|
Iron binding capacity
|
$64.20 |
$64.20 |
$64.20 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$13.50 |
$13.50 |
$13.50 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$124.02 |
$124.02 |
$124.02 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$18.90 |
$18.90 |
$18.90 |
$144.62
|
|
Irrigation vagina and/or appl medicament tx disease
|
$25.50 |
$25.50 |
$25.50 |
$132.00
|
|
Island pedicle flap graft
|
$882.00 |
$882.00 |
$882.00 |
$2,468.80
|
|
Ivc venogram s&i
|
$138.30 |
$138.30 |
$138.30 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$292.50 |
$292.50 |
$292.50 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$137.10 |
$137.10 |
$137.10 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$202.50 |
$202.50 |
$202.50 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$263.10 |
$263.10 |
$263.10 |
$437.45
|
|
Ivp w/nephrotomography
|
$27.30 |
$27.30 |
$27.30 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$765.90 |
$765.90 |
$765.90 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$88.50 |
$88.50 |
$88.50 |
$393.43
|
|
Jejunstmy tube plcmt
|
$241.50 |
$241.50 |
$241.50 |
$2,174.40
|
|
John cunningham antibody
|
$9.00 |
$9.00 |
$9.00 |
$66.31
|
|
J-tube placement
|
$137.40 |
$137.40 |
$137.40 |
$593.08
|
|
Ketamine and metabolite screen - quest
|
$33.00 |
$33.00 |
$33.00 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$38.40 |
$38.40 |
$38.40 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$20.74 |
$20.74 |
$20.74 |
$23.77
|
|
Kidney endoscopy & treatment
|
$396.90 |
$396.90 |
$396.90 |
$5,626.86
|
|
Kidney imaging morphology
|
$24.60 |
$24.60 |
$24.60 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$76.20 |
$76.20 |
$76.20 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$51.90 |
$51.90 |
$51.90 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$371.10 |
$371.10 |
$371.10 |
$673.36
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$38.70 |
$38.70 |
$38.70 |
$174.00
|
|
Kit gene analys d816 variant
|
$84.00 |
$84.00 |
$84.00 |
$366.03
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,679.90 |
$2,679.90 |
$2,679.90 |
$1,667.50
|
|
Knee Arthroscopy (Cartilage Repair)
|
$655.50 |
$655.50 |
$655.50 |
$4,499.12
|
|
Knee arthroscopy/drainage
|
$546.60 |
$546.60 |
$546.60 |
$3,839.54
|
|
Knee arthroscopy dx
|
$441.60 |
$441.60 |
$441.60 |
$3,980.03
|
|
Knee Arthroscopy (Meniscus Repair)
|
$573.60 |
$573.60 |
$573.60 |
$5,148.00
|
|
Knee arthroscopy/surgery
|
$660.60 |
$660.60 |
$660.60 |
$2,834.77
|
|
Knee arthroscopy/surgery
|
$969.60 |
$969.60 |
$969.60 |
$2,974.01
|
|
Knee arthroscopy/surgery
|
$575.70 |
$575.70 |
$575.70 |
$4,198.40
|
|
Knee arthroscopy/surgery
|
$566.10 |
$566.10 |
$566.10 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$526.50 |
$526.50 |
$526.50 |
$4,659.20
|
|
Knee arthroscopy/surgery
|
$687.60 |
$687.60 |
$687.60 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$696.90 |
$696.90 |
$696.90 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$594.30 |
$594.30 |
$594.30 |
$4,623.79
|
|
Knee arthroscopy/surgery
|
$723.00 |
$723.00 |
$723.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$877.80 |
$877.80 |
$877.80 |
$4,137.60
|
|
Knee arthroscopy/surgery
|
$654.30 |
$654.30 |
$654.30 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$673.20 |
$673.20 |
$673.20 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$793.50 |
$793.50 |
$793.50 |
$5,855.00
|
|
Knee arthroscopy/surgery
|
$1,011.00 |
$1,011.00 |
$1,011.00 |
$8,979.74
|
|
Knee arthroscopy/surgery
|
$1,275.30 |
$1,275.30 |
$1,275.30 |
$6,411.60
|
|
Knee control full kneecap
|
$95.70 |
$95.70 |
$95.70 |
$192.00
|
|
Knee disc/dial lock/adj flex
|
$126.30 |
$126.30 |
$126.30 |
$288.41
|
|
Knee MRI (with and without contrast)
|
$4,196.40 |
$4,196.40 |
$4,196.40 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$2,124.90 |
$2,124.90 |
$2,124.90 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,967.40 |
$1,967.40 |
$1,967.40 |
$2,110.76
|
|
Knee X-ray
|
$433.50 |
$433.50 |
$433.50 |
$425.55
|
|
Kyleena, 19.5 mg
|
$789.90 |
$789.90 |
$789.90 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$36.75 |
$36.75 |
$36.75 |
$33.60
|
|
Labioplasty 56800
|
$262.20 |
$262.20 |
$262.20 |
$3,786.00
|
|
Lactate dehydrogenase (ldh)
|
$68.40 |
$68.40 |
$68.40 |
$55.50
|
|
Lactated ringers intravenous solution
|
$14.08 |
$14.08 |
$14.08 |
$44.91
|
|
Lactic acid
|
$113.10 |
$113.10 |
$113.10 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$5.24 |
$5.24 |
$5.24 |
$81.00
|
|
Lam facetc/frmt arthrd lum 1
|
$252.30 |
$252.30 |
$252.30 |
$582.40
|
|
Lam facetec & foramot crv
|
$1,300.20 |
$1,300.20 |
$1,300.20 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$1,690.80 |
$1,690.80 |
$1,690.80 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$1,246.80 |
$1,246.80 |
$1,246.80 |
$8,453.60
|
|
Lam factc/frmt arthrd lum ea
|
$223.80 |
$223.80 |
$223.80 |
$492.80
|
|
Lamie excise intrspinl lesion thrc 63266
|
$1,715.10 |
$1,715.10 |
$1,715.10 |
$5,339.00
|
|
Laminotomy single cervical
|
$1,393.50 |
$1,393.50 |
$1,393.50 |
$8,412.89
|
|
Laminotomy single lumbar
|
$1,315.20 |
$1,315.20 |
$1,315.20 |
$8,453.60
|
|
Lamiotoiotiotinotomy addl cervical 63043
|
$285.30 |
$285.30 |
$285.30 |
$1,506.40
|
|
Laparo ablate renal cyst
|
$936.60 |
$936.60 |
$936.60 |
$9,367.23
|
|
Laparo-asst vag hysterectomy
|
$901.80 |
$901.80 |
$901.80 |
$6,839.00
|
|
Laparo cholecystectomy/explr
|
$1,127.10 |
$1,127.10 |
$1,127.10 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$726.60 |
$726.60 |
$726.60 |
$8,346.00
|
|
Laparo drng lymphocele 49323
|
$650.40 |
$650.40 |
$650.40 |
$5,741.00
|
|
Laparo new ureter/bladder
|
$1,406.40 |
$1,406.40 |
$1,406.40 |
$9,116.80
|
|
Laparo partial colectomy 44204
|
$1,534.50 |
$1,534.50 |
$1,534.50 |
$2,917.80
|
|
Laparo partial nephrectomy
|
$1,518.90 |
$1,518.90 |
$1,518.90 |
$12,320.22
|
|
Laparo proc abdm/per/oment 49329
|
$930.60 |
$930.60 |
$930.60 |
$6,622.75
|
|
Laparo radical nephrectomy
|
$1,356.30 |
$1,356.30 |
$1,356.30 |
$6,360.80
|
|
Laparo remove w/ureter
|
$1,362.00 |
$1,362.00 |
$1,362.00 |
$6,593.60
|
|
Laparoscopic myomectomy
|
$918.30 |
$918.30 |
$918.30 |
$6,461.32
|
|
Laparoscopic nephrectomy
|
$1,227.00 |
$1,227.00 |
$1,227.00 |
$5,686.20
|
|
Laparoscopic proc
|
$1,147.50 |
$1,147.50 |
$1,147.50 |
$2,215.20
|
|
Laparoscopic salpingostomy 58673
|
$804.60 |
$804.60 |
$804.60 |
$5,214.15
|
|
Laparoscopy aspiration
|
$380.10 |
$380.10 |
$380.10 |
$6,839.00
|
|
Laparoscopy biopsy
|
$351.30 |
$351.30 |
$351.30 |
$6,376.26
|
|
Laparoscopye procstom 43659
|
$315.30 |
$315.30 |
$315.30 |
$6,448.00
|
|
Laparoscopy excise lesions
|
$728.10 |
$728.10 |
$728.10 |
$6,904.15
|
|
Laparoscopy fundoplasty
|
$1,076.10 |
$1,076.10 |
$1,076.10 |
$11,424.40
|
|
Laparoscopy gastrostomy
|
$591.90 |
$591.90 |
$591.90 |
$6,457.82
|
|
Laparoscopy lymphadenectomy
|
$678.00 |
$678.00 |
$678.00 |
$12,320.22
|
|
Laparoscopy lymph node biop
|
$529.20 |
$529.20 |
$529.20 |
$6,904.15
|
|
Laparoscopy lysis
|
$696.60 |
$696.60 |
$696.60 |
$5,419.00
|
|
Laparoscopy orchiectomy
|
$675.30 |
$675.30 |
$675.30 |
$6,311.00
|
|
Laparoscopy pyeloplasty
|
$1,260.90 |
$1,260.90 |
$1,260.90 |
$11,963.98
|
|
Laparoscopy remove adnexa
|
$996.60 |
$996.60 |
$996.60 |
$8,607.55
|
|
Laparoscopy splenectomy
|
$170.70 |
$170.70 |
$170.70 |
$10,488.40
|
|
Laparoscopy surg colpopexy
|
$992.40 |
$992.40 |
$992.40 |
$10,897.60
|
|
Laparoscopy tubal block 58671
|
$382.50 |
$382.50 |
$382.50 |
$5,166.25
|
|
Laparo sling operation 51992
|
$849.60 |
$849.60 |
$849.60 |
$5,353.60
|
