|
Insulin total
|
$38.95 |
$38.95 |
$45.00 |
$67.60
|
|
Intens cardiac rehab no exer
|
$419.66 |
$419.66 |
$419.66 |
$149.00
|
|
Intens cardiac rehab w/exerc
|
$419.66 |
$419.66 |
$419.66 |
$226.98
|
|
Interrog dev eval scrms ip
|
$498.00 |
$498.00 |
$498.00 |
$124.80
|
|
Intra-atrial pacing
|
$7,992.00 |
$7,992.00 |
$7,992.00 |
$5,155.51
|
|
Intra-atrial recording
|
$10,085.00 |
$10,085.00 |
$10,085.00 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$16,580.83 |
$16,580.83 |
$16,580.83 |
$3,982.59
|
|
Intracranial complete study
|
$2,120.00 |
$2,120.00 |
$2,120.00 |
$883.30
|
|
Intracranial limited study
|
$303.00 |
$303.00 |
$303.00 |
$423.52
|
|
Intraoral i+d tongue/floor lingual 41000
|
$6,921.73 |
$6,921.73 |
$6,921.73 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$2,282.18 |
$2,282.18 |
$2,282.18 |
$239.52
|
|
Intraventricular pacing
|
$10,085.00 |
$10,085.00 |
$10,085.00 |
$5,775.22
|
|
Intrinsic factor antibody
|
$9.00 |
$9.00 |
$49.88 |
$59.95
|
|
Intro cath dialysis circuit
|
$4,206.48 |
$4,206.48 |
$4,206.48 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$17,295.47 |
$17,295.47 |
$17,295.47 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$34,956.67 |
$34,956.67 |
$34,956.67 |
$15,625.00
|
|
Intro catheter aorta
|
$815.60 |
$815.60 |
$815.60 |
$1,861.61
|
|
Intro cath svc/ivc
|
$424.88 |
$424.88 |
$424.88 |
$1,350.75
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,646.05 |
$1,646.05 |
$1,646.05 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,646.05 |
$1,646.05 |
$1,646.05 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$760.70 |
$760.70 |
$760.70 |
$617.60
|
|
Ionm in operatng room 15 min
|
$160.93 |
$160.93 |
$160.93 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$492.98 |
$492.98 |
$492.98 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$869.73 |
$869.73 |
$869.73 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$43,283.16 |
$43,283.16 |
$43,283.16 |
$52,615.16
|
|
Ipratropium bromide non-comp
|
$11.41 |
$11.41 |
$11.41 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$264.55 |
$264.55 |
$264.55 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,783.14 |
$3,783.14 |
$3,783.14 |
$6,655.71
|
|
Iron
|
$2.00 |
$2.00 |
$228.63 |
$70.72
|
|
Iron binding capacity
|
$29.79 |
$29.79 |
$824.00 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$214.04 |
$214.04 |
$214.04 |
$62.70
|
|
Iron stain peripheral blood
|
$205.00 |
$205.00 |
$205.00 |
$17.60
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$562.77 |
$562.77 |
$562.77 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$456.83 |
$456.83 |
$628.00 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$168.42 |
$168.42 |
$535.00 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$13,121.82 |
$13,121.82 |
$13,121.82 |
$13,419.80
|
|
Ivc venogram s&i
|
$29,295.99 |
$29,295.99 |
$29,295.99 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$209.00 |
$209.00 |
$209.00 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$148.51 |
$148.51 |
$148.51 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$368.81 |
$368.81 |
$368.81 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,065.07 |
$1,065.07 |
$1,065.07 |
$460.85
|
|
Ivp w/nephrotomography
|
$5,097.00 |
$5,097.00 |
$5,097.00 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$1,795.97 |
$1,795.97 |
$1,795.97 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$2,041.83 |
$2,041.83 |
$2,041.83 |
$378.30
|
|
John cunningham antibody
|
$186.22 |
$186.22 |
$186.22 |
$48.57
|
|
Ketogenic steroids fract
|
$45.45 |
$45.45 |
$45.45 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$25.26 |
$25.26 |
$25.26 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$144.01 |
$144.01 |
$144.01 |
$30.08
|
|
Kidney function study
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$549.70
|
|
Kidney imaging morphology
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$6,061.04 |
$6,061.04 |
$11,496.00 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$4,103.83 |
$4,103.83 |
$4,312.00 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,416.02 |
$2,416.02 |
$2,451.00 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$205.68 |
$205.68 |
$205.68 |
$100.00
|
|
Knee Arthroscopy (Meniscus Repair)
|
$33,868.14 |
$33,868.14 |
$33,868.14 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$59,623.90 |
$59,623.90 |
$59,623.90 |
$7,807.24
|
|
Knee MRI (with and without contrast)
|
$11,026.55 |
$11,026.55 |
$11,026.55 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$8,324.68 |
$8,324.68 |
$8,324.68 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$6,973.75 |
$6,973.75 |
$6,973.75 |
$2,181.10
|
|
Knee X-ray
|
$1,820.64 |
$1,820.64 |
$1,820.64 |
$443.90
|
|
Kras gene addl variants
|
$42.66 |
$42.66 |
$42.66 |
$346.45
|
|
Kras gene variants exon 2
|
$42.84 |
$42.84 |
$42.84 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$307.42 |
$307.42 |
$307.42 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$260.13 |
$260.13 |
$260.13 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$171.85 |
$171.85 |
$171.85 |
$53.30
|
|
Lactated ringers intravenous solution
|
$324.13 |
$324.13 |
$324.13 |
$54.11
|
|
Lactic acid
|
$240.62 |
$240.62 |
$240.62 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$67.00 |
$67.00 |
$165.00 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$59,328.34 |
$59,328.34 |
$59,328.34 |
$22,903.90
|
|
Laparoscopy remove adnexa
|
$68,951.27 |
$68,951.27 |
$68,951.27 |
$6,904.15
|
|
Laparo-vag hyst incl t/o
|
$116,946.26 |
$116,946.26 |
$116,946.26 |
$7,595.42
|
|
Largsc w/rmvl foreign bdy(s)
|
$2,330.44 |
$2,330.44 |
$2,330.44 |
$765.97
|
|
Lead capillary
|
$41.28 |
$41.28 |
$41.28 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,940.00 |
$1,940.00 |
$3,090.93 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$590.43 |
$590.43 |
$590.43 |
$146.32
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$3,185.00 |
$3,185.00 |
$3,185.00 |
$6,208.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$478.00 |
$478.00 |
$500.70 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$45.71 |
$45.71 |
$74.00 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$292.07 |
$292.07 |
$292.07 |
$66.59
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$64.12 |
$64.12 |
$64.12 |
$49.11
|
|
Lidocaine therapeutic drug level
|
$161.96 |
$161.96 |
$161.96 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$455.13 |
$455.13 |
$1,309.00 |
$177.90
|
|
Lipase
|
$304.84 |
$304.84 |
$304.84 |
$83.20
|
|
Lipoprotein blood quant
|
$32.94 |
$32.94 |
$388.43 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$202.69 |
$202.69 |
$664.00 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$35.79 |
$35.79 |
$35.79 |
$60.00
|
|
Lithium therapeutic drug level
|
$133.13 |
$133.13 |
$133.13 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$21,309.75 |
$21,309.75 |
$21,309.75 |
$4,371.12
|
|
Liver Function Test
|
$443.33 |
$443.33 |
$511.00 |
$110.50
|
|
Liver/spleen imag static only
|
$6,949.00 |
$6,949.00 |
$6,949.00 |
$1,140.78
|
|
Liver/spleen imag w/vasclr flow
|
$4,311.00 |
$4,311.00 |
$4,311.00 |
$949.00
|
|
Locm 100-199mg/ml iodine,1ml
|
$44.10 |
$44.10 |
$44.10 |
$16.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$59.42 |
$59.42 |
$59.42 |
$45.56
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$5,462.00 |
$5,462.00 |
$7,074.18 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$5,072.00 |
$5,072.00 |
$5,888.58 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$5,496.16 |
$5,496.16 |
$6,570.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$9,555.24 |
$9,555.24 |
$13,323.00 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$8,902.31 |
$8,902.31 |
$11,257.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$7,641.67 |
$7,641.67 |
$9,454.00 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$1,613.33 |
$1,613.33 |
$2,578.00 |
$344.00
|