|
Inst fibrinolysis agent sbsq d
|
$481.60 |
$481.60 |
$481.60 |
$898.12
|
|
Insti hexaminolevulinate hcl
|
$4,339.44 |
$4,339.44 |
$4,339.44 |
$2,359.80
|
|
Instillation anticarcinogenic agent bladder
|
$1,381.45 |
$1,381.45 |
$1,381.45 |
$721.50
|
|
Instill pharm renal pelvis
|
$2,502.15 |
$2,502.15 |
$2,502.15 |
$3,018.72
|
|
Instll rx agnt into rnal tub
|
$606.55 |
$606.55 |
$606.55 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$4,135.60 |
$4,135.60 |
$4,135.60 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$4,068.40 |
$4,068.40 |
$4,068.40 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$2,115.75 |
$2,115.75 |
$2,115.75 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$2,444.40 |
$2,444.40 |
$2,444.40 |
$1,074.68
|
|
Ins vag brachytx device
|
$358.40 |
$358.40 |
$358.40 |
$909.35
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$8,617.32 |
$8,617.32 |
$8,617.32 |
$9,970.16
|
|
Integra meshed bil wound mat
|
$25,450.30 |
$25,450.30 |
$25,450.30 |
$25,450.30
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$2,254.00 |
$2,254.00 |
$2,254.00 |
$2,908.50
|
|
Interdental fixation
|
$1,657.95 |
$1,657.95 |
$1,657.95 |
$2,133.48
|
|
Int hrhc lig 1 hroid without img
|
$2,067.10 |
$2,067.10 |
$2,067.10 |
$3,245.23
|
|
Intra-atrial pacing
|
$2,161.95 |
$2,161.95 |
$2,161.95 |
$5,155.51
|
|
Intra-atrial recording
|
$3,659.60 |
$3,659.60 |
$3,659.60 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$4,024.65 |
$4,024.65 |
$4,024.65 |
$3,982.59
|
|
Intracran angioplsty w/stent
|
$23,821.35 |
$23,821.35 |
$23,821.35 |
$11,364.78
|
|
Intracranial angioplasty
|
$21,361.90 |
$21,361.90 |
$21,361.90 |
$7,149.60
|
|
Intracranial complete study
|
$333.90 |
$333.90 |
$333.90 |
$883.30
|
|
Intracranial limited study
|
$147.00 |
$147.00 |
$147.00 |
$423.52
|
|
Intranasal biopsy 30100
|
$1,657.95 |
$1,657.95 |
$1,657.95 |
$1,850.94
|
|
Intraop epicard/endocard/pace/map/ 93631
|
$278.95 |
$278.95 |
$278.95 |
$3,690.00
|
|
Intraoral i+d tongue/floor lingual 41000
|
$761.60 |
$761.60 |
$761.60 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$390.95 |
$390.95 |
$390.95 |
$239.52
|
|
Intraventricular pacing
|
$3,659.60 |
$3,659.60 |
$3,659.60 |
$5,775.22
|
|
Intro cath dialysis circuit
|
$846.65 |
$846.65 |
$846.65 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$2,289.35 |
$2,289.35 |
$2,289.35 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$4,578.70 |
$4,578.70 |
$4,578.70 |
$15,625.00
|
|
Intro catheter aorta
|
$730.80 |
$730.80 |
$730.80 |
$1,861.61
|
|
Intro cath svc/ivc
|
$626.15 |
$626.15 |
$626.15 |
$1,350.75
|
|
Intro long gi tube
|
$1,348.90 |
$1,348.90 |
$1,348.90 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$232.40 |
$232.40 |
$232.40 |
$477.85
|
|
Intro windpipe wire/tube
|
$1,107.75 |
$1,107.75 |
$1,107.75 |
$2,316.30
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,056.65 |
$1,056.65 |
$1,056.65 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$674.45 |
$674.45 |
$674.45 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$483.70 |
$483.70 |
$483.70 |
$617.60
|
|
Ionm in operatng room 15 min
|
$61.95 |
$61.95 |
$61.95 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$34.25 |
$34.25 |
$34.25 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$52.50 |
$52.50 |
$52.50 |
$182.21
|
|
Io rad tx delivery by x-ray
|
$10,035.20 |
$10,035.20 |
$10,035.20 |
$10,127.56
|
|
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)
|
$161.08 |
$161.08 |
$161.08 |
$203.92
|
|
Iron
|
$110.25 |
$110.25 |
$110.25 |
$70.72
|
|
Iron binding capacity
|
$127.05 |
$127.05 |
$127.05 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$41.34 |
$41.34 |
$41.34 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$66.15 |
$66.15 |
$66.15 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$187.60 |
$187.60 |
$187.60 |
$154.50
|
|
Ivc venogram s&i
|
$1,806.35 |
$1,806.35 |
$1,806.35 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$113.40 |
$113.40 |
$113.40 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$113.40 |
$113.40 |
$113.40 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$113.40 |
$113.40 |
$113.40 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$318.15 |
$318.15 |
$318.15 |
$460.85
|
|
Ivp w/nephrotomography
|
$850.50 |
$850.50 |
$850.50 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$736.05 |
$736.05 |
$736.05 |
$713.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$53.20 |
$53.20 |
$53.20 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$33.60 |
$33.60 |
$33.60 |
$29.52
|
|
Kidney function study
|
$302.75 |
$302.75 |
$302.75 |
$549.70
|
|
Kidney imaging morphology
|
$392.70 |
$392.70 |
$392.70 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$1,341.20 |
$1,341.20 |
$1,341.20 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$580.30 |
$580.30 |
$580.30 |
$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)
|
$2,544.85 |
$2,544.85 |
$2,544.85 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,955.80 |
$1,955.80 |
$1,955.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,789.90 |
$1,789.90 |
$1,789.90 |
$2,181.10
|
|
Knee X-ray
|
$424.55 |
$424.55 |
$424.55 |
$443.90
|
|
Kras gene variants exon 2
|
$136.50 |
$136.50 |
$136.50 |
$495.00
|
|
Kyleena, 19.5 mg
|
$524.62 |
$524.62 |
$524.62 |
$2,211.85
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$141.05 |
$141.05 |
$141.05 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$141.05 |
$141.05 |
$141.05 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$33.68 |
$33.68 |
$33.68 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$106.61 |
$106.61 |
$106.61 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$128.10 |
$128.10 |
$128.10 |
$53.30
|
|
Lactated ringers intravenous solution
|
$68.93 |
$68.93 |
$68.93 |
$48.56
|
|
Lactic acid
|
$225.40 |
$225.40 |
$225.40 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$63.70 |
$63.70 |
$63.70 |
$88.40
|
|
Laparo cholecystectomy/graph
|
$3,113.60 |
$3,113.60 |
$3,113.60 |
$7,220.90
|
|
Largsc w/removal lesion
|
$2,111.55 |
$2,111.55 |
$2,111.55 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$357.35 |
$357.35 |
$357.35 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,229.55 |
$1,229.55 |
$1,229.55 |
$2,480.71
|
|
Laryngoscopy w/bx & op scope
|
$2,085.30 |
$2,085.30 |
$2,085.30 |
$3,986.00
|
|
Laryngoscopy w/fb removal
|
$1,229.55 |
$1,229.55 |
$1,229.55 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$1,174.25 |
$1,174.25 |
$1,174.25 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$341.25 |
$341.25 |
$341.25 |
$660.10
|
|
Lateral canthopexy
|
$2,122.40 |
$2,122.40 |
$2,122.40 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$1,475.60 |
$1,475.60 |
$1,475.60 |
$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)
|
$904.75 |
$904.75 |
$904.75 |
$1,100.74
|
