|
Inj hydroxocobalamin IV 25mg
|
$1,328.00 |
$1,328.00 |
$1,328.00 |
$3,180.35
|
|
Inj ivig privigen 500 mg
|
$9,064.44 |
$9,064.44 |
$9,064.44 |
$7,298.71
|
|
Inj. jivi 1 iu
|
$8.64 |
$8.64 |
$8.64 |
$2.44
|
|
Inj levocarnitine per 1 gm
|
$278.64 |
$278.64 |
$278.64 |
$138.96
|
|
Inj, levothyroxine, freskabi
|
$151.20 |
$151.20 |
$151.20 |
$302.07
|
|
Inj., meropenem, vaborbactam
|
$509.76 |
$509.76 |
$509.76 |
$618.43
|
|
Inj progesterone per 50 mg
|
$183.60 |
$183.60 |
$183.60 |
$48.51
|
|
Inj secretin synthetic human
|
$3,255.12 |
$3,255.12 |
$3,255.12 |
$741.75
|
|
Inj, vancomycin hcl (mylan)
|
$125.00 |
$125.00 |
$125.00 |
$63.82
|
|
Insitu hybridization auto
|
$49.95 |
$49.95 |
$49.95 |
$398.16
|
|
Insitu hybridization (fish)
|
$1,614.49 |
$1,614.49 |
$1,614.49 |
$481.60
|
|
Insitu hybridization manual
|
$130.33 |
$130.33 |
$130.33 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$816.16 |
$816.16 |
$816.16 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$80.29 |
$80.29 |
$80.29 |
$338.40
|
|
Instillation anticarcinogenic agent bladder
|
$991.60 |
$991.60 |
$991.60 |
$721.50
|
|
Insulin total
|
$31.45 |
$31.45 |
$220.97 |
$67.60
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$9,463.86 |
$9,463.86 |
$9,736.00 |
$10,179.63
|
|
Integra meshed bil wound mat
|
$6,097.42 |
$6,097.42 |
$6,097.42 |
$24,354.93
|
|
Interrogate subq defib
|
$261.71 |
$261.71 |
$261.71 |
$139.10
|
|
Interrog dev eval icpms ip
|
$106.01 |
$106.01 |
$106.01 |
$106.80
|
|
Interrog device eval heart
|
$107.58 |
$107.58 |
$107.58 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$107.58 |
$107.58 |
$107.58 |
$127.20
|
|
Intra-atrial pacing
|
$7,090.76 |
$7,090.76 |
$7,090.76 |
$5,155.51
|
|
Intracard echo interv w/s&i
|
$4,328.45 |
$4,328.45 |
$32,059.50 |
$3,982.59
|
|
Intraventricular pacing
|
$28,379.89 |
$28,379.89 |
$28,379.89 |
$5,775.22
|
|
Intrinsic factor antibody
|
$43.94 |
$43.94 |
$43.94 |
$59.95
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.37 |
$0.37 |
$0.37 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$14.25 |
$14.25 |
$14.25 |
$153.98
|
|
Ipratropium bromide non-comp
|
$25.92 |
$25.92 |
$25.92 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$48.00 |
$48.00 |
$48.00 |
$227.39
|
|
Iron
|
$43.48 |
$43.48 |
$43.48 |
$70.72
|
|
Iron binding capacity
|
$1,220.08 |
$1,220.08 |
$1,220.08 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$30.18 |
$30.18 |
$30.18 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$48.10 |
$48.10 |
$1,369.44 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$70.09 |
$70.09 |
$70.09 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$136.72 |
$136.72 |
$136.72 |
$154.50
|
|
Ivc venogram s&i
|
$1,115.09 |
$1,115.09 |
$1,115.09 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$76.41 |
$76.41 |
$76.41 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$701.61 |
$701.61 |
$701.61 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$119.70 |
$119.70 |
$119.70 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$754.71 |
$754.71 |
$754.71 |
$460.85
|
|
IV inj ra drug dx study
|
$1,217.72 |
$1,217.72 |
$1,217.72 |
$560.00
|
|
Ivp w/wo kub w/wo tomography
|
$743.33 |
$743.33 |
$743.33 |
$713.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$17.85 |
$17.85 |
$17.85 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$48.27 |
$48.27 |
$48.27 |
$30.08
|
|
Kidney imaging morphology
|
$3,124.79 |
$3,124.79 |
$3,124.79 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$10,882.51 |
$10,882.51 |
$10,882.51 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,550.95 |
$1,550.95 |
$10,980.49 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$565.36 |
$565.36 |
$565.36 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$654.35 |
$654.35 |
$654.35 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$622.25 |
$622.25 |
$622.25 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$590.15 |
$590.15 |
$590.15 |
$2,181.10
|
|
Knee X-ray
|
$275.74 |
$275.74 |
$275.74 |
$443.90
|
|
Kras gene variants exon 2
|
$144.30 |
$144.30 |
$250.67 |
$495.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.48 |
$0.48 |
$0.48 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$61.88 |
$61.88 |
$61.88 |
$53.30
|
|
Lactated ringers intravenous solution
|
$131.20 |
$131.20 |
$131.20 |
$54.11
|
|
Lactic acid
|
$56.33 |
$56.33 |
$56.33 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$57.81 |
$57.81 |
$540.54 |
$88.40
|
|
Lead capillary
|
$4.44 |
$4.44 |
$4.44 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,088.26 |
$1,088.26 |
$1,088.26 |
$1,100.74
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,694.97 |
$1,694.97 |
$1,694.97 |
$3,271.64
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$28.47 |
$28.47 |
$28.47 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$15.44 |
$15.44 |
$19.61 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$79.92 |
$79.92 |
$79.92 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$21.57 |
$21.57 |
$21.57 |
$319.12
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$889.00 |
$889.00 |
$889.00 |
$49.11
|
|
Lidocaine therapeutic drug level
|
$9.62 |
$9.62 |
$9.62 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$49.12 |
$49.12 |
$833.76 |
$177.90
|
|
Lipase
|
$66.79 |
$66.79 |
$66.79 |
$83.20
|
|
Lipoprotein blood quant
|
$29.69 |
$29.69 |
$29.69 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$45.88 |
$45.88 |
$45.88 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$21.37 |
$21.37 |
$21.37 |
$60.00
|
|
Lithium therapeutic drug level
|
$80.38 |
$80.38 |
$80.38 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,496.21 |
$2,496.21 |
$2,496.21 |
$4,371.12
|
|
Liver Function Test
|
$50.14 |
$50.14 |
$50.14 |
$110.50
|
|
Liver imaging
|
$2,224.32 |
$2,224.32 |
$2,224.32 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$1,600.30 |
$1,600.30 |
$1,600.30 |
$1,255.15
|
|
Liver/spleen imag static only
|
$1,550.95 |
$1,550.95 |
$8,926.46 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$36.86 |
$36.86 |
$36.86 |
$45.56
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$693.10 |
$693.10 |
$693.10 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$647.32 |
$647.32 |
$647.32 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$601.44 |
$601.44 |
$601.44 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$654.35 |
$654.35 |
$654.35 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$622.25 |
$622.25 |
$622.25 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,136.27 |
$1,136.27 |
$1,136.27 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$261.78 |
$261.78 |
$261.78 |
$344.00
|
|
L/s ratio fetal lung
|
$52.27 |
$52.27 |
$52.27 |
$168.00
|
|
Lumbar diskogram s&i
|
$2,805.80 |
$2,805.80 |
$2,805.80 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$1,186.23 |
$1,186.23 |
$1,186.23 |
$182.91
|
|
Lung Function Test (Spirometry)
|
$233.56 |
$233.56 |
$1,347.19 |
$298.50
|
|
Lung perfusion imaging
|
$1,550.95 |
$1,550.95 |
$10,096.36 |
$1,100.39
|
|
Lymphatics/lymph node imaging
|
$1,550.95 |
$1,550.95 |
$17,223.06 |
$1,543.75
|
|
Macroscopic exam arthropod
|
$25.25 |
$25.25 |
$25.25 |
$38.58
|
|
Magnesium
|
$40.05 |
$40.05 |
$40.05 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$24.14 |
$24.14 |
$24.14 |
$65.49
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$97.59 |
$97.59 |
$97.59 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$95.83 |
$95.83 |
$95.83 |
$178.75
|
|
Mannitol 12.5 gm/50 ml inj
|
$47.76 |
$47.76 |
$47.76 |
$40.12
|
|
Map tachycard site(s)
|
$28,379.89 |
$28,379.89 |
$28,379.89 |
$3,960.00
|