|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,106.83 |
$2,106.83 |
$2,106.83 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,108.48 |
$2,108.48 |
$2,108.48 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,308.11 |
$1,308.11 |
$1,308.11 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,999.04 |
$2,999.04 |
$2,999.04 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,155.01 |
$3,155.01 |
$3,155.01 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,488.25 |
$3,488.25 |
$3,488.25 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,454.14 |
$1,454.14 |
$1,454.14 |
$472.76
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$520.31 |
$520.31 |
$520.31 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$506.49 |
$506.49 |
$506.49 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$408.79 |
$408.79 |
$408.79 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$259.91 |
$259.91 |
$259.91 |
$141.60
|
|
Inject sacroiliac joint
|
$2,015.33 |
$2,015.33 |
$2,015.33 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$225,188.93 |
$225,188.93 |
$225,188.93 |
$66,229.74
|
|
Inj for ext venography
|
$1,227.82 |
$1,227.82 |
$1,227.82 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$1,317.39 |
$1,317.39 |
$1,317.39 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$139.79 |
$139.79 |
$139.79 |
$96.70
|
|
Inj hrt cath w/s&i sel left vent
|
$4,124.79 |
$4,124.79 |
$4,124.79 |
$1,214.40
|
|
Inj ivig privigen 500 mg
|
$62,929.00 |
$62,929.00 |
$62,929.00 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$20.77 |
$20.77 |
$20.77 |
$28.41
|
|
Inj multihance
|
$418.45 |
$418.45 |
$418.45 |
$119.25
|
|
Inj proc ankle arthr
|
$1,054.84 |
$1,054.84 |
$1,054.84 |
$405.31
|
|
Inj proc elbow arthro
|
$803.30 |
$803.30 |
$803.30 |
$453.60
|
|
Inj secukinumab intrav 1mg
|
$30,816.99 |
$30,816.99 |
$30,816.99 |
$9,077.39
|
|
Inj, spesolimab-sbzo, 1 mg
|
$744,580.61 |
$744,580.61 |
$744,580.61 |
$253,022.14
|
|
Inj testosterone cypionate
|
$326.64 |
$326.64 |
$326.64 |
$77.15
|
|
Inj, tislelizumab-jsgr
|
$34,437.02 |
$34,437.02 |
$34,437.02 |
$45,250.97
|
|
Inj, vancomycin hcl (mylan)
|
$100.05 |
$100.05 |
$100.05 |
$63.82
|
|
Inj, vegzelma, 10 mg
|
$9,504.89 |
$9,504.89 |
$9,504.89 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$1,287.07 |
$1,287.07 |
$1,287.07 |
$588.90
|
|
Ins cath ren art 1st bi
|
$5,517.06 |
$5,517.06 |
$5,517.06 |
$6,033.75
|
|
Ins cerv dilator (sep proc)
|
$1,604.32 |
$1,604.32 |
$1,604.32 |
$544.00
|
|
Insert and remove bone pin
|
$33,221.96 |
$33,221.96 |
$33,221.96 |
$4,335.60
|
|
Insert cath pleura with image
|
$1,928.01 |
$1,928.01 |
$1,928.01 |
$2,239.02
|
|
Insertion catheter bladder non indwelling
|
$718.99 |
$718.99 |
$718.99 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$710.09 |
$710.09 |
$710.09 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$23,053.87 |
$23,053.87 |
$23,053.87 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$5,928.75 |
$5,928.75 |
$5,928.75 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$5,837.03 |
$5,837.03 |
$5,837.03 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$4,747.63 |
$4,747.63 |
$4,747.63 |
$2,618.40
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$8,849.72 |
$8,849.72 |
$8,849.72 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$6,092.87 |
$6,092.87 |
$6,092.87 |
$2,527.91
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$20,146.63 |
$20,146.63 |
$20,146.63 |
$7,572.47
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$23,173.72 |
$23,173.72 |
$23,173.72 |
$9,793.46
|
|
Insert picvad cath
|
$15,795.92 |
$15,795.92 |
$15,795.92 |
$4,490.00
|
|
Insitu hybridization manual
|
$1,040.84 |
$1,040.84 |
$1,040.84 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$2,591.95 |
$2,591.95 |
$2,591.95 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$1,316.23 |
$1,316.23 |
$1,316.23 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$9,061.83 |
$9,061.83 |
$9,061.83 |
$4,341.66
|
|
Ins pq tunnld ip cath w/img
|
$8,579.66 |
$8,579.66 |
$8,579.66 |
$5,593.60
|
|
Instillation anticarcinogenic agent bladder
|
$828.55 |
$828.55 |
$828.55 |
$721.50
|
|
Instill, bupivac and meloxic
|
$1,985.17 |
$1,985.17 |
$1,985.17 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$6,248.75 |
$6,248.75 |
$6,248.75 |
$4,748.00
|
|
Insulin total
|
$105.13 |
$105.13 |
$105.13 |
$67.60
|
|
Intraoral i+d tongue/floor lingual 41000
|
$2,992.10 |
$2,992.10 |
$2,992.10 |
$1,182.15
|
|
Intrinsic factor antibody
|
$61.82 |
$61.82 |
$61.82 |
$59.95
|
|
Intro cath svc/ivc
|
$1,538.66 |
$1,538.66 |
$1,538.66 |
$1,350.75
|
|
Intro long gi tube
|
$2,010.08 |
$2,010.08 |
$2,010.08 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$1,861.69 |
$1,861.69 |
$1,861.69 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,028.38 |
$4,028.38 |
$4,028.38 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,594.66 |
$2,594.66 |
$2,594.66 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$1,785.44 |
$1,785.44 |
$1,785.44 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$501.96 |
$501.96 |
$501.96 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$782.28 |
$782.28 |
$782.28 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$39,217.77 |
$39,217.77 |
$39,217.77 |
$52,615.16
|
|
Ipratropium bromide non-comp
|
$13.88 |
$13.88 |
$13.88 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$236.99 |
$236.99 |
$236.99 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,439.91 |
$3,439.91 |
$3,439.91 |
$6,655.71
|
|
Iron
|
$130.74 |
$130.74 |
$130.74 |
$70.72
|
|
Iron binding capacity
|
$165.86 |
$165.86 |
$165.86 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$315.57 |
$315.57 |
$315.57 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$825.57 |
$825.57 |
$825.57 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$448.12 |
$448.12 |
$448.12 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$265.77 |
$265.77 |
$265.77 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$11,892.11 |
$11,892.11 |
$11,892.11 |
$13,419.80
|
|
Ivc venogram s&i
|
$3,713.26 |
$3,713.26 |
$3,713.26 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$1,523.43 |
$1,523.43 |
$1,523.43 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$615.97 |
$615.97 |
$615.97 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$256.67 |
$256.67 |
$256.67 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,179.66 |
$1,179.66 |
$1,179.66 |
$460.85
|
|
Jak2 targeted sequence analysis
|
$1,365.60 |
$1,365.60 |
$1,365.60 |
$378.30
|
|
John cunningham antibody
|
$199.17 |
$199.17 |
$199.17 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$158.86 |
$158.86 |
$158.86 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$209.74 |
$209.74 |
$209.74 |
$30.08
|
|
Kidney img w/bldflw sgl without rx
|
$2,490.88 |
$2,490.88 |
$2,490.88 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,362.97 |
$2,362.97 |
$2,362.97 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$6,478.49 |
$6,478.49 |
$6,478.49 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$5,346.98 |
$5,346.98 |
$5,346.98 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$5,932.19 |
$5,932.19 |
$5,932.19 |
$2,181.10
|
|
Knee X-ray
|
$464.39 |
$464.39 |
$464.39 |
$443.90
|
|
Kras gene addl variants
|
$1,481.96 |
$1,481.96 |
$1,481.96 |
$346.45
|
|
Kras gene variants exon 2
|
$2,415.63 |
$2,415.63 |
$2,415.63 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$447.63 |
$447.63 |
$447.63 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$377.64 |
$377.64 |
$377.64 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$174.21 |
$174.21 |
$174.21 |
$53.30
|
|
Lactated ringers intravenous solution
|
$369.83 |
$369.83 |
$369.83 |
$54.11
|
|
Lactic acid
|
$333.13 |
$333.13 |
$333.13 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$88.99 |
$88.99 |
$88.99 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$77,840.18 |
$77,840.18 |
$77,840.18 |
$22,903.90
|
|
Lead capillary
|
$121.03 |
$121.03 |
$121.03 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$3,031.96 |
$3,031.96 |
$3,031.96 |
$1,100.74
|