|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,330.88 |
$3,330.88 |
$3,330.88 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,204.59 |
$1,204.59 |
$1,204.59 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$135.81 |
$135.81 |
$135.81 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$103.72 |
$103.72 |
$103.72 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$100.10 |
$100.10 |
$100.10 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$105.45 |
$105.45 |
$105.45 |
$145.60
|
|
Inject sacroiliac joint
|
$1,464.79 |
$1,464.79 |
$1,464.79 |
$1,029.04
|
|
Inj epidural sgl lumb-sacral without img
|
$226.20 |
$226.20 |
$226.20 |
$1,450.84
|
|
Inj for mammo ductogram
|
$231.13 |
$231.13 |
$231.13 |
$397.80
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$999.69 |
$999.69 |
$999.69 |
$1,413.35
|
|
Inj proc elbow arthro
|
$256.66 |
$256.66 |
$256.66 |
$432.00
|
|
Inj proc myelogram lumbar
|
$455.89 |
$455.89 |
$455.89 |
$838.30
|
|
Inj retacrit esrd on dialysi
|
$4.06 |
$4.06 |
$4.06 |
$349.45
|
|
Inj retro urethrocysto
|
$214.12 |
$214.12 |
$214.12 |
$447.74
|
|
Inj w/fluor eval cv device
|
$606.90 |
$606.90 |
$606.90 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$357.29 |
$357.29 |
$357.29 |
$490.73
|
|
Insert cath pleura without image
|
$197.63 |
$197.63 |
$197.63 |
$2,099.70
|
|
Insertion catheter bladder non indwelling
|
$166.61 |
$166.61 |
$166.61 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,138.19 |
$2,138.19 |
$2,138.19 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,404.53 |
$1,404.53 |
$1,404.53 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,936.99 |
$1,936.99 |
$1,936.99 |
$2,453.83
|
|
In situ hybridization per specimen each additional single probe stain
|
$131.82 |
$131.82 |
$131.82 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$211.90 |
$211.90 |
$211.90 |
$338.40
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,363.41 |
$1,363.41 |
$1,363.41 |
$1,690.00
|
|
Insulin total
|
$35.11 |
$35.11 |
$35.11 |
$66.64
|
|
Intrinsic factor antibody
|
$43.60 |
$43.60 |
$43.60 |
$65.00
|
|
Intro long gi tube
|
$974.17 |
$974.17 |
$974.17 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$306.77 |
$306.77 |
$306.77 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$385.59 |
$385.59 |
$385.59 |
$601.28
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1.20 |
$1.20 |
$1.20 |
$279.10
|
|
Iron
|
$128.13 |
$128.13 |
$128.13 |
$75.00
|
|
Iron binding capacity
|
$16.63 |
$16.63 |
$16.63 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$163.32 |
$163.32 |
$163.32 |
$146.11
|
|
IV Fluids (each additional hour)
|
$62.59 |
$62.59 |
$62.59 |
$133.90
|
|
IV Fluids (first hour)
|
$232.78 |
$232.78 |
$232.78 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$138.90 |
$138.90 |
$138.90 |
$162.68
|
|
IV inj ra drug dx study
|
$305.66 |
$305.66 |
$305.66 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$73.02 |
$73.02 |
$73.02 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$66.98 |
$66.98 |
$66.98 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$247.05 |
$247.05 |
$247.05 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$142.75 |
$142.75 |
$142.75 |
$167.50
|
|
IV Push Injection (first drug)
|
$205.76 |
$205.76 |
$205.76 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$1,023.89 |
$1,023.89 |
$1,023.89 |
$713.40
|
|
Jak2 targeted sequence analysis
|
$351.39 |
$351.39 |
$351.39 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$258.96 |
$258.96 |
$258.96 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$330.01 |
$330.01 |
$330.01 |
$362.05
|
|
John cunningham antibody
|
$37.69 |
$37.69 |
$37.69 |
$78.00
|
|
Ketamine and metabolite screen - quest
|
$89.32 |
$89.32 |
$89.32 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$37.58 |
$37.58 |
$37.58 |
$58.56
|
|
Kidney img w/bldflw sgl without rx
|
$607.26 |
$607.26 |
$607.26 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$800.03 |
$800.03 |
$800.03 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$262.52 |
$262.52 |
$262.52 |
$490.75
|
|
Kit lead specify 5-6-5
|
$16,405.24 |
$16,405.24 |
$16,405.24 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,441.83 |
$1,441.83 |
$1,441.83 |
$1,635.87
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$3,266.18 |
$3,266.18 |
$3,266.18 |
$2,254.50
|
|
Knee MRI (with and without contrast)
|
$2,624.22 |
$2,624.22 |
$2,624.22 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,187.22 |
$2,187.22 |
$2,187.22 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,749.48 |
$1,749.48 |
$1,749.48 |
$2,130.88
|
|
Knee X-ray
|
$388.44 |
$388.44 |
$388.44 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$209.16 |
$209.16 |
$209.16 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$254.98 |
$254.98 |
$254.98 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$349.26 |
$349.26 |
$349.26 |
$251.20
|
|
Kras gene addl variants
|
$366.56 |
$366.56 |
$366.56 |
$387.20
|
|
Kras gene variants exon 2
|
$366.56 |
$366.56 |
$366.56 |
$536.20
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$50.40 |
$50.40 |
$50.40 |
$109.20
|
|
Lactate dehydrogenase (ldh)
|
$35.11 |
$35.11 |
$35.11 |
$55.50
|
|
Lactated ringers intravenous solution
|
$1.54 |
$1.54 |
$1.54 |
$43.74
|
|
Lactic acid
|
$79.46 |
$79.46 |
$79.46 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$60.37 |
$60.37 |
$60.37 |
$82.16
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$867.82 |
$867.82 |
$867.82 |
$740.40
|
|
Lead capillary
|
$48.66 |
$48.66 |
$48.66 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$16,405.24 |
$16,405.24 |
$16,405.24 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$10,546.99 |
$10,546.99 |
$10,546.99 |
$8,202.66
|
|
Leg Artery Ultrasound (complete, both legs)
|
$889.82 |
$889.82 |
$889.82 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,221.20 |
$1,221.20 |
$1,221.20 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$976.84 |
$976.84 |
$976.84 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,026.17 |
$1,026.17 |
$1,026.17 |
$1,092.58
|
|
Lens, intraocular (new tech)
|
$2,045.94 |
$2,045.94 |
$2,045.94 |
$589.05
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$3,690.45 |
$3,690.45 |
$3,690.45 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$3,690.45 |
$3,690.45 |
$3,690.45 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$2,593.94 |
$2,593.94 |
$2,593.94 |
$377.71
|
|
Levetiracetam therapeutic drug level
|
$38.81 |
$38.81 |
$38.81 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$1.06 |
$1.06 |
$1.06 |
$55.69
|
|
Lifileucel til/dose 7.5b-72b snij
|
$2,628,607.60 |
$2,628,607.60 |
$2,628,607.60 |
$30,744.64
|
|
Lipase
|
$35.73 |
$35.73 |
$35.73 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$62.83 |
$62.83 |
$62.83 |
$87.00
|
|
Lipoprotein blood quant
|
$63.45 |
$63.45 |
$63.45 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$39.42 |
$39.42 |
$39.42 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$57.90 |
$57.90 |
$57.90 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$63.45 |
$63.45 |
$63.45 |
$47.18
|
|
Lithium therapeutic drug level
|
$32.03 |
$32.03 |
$32.03 |
$69.75
|
|
Liver elastography 91200
|
$257.20 |
$257.20 |
$257.20 |
$285.18
|
|
Liver Function Test
|
$66.53 |
$66.53 |
$66.53 |
$115.44
|
|
Liver/spleen imag w/vasclr flow
|
$397.30 |
$397.30 |
$397.30 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$1.57 |
$1.57 |
$1.57 |
$49.70
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$327.20 |
$327.20 |
$327.20 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,794.64 |
$2,794.64 |
$2,794.64 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,329.17 |
$2,329.17 |
$2,329.17 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,863.10 |
$1,863.10 |
$1,863.10 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,585.84 |
$1,585.84 |
$1,585.84 |
$3,097.92
|