|
Inj triamcinolone ace X-ray 1mg
|
$503.26 |
$503.26 |
$503.26 |
$17.75
|
|
Inj, vancomycin hcl (mylan)
|
$185.44 |
$185.44 |
$185.44 |
$63.82
|
|
Inj, vegzelma, 10 mg
|
$214.70 |
$214.70 |
$214.70 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$125.00 |
$125.00 |
$125.00 |
$588.90
|
|
Inj xipere 1 mg
|
$1,405.30 |
$1,405.30 |
$1,405.30 |
$48.40
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$17,281.68 |
$17,281.68 |
$17,281.68 |
$3,429.94
|
|
Ins cath ren art 1st bi
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$1,537.50 |
$1,537.50 |
$1,537.50 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$162.50 |
$162.50 |
$162.50 |
$544.00
|
|
Insert cath pleura with image
|
$625.00 |
$625.00 |
$625.00 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$62.50 |
$62.50 |
$62.50 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$62.50 |
$62.50 |
$62.50 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,000.00 |
$1,000.00 |
$1,000.00 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$2,618.40
|
|
Insertion of catheter vein
|
$198.75 |
$198.75 |
$198.75 |
$1,749.80
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,750.00 |
$5,750.00 |
$5,750.00 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,750.00 |
$5,750.00 |
$5,750.00 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$5,500.00 |
$5,500.00 |
$5,500.00 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$625.00 |
$625.00 |
$625.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$625.00 |
$625.00 |
$625.00 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$11,875.00 |
$11,875.00 |
$11,875.00 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$3,250.00 |
$3,250.00 |
$3,250.00 |
$7,572.47
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$4,000.00 |
$4,000.00 |
$4,000.00 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$3,250.00 |
$3,250.00 |
$3,250.00 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$11,875.00 |
$11,875.00 |
$11,875.00 |
$33,948.20
|
|
Insert swan-ganz cath
|
$625.00 |
$625.00 |
$625.00 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$4,705.13
|
|
Insert tunneled cv cath
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$4,520.00
|
|
Insert uteri tandem/ovoids
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$3,986.00
|
|
Insert vad art access left hrt arterial access
|
$2,000.00 |
$2,000.00 |
$2,000.00 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$10,000.00 |
$10,000.00 |
$10,000.00 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$9,150.00 |
$9,150.00 |
$9,150.00 |
$24,159.72
|
|
In situ hybridization per specimen each additional single probe stain
|
$81.25 |
$81.25 |
$81.25 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$81.25 |
$81.25 |
$81.25 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$4,341.66
|
|
Ins pm gen w/exist mlt leads
|
$5,775.00 |
$5,775.00 |
$5,775.00 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$8,750.00 |
$8,750.00 |
$8,750.00 |
$24,135.54
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$7,500.00 |
$7,500.00 |
$7,500.00 |
$25,106.90
|
|
Inst fibrinolysis agent ini day
|
$375.00 |
$375.00 |
$375.00 |
$1,095.00
|
|
Insti hexaminolevulinate hcl
|
$927.68 |
$927.68 |
$927.68 |
$2,359.80
|
|
Instillation anticarcinogenic agent bladder
|
$400.00 |
$400.00 |
$400.00 |
$721.50
|
|
Instill, bupivac and meloxic
|
$46.67 |
$46.67 |
$46.67 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$2,737.50 |
$2,737.50 |
$2,737.50 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$1,750.00 |
$1,750.00 |
$1,750.00 |
$4,657.46
|
|
Insulin total
|
$35.00 |
$35.00 |
$35.00 |
$67.60
|
|
Interdiscal perq aspir dx
|
$557.50 |
$557.50 |
$557.50 |
$1,222.26
|
|
Interferon alfa-2b inj
|
$443.30 |
$443.30 |
$443.30 |
$494.64
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$3,853.81 |
$3,853.81 |
$3,853.81 |
$3,853.81
|
|
Intracard echo interv w/s&i
|
$1,450.00 |
$1,450.00 |
$1,450.00 |
$3,982.59
|
|
Intrinsic factor antibody
|
$26.25 |
$26.25 |
$26.25 |
$59.95
|
|
Intro cath dialysis circuit
|
$625.00 |
$625.00 |
$625.00 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$3,750.00 |
$3,750.00 |
$3,750.00 |
$15,625.00
|
|
Intro catheter aorta
|
$200.00 |
$200.00 |
$200.00 |
$1,861.61
|
|
Intro cath svc/ivc
|
$200.00 |
$200.00 |
$200.00 |
$1,350.75
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$875.00 |
$875.00 |
$875.00 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$375.00 |
$375.00 |
$375.00 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$130.00 |
$130.00 |
$130.00 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$10.93 |
$10.93 |
$10.93 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$13.40 |
$13.40 |
$13.40 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$1,133.96 |
$1,133.96 |
$1,133.96 |
$52,615.16
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$58.25 |
$58.25 |
$58.25 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$427.28 |
$427.28 |
$427.28 |
$6,655.71
|
|
Iron
|
$31.25 |
$31.25 |
$31.25 |
$70.72
|
|
Iron binding capacity
|
$40.00 |
$40.00 |
$40.00 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$40.12 |
$40.12 |
$40.12 |
$62.70
|
|
Iron stain peripheral blood
|
$6.00 |
$6.00 |
$6.00 |
$17.60
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$44.77 |
$44.77 |
$44.77 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$27.50 |
$27.50 |
$27.50 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$50.00 |
$50.00 |
$50.00 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$258.15 |
$258.15 |
$258.15 |
$13,419.80
|
|
Ivc venogram s&i
|
$1,875.00 |
$1,875.00 |
$1,875.00 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$62.50 |
$62.50 |
$62.50 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$43.75 |
$43.75 |
$43.75 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$93.75 |
$93.75 |
$93.75 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$190.00 |
$190.00 |
$190.00 |
$460.85
|
|
Ixabepilone 15 mg intravenous solution
|
$4,460.19 |
$4,460.19 |
$4,460.19 |
$7,216.15
|
|
Jak2 targeted sequence analysis
|
$100.00 |
$100.00 |
$100.00 |
$378.30
|
|
John cunningham antibody
|
$20.00 |
$20.00 |
$20.00 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$25.00 |
$25.00 |
$25.00 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$25.09 |
$25.09 |
$25.09 |
$30.08
|
|
Kidney imag w/bld flow multi
|
$575.00 |
$575.00 |
$575.00 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$575.00 |
$575.00 |
$575.00 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$350.00 |
$350.00 |
$350.00 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$100.00 |
$100.00 |
$100.00 |
$100.00
|
|
Kit sound processor cochlear osia 2
|
$4,210.75 |
$4,210.75 |
$4,210.75 |
$10,444.90
|
|
Knee MRI (with and without contrast)
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,050.00 |
$1,050.00 |
$1,050.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$950.00 |
$950.00 |
$950.00 |
$2,181.10
|
|
Knee X-ray
|
$162.50 |
$162.50 |
$162.50 |
$443.90
|
|
Kyleena, 19.5 mg
|
$330.11 |
$330.11 |
$330.11 |
$2,618.91
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$25.05 |
$25.05 |
$25.05 |
$188.92
|
