|
Inj, vegzelma, 10 mg
|
$5,170.88 |
$5,170.88 |
$5,170.88 |
$1,291.28
|
|
Inj vocal cord bulking agent
|
$1,480.00 |
$1,480.00 |
$1,480.00 |
$1,480.00
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$62,655.04 |
$62,655.04 |
$62,655.04 |
$44,026.28
|
|
Insert drug delivery implant
|
$1,892.50 |
$1,892.50 |
$1,892.50 |
$284.91
|
|
Insertion catheter bladder temporary simple
|
$405.50 |
$405.50 |
$405.50 |
$235.20
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$471.50 |
$471.50 |
$471.50 |
$2,515.80
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,544.50 |
$1,544.50 |
$1,544.50 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,173.00 |
$2,173.00 |
$2,173.00 |
$2,419.65
|
|
Insitu hybridization auto
|
$434.50 |
$434.50 |
$434.50 |
$393.13
|
|
Insitu hybridization manual
|
$272.00 |
$272.00 |
$272.00 |
$401.10
|
|
In situ hybridization per specimen each additional single probe stain
|
$142.50 |
$142.50 |
$142.50 |
$241.80
|
|
In situ hybridization per specimen initial single probe stain
|
$231.00 |
$231.00 |
$231.00 |
$337.20
|
|
Ins mark abd/pel for right perq
|
$2,813.00 |
$2,813.00 |
$2,813.00 |
$2,434.90
|
|
Ins mark thor for right perq
|
$2,813.00 |
$2,813.00 |
$2,813.00 |
$2,477.45
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,844.50 |
$1,844.50 |
$1,844.50 |
$1,627.60
|
|
Insulin total
|
$61.00 |
$61.00 |
$61.00 |
$66.64
|
|
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
|
|
Intracranial complete study
|
$1,121.50 |
$1,121.50 |
$1,121.50 |
$883.30
|
|
Intracranial limited study
|
$899.00 |
$899.00 |
$899.00 |
$467.50
|
|
Intrapul surf admin endo tube
|
$113.50 |
$113.50 |
$113.50 |
$221.27
|
|
Intrinsic factor antibody
|
$138.00 |
$138.00 |
$138.00 |
$63.15
|
|
Intubation endotracheal emergency procedure
|
$257.50 |
$257.50 |
$257.50 |
$600.00
|
|
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 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$7,113.50 |
$7,113.50 |
$7,113.50 |
$5,476.68
|
|
Iron
|
$47.50 |
$47.50 |
$47.50 |
$73.98
|
|
Iron binding capacity
|
$43.50 |
$43.50 |
$43.50 |
$63.84
|
|
Iron dextran 50 mg/ml injection solution
|
$113.28 |
$113.28 |
$113.28 |
$78.46
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$535.58 |
$535.58 |
$535.58 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$140.50 |
$140.50 |
$140.50 |
$116.35
|
|
Irrigation implantable venous access device for drug delivery systems
|
$183.50 |
$183.50 |
$183.50 |
$144.62
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$9,919.62 |
$9,919.62 |
$9,919.62 |
$8,273.35
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$231.50 |
$231.50 |
$231.50 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$173.00 |
$173.00 |
$173.00 |
$162.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$173.00 |
$173.00 |
$173.00 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$483.50 |
$483.50 |
$483.50 |
$443.20
|
|
Ivp w/nephrotomography
|
$638.00 |
$638.00 |
$638.00 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$486.50 |
$486.50 |
$486.50 |
$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
|
$77.00 |
$77.00 |
$77.00 |
$59.00
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$27.20 |
$27.20 |
$27.20 |
$23.77
|
|
Kidney img w/bldflw sgl without rx
|
$1,442.50 |
$1,442.50 |
$1,442.50 |
$1,433.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$480.00 |
$480.00 |
$480.00 |
$668.25
|
|
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 |
$31,365.00
|
|
Kit lead specify 5-6-5
|
$27,426.00 |
$27,426.00 |
$27,426.00 |
$16,625.73
|
|
Knee MRI (with and without contrast)
|
$1,369.50 |
$1,369.50 |
$1,369.50 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,142.00 |
$1,142.00 |
$1,142.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$951.50 |
$951.50 |
$951.50 |
$2,130.88
|
|
Knee X-ray
|
$317.50 |
$317.50 |
$317.50 |
$425.55
|
|
Kras gene addl variants
|
$416.00 |
$416.00 |
$416.00 |
$387.20
|
|
Kras gene variants exon 2
|
$416.00 |
$416.00 |
$416.00 |
$508.95
|
|
Kyleena, 19.5 mg
|
$1,447.36 |
$1,447.36 |
$1,447.36 |
$2,152.80
|
|
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)
|
$42.50 |
$42.50 |
$42.50 |
$55.50
|
|
Lactated ringers intravenous solution
|
$64.00 |
$64.00 |
$64.00 |
$44.91
|
|
Lactic acid
|
$99.50 |
$99.50 |
$99.50 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$158.00 |
$158.00 |
$158.00 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$20,293.00 |
$20,293.00 |
$20,293.00 |
$19,124.00
|
|
Lead acuity x4 spiral l 86cm
|
$7,814.40 |
$7,814.40 |
$7,814.40 |
$5,617.19
|
|
Lead capillary
|
$77.00 |
$77.00 |
$77.00 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$8,260.00 |
$8,260.00 |
$8,260.00 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$16,786.00 |
$16,786.00 |
$16,786.00 |
$8,202.66
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$876.00 |
$876.00 |
$876.00 |
$1,090.23
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$3,383.00 |
$3,383.00 |
$3,383.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,776.00 |
$1,776.00 |
$1,776.00 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$462.50 |
$462.50 |
$462.50 |
$385.34
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$130.80 |
$130.80 |
$130.80 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$29,611.72 |
$29,611.72 |
$29,611.72 |
$5,993.33
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$29,889.80 |
$29,889.80 |
$29,889.80 |
$9,107.80
|
|
Leuprolide acetate injeciton
|
$2,491.23 |
$2,491.23 |
$2,491.23 |
$1,322.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$88.10 |
$88.10 |
$88.10 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$123.50 |
$123.50 |
$123.50 |
$83.50
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$33.60 |
$33.60 |
$33.60 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$353.88 |
$353.88 |
$353.88 |
$420.60
|
|
Liberta rc ipg
|
$50,000.00 |
$50,000.00 |
$50,000.00 |
$38,725.40
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$70.86 |
$70.86 |
$70.86 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$54.80 |
$54.80 |
$54.80 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$223.00 |
$223.00 |
$223.00 |
$88.40
|
|
Lifileucel til/dose 7.5b-72b snij
|
$96,906.66 |
$96,906.66 |
$96,906.66 |
$30,744.64
|
|
Liletta, 52 mg
|
$1,110.58 |
$1,110.58 |
$1,110.58 |
$1,453.50
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$62.75 |
$62.75 |
$62.75 |
$123.78
|
|
Lipase
|
$99.00 |
$99.00 |
$99.00 |
$92.88
|
|
Lipoprotein blood quant
|
$143.00 |
$143.00 |
$143.00 |
$99.60
|
|
Lipoprotein direct measurement hdl
|
$63.00 |
$63.00 |
$63.00 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$57.00 |
$57.00 |
$57.00 |
$61.60
|
|
Lipoprtn dir meas sd ldl chl
|
$90.00 |
$90.00 |
$90.00 |
$47.18
|
|
Lithium therapeutic drug level
|
$112.50 |
$112.50 |
$112.50 |
$69.42
|
|
Liver Function Test
|
$42.50 |
$42.50 |
$42.50 |
$115.44
|
|
Liver imaging
|
$910.50 |
$910.50 |
$910.50 |
$1,093.50
|
|
Locm 100-199mg/ml iodine,1ml
|
$95.83 |
$95.83 |
$95.83 |
$44.10
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$67,584.15 |
$67,584.15 |
$67,584.15 |
$58,923.90
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$37.20 |
$37.20 |
$37.20 |
$37.44
|