|
In-111 pentetreotide
|
$11,712.00 |
$11,712.00 |
$11,712.00 |
$6,610.16
|
|
In-111 satumomab pend
|
$23,462.00 |
$23,462.00 |
$23,462.00 |
$3,524.25
|
|
Infect ag drug suscept pheno predict
|
$2,323.00 |
$2,323.00 |
$2,323.00 |
$325.00
|
|
Infect ag genotype na hiv-1 other region
|
$1,290.00 |
$1,290.00 |
$1,290.00 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$4,568.00 |
$4,568.00 |
$4,568.00 |
$558.00
|
|
Infect ag ia optc obs influenza
|
$143.00 |
$143.00 |
$143.00 |
$65.58
|
|
Infect ag if hep delta agent
|
$320.00 |
$320.00 |
$320.00 |
$123.00
|
|
Infect ag if influenza a
|
$396.00 |
$396.00 |
$396.00 |
$40.61
|
|
Infect ag if influenza b
|
$396.00 |
$396.00 |
$396.00 |
$33.60
|
|
Infect ag if legionella pneumophila
|
$325.00 |
$325.00 |
$325.00 |
$75.75
|
|
Infect ag if nos ea
|
$396.00 |
$396.00 |
$396.00 |
$55.93
|
|
Infect ag if pneumocystis carinii
|
$293.00 |
$293.00 |
$293.00 |
$57.00
|
|
Infect ag na hep b amp
|
$663.00 |
$663.00 |
$663.00 |
$108.44
|
|
Infect ag na influenza r/amp 1st 2 types
|
$168.00 |
$168.00 |
$168.00 |
$227.50
|
|
Infect ag na influenza revr/amp ea type
|
$1,453.00 |
$1,453.00 |
$1,453.00 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$101.00 |
$101.00 |
$101.00 |
$101.00
|
|
Infect ag na resp virus 12-25 targets
|
$981.00 |
$981.00 |
$981.00 |
$835.80
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$8,712.00 |
$8,712.00 |
$8,712.00 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$464.00 |
$464.00 |
$464.00 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$395.00 |
$395.00 |
$395.00 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$395.00 |
$395.00 |
$395.00 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$410.00 |
$410.00 |
$410.00 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$128.00 |
$128.00 |
$128.00 |
$77.62
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$230.00 |
$230.00 |
$230.00 |
$99.75
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$241.00 |
$241.00 |
$241.00 |
$93.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$121.00 |
$121.00 |
$121.00 |
$60.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$664.00 |
$664.00 |
$664.00 |
$139.98
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$473.00 |
$473.00 |
$473.00 |
$173.86
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,763.00 |
$1,763.00 |
$1,763.00 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$2,109.00 |
$2,109.00 |
$2,109.00 |
$173.60
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$614.00 |
$614.00 |
$614.00 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$664.00 |
$664.00 |
$664.00 |
$133.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$74.00 |
$74.00 |
$74.00 |
$103.20
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,491.00 |
$1,491.00 |
$1,491.00 |
$208.91
|
|
Infectious agent nucleic acid quantification hiv-1
|
$834.00 |
$834.00 |
$834.00 |
$381.55
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$393.94 |
$393.94 |
$393.94 |
$76.00
|
|
Inj, bortezomib, dr. reddy's
|
$280.00 |
$280.00 |
$280.00 |
$48.55
|
|
Inj, bortezomib freseniuskab
|
$280.00 |
$280.00 |
$280.00 |
$16.50
|
|
Inj calcitriol per 0.1 mcg
|
$57.00 |
$57.00 |
$57.00 |
$31.89
|
|
Inj, cefiderocol, 10 mg
|
$742.00 |
$742.00 |
$742.00 |
$718.84
|
|
Inj, daptomycin (hospira)
|
$12.00 |
$12.00 |
$12.00 |
$167.85
|
|
Injection, fulvestrant
|
$11,796.00 |
$11,796.00 |
$11,796.00 |
$2,744.26
|
|
Inj, fosaprepitant (teva)
|
$22.00 |
$22.00 |
$22.00 |
$2.04
|
|
Inj, fulvestrant (fresenius)
|
$1,180.00 |
$1,180.00 |
$1,180.00 |
$1,713.99
|
|
Inj, fulvestrant (teva)
|
$1,180.00 |
$1,180.00 |
$1,180.00 |
$26.57
|
|
Inj heparin, pfizer, 1000u
|
$33.00 |
$33.00 |
$33.00 |
$23.19
|
|
Inj hydroxocobalamin IV 25mg
|
$6,332.62 |
$6,332.62 |
$6,332.62 |
$3,180.35
|
|
Inj imip 4 cilas 4 releb 2mg
|
$2,417.76 |
$2,417.76 |
$2,417.76 |
$1,004.42
|
|
Inj, levothyroxine, freskabi
|
$1,251.00 |
$1,251.00 |
$1,251.00 |
$287.00
|
|
Inj multihance
|
$529.00 |
$529.00 |
$529.00 |
$119.77
|
|
Inj pemetrexed (teva) 10mg
|
$291.00 |
$291.00 |
$291.00 |
$5.52
|
|
Inj progesterone per 50 mg
|
$49.00 |
$49.00 |
$49.00 |
$48.51
|
|
Inj secretin synthetic human
|
$5,023.00 |
$5,023.00 |
$5,023.00 |
$610.89
|
|
Inj testosterone cypionate
|
$403.00 |
$403.00 |
$403.00 |
$77.70
|
|
Inj thiotepa nos 1 mg
|
$2,630.00 |
$2,630.00 |
$2,630.00 |
$3,600.00
|
|
Inj, vancomycin hcl (mylan)
|
$503.00 |
$503.00 |
$503.00 |
$63.82
|
|
Inj, vasopressin (baxter)
|
$130.50 |
$130.50 |
$130.50 |
$3.77
|
|
Insitu hybridization auto
|
$468.00 |
$468.00 |
$468.00 |
$393.13
|
|
In situ hybridization per specimen initial single probe stain
|
$722.00 |
$722.00 |
$722.00 |
$341.60
|
|
Insulin total
|
$144.00 |
$144.00 |
$144.00 |
$67.50
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$26,264.00 |
$26,264.00 |
$26,264.00 |
$9,970.16
|
|
Intra-atrial pacing
|
$28,228.00 |
$28,228.00 |
$28,228.00 |
$5,041.63
|
|
Intra-atrial recording
|
$28,228.00 |
$28,228.00 |
$28,228.00 |
$5,644.35
|
|
Intracranial limited study
|
$2,687.00 |
$2,687.00 |
$2,687.00 |
$418.44
|
|
Intrapul surf admin endo tube
|
$838.00 |
$838.00 |
$838.00 |
$240.68
|
|
Intraventricular pacing
|
$28,228.00 |
$28,228.00 |
$28,228.00 |
$5,644.35
|
|
Intrinsic factor antibody
|
$617.00 |
$617.00 |
$617.00 |
$59.66
|
|
Intro long gi tube w/mult fluo
|
$5,079.00 |
$5,079.00 |
$5,079.00 |
$477.85
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$813.00 |
$813.00 |
$813.00 |
$230.00
|
|
Iron binding capacity
|
$194.00 |
$194.00 |
$194.00 |
$61.47
|
|
Iron stain peripheral blood
|
$438.00 |
$438.00 |
$438.00 |
$17.60
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$399.00 |
$399.00 |
$399.00 |
$210.49
|
|
Irradiation of blood product each unit reference
|
$711.00 |
$711.00 |
$711.00 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$391.00 |
$391.00 |
$391.00 |
$154.14
|
|
Ivc venogram s&i
|
$12,293.00 |
$12,293.00 |
$12,293.00 |
$3,316.95
|
|
Ivp w/nephrotomography
|
$7,160.00 |
$7,160.00 |
$7,160.00 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$3,804.00 |
$3,804.00 |
$3,804.00 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$1,058.00 |
$1,058.00 |
$1,058.00 |
$378.30
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$646.00 |
$646.00 |
$646.00 |
$54.16
|
|
Kidney imaging morphology
|
$5,290.00 |
$5,290.00 |
$5,290.00 |
$769.51
|
|
Kidney img w/bldflw sgl without rx
|
$4,104.00 |
$4,104.00 |
$4,104.00 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$8,765.00 |
$8,765.00 |
$8,765.00 |
$668.25
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$30.00 |
$30.00 |
$30.00 |
$42.38
|
|
Lactoferrin fecal qualitative
|
$252.00 |
$252.00 |
$252.00 |
$83.20
|
|
Lactoferrin fecal quant
|
$237.00 |
$237.00 |
$237.00 |
$106.10
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$5,342.00 |
$5,342.00 |
$5,342.00 |
$1,092.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$350.00 |
$350.00 |
$350.00 |
$1,164.69
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,586.00 |
$12,586.00 |
$12,586.00 |
$4,938.88
|
|
Levetiracetam therapeutic drug level
|
$482.00 |
$482.00 |
$482.00 |
$72.00
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$34.20 |
$34.20 |
$34.20 |
$48.48
|
|
Lidocaine therapeutic drug level
|
$178.00 |
$178.00 |
$178.00 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$473.00 |
$473.00 |
$473.00 |
$159.12
|
|
Lipase
|
$1,727.00 |
$1,727.00 |
$1,727.00 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$245.00 |
$245.00 |
$245.00 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$1,483.00 |
$1,483.00 |
$1,483.00 |
$55.25
|
|
Lithium therapeutic drug level
|
$92.00 |
$92.00 |
$92.00 |
$67.20
|
|
Liver Function Test
|
$2,818.00 |
$2,818.00 |
$2,818.00 |
$111.13
|
|
Liver/spleen imag static only
|
$4,468.00 |
$4,468.00 |
$4,468.00 |
$1,140.78
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$11,809.00 |
$11,809.00 |
$11,809.00 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$9,536.00 |
$9,536.00 |
$9,536.00 |
$1,829.25
|
