|
Irradiation of blood product each unit reference
|
$241.02 |
$241.02 |
$241.02 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$329.16 |
$329.16 |
$329.16 |
$146.11
|
|
Ivc venogram s&i
|
$1,994.85 |
$1,994.85 |
$1,994.85 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$110.76 |
$110.76 |
$110.76 |
$133.90
|
|
IV Fluids (first hour)
|
$427.05 |
$427.05 |
$427.05 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$427.05 |
$427.05 |
$427.05 |
$162.68
|
|
IV inj ra drug dx study
|
$281.19 |
$281.19 |
$281.19 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$427.05 |
$427.05 |
$427.05 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$106.47 |
$106.47 |
$106.47 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$427.05 |
$427.05 |
$427.05 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$191.88 |
$191.88 |
$191.88 |
$167.50
|
|
IV Push Injection (first drug)
|
$306.54 |
$306.54 |
$306.54 |
$252.76
|
|
Ivp w/nephrotomography
|
$862.29 |
$862.29 |
$862.29 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$645.84 |
$645.84 |
$645.84 |
$713.40
|
|
Jak2 targeted sequence analysis
|
$601.77 |
$601.77 |
$601.77 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$271.44 |
$271.44 |
$271.44 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$384.93 |
$384.93 |
$384.93 |
$362.05
|
|
John cunningham antibody
|
$1,727.70 |
$1,727.70 |
$1,727.70 |
$78.00
|
|
Ketogenic steroids fract
|
$81.12 |
$81.12 |
$81.12 |
$82.80
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$178.62 |
$178.62 |
$178.62 |
$58.56
|
|
Kidney imaging morphology
|
$553.80 |
$553.80 |
$553.80 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$824.46 |
$824.46 |
$824.46 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$618.54 |
$618.54 |
$618.54 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$290.16 |
$290.16 |
$290.16 |
$490.75
|
|
Kit case 4.2mm spinejack
|
$7,751.14 |
$7,751.14 |
$7,751.14 |
$7,177.60
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$8,081.88 |
$8,081.88 |
$8,081.88 |
$9,423.50
|
|
Kit gene analys d816 variant
|
$170.43 |
$170.43 |
$170.43 |
$374.61
|
|
Kit hfx iq ipg bundle
|
$42,421.35 |
$42,421.35 |
$42,421.35 |
$33,859.00
|
|
Kit ipg optimizer smart
|
$49,011.18 |
$49,011.18 |
$49,011.18 |
$49,011.18
|
|
Kit lead specify 5-6-5
|
$16,965.41 |
$16,965.41 |
$16,965.41 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,340.86 |
$1,340.86 |
$1,340.86 |
$1,635.87
|
|
Kit sound processor cochlear osia 2
|
$16,851.58 |
$16,851.58 |
$16,851.58 |
$8,425.00
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,638.82 |
$1,638.82 |
$1,638.82 |
$2,254.50
|
|
Knee MRI (with and without contrast)
|
$2,072.46 |
$2,072.46 |
$2,072.46 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$1,900.86 |
$1,900.86 |
$1,900.86 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,549.08 |
$1,549.08 |
$1,549.08 |
$2,130.88
|
|
Knee X-ray
|
$273.00 |
$273.00 |
$273.00 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$173.55 |
$173.55 |
$173.55 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$269.88 |
$269.88 |
$269.88 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$201.63 |
$201.63 |
$201.63 |
$251.20
|
|
Kras gene addl variants
|
$799.50 |
$799.50 |
$799.50 |
$387.20
|
|
Kras gene variants exon 2
|
$598.65 |
$598.65 |
$598.65 |
$536.20
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$125.97 |
$125.97 |
$125.97 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$23.01 |
$23.01 |
$23.01 |
$70.20
|
|
Lactate dehydrogenase (ldh)
|
$95.16 |
$95.16 |
$95.16 |
$55.50
|
|
Lactation class
|
$176.67 |
$176.67 |
$176.67 |
$104.96
|
|
Lactic acid
|
$149.37 |
$149.37 |
$149.37 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$114.27 |
$114.27 |
$114.27 |
$82.16
|
|
Lactoferrin fecal quant
|
$169.26 |
$169.26 |
$169.26 |
$108.93
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$905.19 |
$905.19 |
$905.19 |
$740.40
|
|
Largsc w/laser dstrj les
|
$4,240.08 |
$4,240.08 |
$4,240.08 |
$4,931.00
|
|
Largsc w/njx augmentation
|
$577.98 |
$577.98 |
$577.98 |
$3,288.75
|
|
Largsc w/rmvl foreign bdy(s)
|
$2,006.94 |
$2,006.94 |
$2,006.94 |
$765.97
|
|
Largsc w/ther injection
|
$789.36 |
$789.36 |
$789.36 |
$2,447.43
|
|
Laryngeal function studies
|
$708.63 |
$708.63 |
$708.63 |
$342.60
|
|
Laryngoscope w/vc inj
|
$925.47 |
$925.47 |
$925.47 |
$4,108.00
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$3,735.81 |
$3,735.81 |
$3,735.81 |
$2,514.60
|
|
Laryngoscopy telescopic
|
$1,844.31 |
$1,844.31 |
$1,844.31 |
$852.80
|
|
Laryngoscopy w/biopsy
|
$4,188.60 |
$4,188.60 |
$4,188.60 |
$4,362.99
|
|
Laryngoscopy w/fb removal
|
$4,802.46 |
$4,802.46 |
$4,802.46 |
$2,854.09
|
|
Laryngoscopy with biopsy
|
$2,340.78 |
$2,340.78 |
$2,340.78 |
$3,297.83
|
|
Lead acuity x4 spiral l 86cm
|
$5,617.19 |
$5,617.19 |
$5,617.19 |
$5,460.00
|
|
Lead capillary
|
$114.27 |
$114.27 |
$114.27 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$3,047.96 |
$3,047.96 |
$3,047.96 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$5,723.76 |
$5,723.76 |
$5,723.76 |
$8,202.66
|
|
Leg Artery Ultrasound (complete, both legs)
|
$708.63 |
$708.63 |
$708.63 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,269.45 |
$1,269.45 |
$1,269.45 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,167.27 |
$1,167.27 |
$1,167.27 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$984.75 |
$984.75 |
$984.75 |
$1,092.58
|
|
Leishmania antibody
|
$58.50 |
$58.50 |
$58.50 |
$58.50
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$200.91 |
$200.91 |
$200.91 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$977.16 |
$977.16 |
$977.16 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$683.72 |
$683.72 |
$683.72 |
$377.71
|
|
Leukocyte phagocytosis
|
$218.40 |
$218.40 |
$218.40 |
$80.64
|
|
Levetiracetam therapeutic drug level
|
$155.61 |
$155.61 |
$155.61 |
$88.92
|
|
L hrt cath chd nm/abn nt cnj
|
$4,048.20 |
$4,048.20 |
$4,048.20 |
$6,104.00
|
|
Liberta rc ipg
|
$65,883.98 |
$65,883.98 |
$65,883.98 |
$39,189.70
|
|
Lidocaine therapeutic drug level
|
$112.71 |
$112.71 |
$112.71 |
$87.45
|
|
Ligation/biopsy of temporal artery 37609
|
$5,706.09 |
$5,706.09 |
$5,706.09 |
$3,322.80
|
|
Lig/band angioaccess av fistula
|
$2,246.40 |
$2,246.40 |
$2,246.40 |
$4,676.50
|
|
Limited visual field xm
|
$73.32 |
$73.32 |
$73.32 |
$79.20
|
|
Lipase
|
$143.13 |
$143.13 |
$143.13 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$143.13 |
$143.13 |
$143.13 |
$87.00
|
|
Lipoprotein blood quant
|
$198.51 |
$198.51 |
$198.51 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$90.48 |
$90.48 |
$90.48 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$96.72 |
$96.72 |
$96.72 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$83.85 |
$83.85 |
$83.85 |
$47.18
|
|
Listeria monocytogenes
|
$60.84 |
$60.84 |
$60.84 |
$100.40
|
|
Lithium therapeutic drug level
|
$69.42 |
$69.42 |
$69.42 |
$69.75
|
|
Lithotripsy transluminal coronary percutaneous
|
$4,371.12 |
$4,371.12 |
$4,371.12 |
$4,371.12
|
|
Liver elastography 91200
|
$258.18 |
$258.18 |
$258.18 |
$285.18
|
|
Liver Function Test
|
$115.44 |
$115.44 |
$115.44 |
$115.44
|
|
Liver imaging
|
$453.96 |
$453.96 |
$453.96 |
$1,109.00
|
|
Liver imag w/vasclr flow
|
$904.41 |
$904.41 |
$904.41 |
$1,227.60
|
|
Liver/spleen imag static only
|
$638.43 |
$638.43 |
$638.43 |
$1,138.55
|
|
Liver/spleen imag w/vasclr flow
|
$727.35 |
$727.35 |
$727.35 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$171.60 |
$171.60 |
$171.60 |
$49.70
|
|
Low cost skin substitute app
|
$1,533.48 |
$1,533.48 |
$1,533.48 |
$933.60
|
|
Low cost skin substitute app
|
$1,533.48 |
$1,533.48 |
$1,533.48 |
$2,164.64
|
|
Low cost skin substitute app
|
$1,533.48 |
$1,533.48 |
$1,533.48 |
$1,012.00
|
