|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,612.00 |
$1,612.00 |
$1,612.00 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,268.50 |
$2,268.50 |
$2,268.50 |
$2,414.16
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$18,933.50 |
$18,933.50 |
$18,933.50 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$5,494.50 |
$5,494.50 |
$5,494.50 |
$7,216.00
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,613.00 |
$7,613.00 |
$7,613.00 |
$7,429.39
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$10,601.00 |
$10,601.00 |
$10,601.00 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,493.00 |
$6,493.00 |
$6,493.00 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$8,056.50 |
$8,056.50 |
$8,056.50 |
$7,264.40
|
|
Insert/repl sq defib w/eltrd
|
$30,373.50 |
$30,373.50 |
$30,373.50 |
$32,052.60
|
|
Insert uteri tandem/ovoids
|
$2,585.00 |
$2,585.00 |
$2,585.00 |
$3,905.20
|
|
Insert vad art access left hrt arterial access
|
$1,690.50 |
$1,690.50 |
$1,690.50 |
$4,386.00
|
|
Ins icd gen exist mlt leads
|
$8,303.50 |
$8,303.50 |
$8,303.50 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$7,958.00 |
$7,958.00 |
$7,958.00 |
$23,701.47
|
|
Insitu hybridization auto
|
$453.50 |
$453.50 |
$453.50 |
$386.10
|
|
Insitu hybridization manual
|
$284.00 |
$284.00 |
$284.00 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$148.50 |
$148.50 |
$148.50 |
$241.80
|
|
In situ hybridization per specimen initial single probe stain
|
$241.00 |
$241.00 |
$241.00 |
$337.20
|
|
Insj phrnc nrv stim sys
|
$32,972.50 |
$32,972.50 |
$32,972.50 |
$52,995.29
|
|
Ins lv lead exist pm/icd
|
$12,295.50 |
$12,295.50 |
$12,295.50 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$2,936.50 |
$2,936.50 |
$2,936.50 |
$2,393.43
|
|
Ins mark thor for right perq
|
$2,936.50 |
$2,936.50 |
$2,936.50 |
$2,477.45
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,925.50 |
$1,925.50 |
$1,925.50 |
$1,610.00
|
|
Ins pm gen exist dual lead
|
$8,303.50 |
$8,303.50 |
$8,303.50 |
$24,159.72
|
|
Ins pm gen w/exist mlt leads
|
$14,712.50 |
$14,712.50 |
$14,712.50 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$9,640.50 |
$9,640.50 |
$9,640.50 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$20,683.00 |
$20,683.00 |
$20,683.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$23,152.00 |
$23,152.00 |
$23,152.00 |
$11,408.40
|
|
Ins/rpl pm w/tv ld atrl
|
$13,246.00 |
$13,246.00 |
$13,246.00 |
$11,742.60
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$30,566.00 |
$30,566.00 |
$30,566.00 |
$25,106.90
|
|
Ins tun cv cath wo subq prt/pm
|
$5,950.50 |
$5,950.50 |
$5,950.50 |
$4,202.70
|
|
Insulin total
|
$63.50 |
$63.50 |
$63.50 |
$66.64
|
|
Ins vag brachytx device
|
$935.50 |
$935.50 |
$935.50 |
$927.55
|
|
Integra meshed bil wound mat
|
$9,924.16 |
$9,924.16 |
$9,924.16 |
$9,924.16
|
|
Interferon alfa-n3 inj
|
$661.02 |
$661.02 |
$661.02 |
$59.64
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$19,967.35 |
$19,967.35 |
$19,967.35 |
$10,427.90
|
|
Interferon beta-1b / .25 mg
|
$841.69 |
$841.69 |
$841.69 |
$1,662.71
|
|
Intracard echo interv w/s&i
|
$7,568.50 |
$7,568.50 |
$7,568.50 |
$3,436.00
|
|
Intracran angioplsty w/stent
|
$35,912.00 |
$35,912.00 |
$35,912.00 |
$8,257.80
|
|
Intracranial angioplasty
|
$16,274.00 |
$16,274.00 |
$16,274.00 |
$5,350.00
|
|
Intracranial complete study
|
$1,170.50 |
$1,170.50 |
$1,170.50 |
$882.00
|
|
Intracranial limited study
|
$938.50 |
$938.50 |
$938.50 |
$473.85
|
|
Intrapul surf admin endo tube
|
$118.50 |
$118.50 |
$118.50 |
$221.85
|
|
Intrinsic factor antibody
|
$144.00 |
$144.00 |
$144.00 |
$64.20
|
|
Intro cath dialysis circuit
|
$3,683.00 |
$3,683.00 |
$3,683.00 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$15,573.00 |
$15,573.00 |
$15,573.00 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$19,677.00 |
$19,677.00 |
$19,677.00 |
$15,620.00
|
|
Intro catheter aorta
|
$714.00 |
$714.00 |
$714.00 |
$1,678.05
|
|
Intro cath svc/ivc
|
$714.00 |
$714.00 |
$714.00 |
$1,329.90
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$2,205.00 |
$2,205.00 |
$2,205.00 |
$3,471.05
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$1,801.10
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$212.28 |
$212.28 |
$212.28 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$764.75 |
$764.75 |
$764.75 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$87,057.20 |
$87,057.20 |
$87,057.20 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$109.59 |
$109.59 |
$109.59 |
$173.40
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$7,113.50 |
$7,113.50 |
$7,113.50 |
$5,476.68
|
|
Iron
|
$49.50 |
$49.50 |
$49.50 |
$74.40
|
|
Iron binding capacity
|
$45.50 |
$45.50 |
$45.50 |
$63.84
|
|
Iron dextran 50 mg/ml injection solution
|
$113.28 |
$113.28 |
$113.28 |
$79.47
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$535.58 |
$535.58 |
$535.58 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$146.50 |
$146.50 |
$146.50 |
$117.60
|
|
Irrigation implantable venous access device for drug delivery systems
|
$191.50 |
$191.50 |
$191.50 |
$143.76
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$9,919.62 |
$9,919.62 |
$9,919.62 |
$8,273.35
|
|
Ivc venogram s&i
|
$2,959.00 |
$2,959.00 |
$2,959.00 |
$3,317.44
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$241.50 |
$241.50 |
$241.50 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$180.50 |
$180.50 |
$180.50 |
$158.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$180.50 |
$180.50 |
$180.50 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$504.50 |
$504.50 |
$504.50 |
$444.49
|
|
Ivp w/nephrotomography
|
$666.00 |
$666.00 |
$666.00 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$508.00 |
$508.00 |
$508.00 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$2,835.60 |
$2,835.60 |
$2,835.60 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$80.50 |
$80.50 |
$80.50 |
$60.32
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$27.20 |
$27.20 |
$27.20 |
$23.77
|
|
Kidney img w/bldflw sgl without rx
|
$1,506.00 |
$1,506.00 |
$1,506.00 |
$1,435.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$501.00 |
$501.00 |
$501.00 |
$666.00
|
|
Kit case 4.2mm spinejack
|
$11,056.60 |
$11,056.60 |
$11,056.60 |
$7,751.14
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$13,865.00 |
$13,865.00 |
$13,865.00 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$67,500.00 |
$67,500.00 |
$67,500.00 |
$31,318.14
|
|
Kit lead specify 5-6-5
|
$27,426.00 |
$27,426.00 |
$27,426.00 |
$16,405.24
|
|
Knee MRI (with and without contrast)
|
$1,429.50 |
$1,429.50 |
$1,429.50 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,192.00 |
$1,192.00 |
$1,192.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$993.00 |
$993.00 |
$993.00 |
$2,139.80
|
|
Knee X-ray
|
$331.50 |
$331.50 |
$331.50 |
$425.55
|
|
Kras gene addl variants
|
$434.00 |
$434.00 |
$434.00 |
$384.80
|
|
Kras gene variants exon 2
|
$434.00 |
$434.00 |
$434.00 |
$495.00
|
|
Kyleena, 19.5 mg
|
$1,447.36 |
$1,447.36 |
$1,447.36 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$57.34 |
$57.34 |
$57.34 |
$33.14
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$500.32 |
$500.32 |
$500.32 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$44.50 |
$44.50 |
$44.50 |
$55.50
|
|
Lactated ringers intravenous solution
|
$64.00 |
$64.00 |
$64.00 |
$44.91
|
|
Lactic acid
|
$104.00 |
$104.00 |
$104.00 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$165.00 |
$165.00 |
$165.00 |
$81.25
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$20,293.00 |
$20,293.00 |
$20,293.00 |
$19,124.00
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$128.80 |
$128.80 |
$128.80 |
$2,480.71
|
|
Lead acuity x4 spiral l 86cm
|
$7,814.40 |
$7,814.40 |
$7,814.40 |
$5,617.19
|
|
Lead capillary
|
$80.50 |
$80.50 |
$80.50 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$8,260.00 |
$8,260.00 |
$8,260.00 |
$3,154.46
|
|
Lead tachy durata sj4 58cm
|
$16,786.00 |
$16,786.00 |
$16,786.00 |
$8,202.66
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$914.50 |
$914.50 |
$914.50 |
$1,090.23
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$3,383.00 |
$3,383.00 |
$3,383.00 |
$1,012.32
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,041.25
|
