.90
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$49.98 |
$49.98 |
$49.98 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$80.07 |
$80.07 |
$80.07 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$39.72
|
|
Lactate dehydrogenase (ldh)
|
$69.87 |
$69.87 |
$69.87 |
$53.30
|
|
Lactated ringers intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$48.56
|
|
Lactic acid
|
$103.53 |
$103.53 |
$103.53 |
$102.90
|
|
Lam facetec & foramot lumbar
|
$2,237.37 |
$2,237.37 |
$2,237.37 |
$7,907.11
|
|
Laparo cholecystectomy/graph
|
$5,316.24 |
$5,316.24 |
$5,316.24 |
$7,220.90
|
|
Laparo partial colectomy 44204
|
$2,750.94 |
$2,750.94 |
$2,750.94 |
$3,790.40
|
|
Laparoscopic myomectomy
|
$1,637.61 |
$1,637.61 |
$1,637.61 |
$6,376.26
|
|
Laparoscopy excise lesions
|
$1,322.94 |
$1,322.94 |
$1,322.94 |
$6,376.26
|
|
Laparoscopy lysis
|
$1,238.28 |
$1,238.28 |
$1,238.28 |
$5,057.88
|
|
Laparoscopy remove adnexa
|
$1,206.15 |
$1,206.15 |
$1,206.15 |
$6,904.15
|
|
Lap enterolysis
|
$1,653.93 |
$1,653.93 |
$1,653.93 |
$5,741.00
|
|
Lap ing hernia repair init
|
$1,349.97 |
$1,349.97 |
$1,349.97 |
$5,741.00
|