|
Insitu hybridization manual
|
$731.40 |
$731.40 |
$731.40 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$740.40 |
$740.40 |
$740.40 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$470.40 |
$470.40 |
$470.40 |
$326.04
|
|
Ins lv lead exist pm/icd
|
$10,154.40 |
$10,154.40 |
$10,154.40 |
$12,087.24
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,734.00 |
$1,734.00 |
$1,734.00 |
$1,609.25
|
|
Ins pm gen exist dual lead
|
$9,274.80 |
$9,274.80 |
$9,274.80 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$7,251.60 |
$7,251.60 |
$7,251.60 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$7,857.60 |
$7,857.60 |
$7,857.60 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$29,049.00 |
$29,049.00 |
$29,049.00 |
$23,369.00
|
|
Ins/rpl pm gen exist dual lead
|
$6,593.40 |
$6,593.40 |
$6,593.40 |
$11,408.40
|
|
Ins/rpl pm gen exist sgl lead
|
$6,640.80 |
$6,640.80 |
$6,640.80 |
$9,558.78
|
|
Ins/rpl pm w/tv ld atrl
|
$10,154.40 |
$10,154.40 |
$10,154.40 |
$12,371.40
|
|
Instillation anticarcinogenic agent bladder
|
$442.80 |
$442.80 |
$442.80 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$5,681.40 |
$5,681.40 |
$5,681.40 |
$4,202.70
|
|
Ins tun intraperit dia cath
|
$2,828.40 |
$2,828.40 |
$2,828.40 |
$4,657.46
|
|
Insulin total
|
$73.20 |
$73.20 |
$73.20 |
$66.64
|
|
Interdental fixation
|
$1,760.40 |
$1,760.40 |
$1,760.40 |
$2,162.05
|
|
Interdiscal perq aspir dx
|
$1,687.80 |
$1,687.80 |
$1,687.80 |
$1,180.84
|
|
Interrogate subq defib
|
$106.80 |
$106.80 |
$106.80 |
$125.76
|
|
Interrog dev eval scrms ip
|
$148.80 |
$148.80 |
$148.80 |
$124.80
|
|
Interrog device eval heart
|
$244.20 |
$244.20 |
$244.20 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$148.80 |
$148.80 |
$148.80 |
$124.80
|
|
Intra-atrial pacing
|
$2,665.20 |
$2,665.20 |
$2,665.20 |
$4,683.25
|
|
Intra-atrial recording
|
$2,723.40 |
$2,723.40 |
$2,723.40 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$5,200.80 |
$5,200.80 |
$5,200.80 |
$3,429.40
|
|
Intrapul surf admin endo tube
|
$147.00 |
$147.00 |
$147.00 |
$220.80
|
|
Intraventricular pacing
|
$2,665.20 |
$2,665.20 |
$2,665.20 |
$5,609.50
|
|
Intrinsic factor antibody
|
$191.40 |
$191.40 |
$191.40 |
$66.60
|
|
Intro cath dialysis circuit
|
$12,679.80 |
$12,679.80 |
$12,679.80 |
$2,035.00
|
|
Intro cath dialysis circuit w/pta
|
$27,252.00 |
$27,252.00 |
$27,252.00 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$52,693.80 |
$52,693.80 |
$52,693.80 |
$15,805.00
|
|
Intro catheter aorta
|
$1,856.40 |
$1,856.40 |
$1,856.40 |
$1,654.05
|
|
Intro cath svc/ivc
|
$1,183.80 |
$1,183.80 |
$1,183.80 |
$1,329.90
|
|
Intro long gi tube
|
$2,308.20 |
$2,308.20 |
$2,308.20 |
$990.00
|
|
Intro long gi tube w/mult fluo
|
$255.60 |
$255.60 |
$255.60 |
$449.40
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,274.20 |
$3,274.20 |
$3,274.20 |
$3,303.76
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,263.80 |
$2,263.80 |
$2,263.80 |
$1,633.03
|
|
Intubation endotracheal emergency procedure
|
$625.20 |
$625.20 |
$625.20 |
$589.60
|
|
Ionm in operatng room 15 min
|
$232.80 |
$232.80 |
$232.80 |
$191.40
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$279.10
|
|
Iron
|
$127.20 |
$127.20 |
$127.20 |
$74.40
|
|
Iron binding capacity
|
$118.80 |
$118.80 |
$118.80 |
$63.79
|
|
Irradiation of blood product each unit reference
|
$87.00 |
$87.00 |
$87.00 |
$119.83
|
|
Irrigation implantable venous access device for drug delivery systems
|
$285.00 |
$285.00 |
$285.00 |
$142.20
|
|
Ivc venogram s&i
|
$3,962.40 |
$3,962.40 |
$3,962.40 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$400.20 |
$400.20 |
$400.20 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$200.40 |
$200.40 |
$200.40 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$425.40 |
$425.40 |
$425.40 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,008.60 |
$1,008.60 |
$1,008.60 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$783.60 |
$783.60 |
$783.60 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$131.40 |
$131.40 |
$131.40 |
$60.20
|
|
Kidney imag w/bld flow multi
|
$2,223.60 |
$2,223.60 |
$2,223.60 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,733.40 |
$1,733.40 |
$1,733.40 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$961.20 |
$961.20 |
$961.20 |
$666.00
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$585.60 |
$585.60 |
$585.60 |
$104.52
|
|
Kit gene analys d816 variant
|
$1,476.00 |
$1,476.00 |
$1,476.00 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$7,381.20 |
$7,381.20 |
$7,381.20 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$7,381.20 |
$7,381.20 |
$7,381.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$7,156.80 |
$7,156.80 |
$7,156.80 |
$2,169.60
|
|
Knee orth pos locking joint
|
$585.60 |
$585.60 |
$585.60 |
$585.60
|
|
Knee X-ray
|
$982.20 |
$982.20 |
$982.20 |
$425.55
|
|
Kras gene addl variants
|
$817.80 |
$817.80 |
$817.80 |
$384.80
|
|
Kras gene variants exon 2
|
$1,053.60 |
$1,053.60 |
$1,053.60 |
$486.45
|
|
Lactate dehydrogenase (ldh)
|
$111.60 |
$111.60 |
$111.60 |
$55.50
|
|
Lactic acid
|
$291.60 |
$291.60 |
$291.60 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$61.20 |
$61.20 |
$61.20 |
$80.40
|
|
Largsc w/rmvl foreign bdy(s)
|
$246.60 |
$246.60 |
$246.60 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$3,756.00 |
$3,756.00 |
$3,756.00 |
$2,480.71
|
|
Lead capillary
|
$174.60 |
$174.60 |
$174.60 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$1,088.26
|
|
Levetiracetam therapeutic drug level
|
$187.20 |
$187.20 |
$187.20 |
$88.92
|
|
L hrt cath chd nm/abn nt cnj
|
$7,090.80 |
$7,090.80 |
$7,090.80 |
$6,104.00
|
|
Lidocaine therapeutic drug level
|
$151.80 |
$151.80 |
$151.80 |
$89.70
|
|
Lift heel adj small gl60404sm
|
$85.20 |
$85.20 |
$85.20 |
$148.39
|
|
Ligation/major artery/extremity 37618
|
$2,981.40 |
$2,981.40 |
$2,981.40 |
$1,525.00
|
|
Limited ankle motion ea jnt
|
$585.60 |
$585.60 |
$585.60 |
$123.05
|
|
Lipase
|
$226.80 |
$226.80 |
$226.80 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$153.00 |
$153.00 |
$153.00 |
$90.35
|
|
Lipoprotein blood quant
|
$228.00 |
$228.00 |
$228.00 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$138.00 |
$138.00 |
$138.00 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$82.80 |
$82.80 |
$82.80 |
$61.60
|
|
Lithium therapeutic drug level
|
$130.80 |
$130.80 |
$130.80 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$612.00 |
$612.00 |
$612.00 |
$340.00
|
|
Liver Function Test
|
$306.60 |
$306.60 |
$306.60 |
$115.44
|
|
Liver imag w/vasclr flow
|
$937.20 |
$937.20 |
$937.20 |
$1,238.65
|
|
Liver/spleen imag static only
|
$1,141.80 |
$1,141.80 |
$1,141.80 |
$1,123.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$6.00 |
$6.00 |
$6.00 |
$45.90
|
|
Lo sag rig pnl stays pre cst
|
$85.20 |
$85.20 |
$85.20 |
$167.74
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$3,577.20 |
$3,577.20 |
$3,577.20 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$4,771.20 |
$4,771.20 |
$4,771.20 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$415.80 |
$415.80 |
$415.80 |
$352.32
|
|
Low frequency non-thermal Ultrasound
|
$414.60 |
$414.60 |
$414.60 |
$364.00
|
|
L/s ratio fetal lung
|
$322.80 |
$322.80 |
$322.80 |
$176.15
|
|
Lung function test (mbc/mvv)
|
$119.40 |
$119.40 |
$119.40 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$359.40 |
$359.40 |
$359.40 |
$295.35
|
