|
Inj for ext venography
|
$2,190.00 |
$2,190.00 |
$2,190.00 |
$946.64
|
|
Inj for mammo ductogram
|
$606.60 |
$606.60 |
$606.60 |
$469.16
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,525.00 |
$3,525.00 |
$3,525.00 |
$1,646.97
|
|
Inj hrt cath w/s&i sel right vent
|
$3,042.60 |
$3,042.60 |
$3,042.60 |
$1,352.65
|
|
Inj hydroxocobalamin IV 25mg
|
$1,593.19 |
$1,593.19 |
$1,593.19 |
$1,593.19
|
|
Inj ivig privigen 500 mg
|
$7,298.71 |
$7,298.71 |
$7,298.71 |
$6,144.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$12,160.05 |
$12,160.05 |
$12,160.05 |
$12,160.05
|
|
Inj mepivacaine hcl/10 ml
|
$41.81 |
$41.81 |
$41.81 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$426.85 |
$426.85 |
$426.85 |
$426.85
|
|
Inj, moxifloxacin 100 mg
|
$262.28 |
$262.28 |
$262.28 |
$100.44
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,360.00 |
$3,360.00 |
$3,360.00 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,135.20 |
$1,135.20 |
$1,135.20 |
$2,154.21
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,090.40 |
$2,090.40 |
$2,090.40 |
$2,058.43
|
|
Inj proc elbow arthro
|
$498.60 |
$498.60 |
$498.60 |
$483.15
|
|
Inj proc myelogram lumbar
|
$1,756.20 |
$1,756.20 |
$1,756.20 |
$1,026.35
|
|
Inj, releuko 1 mcg
|
$332.39 |
$332.39 |
$332.39 |
$775.12
|
|
Inj retacrit esrd on dialysi
|
$1,074.20 |
$1,074.20 |
$1,074.20 |
$307.40
|
|
Inj retro urethrocysto
|
$1,413.60 |
$1,413.60 |
$1,413.60 |
$569.60
|
|
Inj scleros sol sgl vein
|
$1,404.60 |
$1,404.60 |
$1,404.60 |
$534.40
|
|
Inj w/fluor eval cv device
|
$818.40 |
$818.40 |
$818.40 |
$573.00
|
|
Ins cath ren art 1st bi
|
$17,182.20 |
$17,182.20 |
$17,182.20 |
$6,012.50
|
|
Ins cath ren art 1st uni
|
$9,257.40 |
$9,257.40 |
$9,257.40 |
$4,628.00
|
|
Ins cath ren art 2nd+ bi
|
$18,044.40 |
$18,044.40 |
$18,044.40 |
$5,251.20
|
|
Ins cath ren art 2nd+ uni
|
$9,691.80 |
$9,691.80 |
$9,691.80 |
$5,528.94
|
|
Insert cath pleura with image
|
$3,710.40 |
$3,710.40 |
$3,710.40 |
$2,239.02
|
|
Insertion catheter bladder non indwelling
|
$280.20 |
$280.20 |
$280.20 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$250.80 |
$250.80 |
$250.80 |
$245.00
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,235.60 |
$2,235.60 |
$2,235.60 |
$4,923.19
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$10,951.80 |
$10,951.80 |
$10,951.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,296.40 |
$3,296.40 |
$3,296.40 |
$2,457.24
|
|
Insertion of catheter vein
|
$3,947.40 |
$3,947.40 |
$3,947.40 |
$1,079.00
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,260.20 |
$5,260.20 |
$5,260.20 |
$2,367.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,721.00 |
$2,721.00 |
$2,721.00 |
$7,513.67
|
|
Insitu hybridization manual
|
$1,079.40 |
$1,079.40 |
$1,079.40 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$265.80 |
$265.80 |
$265.80 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$501.00 |
$501.00 |
$501.00 |
$364.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$5,410.20 |
$5,410.20 |
$5,410.20 |
$1,483.95
|
|
Instillation anticarcinogenic agent bladder
|
$1,764.60 |
$1,764.60 |
$1,764.60 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$5,127.00 |
$5,127.00 |
$5,127.00 |
$4,314.75
|
|
Insulin total
|
$217.20 |
$217.20 |
$217.20 |
$72.15
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$6,031.20 |
$6,031.20 |
$6,031.20 |
$9,463.86
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$3,825.00 |
$3,825.00 |
$3,825.00 |
$6,018.75
|
|
Interferon alfa-2b inj
|
$51.21 |
$51.21 |
$51.21 |
$51.21
|
|
Intracranial limited study
|
$1,031.40 |
$1,031.40 |
$1,031.40 |
$398.34
|
|
Intrapul surf admin endo tube
|
$127.80 |
$127.80 |
$127.80 |
$220.80
|
|
Intrinsic factor antibody
|
$145.80 |
$145.80 |
$145.80 |
$76.77
|
|
Intro cath dialysis circuit
|
$9,280.20 |
$9,280.20 |
$9,280.20 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$20,616.60 |
$20,616.60 |
$20,616.60 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$38,277.00 |
$38,277.00 |
$38,277.00 |
$18,260.50
|
|
Intro catheter aorta
|
$2,442.00 |
$2,442.00 |
$2,442.00 |
$1,963.80
|
|
Intro cath svc/ivc
|
$4,053.60 |
$4,053.60 |
$4,053.60 |
$1,942.50
|
|
Intro long gi tube
|
$1,132.20 |
$1,132.20 |
$1,132.20 |
$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
|
$454.80 |
$454.80 |
$454.80 |
$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
|
$0.67 |
$0.67 |
$0.67 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$261.10 |
$261.10 |
$261.10 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$181.38 |
$181.38 |
$181.38 |
$254.59
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$111.98 |
$111.98 |
$111.98 |
$111.98
|
|
Iron
|
$121.20 |
$121.20 |
$121.20 |
$67.50
|
|
Iron binding capacity
|
$159.00 |
$159.00 |
$159.00 |
$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
|
$168.60 |
$168.60 |
$168.60 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$101.40 |
$101.40 |
$101.40 |
$149.00
|
|
Ivc venogram s&i
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$2,975.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$303.60 |
$303.60 |
$303.60 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$303.60 |
$303.60 |
$303.60 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$190.20 |
$190.20 |
$190.20 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$753.00 |
$753.00 |
$753.00 |
$476.50
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$197.51 |
$197.51 |
$189.96
|
|
Jak2 targeted sequence analysis
|
$333.60 |
$333.60 |
$333.60 |
$465.74
|
|
John cunningham antibody
|
$970.80 |
$970.80 |
$970.80 |
$39.65
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$129.60 |
$129.60 |
$129.60 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$165.89 |
$165.89 |
$165.89 |
$17.11
|
|
Kidney imaging morphology
|
$1,155.60 |
$1,155.60 |
$1,155.60 |
$693.60
|
|
Kidney imag w/bld flow multi
|
$2,314.20 |
$2,314.20 |
$2,314.20 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$1,968.00 |
$1,968.00 |
$1,968.00 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$319.20 |
$319.20 |
$319.20 |
$618.54
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$20,310.60 |
$20,310.60 |
$20,310.60 |
$179.32
|
|
Knee MRI (with and without contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$1,165.20 |
$1,165.20 |
$1,165.20 |
$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
|
$270.00 |
$270.00 |
$270.00 |
$366.56
|
|
Kras gene variants exon 2
|
$270.00 |
$270.00 |
$270.00 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$345.00 |
$345.00 |
$345.00 |
$102.70
|
|
Lab draw <3 yrs scalp vein 36405
|
$345.00 |
$345.00 |
$345.00 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$50.65 |
$50.65 |
$50.65 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$130.51 |
$130.51 |
$130.51 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$108.60 |
$108.60 |
$108.60 |
$50.55
|
|
Lactated ringers intravenous solution
|
$78.68 |
$78.68 |
$78.68 |
$46.35
|
|
Lactic acid
|
$193.80 |
$193.80 |
$193.80 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$90.60 |
$90.60 |
$90.60 |
$88.40
|
|
Lactoferrin fecal quant
|
$254.40 |
$254.40 |
$254.40 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$14,343.00 |
$14,343.00 |
$21,470.76
|
|
Lead capillary
|
$221.40 |
$221.40 |
$221.40 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,635.60 |
$1,635.60 |
$1,635.60 |
$1,053.00
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$537.00 |
$537.00 |
$537.00 |
$609.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,866.60 |
$1,866.60 |
$1,866.60 |
$1,136.25
|
