|
Ip/obs cnsltj new/est low 45
|
$327.60 |
$327.60 |
$327.60 |
|
|
Ip/obs cnsltj new/est mod 60
|
$396.00 |
$396.00 |
$396.00 |
|
|
Ip/obs consltj new/est sf 35
|
$299.40 |
$299.40 |
$299.40 |
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$109.59 |
$181.38 |
$1,341.98 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$111.98 |
$732.38 |
$7,113.50 |
|
|
Iron
|
$40.75 |
$89.40 |
$495.30 |
|
|
Iron binding capacity
|
$33.00 |
$46.80 |
$174.60 |
|
|
Iron dextran 50 mg/ml injection solution
|
$113.28 |
$113.28 |
$180.83 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$122.33 |
$535.58 |
$660.70 |
|
|
Irradiation of blood product each unit reference
|
$139.50 |
$178.25 |
$370.80 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$101.40 |
$186.00 |
$355.80 |
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$922.75 |
$9,919.62 |
$9,919.62 |
|
|
Ivc venogram s&i
|
$1,770.00 |
$1,770.00 |
$11,809.81 |
|
|
IV Fluids (each additional hour)
|
$86.38 |
$134.00 |
$337.80 |
|
|
IV Fluids (first hour)
|
$373.88 |
$424.50 |
$1,213.91 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$105.60 |
$177.00 |
$891.94 |
|
|
IV inj ra drug dx study
|
$231.60 |
$231.60 |
$1,070.66 |
|
|
IV Medicine Infusion (additional drug)
|
$130.80 |
$221.40 |
$871.59 |
|
|
IV Medicine Infusion (each additional hour)
|
$95.75 |
$162.00 |
$372.28 |
|
|
IV Medicine Infusion (first hour)
|
$389.62 |
$517.20 |
$1,519.28 |
|
|
IV Push Injection (each additional drug)
|
$104.50 |
$211.80 |
$343.64 |
|
|
IV Push Injection (first drug)
|
$160.80 |
$302.40 |
$410.00 |
|
|
Ivp w/nephrotomography
|
$634.00 |
$644.00 |
$666.00 |
|
|
Ivp w/wo kub w/wo tomography
|
$281.40 |
$540.00 |
$3,034.39 |
|
|
Ixabepilone 15 mg intravenous solution
|
$197.51 |
$2,835.60 |
$62,733.40 |
|
|
Jak2 targeted sequence analysis
|
$333.60 |
$333.60 |
$2,225.84 |
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$262.20 |
$281.40 |
$1,103.21 |
|
|
Jaw (Mandible) X-ray (complete)
|
$250.50 |
$264.50 |
$966.84 |
|
|
John cunningham antibody
|
$970.80 |
$970.80 |
$2,212.96 |
|
|
Ketogenic steroids fract
|
$166.66 |
$166.66 |
$166.66 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$24.50 |
$105.60 |
$241.80 |
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$27.20 |
$39.01 |
$165.89 |
|
|
Kidney function study
|
$1,527.60 |
$1,527.60 |
$1,527.60 |
|
|
Kidney imaging morphology
|
$1,146.00 |
$1,155.60 |
$1,651.28 |
|
|
Kidney imag w/bld flow multi
|
$2,314.20 |
$2,595.89 |
$2,606.40 |
|
|
Kidney img w/bldflw sgl without rx
|
$1,433.50 |
$1,600.20 |
$4,592.23 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$319.20 |
$484.50 |
$859.06 |
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$239.40 |
$344.50 |
$1,962.27 |
|
|
Kit case 4.2mm spinejack
|
$11,056.50 |
$11,056.60 |
$11,056.60 |
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$13,865.00 |
$13,865.00 |
$45,602.63 |
|
|
Kit gene analys d816 variant
|
$622.80 |
$622.80 |
$814.13 |
|
|
Kit hfx iq ipg bundle
|
$67,500.00 |
$67,500.00 |
$190,026.00 |
|
|
Kit ipg optimizer smart
|
$228,735.00 |
$228,735.00 |
$228,735.00 |
|
|
Kit lead specify 5-6-5
|
$27,426.00 |
$27,426.00 |
$83,532.26 |
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$6,466.16 |
$6,466.16 |
$6,466.16 |
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$20,310.60 |
$20,310.60 |
$20,310.60 |
|
|
Kit sound processor cochlear osia 2
|
$8,303.40 |
$18,128.40 |
$26,452.80 |
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$10,649.07 |
$10,649.07 |
$10,649.07 |
|
|
Knee jnt ratchet lock ea jnt
|
$1,940.54 |
$1,940.54 |
$1,940.54 |
|
|
Knee MRI (with and without contrast)
|
$582.60 |
$1,402.50 |
$8,469.40 |
|
|
Knee MRI (with contrast)
|
$582.60 |
$1,165.20 |
$6,702.13 |
|
|
Knee MRI (without contrast)
|
$945.50 |
$1,165.20 |
$6,516.07 |
|
|
Knee X-ray
|
$310.80 |
$523.20 |
$2,691.05 |
|
|
Knee X-ray (1 to 2 views, both knees)
|
$228.00 |
$417.60 |
$1,749.35 |
|
|
Knee X-ray (3 views, both knees)
|
$229.20 |
$458.40 |
$1,974.34 |
|
|
Knee X-ray (standing, both knees)
|
$117.60 |
$208.80 |
$1,061.36 |
|
|
Ko elastic w/joints pre ots
|
$532.19 |
$532.19 |
$532.19 |
|
|
Kras gene addl variants
|
$270.00 |
$415.80 |
$1,815.59 |
|
|
Kras gene variants exon 2
|
$234.60 |
$411.60 |
$2,433.26 |
|
|
Kyleena, 19.5 mg
|
$1,447.36 |
$1,447.36 |
$1,447.36 |
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$345.00 |
$345.00 |
$345.00 |
|
|
Lab draw <3 yrs scalp vein 36405
|
$345.00 |
$345.00 |
$345.00 |
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$44.90 |
$50.65 |
$70.38 |
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$130.51 |
$196.60 |
$500.32 |
|
|
Lactate dehydrogenase (ldh)
|
$34.00 |
$61.80 |
$120.00 |
|
|
Lactated ringers intravenous solution
|
$64.00 |
$78.68 |
$119.23 |
|
|
Lactic acid
|
$71.12 |
$123.60 |
$382.27 |
|
|
Lactoferrin fecal qualitative
|
$59.40 |
$157.00 |
$244.76 |
|
|
Lactoferrin fecal quant
|
$48.60 |
$228.00 |
$522.60 |
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$14,343.00 |
$20,293.00 |
$82,697.46 |
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$365.00 |
$872.40 |
$2,850.77 |
|
|
Laryngeal function studies
|
$342.60 |
$342.60 |
$675.51 |
|
|
Laryngoscopic sensory vid
|
$267.47 |
$267.47 |
$267.47 |
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$128.80 |
$128.80 |
$128.80 |
|
|
Laryngoscopy telescopic
|
$1,322.03 |
$2,383.20 |
$2,383.20 |
|
|
Lead acuity x4 spiral l 86cm
|
$7,814.40 |
$7,814.40 |
$14,570.86 |
|
|
Lead capillary
|
$57.50 |
$138.60 |
$221.40 |
|
|
Lead ingevity 45cm pfret MRI
|
$6,158.25 |
$8,260.00 |
$8,260.00 |
|
|
Lead tachy durata sj4 58cm
|
$16,786.00 |
$16,786.00 |
$52,741.01 |
|
|
Leg Artery Ultrasound (complete, both legs)
|
$543.12 |
$1,342.20 |
$1,703.47 |
|
|
Leg CT Scan (with contrast, both legs)
|
$766.12 |
$1,100.00 |
$8,708.70 |
|
|
Leg CT Scan (without contrast, both legs)
|
$819.00 |
$1,084.80 |
$8,515.41 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$629.00 |
$1,554.60 |
$2,964.50 |
|
|
Leishmania antibody
|
$144.53 |
$144.53 |
$144.53 |
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$267.00 |
$1,149.75 |
$3,383.00 |
|
|
Lens iol ant bicnvx 24.0 multi
|
$486.60 |
$1,776.00 |
$128,865.78 |
|
|
Lens iol ant chamb 10.5
|
$438.00 |
$462.50 |
$1,164.60 |
|
|
Lepirudin
|
$1,259.22 |
$1,259.22 |
$1,259.22 |
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$43.18 |
$130.80 |
$1,489.53 |
|
|
Leukocyte phagocytosis
|
$67.80 |
$67.80 |
$198.60 |
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,094.81 |
$9,502.54 |
$29,611.72 |
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,530.56 |
$18,194.72 |
$29,889.80 |
|
|
Leuprolide acetate injeciton
|
$1,346.20 |
$2,491.23 |
$2,491.23 |
|
|
Leuprolide inj, camcevi, 1mg
|
$867.93 |
$867.93 |
$867.93 |
|
|
Levalbuterol non-comp unit
|
$20.15 |
$20.15 |
$226.39 |
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$40.91 |
$88.10 |
$679.37 |
|
|
Levetiracetam therapeutic drug level
|
$88.80 |
$225.00 |
$464.96 |
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$33.60 |
$64.88 |
$277.15 |
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$353.88 |
$420.60 |
$1,304.15 |
|
|
L hrt cath chd nm/abn nt cnj
|
$6,415.80 |
$6,415.80 |
$12,033.26 |
|
