|
Iodine i-125 sodium iodide
|
$55.25 |
$55.25 |
$55.25 |
$245.64
|
|
Io ga n-stim subsq w/reprog
|
$115.05 |
$115.05 |
$115.05 |
$187.43
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$3.25 |
$3.25 |
$3.25 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$3.25 |
$3.25 |
$3.25 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$733.20 |
$733.20 |
$733.20 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$53.95 |
$53.95 |
$885.00 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$302.90 |
$302.90 |
$302.90 |
$5,517.12
|
|
Iron
|
$429.00 |
$429.00 |
$429.00 |
$75.00
|
|
Iron binding capacity
|
$142.35 |
$142.35 |
$602.00 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$139.10 |
$139.10 |
$882.00 |
$80.67
|
|
Iron stain peripheral blood
|
$676.00 |
$676.00 |
$676.00 |
$30.55
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$417.00 |
$1,758.25 |
$1,758.25 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$81.25 |
$81.25 |
$106.00 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$347.75 |
$347.75 |
$347.75 |
$146.11
|
|
Irrigation vagina and/or appl medicament tx disease
|
$343.20 |
$343.20 |
$343.20 |
$132.00
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$364.00 |
$364.00 |
$364.00 |
$8,273.35
|
|
Island pedicle flap graft
|
$5,709.60 |
$5,709.60 |
$5,709.60 |
$2,468.80
|
|
Ivc venogram s&i
|
$6,561.75 |
$6,561.75 |
$6,561.75 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$174.85 |
$174.85 |
$174.85 |
$133.90
|
|
IV Fluids (first hour)
|
$318.50 |
$318.50 |
$318.50 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$55.90 |
$55.90 |
$55.90 |
$162.68
|
|
IV inj ra drug dx study
|
$1,082.90 |
$1,082.90 |
$1,082.90 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$191.75 |
$191.75 |
$191.75 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$199.55 |
$199.55 |
$199.55 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$460.85 |
$460.85 |
$460.85 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$155.35 |
$155.35 |
$155.35 |
$167.50
|
|
IV Push Injection (first drug)
|
$318.50 |
$318.50 |
$318.50 |
$252.76
|
|
Ivp w/nephrotomography
|
$1,518.40 |
$1,518.40 |
$5,159.00 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,416.35 |
$1,416.35 |
$1,416.35 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$850.85 |
$850.85 |
$13,459.00 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$484.90 |
$484.90 |
$484.90 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$806.00 |
$806.00 |
$806.00 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$849.55 |
$849.55 |
$849.55 |
$362.05
|
|
J-tube placement
|
$1,337.05 |
$1,337.05 |
$1,337.05 |
$593.08
|
|
Kerecis marigen shld sq cm
|
$1.00 |
$1.00 |
$1.00 |
$1.00
|
|
Ketamine and metabolite screen - quest
|
$7.15 |
$7.15 |
$7.15 |
$72.14
|
|
Ketogenic steroids fract
|
$233.00 |
$233.00 |
$233.00 |
$82.80
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$25.00 |
$50.70 |
$50.70 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$31.85 |
$31.85 |
$31.85 |
$23.52
|
|
Kidney function study
|
$1,061.00 |
$1,064.05 |
$1,064.05 |
$935.22
|
|
Kidney imaging morphology
|
$3,421.00 |
$3,421.00 |
$3,421.00 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$2,680.00 |
$4,563.00 |
$4,563.00 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,928.55 |
$1,928.55 |
$4,537.00 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,302.60 |
$1,302.60 |
$1,302.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$1,166.10 |
$1,166.10 |
$1,166.10 |
$490.75
|
|
Kit case 4.2mm spinejack
|
$17,965.35 |
$17,965.35 |
$17,965.35 |
$7,177.60
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$21,799.05 |
$21,799.05 |
$21,799.05 |
$9,423.50
|
|
Kit hfx iq ipg bundle
|
$73,101.60 |
$73,101.60 |
$73,101.60 |
$33,859.00
|
|
Kit ipg optimizer smart
|
$130,070.85 |
$130,070.85 |
$130,070.85 |
$49,011.18
|
|
Kit lead specify 5-6-5
|
$29,240.90 |
$29,240.90 |
$29,240.90 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$4,478.50 |
$4,478.50 |
$4,478.50 |
$1,635.87
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$360.12
|
|
Kit sound processor cochlear osia 2
|
$32,397.30 |
$32,397.30 |
$32,397.30 |
$8,425.00
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$5,739.50 |
$5,739.50 |
$5,739.50 |
$2,254.50
|
|
Kit trach suct cls 30.5cm
|
$92.30 |
$92.30 |
$92.30 |
$35.26
|
|
Knee MRI (with and without contrast)
|
$5,699.20 |
$5,699.20 |
$5,699.20 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$4,427.80 |
$4,427.80 |
$4,427.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,591.90 |
$3,591.90 |
$3,591.90 |
$2,130.88
|
|
Knee X-ray
|
$662.35 |
$662.35 |
$662.35 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$460.85 |
$460.85 |
$483.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$562.90 |
$562.90 |
$562.90 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$624.00 |
$624.00 |
$624.00 |
$251.20
|
|
Kras gene variants exon 2
|
$580.00 |
$816.40 |
$816.40 |
$536.20
|
|
Kyleena, 19.5 mg
|
$3,365.70 |
$3,365.70 |
$3,365.70 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$15.00 |
$104.65 |
$104.65 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$731.90 |
$731.90 |
$731.90 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$120.90 |
$120.90 |
$120.90 |
$55.50
|
|
Lactated ringers intravenous solution
|
$215.80 |
$215.80 |
$923.00 |
$43.74
|
|
Lactation class
|
$55.90 |
$55.90 |
$55.90 |
$104.96
|
|
Lactic acid
|
$351.65 |
$351.65 |
$351.65 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$315.00 |
$315.00 |
$315.00 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$390.00 |
$390.00 |
$390.00 |
$19,124.00
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$2,145.65 |
$2,145.65 |
$2,145.65 |
$740.40
|
|
Laronidase injection
|
$8,478.00 |
$8,478.00 |
$8,478.00 |
$1,927.01
|
|
Laryngeal function studies
|
$417.30 |
$417.30 |
$417.30 |
$342.60
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$5,127.85 |
$5,127.85 |
$5,127.85 |
$2,514.60
|
|
Laryngoscopy w/biopsy
|
$9,647.30 |
$9,647.30 |
$9,647.30 |
$4,362.99
|
|
Laryngoscopy w/bx & op scope
|
$9,647.30 |
$9,647.30 |
$9,647.30 |
$4,627.00
|
|
Laryngoscopy with biopsy
|
$8,966.75 |
$8,966.75 |
$8,966.75 |
$3,297.83
|
|
Laryngoscopy with biopsy 31510
|
$9,586.20 |
$9,586.20 |
$9,586.20 |
$3,934.14
|
|
Laser surg penis lesion(s)
|
$575.90 |
$575.90 |
$575.90 |
$3,562.00
|
|
Lb with mastopexy 15839
|
$7,902.70 |
$7,902.70 |
$7,902.70 |
$3,722.04
|
|
Lead acuity x4 spiral l 86cm
|
$11,965.20 |
$11,965.20 |
$11,965.20 |
$5,460.00
|
|
Lead capillary
|
$553.15 |
$553.15 |
$553.15 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$17,856.80 |
$17,856.80 |
$17,856.80 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$20,643.35 |
$20,643.35 |
$20,643.35 |
$8,202.66
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,171.95 |
$1,171.95 |
$1,171.95 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,622.10 |
$2,622.10 |
$2,682.55 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,312.05 |
$2,312.05 |
$2,423.20 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,136.20 |
$1,136.20 |
$1,136.20 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,159.95 |
$2,159.95 |
$2,159.95 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,023.10 |
$1,023.10 |
$1,023.10 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$0.01 |
$0.01 |
$0.01 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$85.80 |
$85.80 |
$174.00 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$5,664.10 |
$5,664.10 |
$5,664.10 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$9,107.80 |
$9,107.80 |
$9,107.80 |
$8,348.12
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$243.10 |
$243.10 |
$243.10 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$37.70 |
$37.70 |
$152.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$152.10 |
$152.10 |
$152.10 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$62.00 |
$806.65 |
$806.65 |
$420.60
|
