|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,844.67 |
$1,844.67 |
$1,844.67 |
$460.85
|
|
IV inj ra drug dx study
|
$905.25 |
$905.25 |
$905.25 |
$560.00
|
|
Ivp w/wo kub w/wo tomography
|
$1,625.88 |
$1,625.88 |
$1,625.88 |
$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
|
$236.13 |
$236.13 |
$236.13 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$29.52
|
|
Kidney function study
|
$1,430.04 |
$1,430.04 |
$1,430.04 |
$549.70
|
|
Kidney imag w/bld flow multi
|
$3,581.22 |
$3,581.22 |
$3,581.22 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$3,571.02 |
$3,571.02 |
$3,571.02 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,345.49 |
$2,345.49 |
$2,345.49 |
$668.25
|
|
Kit cath f 8f w/glv + wipe ster
|
$7.58 |
$7.58 |
$7.58 |
$8.68
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$14,621.70 |
$14,621.70 |
$14,621.70 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$31,365.00 |
$31,365.00 |
$31,365.00 |
$31,352.76
|
|
Kit ipg optimizer smart
|
$79,825.20 |
$79,825.20 |
$79,825.20 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$39,206.25 |
$39,206.25 |
$39,206.25 |
$15,875.64
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,369.05 |
$2,369.05 |
$2,369.05 |
$1,391.79
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$6,928.00 |
$6,928.00 |
$6,928.00 |
$234.08
|
|
Kit sound processor cochlear osia 2
|
$13,115.47 |
$13,115.47 |
$13,115.47 |
$10,653.60
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$3,212.95 |
$3,212.95 |
$3,212.95 |
$2,306.56
|
|
Knee MRI (with and without contrast)
|
$11,846.28 |
$11,846.28 |
$11,846.28 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$8,601.15 |
$8,601.15 |
$8,601.15 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$6,729.45 |
$6,729.45 |
$6,729.45 |
$2,181.10
|
|
Knee X-ray
|
$1,195.44 |
$1,195.44 |
$1,195.44 |
$443.90
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$174.93 |
$174.93 |
$174.93 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$77.52 |
$77.52 |
$77.52 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$84.15 |
$84.15 |
$84.15 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$132.74 |
$132.74 |
$132.74 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$308.04 |
$308.04 |
$308.04 |
$53.30
|
|
Lactated ringers intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$48.56
|
|
Lactic acid
|
$421.26 |
$421.26 |
$421.26 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$71.91 |
$71.91 |
$71.91 |
$88.40
|
|
Lactoferrin fecal quant
|
$109.65 |
$109.65 |
$109.65 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$21,487.67 |
$21,487.67 |
$21,487.67 |
$21,487.67
|
|
Laparo cholecystectomy/graph
|
$11,485.20 |
$11,485.20 |
$11,485.20 |
$7,220.90
|
|
Largsc w/removal lesion
|
$9,704.28 |
$9,704.28 |
$9,704.28 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$1,097.52 |
$1,097.52 |
$1,097.52 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$7,875.42 |
$7,875.42 |
$7,875.42 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$4,653.75 |
$4,653.75 |
$4,653.75 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$4,653.75 |
$4,653.75 |
$4,653.75 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$1,097.52 |
$1,097.52 |
$1,097.52 |
$660.10
|
|
Lateral canthopexy
|
$6,268.92 |
$6,268.92 |
$6,268.92 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$5,692.11 |
$5,692.11 |
$5,692.11 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$5,149.06 |
$5,149.06 |
$5,149.06 |
$5,831.00
|
|
Lead capillary
|
$52.02 |
$52.02 |
$52.02 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$6,701.70 |
$6,701.70 |
$6,701.70 |
$3,844.75
|
|
Lead tachy durata sj4 58cm
|
$6,895.20 |
$6,895.20 |
$6,895.20 |
$6,696.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,416.27 |
$1,416.27 |
$1,416.27 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$3,202.01 |
$3,202.01 |
$3,202.01 |
$1,489.57
|
|
Lens iol ant bicnvx 24.0 multi
|
$3,202.01 |
$3,202.01 |
$3,202.01 |
$1,023.10
|
|
Lens iol ant chamb 10.5
|
$285.24 |
$285.24 |
$285.24 |
$216.48
|
|
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 |
$5,001.00
|
|
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 |
$97.62
|
|
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 |
$64.88
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$248.30 |
$248.30 |
$248.30 |
$420.60
|
|
Liberta rc ipg
|
$47,037.05 |
$47,037.05 |
$47,037.05 |
$39,840.21
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$65.33 |
$65.33 |
$65.33 |
$39.75
|
|
Lidocaine therapeutic drug level
|
$50.97 |
$50.97 |
$50.97 |
$83.85
|
|
Ligation/biopsy of temporal artery 37609
|
$3,375.69 |
$3,375.69 |
$3,375.69 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$5,057.67 |
$5,057.67 |
$5,057.67 |
$1,567.80
|
|
Ligation major artery neck
|
$5,780.85 |
$5,780.85 |
$5,780.85 |
$3,724.63
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$262.55 |
$262.55 |
$262.55 |
$172.25
|
|
Lipase
|
$353.94 |
$353.94 |
$353.94 |
$83.20
|
|
Lipoprotein blood quant
|
$32.02 |
$32.02 |
$32.02 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$300.39 |
$300.39 |
$300.39 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$163.71 |
$163.71 |
$163.71 |
$60.00
|
|
Lithium therapeutic drug level
|
$341.19 |
$341.19 |
$341.19 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$3,079.89 |
$3,079.89 |
$3,079.89 |
$4,371.12
|
|
Liver Function Test
|
$478.89 |
$478.89 |
$478.89 |
$110.50
|
|
Liver imaging
|
$1,674.33 |
$1,674.33 |
$1,674.33 |
$1,241.25
|
|
Locm 100-199mg/ml iodine,1ml
|
$45.90 |
$45.90 |
$45.90 |
$15.38
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$85.68 |
$85.68 |
$85.68 |
$43.95
|
|
Low cost skin substitute app
|
$1,308.15 |
$1,308.15 |
$1,308.15 |
$1,030.00
|
|
Low cost skin substitute app
|
$3,885.18 |
$3,885.18 |
$3,885.18 |
$2,164.64
|
|
Low cost skin substitute app
|
$1,308.15 |
$1,308.15 |
$1,308.15 |
$1,132.56
|
|
Low cost skin substitute app
|
$1,308.15 |
$1,308.15 |
$1,308.15 |
$1,030.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$6,473.94 |
$6,473.94 |
$6,473.94 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$6,166.41 |
$6,166.41 |
$6,166.41 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$5,683.95 |
$5,683.95 |
$5,683.95 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$13,848.54 |
$13,848.54 |
$13,848.54 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$10,753.86 |
$10,753.86 |
$10,753.86 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$9,041.79 |
$9,041.79 |
$9,041.79 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$1,225.02 |
$1,225.02 |
$1,225.02 |
$344.00
|
|
Low frequency non-thermal Ultrasound
|
$256.02 |
$256.02 |
$256.02 |
$275.88
|
|
Lung function test (mbc/mvv)
|
$242.76 |
$242.76 |
$242.76 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$919.53 |
$919.53 |
$919.53 |
$298.50
|
|
Lung perfusion imaging
|
$3,006.96 |
$3,006.96 |
$3,006.96 |
$1,100.39
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$26,131.86 |
$26,131.86 |
$26,131.86 |
$25,341.71
|
|
Lvad shower bag heartmate
|
$1,586.30 |
$1,586.30 |
$1,586.30 |
$972.60
|
|
Lymphatics/lymph node imaging
|
$1,625.37 |
$1,625.37 |
$1,625.37 |
$1,543.75
|
|
Magnesium
|
$250.41 |
$250.41 |
$250.41 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$145.35 |
$145.35 |
$145.35 |
$69.30
|
|
Mammosite ced
|
$7,854.00 |
$7,854.00 |
$7,854.00 |
$5,100.00
|
|
Manipulate wrist w/anesthes
|
$3,229.32 |
$3,229.32 |
$3,229.32 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$720.12 |
$720.12 |
$720.12 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$786.93 |
$786.93 |
$786.93 |
$178.75
|