|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$830.43 |
$830.43 |
$830.43 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$558.26 |
$558.26 |
$558.26 |
$627.00
|
|
Inj allopurinol sodium 1 mg
|
$7,866.72 |
$7,866.72 |
$7,866.72 |
$5,937.23
|
|
Inj, artesunate, 1mg
|
$26,506.38 |
$26,506.38 |
$26,506.38 |
$20,169.00
|
|
Inj, bupivacaine liposome
|
$2,051.17 |
$2,051.17 |
$2,051.17 |
$1,040.36
|
|
Inj calcitriol per 0.1 mcg
|
$162.17 |
$162.17 |
$162.17 |
$31.69
|
|
Inj cefazolin (wg crit care)
|
$18.43 |
$18.43 |
$18.43 |
$20.26
|
|
Inj, cefiderocol, 10 mg
|
$923.14 |
$923.14 |
$923.14 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$436.64 |
$436.64 |
$436.64 |
$381.60
|
|
Inj crotalidae im f(ab')2 eq
|
$4,214.11 |
$4,214.11 |
$4,214.11 |
$2,836.95
|
|
Injection, cangrelor
|
$3,643.52 |
$3,643.52 |
$3,643.52 |
$2,457.89
|
|
Injection, fulvestrant
|
$946.70 |
$946.70 |
$946.70 |
$2,744.26
|
|
Injection,onabotulinumtoxina
|
$4,460.65 |
$4,460.65 |
$4,460.65 |
$2,154.07
|
|
Injection, peramivir
|
$1,667.67 |
$1,667.67 |
$1,667.67 |
$1,257.68
|
|
Inj, factor x, (human), 1iu
|
$17.81 |
$17.81 |
$17.81 |
$9.91
|
|
Inj heparin, pfizer, 1000u
|
$18.12 |
$18.12 |
$18.12 |
$20.54
|
|
Inj hydroxocobalamin IV 25mg
|
$4,919.00 |
$4,919.00 |
$4,919.00 |
$3,180.35
|
|
Inj imip 4 cilas 4 releb 2mg
|
$1,184.19 |
$1,184.19 |
$1,184.19 |
$1,004.42
|
|
Inj levocarnitine per 1 gm
|
$164.36 |
$164.36 |
$164.36 |
$132.69
|
|
Inj melpha hydroch nos 50 mg
|
$4,130.01 |
$4,130.01 |
$4,130.01 |
$1,627.50
|
|
Inj mepivacaine hcl/10 ml
|
$47.25 |
$47.25 |
$47.25 |
$23.93
|
|
Inj meropenem (wg crit care)
|
$133.35 |
$133.35 |
$133.35 |
$104.12
|
|
Inj, moxifloxacin 100 mg
|
$234.21 |
$234.21 |
$234.21 |
$181.67
|
|
Inj. mycophenolate mofetil
|
$330.21 |
$330.21 |
$330.21 |
$365.20
|
|
Inj, nithiodote, 3mg / 125mg
|
$1,040.16 |
$1,040.16 |
$1,040.16 |
$644.66
|
|
Inj, pedmark, 100 mg
|
$589.22 |
$589.22 |
$589.22 |
$96.08
|
|
Inj prohance multipack
|
$9.59 |
$9.59 |
$9.59 |
$51.48
|
|
Inj testosterone cypionate
|
$1.00 |
$1.00 |
$1.00 |
$80.28
|
|
Insertion of catheter vein
|
$681.00 |
$681.00 |
$681.00 |
$870.59
|
|
In situ hybridization per specimen each additional single probe stain
|
$101.25 |
$101.25 |
$101.25 |
$251.55
|
|
Insulin total
|
$4.87 |
$4.87 |
$4.87 |
$67.50
|
|
Interferon alfa-2b inj
|
$1,786.56 |
$1,786.56 |
$1,786.56 |
$473.03
|
|
Intracard echo interv w/s&i
|
$23,399.17 |
$23,399.17 |
$23,399.17 |
$4,013.16
|
|
Intracranial limited study
|
$1,728.14 |
$1,728.14 |
$1,728.14 |
$418.44
|
|
Intrapul surf admin endo tube
|
$285.71 |
$285.71 |
$285.71 |
$240.68
|
|
Intrinsic factor antibody
|
$8.24 |
$8.24 |
$8.24 |
$59.95
|
|
Ipratropium bromide non-comp
|
$3.29 |
$3.29 |
$3.29 |
$10.36
|
|
Iron dextran 50 mg/ml injection solution
|
$335.56 |
$335.56 |
$335.56 |
$62.12
|
|
Irradiation of blood product each unit reference
|
$203.59 |
$203.59 |
$203.59 |
$124.24
|
|
Ivc venogram s&i
|
$8,121.76 |
$8,121.76 |
$8,121.76 |
$3,258.00
|
|
Kerecis marigen shld sq cm
|
$1.00 |
$1.00 |
$1.00 |
$171.12
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$96.53 |
$96.53 |
$96.53 |
$53.78
|
|
Kidney img w/bldflw sgl without rx
|
$8,948.94 |
$8,948.94 |
$8,948.94 |
$1,468.04
|
|
Kras gene variants exon 2
|
$909.98 |
$909.98 |
$909.98 |
$495.00
|
|
Kyleena, 19.5 mg
|
$6,718.48 |
$6,718.48 |
$6,718.48 |
$2,992.45
|
|
Levetiracetam therapeutic drug level
|
$15.30 |
$15.30 |
$15.30 |
$74.00
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$524.30 |
$524.30 |
$524.30 |
$277.50
|
|
Lidocaine therapeutic drug level
|
$3.61 |
$3.61 |
$3.61 |
$85.15
|
|
Liletta, 52 mg
|
$5,165.53 |
$5,165.53 |
$5,165.53 |
$2,360.29
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$814.39 |
$814.39 |
$814.39 |
$141.75
|
|
Lipoprotein blood high res frac & quant
|
$31.36 |
$31.36 |
$31.36 |
$89.52
|
|
Lisocabtagene mara car pos t
|
$9,635,877.70 |
$9,635,877.70 |
$9,635,877.70 |
$516,726.08
|
|
Listeria monocytogenes
|
$150.68 |
$150.68 |
$150.68 |
$95.40
|
|
Liver imaging
|
$2,617.28 |
$2,617.28 |
$2,617.28 |
$1,241.25
|
|
Liver/spleen imag w/vasclr flow
|
$8,164.40 |
$8,164.40 |
$8,164.40 |
$928.20
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$9,824.27 |
$9,824.27 |
$9,824.27 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$7,857.35 |
$7,857.35 |
$7,857.35 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$6,544.52 |
$6,544.52 |
$6,544.52 |
$2,065.69
|
|
L/s ratio fetal lung
|
$23.54 |
$23.54 |
$23.54 |
$168.00
|
|
Lumbar diskogram s&i
|
$38,281.72 |
$38,281.72 |
$38,281.72 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$1,143.10 |
$1,143.10 |
$1,143.10 |
$295.35
|
|
Lung perfusion imaging
|
$8,958.48 |
$8,958.48 |
$8,958.48 |
$1,082.75
|
|
Lymphatics/lymph node imaging
|
$6,945.76 |
$6,945.76 |
$6,945.76 |
$1,526.38
|
|
Macroscopic exam arthropod
|
$19.72 |
$19.72 |
$19.72 |
$38.58
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$247.04 |
$247.04 |
$247.04 |
$140.87
|
|
Manipulation chest wall initial demonstration/evaluation
|
$312.00 |
$312.00 |
$312.00 |
$170.00
|
|
Matrion 1 sq cm
|
$1.00 |
$1.00 |
$1.00 |
$764.03
|
|
Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm
|
$1.00 |
$1.00 |
$1.00 |
$4,371.37
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$10.86 |
$10.86 |
$10.86 |
$67.00
|
|
Mayo activated protein c resistance assay
|
$43.15 |
$43.15 |
$43.15 |
$97.50
|
|
Mayo analysis gene jak2 p.val617phe variant
|
$191.76 |
$191.76 |
$191.76 |
$338.00
|
|
Mayo androstenedione
|
$26.19 |
$26.19 |
$26.19 |
$103.89
|
|
Mayo antithrombin iii antigen
|
$11.77 |
$11.77 |
$11.77 |
$67.13
|
|
Mayo avwpr vw factor activity
|
$197.77 |
$197.77 |
$197.77 |
$159.00
|
|
Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative
|
$161.87 |
$161.87 |
$161.87 |
$353.60
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$15.00 |
$15.00 |
$15.00 |
$96.85
|
|
Mayo carnitine total and free quantitative each specimen plasma
|
$34.53 |
$34.53 |
$34.53 |
$85.17
|
|
Mayo ceruloplasmin
|
$5.89 |
$5.89 |
$5.89 |
$64.80
|
|
Mayo chrcb tissue culture non-neoplastic disorders lymphocyte
|
$904.68 |
$904.68 |
$904.68 |
$349.47
|
|
Mayo chromium
|
$18.84 |
$18.84 |
$18.84 |
$74.94
|
|
Mayo cocaine definitive assay confirmation urine
|
$16.31 |
$16.31 |
$16.31 |
$85.80
|
|
Mayo cortisol free
|
$11.77 |
$11.77 |
$11.77 |
$101.40
|
|
Mayo csmpu benzodiazepines definitive assay >=13 urine
|
$16.31 |
$16.31 |
$16.31 |
$106.70
|
|
Mayo cyanide
|
$43.56 |
$43.56 |
$43.56 |
$87.10
|
|
Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual
|
$482.80 |
$482.80 |
$482.80 |
$642.40
|
|
Mayo deoxyribonuclease antibody titer
|
$21.19 |
$21.19 |
$21.19 |
$59.15
|
|
Mayo dhea (dehydroepiandrosterone)
|
$10.59 |
$10.59 |
$10.59 |
$90.06
|
|
Mayo efpo chloride stool
|
$31.35 |
$31.35 |
$31.35 |
$42.60
|
|
Mayo estrone
|
$19.18 |
$19.18 |
$19.18 |
$83.20
|
|
Mayo ethosuximide therapeutic drug level
|
$14.13 |
$14.13 |
$14.13 |
$70.20
|
|
Mayo everolimus therapeutic drug level
|
$138.91 |
$138.91 |
$138.91 |
$78.65
|
|
Mayo factor ii
|
$82.40 |
$82.40 |
$82.40 |
$92.30
|
|
Mayo factor v
|
$17.66 |
$17.66 |
$17.66 |
$127.80
|
|
Mayo factor vii
|
$58.86 |
$58.86 |
$58.86 |
$141.70
|
|
Mayo factor viii vw factor multimetric analysis
|
$70.95 |
$70.95 |
$70.95 |
$125.00
|
|
Mayo factor viii vw factor ristocetin cofactor
|
$108.02 |
$108.02 |
$108.02 |
$126.00
|
|
Mayo factor x
|
$88.29 |
$88.29 |
$88.29 |
$139.50
|
|
Mayo factor xi
|
$82.40 |
$82.40 |
$82.40 |
$117.50
|
|
Mayo fat/lipids feces quantitative
|
$79.11 |
$79.11 |
$79.11 |
$70.67
|
|
Mayo gabapentin bld/srm/plasma therapeutic drug level
|
$11.77 |
$11.77 |
$11.77 |
$69.55
|
