|
Insti hexaminolevulinate hcl
|
$2,356.80 |
$2,356.80 |
$2,356.80 |
$2,356.80
|
|
Ins tun cv cath wo subq prt/pm
|
$5,600.40 |
$5,600.40 |
$5,600.40 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$5,600.40 |
$5,600.40 |
$5,600.40 |
$4,314.75
|
|
Insulin total
|
$85.80 |
$85.80 |
$85.80 |
$72.15
|
|
Interdiscal perq aspir dx
|
$2,135.40 |
$2,135.40 |
$2,135.40 |
$1,222.26
|
|
Interferon alfa-2b inj
|
$51.21 |
$51.21 |
$51.21 |
$51.21
|
|
Interferon beta-1a inj
|
$12,503.22 |
$12,503.22 |
$12,503.22 |
$2,203.14
|
|
Intrinsic factor antibody
|
$183.60 |
$183.60 |
$183.60 |
$76.77
|
|
Intro long gi tube
|
$697.80 |
$697.80 |
$697.80 |
$880.75
|
|
Intro long gi tube w/mult fluo
|
$258.00 |
$258.00 |
$258.00 |
$469.00
|
|
Iodine i-123 sod iodide mil
|
$553.80 |
$553.80 |
$553.80 |
$650.00
|
|
Ionm in operatng room 15 min
|
$451.20 |
$451.20 |
$451.20 |
$238.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.63 |
$0.63 |
$0.63 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$145.52 |
$145.52 |
$145.52 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$261.10 |
$261.10 |
$261.10 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$188.06 |
$188.06 |
$188.06 |
$254.59
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$111.98 |
$111.98 |
$111.98 |
$111.98
|
|
Iron
|
$136.80 |
$136.80 |
$136.80 |
$67.50
|
|
Iron binding capacity
|
$33.00 |
$33.00 |
$33.00 |
$55.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$660.70 |
$660.70 |
$660.70 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$286.80 |
$286.80 |
$286.80 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$302.40 |
$302.40 |
$302.40 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$221.40 |
$221.40 |
$221.40 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$221.40 |
$221.40 |
$221.40 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$129.00 |
$129.00 |
$129.00 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$517.20 |
$517.20 |
$517.20 |
$476.50
|
|
IV inj ra drug dx study
|
$231.60 |
$231.60 |
$231.60 |
$473.22
|
|
Ivp w/wo kub w/wo tomography
|
$540.00 |
$540.00 |
$540.00 |
$687.80
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$197.51 |
$197.51 |
$189.96
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$217.80 |
$217.80 |
$217.80 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$165.89 |
$165.89 |
$165.89 |
$17.11
|
|
Kidney imaging morphology
|
$1,146.00 |
$1,146.00 |
$1,146.00 |
$693.60
|
|
Kidney imag w/bld flow multi
|
$2,606.40 |
$2,606.40 |
$2,606.40 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$2,014.20 |
$2,014.20 |
$2,014.20 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$319.20 |
$319.20 |
$319.20 |
$618.54
|
|
Kit sound processor cochlear osia 2
|
$8,303.40 |
$8,303.40 |
$8,303.40 |
$22,008.58
|
|
Knee MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$2,120.00
|
|
Knee X-ray
|
$523.20 |
$523.20 |
$523.20 |
$387.20
|
|
Kras gene addl variants
|
$415.80 |
$415.80 |
$415.80 |
$366.56
|
|
Kras gene variants exon 2
|
$411.60 |
$411.60 |
$411.60 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.65 |
$50.65 |
$50.65 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$196.60 |
$196.60 |
$196.60 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$101.40 |
$101.40 |
$101.40 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.68 |
$78.68 |
$78.68 |
$46.35
|
|
Lactic acid
|
$217.20 |
$217.20 |
$217.20 |
$85.20
|
|
Lactoferrin fecal quant
|
$228.00 |
$228.00 |
$228.00 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$14,343.00 |
$14,343.00 |
$21,470.76
|
|
Laryngeal function studies
|
$342.60 |
$342.60 |
$342.60 |
$335.40
|
|
Laryngoscopy telescopic
|
$2,383.20 |
$2,383.20 |
$2,383.20 |
$685.43
|
|
Lead capillary
|
$198.60 |
$198.60 |
$198.60 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,751.40 |
$1,751.40 |
$1,751.40 |
$1,053.00
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$310.43 |
$310.43 |
$310.43 |
$115.27
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$9,320.28 |
$9,320.28 |
$9,320.28 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$7,821.38 |
$7,821.38 |
$7,821.38 |
$4,308.91
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$20.15 |
$20.15
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$124.96 |
$124.96 |
$124.96 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$346.80 |
$346.80 |
$346.80 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$64.88 |
$64.88 |
$64.88 |
$43.61
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$665.44 |
$665.44 |
$665.44 |
$343.13
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$64.09 |
$64.09 |
$64.09 |
$25.89
|
|
Lidocaine therapeutic drug level
|
$204.00 |
$204.00 |
$204.00 |
$82.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$206.92 |
$206.92 |
$206.92 |
$84.28
|
|
Lipase
|
$174.60 |
$174.60 |
$174.60 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$60.60 |
$60.60 |
$60.60 |
$90.60
|
|
Lipoprotein blood quant
|
$303.60 |
$303.60 |
$303.60 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$195.00 |
$195.00 |
$195.00 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$170.40 |
$170.40 |
$170.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$189.60 |
$189.60 |
$189.60 |
$62.40
|
|
Liver Function Test
|
$241.20 |
$241.20 |
$241.20 |
$92.85
|
|
Liver imaging
|
$1,031.40 |
$1,031.40 |
$1,031.40 |
$827.28
|
|
Liver/spleen imag static only
|
$1,635.00 |
$1,635.00 |
$1,635.00 |
$1,135.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$2.57 |
$2.57 |
$2.57 |
$2.57
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$261.04 |
$261.04 |
$261.04 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,705.08
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$542.40 |
$542.40 |
$542.40 |
$1,450.15
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,631.85
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$582.60 |
$582.60 |
$582.60 |
$2,181.58
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$582.60 |
$582.60 |
$582.60 |
$1,791.60
|
|
Lower Back (Lumbar Spine) X-ray
|
$240.00 |
$240.00 |
$240.00 |
$328.23
|
|
Low frequency non-thermal Ultrasound
|
$233.40 |
$233.40 |
$233.40 |
$275.88
|
|
L/s ratio fetal lung
|
$82.80 |
$82.80 |
$82.80 |
$173.55
|
|
Lumbar diskogram s&i
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$2,358.23
|
|
Lung perfusion imaging
|
$1,709.40 |
$1,709.40 |
$1,709.40 |
$919.75
|
|
Lurbinectedin 4 mg intravenous solution
|
$298.13 |
$298.13 |
$298.13 |
$298.13
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$237.20 |
$237.20 |
$237.20 |
$68.76
|
|
Lymphatics/lymph node imaging
|
$2,593.80 |
$2,593.80 |
$2,593.80 |
$1,330.00
|
|
Lymphocytotoxicity assay
|
$408.00 |
$408.00 |
$408.00 |
$379.20
|
|
Macroscopic exam arthropod
|
$85.80 |
$85.80 |
$85.80 |
$38.50
|
|
Magnesium
|
$145.20 |
$145.20 |
$145.20 |
$64.80
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$118.81 |
$118.81 |
$118.81 |
$39.81
|
|
Magnetic image bone marrow
|
$582.60 |
$582.60 |
$582.60 |
$880.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$129.00 |
$129.00 |
$129.00 |
$129.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$142.20 |
$142.20 |
$142.20 |
$147.72
|
|
Mannitol 12.5 gm/50 ml inj
|
$40.12 |
$40.12 |
$40.12 |
$33.24
|
|
Manual diff wbc count b-coat
|
$75.60 |
$75.60 |
$75.60 |
$22.75
|
|
Marker biop eviva buckle ss
|
$2,700.60 |
$2,700.60 |
$2,700.60 |
$1,126.34
|
|
Mastoids complete
|
$390.00 |
$390.00 |
$390.00 |
$271.95
|