|
Intro windpipe wire/tube
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$2,316.30
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$510.30 |
$510.30 |
$510.30 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$382.90 |
$382.90 |
$382.90 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$712.25 |
$712.25 |
$712.25 |
$617.60
|
|
Ionm in operatng room 15 min
|
$50.75 |
$50.75 |
$50.75 |
$200.78
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$70.56 |
$70.56 |
$70.56 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$63,066.15 |
$63,066.15 |
$63,066.15 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$0.61 |
$0.61 |
$0.61 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$410.13 |
$410.13 |
$410.13 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$10,986.98 |
$10,986.98 |
$10,986.98 |
$5,837.00
|
|
Iron
|
$148.40 |
$148.40 |
$148.40 |
$70.72
|
|
Iron binding capacity
|
$158.20 |
$158.20 |
$158.20 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$58.15 |
$58.15 |
$58.15 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$88.90 |
$88.90 |
$88.90 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$154.00 |
$154.00 |
$154.00 |
$154.50
|
|
Ivc venogram s&i
|
$1,909.25 |
$1,909.25 |
$1,909.25 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$252.35 |
$252.35 |
$252.35 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$252.35 |
$252.35 |
$252.35 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$252.35 |
$252.35 |
$252.35 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$534.10 |
$534.10 |
$534.10 |
$460.85
|
|
Ivp w/nephrotomography
|
$1,419.60 |
$1,419.60 |
$1,419.60 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$1,020.60 |
$1,020.60 |
$1,020.60 |
$713.05
|
|
Ixabepilone 15 mg intravenous solution
|
$10,966.68 |
$10,966.68 |
$10,966.68 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$185.50 |
$185.50 |
$185.50 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$32.76 |
$32.76 |
$32.76 |
$29.52
|
|
Kidney imaging morphology
|
$362.60 |
$362.60 |
$362.60 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$575.75 |
$575.75 |
$575.75 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$502.60 |
$502.60 |
$502.60 |
$668.25
|
|
Kit cath f 8f w/glv + wipe ster
|
$3.99 |
$3.99 |
$3.99 |
$8.68
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,941.90 |
$6,941.90 |
$6,941.90 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$21,787.50 |
$21,787.50 |
$21,787.50 |
$31,352.76
|
|
Kit ipg optimizer smart
|
$37,492.00 |
$37,492.00 |
$37,492.00 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$27,234.38 |
$27,234.38 |
$27,234.38 |
$15,875.64
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,234.80 |
$1,234.80 |
$1,234.80 |
$1,391.79
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$3,931.62 |
$3,931.62 |
$3,931.62 |
$234.08
|
|
Kit sound processor cochlear osia 2
|
$8,308.44 |
$8,308.44 |
$8,308.44 |
$10,653.60
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,659.84 |
$1,659.84 |
$1,659.84 |
$2,306.56
|
|
Knee MRI (with and without contrast)
|
$3,769.85 |
$3,769.85 |
$3,769.85 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$3,473.05 |
$3,473.05 |
$3,473.05 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,280.25 |
$2,280.25 |
$2,280.25 |
$2,181.10
|
|
Knee X-ray
|
$475.30 |
$475.30 |
$475.30 |
$443.90
|
|
Kras gene variants exon 2
|
$136.50 |
$136.50 |
$136.50 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$96.60 |
$96.60 |
$96.60 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$96.60 |
$96.60 |
$96.60 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$32.74 |
$32.74 |
$32.74 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$106.61 |
$106.61 |
$106.61 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$166.25 |
$166.25 |
$166.25 |
$53.30
|
|
Lactated ringers intravenous solution
|
$68.93 |
$68.93 |
$68.93 |
$48.56
|
|
Lactic acid
|
$298.20 |
$298.20 |
$298.20 |
$102.90
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$38,785.58 |
$38,785.58 |
$38,785.58 |
$21,487.67
|
|
Laparo cholecystectomy/graph
|
$2,747.15 |
$2,747.15 |
$2,747.15 |
$7,220.90
|
|
Largsc w/removal lesion
|
$1,464.40 |
$1,464.40 |
$1,464.40 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$555.80 |
$555.80 |
$555.80 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,151.15 |
$1,151.15 |
$1,151.15 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$1,151.15 |
$1,151.15 |
$1,151.15 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$1,001.00 |
$1,001.00 |
$1,001.00 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$483.35 |
$483.35 |
$483.35 |
$660.10
|
|
Lateral canthopexy
|
$1,653.05 |
$1,653.05 |
$1,653.05 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$2,188.90 |
$2,188.90 |
$2,188.90 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$5,831.00 |
$5,831.00 |
$5,831.00 |
$5,831.00
|
|
Lead ingevity 45cm pfret MRI
|
$4,494.00 |
$4,494.00 |
$4,494.00 |
$3,844.75
|
|
Lead tachy durata sj4 58cm
|
$4,905.95 |
$4,905.95 |
$4,905.95 |
$6,696.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,194.90 |
$1,194.90 |
$1,194.90 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$1,654.19 |
$1,654.19 |
$1,654.19 |
$1,489.57
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,654.19 |
$1,654.19 |
$1,654.19 |
$1,023.10
|
|
Lens iol ant chamb 10.5
|
$148.75 |
$148.75 |
$148.75 |
$216.48
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$200.90 |
$200.90 |
$200.90 |
$164.09
|
|
Leukocyte phagocytosis
|
$224.91 |
$224.91 |
$224.91 |
$49.28
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,791.81 |
$1,791.81 |
$1,791.81 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$4,620.05 |
$4,620.05 |
$4,620.05 |
$6,694.24
|
|
Leuprolide depot cipla 7.5mg
|
$4,514.99 |
$4,514.99 |
$4,514.99 |
$257.70
|
|
Levalbuterol non-comp unit
|
$0.78 |
$0.78 |
$0.78 |
$8.13
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$33.29 |
$33.29 |
$33.29 |
$97.62
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$86.49 |
$86.49 |
$86.49 |
$64.88
|
|
Liberta rc ipg
|
$32,673.99 |
$32,673.99 |
$32,673.99 |
$39,840.21
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$68.93 |
$68.93 |
$68.93 |
$39.75
|
|
Ligation/biopsy of temporal artery 37609
|
$1,360.45 |
$1,360.45 |
$1,360.45 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$2,594.20 |
$2,594.20 |
$2,594.20 |
$1,567.80
|
|
Ligation major artery neck
|
$2,594.20 |
$2,594.20 |
$2,594.20 |
$3,724.63
|
|
Liletta, 52 mg
|
$443.68 |
$443.68 |
$443.68 |
$1,790.04
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$259.43 |
$259.43 |
$259.43 |
$172.25
|
|
Lipase
|
$148.40 |
$148.40 |
$148.40 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$134.40 |
$134.40 |
$134.40 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$131.60 |
$131.60 |
$131.60 |
$60.00
|
|
Lithium therapeutic drug level
|
$141.75 |
$141.75 |
$141.75 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$3,404.80 |
$3,404.80 |
$3,404.80 |
$4,371.12
|
|
Liver Function Test
|
$207.55 |
$207.55 |
$207.55 |
$110.50
|
|
Liver imaging
|
$463.05 |
$463.05 |
$463.05 |
$1,241.25
|
|
Liver/spleen imag static only
|
$518.70 |
$518.70 |
$518.70 |
$1,140.78
|
|
Locm 100-199mg/ml iodine,1ml
|
$31.50 |
$31.50 |
$31.50 |
$15.38
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$43.75 |
$43.75 |
$43.75 |
$43.95
|
|
Low cost skin substitute app
|
$506.45 |
$506.45 |
$506.45 |
$1,030.00
|
|
Low cost skin substitute app
|
$1,655.85 |
$1,655.85 |
$1,655.85 |
$2,164.64
|
|
Low cost skin substitute app
|
$506.45 |
$506.45 |
$506.45 |
$1,132.56
|
|
Low cost skin substitute app
|
$506.45 |
$506.45 |
$506.45 |
$1,030.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,800.05 |
$1,800.05 |
$1,800.05 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,704.50 |
$1,704.50 |
$1,704.50 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,556.10 |
$1,556.10 |
$1,556.10 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,739.70 |
$4,739.70 |
$4,739.70 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,769.85 |
$3,769.85 |
$3,769.85 |
$2,441.25
|