|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$5,966.40 |
$5,966.40 |
$5,966.40 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$4,132.70 |
$4,132.70 |
$4,132.70 |
$627.00
|
|
Inj allopurinol sodium 1 mg
|
$15,106.56 |
$15,106.56 |
$15,106.56 |
$5,937.23
|
|
Inj, artesunate, 1mg
|
$23,297.68 |
$23,297.68 |
$23,297.68 |
$23,297.68
|
|
Inj., benralizumab, 1 mg
|
$35,474.88 |
$35,474.88 |
$35,474.88 |
$18,984.78
|
|
Inj, bezlotoxumab, 10 mg
|
$28,367.36 |
$28,367.36 |
$28,367.36 |
$8,698.20
|
|
Inj, cefiderocol, 10 mg
|
$1,045.52 |
$1,045.52 |
$1,045.52 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$977.20 |
$977.20 |
$977.20 |
$333.00
|
|
Inj crotalidae im f(ab')2 eq
|
$7,920.08 |
$7,920.08 |
$7,920.08 |
$2,735.85
|
|
Injection, doxercalciferol
|
$1,513.12 |
$1,513.12 |
$1,513.12 |
$28.25
|
|
Injection, isavuconazonium
|
$1,468.88 |
$1,468.88 |
$1,468.88 |
$634.28
|
|
Injection, peramivir
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$1,257.68
|
|
Injection, renflexis
|
$6,224.96 |
$6,224.96 |
$6,224.96 |
$1,407.33
|
|
Inj., emapalumab-lzsg, 1 mg
|
$1,771.28 |
$1,771.28 |
$1,771.28 |
$381.64
|
|
Inj fluphenazine hcl 1.25 mg
|
$850.08 |
$850.08 |
$850.08 |
$29.65
|
|
Inj, fulvestrant (fresenius)
|
$2,357.04 |
$2,357.04 |
$2,357.04 |
$1,713.99
|
|
Inj imip 4 cilas 4 releb 2mg
|
$4,954.32 |
$4,954.32 |
$4,954.32 |
$1,004.42
|
|
Inj levocarnitine per 1 gm
|
$804.72 |
$804.72 |
$804.72 |
$122.28
|
|
Inj melpha hydroch nos 50 mg
|
$15,692.88 |
$15,692.88 |
$15,692.88 |
$1,627.50
|
|
Inj., meropenem, vaborbactam
|
$733.04 |
$733.04 |
$733.04 |
$618.43
|
|
Inj. mycophenolate mofetil
|
$2,560.88 |
$2,560.88 |
$2,560.88 |
$374.72
|
|
Inj., patisiran, 0.1 mg
|
$61,664.96 |
$61,664.96 |
$61,664.96 |
$99.82
|
|
Inj progesterone per 50 mg
|
$505.68 |
$505.68 |
$505.68 |
$49.00
|
|
Inj prohance multipack
|
$40.88 |
$40.88 |
$40.88 |
$51.48
|
|
Inj tedizolid phosphate
|
$1,356.13 |
$1,356.13 |
$1,356.13 |
$1,001.48
|
|
Inj thiotepa nos 1 mg
|
$7,126.56 |
$7,126.56 |
$7,126.56 |
$3,600.00
|
|
Insertion catheter artery nfs ther chemotx 36640
|
$14,903.35 |
$14,903.35 |
$14,903.35 |
$3,706.68
|
|
Insitu hybridization auto
|
$2,852.47 |
$2,852.47 |
$2,852.47 |
$398.51
|
|
In situ hybridization per specimen initial single probe stain
|
$4,899.86 |
$4,899.86 |
$4,899.86 |
$341.90
|
|
Insulin total
|
$1,450.10 |
$1,450.10 |
$1,450.10 |
$67.50
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$15,580.00 |
$15,580.00 |
$15,580.00 |
$9,736.00
|
|
Interrog device eval heart
|
$722.70 |
$722.70 |
$722.70 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$425.15 |
$425.15 |
$425.15 |
$124.80
|
|
Intra-atrial pacing
|
$16,159.55 |
$16,159.55 |
$16,159.55 |
$5,155.51
|
|
Intra-atrial recording
|
$16,159.55 |
$16,159.55 |
$16,159.55 |
$5,593.09
|
|
Intrapul surf admin endo tube
|
$891.00 |
$891.00 |
$891.00 |
$240.68
|
|
Intrauterine transfusion ftl
|
$5,013.80 |
$5,013.80 |
$5,013.80 |
$963.95
|
|
Intraventricular pacing
|
$21,329.55 |
$21,329.55 |
$21,329.55 |
$5,644.35
|
|
Intrinsic factor antibody
|
$827.86 |
$827.86 |
$827.86 |
$59.95
|
|
Intro long gi tube w/mult fluo
|
$2,736.80 |
$2,736.80 |
$2,736.80 |
$477.85
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$41,315.12 |
$41,315.12 |
$41,315.12 |
$51,535.10
|
|
Iron binding capacity
|
$794.22 |
$794.22 |
$794.22 |
$61.47
|
|
Iron stain peripheral blood
|
$1,246.12 |
$1,246.12 |
$1,246.12 |
$17.60
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$3,162.32 |
$3,162.32 |
$3,162.32 |
$255.60
|
|
Irradiation of blood product each unit reference
|
$664.95 |
$664.95 |
$664.95 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$977.00 |
$977.00 |
$977.00 |
$153.75
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$17,083.36 |
$17,083.36 |
$17,083.36 |
$13,121.82
|
|
Ivc venogram s&i
|
$21,209.65 |
$21,209.65 |
$21,209.65 |
$3,258.00
|
|
IV inj ra drug dx study
|
$5,809.50 |
$5,809.50 |
$5,809.50 |
$544.45
|
|
Ivp w/nephrotomography
|
$10,511.60 |
$10,511.60 |
$10,511.60 |
$712.53
|
|
Ivp w/wo kub w/wo tomography
|
$10,443.40 |
$10,443.40 |
$10,443.40 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$22,073.52 |
$22,073.52 |
$22,073.52 |
$6,384.11
|
|
Ketogenic steroids fract
|
$1,028.58 |
$1,028.58 |
$1,028.58 |
$79.54
|
|
Kidney function study
|
$8,502.00 |
$8,502.00 |
$8,502.00 |
$545.55
|
|
Kidney imaging morphology
|
$5,223.50 |
$5,223.50 |
$5,223.50 |
$769.51
|
|
Kidney img w/bldflw sgl without rx
|
$6,650.50 |
$6,650.50 |
$6,650.50 |
$1,468.04
|
|
Kit gene analys d816 variant
|
$931.47 |
$931.47 |
$931.47 |
$355.00
|
|
Kras gene addl variants
|
$1,527.68 |
$1,527.68 |
$1,527.68 |
$346.45
|
|
Kras gene variants exon 2
|
$2,593.15 |
$2,593.15 |
$2,593.15 |
$496.60
|
|
Lactoferrin fecal qualitative
|
$903.81 |
$903.81 |
$903.81 |
$88.40
|
|
Lactoferrin fecal quant
|
$484.45 |
$484.45 |
$484.45 |
$106.10
|
|
Leishmania antibody
|
$579.39 |
$579.39 |
$579.39 |
$58.50
|
|
Lens iol ant chamb 10.5
|
$695.00 |
$695.00 |
$695.00 |
$203.84
|
|
Levalbuterol non-comp unit
|
$65.52 |
$65.52 |
$65.52 |
$20.15
|
|
Levetiracetam therapeutic drug level
|
$757.87 |
$757.87 |
$757.87 |
$74.92
|
|
Lidocaine therapeutic drug level
|
$1,484.82 |
$1,484.82 |
$1,484.82 |
$87.45
|
|
Lift heel adjustable med
|
$2,217.00 |
$2,217.00 |
$2,217.00 |
$59.90
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$4,109.28 |
$4,109.28 |
$4,109.28 |
$130.49
|
|
Lipase
|
$1,067.64 |
$1,067.64 |
$1,067.64 |
$81.25
|
|
Lipoprotein blood high res frac & quant
|
$384.63 |
$384.63 |
$384.63 |
$89.52
|
|
Lipoprotein blood quant
|
$333.10 |
$333.10 |
$333.10 |
$103.90
|
|
Lipoprotein direct measurement hdl
|
$1,009.05 |
$1,009.05 |
$1,009.05 |
$54.60
|
|
Lithium therapeutic drug level
|
$1,009.05 |
$1,009.05 |
$1,009.05 |
$66.43
|
|
Liver imaging
|
$5,585.00 |
$5,585.00 |
$5,585.00 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$11,410.00 |
$11,410.00 |
$11,410.00 |
$1,255.15
|
|
Liver/spleen imag static only
|
$9,508.00 |
$9,508.00 |
$9,508.00 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$3,433.50 |
$3,433.50 |
$3,433.50 |
$928.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$34.16 |
$34.16 |
$34.16 |
$13.65
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$137,950.40 |
$137,950.40 |
$137,950.40 |
$76,416.24
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$24,445.85 |
$24,445.85 |
$24,445.85 |
$2,919.75
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$21,645.25 |
$21,645.25 |
$21,645.25 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$19,472.20 |
$19,472.20 |
$19,472.20 |
$2,013.08
|
|
L/s ratio fetal lung
|
$2,372.35 |
$2,372.35 |
$2,372.35 |
$168.00
|
|
Lung function test (mbc/mvv)
|
$3,529.35 |
$3,529.35 |
$3,529.35 |
$182.91
|
|
Lung perfusion imaging
|
$7,926.00 |
$7,926.00 |
$7,926.00 |
$1,082.75
|
|
Lurbinectedin 4 mg intravenous solution
|
$37,439.92 |
$37,439.92 |
$37,439.92 |
$21,982.48
|
|
Lymphatics/lymph node imaging
|
$8,480.50 |
$8,480.50 |
$8,480.50 |
$1,526.38
|
|
Lymphocyte transformation mitogen
|
$802.36 |
$802.36 |
$802.36 |
$266.20
|
|
Lymph vessel x-ray trunk
|
$8,605.30 |
$8,605.30 |
$8,605.30 |
$2,542.41
|
|
Lymph vessel x-ray trunk
|
$8,605.30 |
$8,605.30 |
$8,605.30 |
$3,332.55
|
|
Macroscopic exam arthropod
|
$482.83 |
$482.83 |
$482.83 |
$38.58
|
|
Macroscopic exam parasite
|
$352.08 |
$352.08 |
$352.08 |
$36.40
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$659.12 |
$659.12 |
$659.12 |
$57.51
|
|
Malaria antibody
|
$1,059.50 |
$1,059.50 |
$1,059.50 |
$38.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$736.45 |
$736.45 |
$736.45 |
$137.25
|
|
Manipulation chest wall initial demonstration/evaluation
|
$736.45 |
$736.45 |
$736.45 |
$163.15
|
|
Mannitol 12.5 gm/50 ml inj
|
$441.84 |
$441.84 |
$441.84 |
$40.12
|
|
Manual diff wbc count b-coat
|
$1,035.63 |
$1,035.63 |
$1,035.63 |
$22.75
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$1,524.97 |
$1,524.97 |
$1,524.97 |
$70.85
|
|
Mayo activated protein c resistance assay
|
$2,695.68 |
$2,695.68 |
$2,695.68 |
$100.10
|
