|
Inj fluphenazine hcl 1.25 mg
|
$21.95 |
$21.95 |
$21.95 |
$40.33
|
|
Inj levocarnitine per 1 gm
|
$178.80 |
$178.80 |
$178.80 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$64.80 |
$64.80 |
$64.80 |
$34.34
|
|
Inj. mycophenolate mofetil
|
$108.10 |
$108.10 |
$108.10 |
$252.66
|
|
Inj, nithiodote, 3mg / 125mg
|
$984.90 |
$984.90 |
$984.90 |
$468.10
|
|
Inj pantoprazole(hikma) 40mg
|
$16.80 |
$16.80 |
$16.80 |
$34.67
|
|
Inj progesterone per 50 mg
|
$3.00 |
$3.00 |
$3.00 |
$13.76
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$73,182.85 |
$73,182.85 |
$73,182.85 |
$41,083.73
|
|
In situ hybridization per specimen each additional single probe stain
|
$158.60 |
$158.60 |
$158.60 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$280.15 |
$280.15 |
$280.15 |
$338.40
|
|
Insole orthotic freedom sz6 6816
|
$44.30 |
$44.30 |
$44.30 |
$84.00
|
|
Insulin total
|
$85.80 |
$85.80 |
$85.80 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$2,333.79 |
$2,333.79 |
$2,333.79 |
$8,617.32
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$146.76 |
$146.76 |
$146.76 |
$3,803.11
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$10,427.90 |
$10,427.90 |
$10,427.90 |
$10,427.90
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$192.00 |
$192.00 |
$192.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$227.50 |
$227.50 |
$227.50 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$110,829.85 |
$110,829.85 |
$110,829.85 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$522.90 |
$522.90 |
$522.90 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,268.95 |
$9,268.95 |
$9,268.95 |
$5,517.12
|
|
Iron
|
$53.30 |
$53.30 |
$53.30 |
$75.00
|
|
Iron binding capacity
|
$63.05 |
$63.05 |
$63.05 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$185.90 |
$185.90 |
$185.90 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$174.00 |
$174.00 |
$174.00 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$202.15 |
$202.15 |
$202.15 |
$115.20
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$2,779.35 |
$2,779.35 |
$2,779.35 |
$8,273.35
|
|
IV Fluids (each additional hour)
|
$20,420.72 |
$20,420.72 |
$20,420.72 |
$133.90
|
|
IV Fluids (first hour)
|
$239.85 |
$239.85 |
$239.85 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$113.10 |
$113.10 |
$113.10 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$10,741.15 |
$10,741.15 |
$10,741.15 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$96.85 |
$96.85 |
$96.85 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$14,463.15 |
$14,463.15 |
$14,463.15 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$27,759.06 |
$27,759.06 |
$27,759.06 |
$167.50
|
|
IV Push Injection (first drug)
|
$5,813.86 |
$5,813.86 |
$5,813.86 |
$252.76
|
|
Ixabepilone 15 mg intravenous solution
|
$18,131.05 |
$18,131.05 |
$18,131.05 |
$10,695.32
|
|
Jkt lso inter
|
$41.27 |
$41.27 |
$41.27 |
$41.27
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$72.80 |
$72.80 |
$72.80 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$30.05 |
$30.05 |
$30.05 |
$23.52
|
|
Kit case 4.2mm spinejack
|
$5,937.40 |
$5,937.40 |
$5,937.40 |
$7,177.60
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$257.21 |
$257.21 |
$257.21 |
$174.00
|
|
Kit cath f 8f w/glv + wipe ster
|
$1.31 |
$1.31 |
$1.31 |
$9.49
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,430.77 |
$6,430.77 |
$6,430.77 |
$9,423.50
|
|
Kit hfx iq ipg bundle
|
$26,541.53 |
$26,541.53 |
$26,541.53 |
$33,859.00
|
|
Kit ipg optimizer smart
|
$29,051.10 |
$29,051.10 |
$29,051.10 |
$49,011.18
|
|
Kit irrigator stoma cone 7721
|
$2.05 |
$2.05 |
$2.05 |
$7.20
|
|
Kit lead specify 5-6-5
|
$13,454.45 |
$13,454.45 |
$13,454.45 |
$16,672.10
|
|
Kit monitr cath camino icp w/integratd licox bolt fitting
|
$1,313.77 |
$1,313.77 |
$1,313.77 |
$1,313.77
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,391.79 |
$1,391.79 |
$1,391.79 |
$1,635.87
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$234.08 |
$234.08 |
$234.08 |
$360.12
|
|
Kit sound processor cochlear osia 2
|
$6,106.28 |
$6,106.28 |
$6,106.28 |
$8,425.00
|
|
Kit trach suct cls 30.5cm
|
$3,140.14 |
$3,140.14 |
$3,140.14 |
$35.26
|
|
Knee X-ray
|
$483.60 |
$483.60 |
$483.60 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$266.50 |
$266.50 |
$266.50 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$319.15 |
$319.15 |
$319.15 |
$363.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$356.60 |
$356.60 |
$356.60 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$48.75 |
$48.75 |
$48.75 |
$55.50
|
|
Lactated ringers intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$43.74
|
|
Lactic acid
|
$81.90 |
$81.90 |
$81.90 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$126.75 |
$126.75 |
$126.75 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$29,832.00 |
$29,832.00 |
$29,832.00 |
$19,124.00
|
|
Lead acuity x4 spiral l 86cm
|
$2,873.32 |
$2,873.32 |
$2,873.32 |
$5,460.00
|
|
Lead capillary
|
$90.35 |
$90.35 |
$90.35 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$4,159.75 |
$4,159.75 |
$4,159.75 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$8,202.66 |
$8,202.66 |
$8,202.66 |
$8,202.66
|
|
Leg CT Scan (with contrast, both legs)
|
$2,269.15 |
$2,269.15 |
$2,269.15 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,120.95 |
$2,120.95 |
$2,120.95 |
$1,372.50
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$419.25 |
$419.25 |
$419.25 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$5,701.93 |
$5,701.93 |
$5,701.93 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$354.25 |
$354.25 |
$354.25 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$396.40 |
$396.40 |
$396.40 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$37,312.35 |
$37,312.35 |
$37,312.35 |
$6,360.76
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$8.10 |
$8.10 |
$8.10 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$130.00 |
$130.00 |
$130.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$61.50 |
$61.50 |
$61.50 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$553.55 |
$553.55 |
$553.55 |
$420.60
|
|
Liberta rc ipg
|
$29,884.39 |
$29,884.39 |
$29,884.39 |
$39,189.70
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$37.50 |
$37.50 |
$37.50 |
$39.75
|
|
Lidocaine therapeutic drug level
|
$43.55 |
$43.55 |
$43.55 |
$87.45
|
|
Lift heel adj small gl60404sm
|
$38.34 |
$38.34 |
$38.34 |
$133.50
|
|
Lift heel adjustable med
|
$3.03 |
$3.03 |
$3.03 |
$58.56
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$64.50 |
$64.50 |
$64.50 |
$121.00
|
|
Lipase
|
$83.20 |
$83.20 |
$83.20 |
$93.58
|
|
Lipoprotein direct measurement hdl
|
$62.40 |
$62.40 |
$62.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$62.40 |
$62.40 |
$62.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$61.10 |
$61.10 |
$61.10 |
$69.75
|
|
Liver Function Test
|
$110.50 |
$110.50 |
$110.50 |
$115.44
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$87,089.35 |
$87,089.35 |
$87,089.35 |
$62,704.30
|
|
Loop ostmy bridg ster
|
$45.43 |
$45.43 |
$45.43 |
$45.43
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$22.20 |
$22.20 |
$22.20 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,517.10 |
$1,517.10 |
$1,517.10 |
$1,468.80
|
|
Lower Back (Lumbar Spine) X-ray
|
$286.00 |
$286.00 |
$286.00 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$369.20 |
$369.20 |
$369.20 |
$505.83
|
|
Lower Leg (Shin) X-ray (both sides)
|
$295.75 |
$295.75 |
$295.75 |
$338.40
|
|
Lurbinectedin 4 mg intravenous solution
|
$25,230.00 |
$25,230.00 |
$25,230.00 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$37,758.50 |
$37,758.50 |
$37,758.50 |
$22,771.63
|
|
Lvad shower bag heartmate
|
$887.68 |
$887.68 |
$887.68 |
$893.74
|
|
Macroscopic exam arthropod
|
$40.95 |
$40.95 |
$40.95 |
$38.58
|
|
Macroscopic exam parasite
|
$19.50 |
$19.50 |
$19.50 |
$37.05
|
|
Magnesium
|
$69.55 |
$69.55 |
$69.55 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$522.50 |
$522.50 |
$522.50 |
$58.70
|