|
Inj peritoneal venous shunt
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$413.70
|
|
Inj proc ankle arthr
|
$418.80 |
$418.80 |
$418.80 |
$405.60
|
|
Inj proc elbow arthro
|
$984.00 |
$984.00 |
$984.00 |
$438.00
|
|
Inj proc myelogram lumbar
|
$1,203.60 |
$1,203.60 |
$1,203.60 |
$859.98
|
|
Inj prohance multipack
|
$13.80 |
$13.80 |
$13.80 |
$9.60
|
|
Inj retro urethrocysto
|
$1,325.40 |
$1,325.40 |
$1,325.40 |
$450.00
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$633.60 |
$633.60 |
$633.60 |
$436.80
|
|
Inj w/fluor eval cv device
|
$624.00 |
$624.00 |
$624.00 |
$504.40
|
|
Insert and remove bone pin
|
$2,812.20 |
$2,812.20 |
$2,812.20 |
$4,421.00
|
|
Insert heyman uteri capsule
|
$1,187.40 |
$1,187.40 |
$1,187.40 |
$5,841.60
|
|
Insert intrauterine device iud
|
$131.40 |
$131.40 |
$131.40 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$199.20 |
$199.20 |
$199.20 |
$207.00
|
|
Insertion catheter bladder temporary simple
|
$199.20 |
$199.20 |
$199.20 |
$234.40
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,187.60 |
$2,187.60 |
$2,187.60 |
$2,523.30
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$6,538.20 |
$6,538.20 |
$6,538.20 |
$12,843.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$6,538.20 |
$6,538.20 |
$6,538.20 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,865.40 |
$1,865.40 |
$1,865.40 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,083.80 |
$2,083.80 |
$2,083.80 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$20,305.80 |
$20,305.80 |
$20,305.80 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,241.00 |
$5,241.00 |
$5,241.00 |
$7,388.80
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,167.80 |
$5,167.80 |
$5,167.80 |
$7,447.01
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,449.20 |
$8,449.20 |
$8,449.20 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,189.00 |
$3,189.00 |
$3,189.00 |
$5,236.80
|
|
Insert pessary/other device
|
$205.80 |
$205.80 |
$205.80 |
$275.80
|
|
Insert pm/icd lead dual
|
$5,167.80 |
$5,167.80 |
$5,167.80 |
$7,312.80
|
|
Insert tunneled cv cath
|
$2,716.80 |
$2,716.80 |
$2,716.80 |
$4,350.11
|
|
Insert uteri tandem/ovoids
|
$747.60 |
$747.60 |
$747.60 |
$3,940.41
|
|
Ins icd gen exist sgl lead
|
$14,535.60 |
$14,535.60 |
$14,535.60 |
$23,742.75
|
|
Insitu hybridization auto
|
$603.00 |
$603.00 |
$603.00 |
$377.37
|
|
Insitu hybridization (fish)
|
$553.20 |
$553.20 |
$553.20 |
$481.60
|
|
Insitu hybridization manual
|
$532.20 |
$532.20 |
$532.20 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$529.20 |
$529.20 |
$529.20 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$476.40 |
$476.40 |
$476.40 |
$337.20
|
|
Ins mark abd/pel for right perq
|
$841.20 |
$841.20 |
$841.20 |
$2,414.36
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,179.60 |
$1,179.60 |
$1,179.60 |
$1,609.25
|
|
Instillation anticarcinogenic agent bladder
|
$457.80 |
$457.80 |
$457.80 |
$653.25
|
|
Ins tun cv cath wo subq prt/pm
|
$3,697.80 |
$3,697.80 |
$3,697.80 |
$4,218.00
|
|
Insulin total
|
$74.40 |
$74.40 |
$74.40 |
$66.64
|
|
Ins vag brachytx device
|
$393.60 |
$393.60 |
$393.60 |
$909.35
|
|
Interdental fixation
|
$1,783.20 |
$1,783.20 |
$1,783.20 |
$2,133.48
|
|
Interstitial brachy inter
|
$2,436.60 |
$2,436.60 |
$2,436.60 |
$1,194.42
|
|
Intrapul surf admin endo tube
|
$137.40 |
$137.40 |
$137.40 |
$222.28
|
|
Intrinsic factor antibody
|
$101.40 |
$101.40 |
$101.40 |
$64.20
|
|
Intro cath dialysis circuit
|
$5,362.80 |
$5,362.80 |
$5,362.80 |
$2,043.30
|
|
Intro cath dialysis circuit w/pta
|
$13,668.00 |
$13,668.00 |
$13,668.00 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$19,667.40 |
$19,667.40 |
$19,667.40 |
$15,640.00
|
|
Intro cath svc/ivc
|
$1,098.60 |
$1,098.60 |
$1,098.60 |
$1,346.13
|
|
Intro long gi tube w/mult fluo
|
$73.20 |
$73.20 |
$73.20 |
$457.60
|
|
Intubation endotracheal emergency procedure
|
$598.80 |
$598.80 |
$598.80 |
$600.00
|
|
Ionm in operatng room 15 min
|
$235.80 |
$235.80 |
$235.80 |
$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
|
$8.40 |
$8.40 |
$8.40 |
$288.11
|
|
Ip/obs cnsltj new/est low 45
|
$334.20 |
$334.20 |
$334.20 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$535.20 |
$535.20 |
$535.20 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$741.00 |
$741.00 |
$741.00 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$334.20 |
$334.20 |
$334.20 |
$134.46
|
|
Iron
|
$130.20 |
$130.20 |
$130.20 |
$75.26
|
|
Iron binding capacity
|
$166.20 |
$166.20 |
$166.20 |
$63.84
|
|
Irrigation implantable venous access device for drug delivery systems
|
$288.60 |
$288.60 |
$288.60 |
$143.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$219.00 |
$219.00 |
$219.00 |
$192.40
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$203.40 |
$203.40 |
$203.40 |
$160.05
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$201.60 |
$201.60 |
$201.60 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$480.00 |
$480.00 |
$480.00 |
$444.49
|
|
Ivp w/wo kub w/wo tomography
|
$793.20 |
$793.20 |
$793.20 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$113.40 |
$113.40 |
$113.40 |
$60.50
|
|
Kidney imaging morphology
|
$920.40 |
$920.40 |
$920.40 |
$817.60
|
|
Kidney imag w/bld flow multi
|
$2,252.40 |
$2,252.40 |
$2,252.40 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,755.60 |
$1,755.60 |
$1,755.60 |
$1,442.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$973.20 |
$973.20 |
$973.20 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$585.60 |
$585.60 |
$585.60 |
$185.30
|
|
Kit gene analys d816 variant
|
$1,528.80 |
$1,528.80 |
$1,528.80 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$5,722.20 |
$5,722.20 |
$5,722.20 |
$3,021.20
|
|
Knee MRI (with contrast)
|
$5,509.20 |
$5,509.20 |
$5,509.20 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$4,233.00 |
$4,233.00 |
$4,233.00 |
$2,159.09
|
|
Knee orth pos locking joint
|
$585.60 |
$585.60 |
$585.60 |
$585.60
|
|
Knee X-ray
|
$580.80 |
$580.80 |
$580.80 |
$433.50
|
|
Kras gene addl variants
|
$735.60 |
$735.60 |
$735.60 |
$386.75
|
|
Kras gene variants exon 2
|
$1,073.40 |
$1,073.40 |
$1,073.40 |
$500.13
|
|
Lactate dehydrogenase (ldh)
|
$111.60 |
$111.60 |
$111.60 |
$55.50
|
|
Lactic acid
|
$271.80 |
$271.80 |
$271.80 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$184.20 |
$184.20 |
$184.20 |
$81.25
|
|
Laryngeal function studies
|
$225.60 |
$225.60 |
$225.60 |
$335.40
|
|
Lead capillary
|
$162.60 |
$162.60 |
$162.60 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,713.60 |
$1,713.60 |
$1,713.60 |
$1,092.58
|
|
Levetiracetam therapeutic drug level
|
$177.60 |
$177.60 |
$177.60 |
$84.40
|
|
Lidocaine therapeutic drug level
|
$126.00 |
$126.00 |
$126.00 |
$90.47
|
|
Lift heel adj small gl60404sm
|
$85.20 |
$85.20 |
$85.20 |
$146.52
|
|
Limited ankle motion ea jnt
|
$585.60 |
$585.60 |
$585.60 |
$111.30
|
|
Lipase
|
$229.80 |
$229.80 |
$229.80 |
$93.58
|
|
Lipoprotein blood quant
|
$208.80 |
$208.80 |
$208.80 |
$101.14
|
|
Lipoprotein direct measurement hdl
|
$149.40 |
$149.40 |
$149.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$85.80 |
$85.80 |
$85.80 |
$61.60
|
|
Lithium therapeutic drug level
|
$133.20 |
$133.20 |
$133.20 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$612.00 |
$612.00 |
$612.00 |
$361.10
|
|
Liver Function Test
|
$201.60 |
$201.60 |
$201.60 |
$115.44
|
|
Liver/spleen imag static only
|
$1,156.20 |
$1,156.20 |
$1,156.20 |
$1,140.78
|
|
Locm 100-199mg/ml iodine,1ml
|
$13.20 |
$13.20 |
$13.20 |
$44.91
|
|
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)
|
$3,219.00 |
$3,219.00 |
$3,219.00 |
$1,937.91
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,994.60 |
$2,994.60 |
$2,994.60 |
$1,828.00
|