|
Inj. herceptin hylecta, 10mg
|
$53.56 |
$53.56 |
$53.56 |
$63.79
|
|
Inj human fibrinogen con nos
|
$2.41 |
$2.41 |
$2.41 |
$1.52
|
|
Inj. inebilizumab-cdon, 1 mg
|
$522.50 |
$522.50 |
$522.50 |
$494.43
|
|
Inj ivig privigen 500 mg
|
$94.04 |
$94.04 |
$94.04 |
$7,298.71
|
|
Inj, kovaltry, 1 i.u
|
$3.44 |
$3.44 |
$3.44 |
$1.48
|
|
Inj, lanreotide, (cipla) 1mg
|
$22.04 |
$22.04 |
$22.04 |
$12,160.05
|
|
Inj, lecanemab-irmb, 1 mg
|
$2.00 |
$2.00 |
$2.00 |
$1,729.21
|
|
Inj levocarnitine per 1 gm
|
$90.40 |
$90.40 |
$90.40 |
$138.96
|
|
Inj melpha hydroch nos 50 mg
|
$1,771.40 |
$1,771.40 |
$1,771.40 |
$1,518.68
|
|
Inj, mirikizumab-mrkz, 1 mg
|
$38.20 |
$38.20 |
$38.20 |
$39.54
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$280.52 |
$280.52 |
$280.52 |
$788.73
|
|
Inj ogivri 10 mg
|
$39.60 |
$39.60 |
$39.60 |
$3,968.67
|
|
Inj., omadacycline, 1 mg
|
$7.00 |
$7.00 |
$7.00 |
$3.80
|
|
Inj ontruzant 10 mg
|
$34.96 |
$34.96 |
$34.96 |
$34.17
|
|
Inj., patisiran, 0.1 mg
|
$115.10 |
$115.10 |
$115.10 |
$11,742.00
|
|
Inj, pedmark, 100 mg
|
$170.54 |
$170.54 |
$170.54 |
$96.08
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$144.41 |
$144.41 |
$144.41 |
$6,403.59
|
|
Inj. pemetrexed, 10 mg
|
$47.78 |
$47.78 |
$47.78 |
$50.83
|
|
Inj pemetrexed (teva) 10mg
|
$6.60 |
$6.60 |
$6.60 |
$5.52
|
|
Inj secretin synthetic human
|
$53.12 |
$53.12 |
$53.12 |
$741.75
|
|
Inj secukinumab intrav 1mg
|
$38.28 |
$38.28 |
$38.28 |
$9,077.39
|
|
Inj, sutimlimab-jome, 10 mg
|
$19.21 |
$19.21 |
$19.21 |
$18.13
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$293.76 |
$293.76 |
$293.76 |
$92,981.70
|
|
Inj teclistamab cqyv 0.5 mg
|
$34.90 |
$34.90 |
$34.90 |
$14,653.61
|
|
Inj. teprotumumab-trbw 10 mg
|
$356.58 |
$356.58 |
$356.58 |
$47,971.67
|
|
Inj testosterone cypionate
|
$0.04 |
$0.04 |
$0.04 |
$77.15
|
|
Inj, tofidence, 1 mg
|
$6.48 |
$6.48 |
$6.48 |
$5.72
|
|
Inj, tyenne, 1 mg
|
$4.12 |
$4.12 |
$4.12 |
$860.68
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$3,429.94 |
$3,429.94 |
$3,429.94 |
$3,429.94
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$31,482.00 |
$31,482.00 |
$31,482.00 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$26,326.00 |
$26,326.00 |
$26,326.00 |
$12,813.28
|
|
Insitu hybridization (fish)
|
$255.60 |
$255.60 |
$255.60 |
$481.60
|
|
Insitu hybridization manual
|
$262.80 |
$262.80 |
$262.80 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$148.00 |
$148.00 |
$148.00 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$66.00 |
$66.00 |
$66.00 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$28,872.00 |
$28,872.00 |
$28,872.00 |
$12,384.25
|
|
Ins/rpl pm gen exist sgl lead
|
$8,704.00 |
$8,704.00 |
$8,704.00 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$10,066.40 |
$10,066.40 |
$10,066.40 |
$12,384.25
|
|
Instillation anticarcinogenic agent bladder
|
$1,030.40 |
$1,030.40 |
$1,030.40 |
$721.50
|
|
Insulin total
|
$45.68 |
$45.68 |
$45.68 |
$67.60
|
|
Integra meshed bil wound mat
|
$6,188.00 |
$6,188.00 |
$6,188.00 |
$24,354.93
|
|
Interferon alfa-2b inj
|
$35.02 |
$35.02 |
$35.02 |
$494.64
|
|
Intra-atrial pacing
|
$3,349.20 |
$3,349.20 |
$3,349.20 |
$5,155.51
|
|
Intra-atrial recording
|
$12,688.00 |
$12,688.00 |
$12,688.00 |
$5,707.00
|
|
Intracranial complete study
|
$1,083.20 |
$1,083.20 |
$1,083.20 |
$883.30
|
|
Intracranial limited study
|
$516.40 |
$516.40 |
$516.40 |
$423.52
|
|
Intrinsic factor antibody
|
$8.30 |
$8.30 |
$8.30 |
$59.95
|
|
Iodine i-123 sod iodide mil
|
$530.80 |
$530.80 |
$530.80 |
$677.98
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$2.92 |
$2.92 |
$2.92 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$14.24 |
$14.24 |
$14.24 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$183.80 |
$183.80 |
$183.80 |
$52,615.16
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$361.40 |
$361.40 |
$361.40 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$40.96 |
$40.96 |
$40.96 |
$6,655.71
|
|
Iron
|
$24.76 |
$24.76 |
$24.76 |
$70.72
|
|
Iron binding capacity
|
$28.56 |
$28.56 |
$28.56 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$11.56 |
$11.56 |
$11.56 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1.36 |
$1.36 |
$1.36 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$78.08 |
$78.08 |
$78.08 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$36.40 |
$36.40 |
$36.40 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$75.00 |
$75.00 |
$75.00 |
$13,419.80
|
|
Ivc venogram s&i
|
$1,741.60 |
$1,741.60 |
$1,741.60 |
$3,332.55
|
|
Ixabepilone 15 mg intravenous solution
|
$110.48 |
$110.48 |
$110.48 |
$7,216.15
|
|
Jak2 targeted sequence analysis
|
$288.00 |
$288.00 |
$288.00 |
$378.30
|
|
Ketamine and metabolite screen - quest
|
$42.40 |
$42.40 |
$42.40 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$15.08 |
$15.08 |
$15.08 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$19.92 |
$19.92 |
$19.92 |
$30.08
|
|
Kidney endoscopy & biopsy
|
$17,280.80 |
$17,280.80 |
$17,280.80 |
$5,110.00
|
|
Kidney img w/bldflw sgl without rx
|
$2,789.20 |
$2,789.20 |
$2,789.20 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$926.40 |
$926.40 |
$926.40 |
$668.25
|
|
Kit gene analys d816 variant
|
$112.00 |
$112.00 |
$112.00 |
$355.00
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$179.32 |
$179.32 |
$179.32 |
$5,329.23
|
|
Knee MRI (with and without contrast)
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,499.20 |
$1,499.20 |
$1,499.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,405.20 |
$1,405.20 |
$1,405.20 |
$2,181.10
|
|
Knee X-ray
|
$1,081.20 |
$1,081.20 |
$1,081.20 |
$443.90
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$4.30 |
$4.30 |
$4.30 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.52 |
$0.52 |
$0.52 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$21.24 |
$21.24 |
$21.24 |
$53.30
|
|
Lactated ringers intravenous solution
|
$15.44 |
$15.44 |
$15.44 |
$54.11
|
|
Lactic acid
|
$66.76 |
$66.76 |
$66.76 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$11.44 |
$11.44 |
$11.44 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$31.72 |
$31.72 |
$31.72 |
$22,903.90
|
|
Laronidase injection
|
$86.40 |
$86.40 |
$86.40 |
$39.88
|
|
Lead capillary
|
$29.88 |
$29.88 |
$29.88 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$929.20 |
$929.20 |
$929.20 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$42.80 |
$42.80 |
$42.80 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$639.08 |
$639.08 |
$639.08 |
$3,271.64
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,238.80 |
$1,238.80 |
$1,238.80 |
$6,208.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$1.60 |
$1.60 |
$1.60 |
$89.14
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$291.12 |
$291.12 |
$291.12 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$19.70 |
$19.70 |
$19.70 |
$319.12
|
|
Lidocaine therapeutic drug level
|
$173.44 |
$173.44 |
$173.44 |
$83.85
|
|
Lincomycin injection
|
$7.04 |
$7.04 |
$7.04 |
$13.25
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$84.28 |
$84.28 |
$84.28 |
$177.90
|
|
Lipase
|
$30.88 |
$30.88 |
$30.88 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$16.80 |
$16.80 |
$16.80 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$30.20 |
$30.20 |
$30.20 |
$60.00
|
|
Lithium therapeutic drug level
|
$43.64 |
$43.64 |
$43.64 |
$67.60
|
|
Liver Function Test
|
$24.76 |
$24.76 |
$24.76 |
$110.50
|
|
Liver/spleen imag static only
|
$2,086.00 |
$2,086.00 |
$2,086.00 |
$1,140.78
|