|
IV Medicine Infusion (each additional hour)
|
$57.00 |
$57.00 |
$64.20 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$277.80 |
$277.80 |
$309.60 |
$441.75
|
|
IV Push Injection (each additional drug)
|
$61.20 |
$61.20 |
$68.40 |
$166.80
|
|
IV Push Injection (first drug)
|
$162.60 |
$162.60 |
$181.20 |
$254.52
|
|
Ivp w/nephrotomography
|
$440.40 |
$440.40 |
$481.20 |
$729.00
|
|
Ivp w/wo kub w/wo tomography
|
$390.00 |
$390.00 |
$426.00 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$5,633.09 |
$5,633.09 |
$5,633.09 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$444.60 |
$444.60 |
$495.00 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$212.40 |
$212.40 |
$232.20 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$213.00 |
$213.00 |
$232.80 |
$362.05
|
|
Jejunstmy tube plcmt
|
$346.80 |
$346.80 |
$364.20 |
$2,174.40
|
|
J-tube placement
|
$416.40 |
$416.40 |
$437.40 |
$593.08
|
|
Ketamine and metabolite screen - quest
|
$70.80 |
$70.80 |
$79.20 |
$72.14
|
|
Ketogenic steroids fract
|
$82.80 |
$82.80 |
$242.40 |
$82.74
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$39.00 |
$39.00 |
$43.80 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$25.15 |
$25.15 |
$26.95 |
$23.50
|
|
Kidney endoscopy
|
$4,414.20 |
$4,414.20 |
$5,098.80 |
$5,728.00
|
|
Kidney imaging morphology
|
$693.60 |
$693.60 |
$757.80 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$639.60 |
$639.60 |
$699.00 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$738.60 |
$738.60 |
$806.40 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$444.60 |
$444.60 |
$486.00 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$340.20 |
$340.20 |
$372.00 |
$492.25
|
|
Kit case 4.2mm spinejack
|
$10,027.20 |
$10,027.20 |
$10,027.20 |
$7,177.60
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$82.20 |
$82.20 |
$86.40 |
$174.00
|
|
Kit cath f 8f w/glv + wipe ster
|
$6.00 |
$6.00 |
$6.60 |
$9.49
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$10,575.00 |
$10,575.00 |
$10,575.00 |
$9,423.50
|
|
Kit irrigator stoma cone 7721
|
$7.20 |
$7.20 |
$7.20 |
$7.20
|
|
Kit lead specify 5-6-5
|
$12,555.00 |
$12,555.00 |
$12,555.00 |
$16,672.10
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$1,777.20 |
$1,777.20 |
$1,866.60 |
$360.12
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,969.20 |
$1,969.20 |
$1,969.20 |
$2,254.50
|
|
Kit trach suct cls 30.5cm
|
$28.20 |
$28.20 |
$28.20 |
$35.26
|
|
Knee Arthroscopy (Meniscus Trimming)
|
$755.40 |
$755.40 |
$755.40 |
$5,148.00
|
|
Knee arthroscopy/surgery
|
$784.20 |
$784.20 |
$784.20 |
$4,629.00
|
|
Knee MRI (with and without contrast)
|
$2,514.00 |
$2,514.00 |
$3,717.00 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$1,818.00 |
$1,818.00 |
$2,693.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,406.00 |
$2,406.00 |
$2,653.20 |
$2,122.12
|
|
Knee X-ray
|
$268.20 |
$268.20 |
$293.40 |
$428.12
|
|
Knee X-ray (1 to 2 views, both knees)
|
$217.80 |
$217.80 |
$238.20 |
$291.20
|
|
Knee X-ray (3 views, both knees)
|
$264.00 |
$264.00 |
$288.60 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$117.00 |
$117.00 |
$128.40 |
$252.50
|
|
Kyleena, 19.5 mg
|
$1,961.17 |
$1,961.17 |
$2,161.19 |
$2,125.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$51.00 |
$51.00 |
$53.40 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$47.40 |
$47.40 |
$49.80 |
$70.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$120.00 |
$120.00 |
$120.00 |
$33.60
|
|
Labioplasty 56800
|
$446.40 |
$446.40 |
$468.60 |
$3,905.53
|
|
Lactate dehydrogenase (ldh)
|
$53.40 |
$53.40 |
$56.40 |
$55.50
|
|
Lactated ringers intravenous solution
|
$43.74 |
$43.74 |
$43.74 |
$43.74
|
|
Lactic acid
|
$75.00 |
$75.00 |
$84.00 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$72.60 |
$72.60 |
$81.00 |
$82.40
|
|
Lactoferrin fecal quant
|
$78.00 |
$78.00 |
$87.00 |
$108.93
|
|
Lam facetec & foramot crv
|
$2,593.20 |
$2,593.20 |
$2,722.80 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$2,215.20 |
$2,215.20 |
$2,326.20 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$2,500.20 |
$2,500.20 |
$2,625.00 |
$8,453.60
|
|
Lamie bx/exc idrl spine lesn lmbr 63282
|
$3,461.40 |
$3,461.40 |
$3,634.20 |
$4,650.40
|
|
Lamie bx/exc idrl spine lesn thrc 63281
|
$4,145.40 |
$4,145.40 |
$4,352.40 |
$4,925.60
|
|
Lamie excise intrspinl lesion thrc 63266
|
$3,028.80 |
$3,028.80 |
$3,180.00 |
$5,178.00
|
|
Laminotomy single lumbar
|
$2,888.40 |
$2,888.40 |
$3,033.00 |
$8,453.60
|
|
Lamiotoiotiotinotomy addl cervical 63043
|
$938.40 |
$938.40 |
$985.20 |
$1,506.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$16,948.63 |
$16,948.63 |
$16,948.63 |
$19,124.00
|
|
Laparo-asst vag hysterectomy
|
$2,753.40 |
$2,753.40 |
$2,890.80 |
$6,463.42
|
|
Laparo cholecystectomy/explr
|
$2,019.60 |
$2,019.60 |
$2,120.40 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$1,285.20 |
$1,285.20 |
$1,349.40 |
$8,346.00
|
|
Laparo drng lymphocele 49323
|
$1,161.00 |
$1,161.00 |
$1,219.20 |
$5,419.00
|
|
Laparo-myomectomy complex
|
$2,094.00 |
$2,094.00 |
$2,199.00 |
$11,419.92
|
|
Laparo partial colectomy 44204
|
$2,778.60 |
$2,778.60 |
$2,917.80 |
$2,778.60
|
|
Laparo proc abdm/per/oment 49329
|
$1,421.40 |
$1,421.40 |
$1,492.20 |
$6,622.75
|
|
Laparo radical nephrectomy
|
$2,389.80 |
$2,389.80 |
$2,509.20 |
$2,983.86
|
|
Laparoscopic myomectomy
|
$1,659.00 |
$1,659.00 |
$1,741.80 |
$6,461.32
|
|
Laparoscopic proc
|
$2,109.60 |
$2,109.60 |
$2,215.20 |
$2,109.60
|
|
Laparoscopic salpingostomy 58673
|
$1,486.20 |
$1,486.20 |
$1,560.60 |
$5,214.15
|
|
Laparoscopy adrenalectomy
|
$2,151.60 |
$2,151.60 |
$2,259.00 |
$5,389.80
|
|
Laparoscopy aspiration
|
$672.60 |
$672.60 |
$706.20 |
$6,904.15
|
|
Laparoscopy biopsy
|
$623.40 |
$623.40 |
$654.60 |
$6,463.42
|
|
Laparoscopye procstom 43659
|
$2,556.00 |
$2,556.00 |
$2,683.80 |
$6,448.00
|
|
Laparoscopy excise lesions
|
$1,307.40 |
$1,307.40 |
$1,372.80 |
$7,243.60
|
|
Laparoscopy fundoplasty
|
$1,944.60 |
$1,944.60 |
$2,041.80 |
$11,424.40
|
|
Laparoscopy gastrostomy
|
$1,022.40 |
$1,022.40 |
$1,073.40 |
$6,376.26
|
|
Laparoscopy lymphadenectomy
|
$1,486.80 |
$1,486.80 |
$1,561.20 |
$12,320.22
|
|
Laparoscopy lymphadenectomy
|
$1,748.40 |
$1,748.40 |
$1,836.00 |
$8,932.00
|
|
Laparoscopy lymph node biop
|
$982.80 |
$982.80 |
$1,032.00 |
$6,904.15
|
|
Laparoscopy lysis
|
$1,244.40 |
$1,244.40 |
$1,306.80 |
$5,741.00
|
|
Laparoscopy remove adnexa
|
$1,194.60 |
$1,194.60 |
$1,254.60 |
$8,777.57
|
|
Laparoscopy splenectomy
|
$1,976.40 |
$1,976.40 |
$2,075.40 |
$9,114.50
|
|
Laparoscopy surg colpopexy
|
$1,473.00 |
$1,473.00 |
$1,546.80 |
$10,897.60
|
|
Laparoscopy tubal block 58671
|
$676.80 |
$676.80 |
$710.40 |
$5,419.00
|
|
Laparo sling operation 51992
|
$1,587.60 |
$1,587.60 |
$1,666.80 |
$5,353.60
|
|
Laparotomy; inject/aspirate liver cyst 47015
|
$1,618.80 |
$1,618.80 |
$1,699.80 |
$1,591.12
|
|
Laparo total proctocolectomy
|
$2,792.40 |
$2,792.40 |
$2,792.40 |
$5,071.20
|
|
Laparo urethral suspension
|
$1,414.20 |
$1,414.20 |
$1,485.00 |
$5,353.60
|
|
Laparo-vag hyst incl t/o
|
$1,819.20 |
$1,819.20 |
$1,910.40 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$4,275.00 |
$4,275.00 |
$4,488.60 |
$8,917.26
|
|
Laparscpy ablat 1>lvr tum cryo
|
$2,280.00 |
$2,280.00 |
$2,394.00 |
$11,221.60
|
|
Lap close enterostomy with resect 44227
|
$3,411.60 |
$3,411.60 |
$3,582.00 |
$3,411.60
|
|
Lap colectomy/coloproctostomy 44207
|
$2,535.60 |
$2,535.60 |
$2,662.20 |
$4,491.20
|
|
Lap colectomy/coloproctostomy w/clst 44208
|
$3,601.80 |
$3,601.80 |
$3,781.80 |
$4,896.80
|
|
Lap colectomy part w/ileum 44205
|
$2,419.20 |
$2,419.20 |
$2,540.40 |
$2,653.92
|
|
Lap colectomy w/proctectomy 44211
|
$3,068.40 |
$3,068.40 |
$3,222.00 |
$3,222.00
|
|
Lap colostomy 44188
|
$2,208.00 |
$2,208.00 |
$2,318.40 |
$3,008.00
|
|
Lap enterectomy 44202
|
$2,040.00 |
$2,040.00 |
$2,142.00 |
$2,142.00
|
|
Lap enterolysis
|
$1,653.60 |
$1,653.60 |
$1,736.40 |
$6,457.82
|
