|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$302.30 |
$302.30 |
$302.30 |
$5,568.57
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$232.65 |
$232.65 |
$232.65 |
$188.21
|
|
Hydralazine 20 mg/ml injection solution
|
$143.64 |
$143.64 |
$143.64 |
$56.70
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$29.16 |
$29.16 |
$29.16 |
$80.11
|
|
Hydroxyzine pamoate 25 mg capsule
|
$3.24 |
$3.24 |
$3.24 |
$16.14
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$20.58 |
$20.58 |
$20.58 |
$73.45
|
|
Hysterosalpingography s&i
|
$3,730.14 |
$3,730.14 |
$3,730.14 |
$591.80
|
|
I-123 sod iodide diag per 100 uci
|
$1,764.76 |
$1,764.76 |
$1,764.76 |
$158.05
|
|
I131 iodide cap, rx
|
$514.45 |
$514.45 |
$514.45 |
$95.00
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$3,851.28 |
$3,851.28 |
$3,851.28 |
$918.69
|
|
Idarubicin hcl injection
|
$3,252.96 |
$3,252.96 |
$3,252.96 |
$533.16
|
|
Ifosfamide 1 gram intravenous solution
|
$899.64 |
$899.64 |
$899.64 |
$289.34
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$547.31 |
$547.31 |
$547.31 |
$348.15
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,674.08 |
$2,674.08 |
$2,674.08 |
$1,770.41
|
|
Immunodiff gel qual ea antigen/ab
|
$25.18 |
$25.18 |
$25.18 |
$50.78
|
|
Immunodiffusion nes
|
$16.25 |
$16.25 |
$16.25 |
$56.71
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$22.32 |
$22.32 |
$22.32 |
$161.85
|
|
Implant ureth bulk agent
|
$4,928.30 |
$4,928.30 |
$4,928.30 |
$1,708.88
|
|
In-111 oxyquinolin per 0.5 mci
|
$11,365.21 |
$11,365.21 |
$11,365.21 |
$2,703.60
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,148.19 |
$11,148.19 |
$11,148.19 |
$2,106.00
|
|
In-111 pentetreotide
|
$20,845.58 |
$20,845.58 |
$20,845.58 |
$6,610.16
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,492.72 |
$1,492.72 |
$1,492.72 |
$1,099.05
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$142.62 |
$142.62 |
$142.62 |
$558.00
|
|
Infect ag ia optc obs influenza
|
$317.79 |
$317.79 |
$317.79 |
$65.58
|
|
Infect ag if influenza a
|
$15.30 |
$15.30 |
$15.30 |
$40.61
|
|
Infect ag if influenza b
|
$15.30 |
$15.30 |
$15.30 |
$33.60
|
|
Infect ag if varicella zoster
|
$32.36 |
$32.36 |
$32.36 |
$66.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$215.70 |
$215.70 |
$215.70 |
$227.50
|
|
Infect ag na influenza revr/amp ea type
|
$217.75 |
$217.75 |
$217.75 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$90.63 |
$90.63 |
$90.63 |
$101.00
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$117.76 |
$117.76 |
$117.76 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$117.76 |
$117.76 |
$117.76 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$233.05 |
$233.05 |
$233.05 |
$81.40
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$86.63 |
$86.63 |
$86.63 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$402.53 |
$402.53 |
$402.53 |
$93.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$233.05 |
$233.05 |
$233.05 |
$60.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$199.21 |
$199.21 |
$199.21 |
$855.45
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$147.13 |
$147.13 |
$147.13 |
$210.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$275.42 |
$275.42 |
$275.42 |
$103.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$282.48 |
$282.48 |
$282.48 |
$285.60
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$105.93 |
$105.93 |
$105.93 |
$208.91
|
|
Influenza virus vaccine, live trivalent intranasal
|
$140.40 |
$140.40 |
$140.40 |
$40.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$481.40 |
$481.40 |
$481.40 |
$359.64
|
|
Inj, bupivacaine liposome
|
$1,767.76 |
$1,767.76 |
$1,767.76 |
$886.63
|
|
Inj calcitriol per 0.1 mcg
|
$64.80 |
$64.80 |
$64.80 |
$31.89
|
|
Inj cefazolin (wg crit care)
|
$10.86 |
$10.86 |
$10.86 |
$20.48
|
|
Inj ceftolozane tazobactam
|
$535.68 |
$535.68 |
$535.68 |
$426.29
|
|
Inj crotalidae im f(ab')2 eq
|
$3,673.40 |
$3,673.40 |
$3,673.40 |
$2,836.95
|
|
Injection, fulvestrant
|
$15.42 |
$15.42 |
$15.42 |
$2,744.26
|
|
Injection, isavuconazonium
|
$1,446.12 |
$1,446.12 |
$1,446.12 |
$634.28
|
|
Injection, peramivir
|
$2,667.60 |
$2,667.60 |
$2,667.60 |
$1,257.68
|
|
Inj, levothyroxine, freskabi
|
$66.65 |
$66.65 |
$66.65 |
$287.00
|
|
Inj mepivacaine hcl/10 ml
|
$45.36 |
$45.36 |
$45.36 |
$27.46
|
|
Inj meropenem (wg crit care)
|
$118.72 |
$118.72 |
$118.72 |
$104.12
|
|
Inj, moxifloxacin 100 mg
|
$380.16 |
$380.16 |
$380.16 |
$190.81
|
|
Inj progesterone per 50 mg
|
$276.48 |
$276.48 |
$276.48 |
$48.51
|
|
Inj testosterone cypionate
|
$3.24 |
$3.24 |
$3.24 |
$77.70
|
|
Insitu hybridization auto
|
$122.08 |
$122.08 |
$122.08 |
$393.13
|
|
Insitu hybridization (fish)
|
$317.79 |
$317.79 |
$317.79 |
$481.60
|
|
Insitu hybridization manual
|
$95.82 |
$95.82 |
$95.82 |
$411.33
|
|
In situ hybridization per specimen each additional single probe stain
|
$103.58 |
$103.58 |
$103.58 |
$259.01
|
|
In situ hybridization per specimen initial single probe stain
|
$65.47 |
$65.47 |
$65.47 |
$341.60
|
|
Insti hexaminolevulinate hcl
|
$6,345.00 |
$6,345.00 |
$6,345.00 |
$2,359.80
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$6,329.32 |
$6,329.32 |
$6,329.32 |
$9,970.16
|
|
Integra meshed bil wound mat
|
$535.55 |
$535.55 |
$535.55 |
$13,503.69
|
|
Interferon alfa-2b inj
|
$568.08 |
$568.08 |
$568.08 |
$494.64
|
|
Intra-atrial pacing
|
$2,603.08 |
$2,603.08 |
$2,603.08 |
$5,041.63
|
|
Intra-atrial recording
|
$11,227.51 |
$11,227.51 |
$11,227.51 |
$5,644.35
|
|
Intracard echo interv w/s&i
|
$3,164.90 |
$3,164.90 |
$3,164.90 |
$3,982.59
|
|
Intraventricular pacing
|
$8,013.04 |
$8,013.04 |
$8,013.04 |
$5,644.35
|
|
Intrinsic factor antibody
|
$8.24 |
$8.24 |
$8.24 |
$59.66
|
|
Iron dextran 50 mg/ml injection solution
|
$155.52 |
$155.52 |
$155.52 |
$62.12
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$520.56 |
$520.56 |
$520.56 |
$210.49
|
|
Irradiation of blood product each unit reference
|
$267.18 |
$267.18 |
$267.18 |
$124.24
|
|
Ivc venogram s&i
|
$4,857.24 |
$4,857.24 |
$4,857.24 |
$3,316.95
|
|
Ivp w/nephrotomography
|
$5,961.90 |
$5,961.90 |
$5,961.90 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$5,194.86 |
$5,194.86 |
$5,194.86 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$42.37 |
$42.37 |
$42.37 |
$54.16
|
|
Kidney imag w/bld flow multi
|
$15,711.02 |
$15,711.02 |
$15,711.02 |
$1,574.40
|
|
Kidney img w/bldflw sgl without rx
|
$11,194.46 |
$11,194.46 |
$11,194.46 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,721.71 |
$2,721.71 |
$2,721.71 |
$668.25
|
|
Lactoferrin fecal quant
|
$217.75 |
$217.75 |
$217.75 |
$106.10
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$32.40 |
$32.40 |
$32.40 |
$140.68
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$7,064.28 |
$7,064.28 |
$7,064.28 |
$3,844.90
|
|
Levetiracetam therapeutic drug level
|
$15.30 |
$15.30 |
$15.30 |
$72.00
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$17.86 |
$17.86 |
$17.86 |
$48.48
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$1,033.56 |
$1,033.56 |
$1,033.56 |
$159.12
|
|
Lipoprotein blood high res frac & quant
|
$37.66 |
$37.66 |
$37.66 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$266.00 |
$266.00 |
$266.00 |
$55.25
|
|
Lithium therapeutic drug level
|
$145.95 |
$145.95 |
$145.95 |
$67.20
|
|
Liver Function Test
|
$330.74 |
$330.74 |
$330.74 |
$111.13
|
|
Liver/spleen imag static only
|
$9,815.26 |
$9,815.26 |
$9,815.26 |
$1,140.78
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$9.72 |
$9.72 |
$9.72 |
$43.75
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$14,091.62 |
$14,091.62 |
$14,091.62 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$11,431.32 |
$11,431.32 |
$11,431.32 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$10,993.63 |
$10,993.63 |
$10,993.63 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$19,518.84 |
$19,518.84 |
$19,518.84 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$16,470.92 |
$16,470.92 |
$16,470.92 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$5,830.00 |
$5,830.00 |
$5,830.00 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$2,036.94 |
$2,036.94 |
$2,036.94 |
$341.64
|