|
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)
|
$69.00 |
$69.00 |
$69.00 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,268.95 |
$9,268.95 |
$9,268.95 |
$5,517.12
|
|
Iron
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$75.00
|
|
Iron binding capacity
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$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)
|
$82.80 |
$82.80 |
$82.80 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$32.50 |
$32.50 |
$32.50 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$191.10 |
$191.10 |
$191.10 |
$146.11
|
|
Irrigation vagina and/or appl medicament tx disease
|
$131.88 |
$131.88 |
$131.88 |
$132.00
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$2,779.35 |
$2,779.35 |
$2,779.35 |
$8,273.35
|
|
Ivc venogram s&i
|
$6,602.05 |
$6,602.05 |
$6,602.05 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$33,215.50 |
$33,215.50 |
$33,215.50 |
$133.90
|
|
IV Fluids (first hour)
|
$33,215.50 |
$33,215.50 |
$33,215.50 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$12,413.10 |
$12,413.10 |
$12,413.10 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$27,709.80 |
$27,709.80 |
$27,709.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$10,354.25 |
$10,354.25 |
$10,354.25 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$1,634.00 |
$1,634.00 |
$1,634.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$15,675.00 |
$15,675.00 |
$15,675.00 |
$167.50
|
|
IV Push Injection (first drug)
|
$11,062.20 |
$11,062.20 |
$11,062.20 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$619.45 |
$619.45 |
$619.45 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$18,131.05 |
$18,131.05 |
$18,131.05 |
$10,695.32
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$227.50 |
$227.50 |
$227.50 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$330.85 |
$330.85 |
$330.85 |
$362.05
|
|
Jkt lso inter
|
$41.27 |
$41.27 |
$41.27 |
$41.27
|
|
John cunningham antibody
|
$65.65 |
$65.65 |
$65.65 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$30.55 |
$30.55 |
$30.55 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$45.90 |
$45.90 |
$45.90 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,398.15 |
$1,398.15 |
$1,398.15 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,860.00 |
$1,860.00 |
$1,860.00 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$87.10 |
$87.10 |
$87.10 |
$490.75
|
|
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 gene analys d816 variant
|
$471.25 |
$471.25 |
$471.25 |
$374.61
|
|
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
|
$2.06 |
$2.06 |
$2.06 |
$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
|
$76,267.30 |
$76,267.30 |
$76,267.30 |
$8,425.00
|
|
Kit trach suct cls 30.5cm
|
$3,140.14 |
$3,140.14 |
$3,140.14 |
$35.26
|
|
Knee Arthroscopy (Meniscus Trimming)
|
$45,685.12 |
$45,685.12 |
$45,685.12 |
$5,339.00
|
|
Knee arthroscopy/surgery
|
$83,116.25 |
$83,116.25 |
$83,116.25 |
$9,001.20
|
|
Knee MRI (with and without contrast)
|
$2,465.45 |
$2,465.45 |
$2,465.45 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,047.85 |
$3,047.85 |
$3,047.85 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,550.25 |
$1,550.25 |
$1,550.25 |
$2,130.88
|
|
Knee X-ray
|
$216.45 |
$216.45 |
$216.45 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$2,413.00 |
$2,413.00 |
$2,413.00 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$225.55 |
$225.55 |
$225.55 |
$363.60
|
|
Kras gene addl variants
|
$604.50 |
$604.50 |
$604.50 |
$387.20
|
|
Kras gene variants exon 2
|
$657.80 |
$657.80 |
$657.80 |
$536.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$19.45 |
$19.45 |
$19.45 |
$33.60
|
|
Labioplasty 56800
|
$762.00 |
$762.00 |
$762.00 |
$3,905.53
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$55.60 |
$55.60 |
$55.60 |
$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
|
$2,232.00 |
$2,232.00 |
$2,232.00 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$84.50 |
$84.50 |
$84.50 |
$82.16
|
|
Lam facetc/frmt arthrd lum 1
|
$108,801.31 |
$108,801.31 |
$108,801.31 |
$582.40
|
|
Lam facetec & foramot crv
|
$63,253.97 |
$63,253.97 |
$63,253.97 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$70,565.05 |
$70,565.05 |
$70,565.05 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$119,324.09 |
$119,324.09 |
$119,324.09 |
$8,453.60
|
|
Lam factc/frmt arthrd lum ea
|
$103,213.12 |
$103,213.12 |
$103,213.12 |
$492.80
|
|
Lamie excise intrspinl lesion thrc 63266
|
$5,178.00 |
$5,178.00 |
$5,178.00 |
$5,339.00
|
|
Laminotomy single lumbar
|
$56,154.77 |
$56,154.77 |
$56,154.77 |
$8,453.60
|
|
Lanthanum carbonate oral 5mg
|
$5.15 |
$5.15 |
$5.15 |
$14.53
|
|
Laparo cholecystectomy/graph
|
$62,856.95 |
$62,856.95 |
$62,856.95 |
$8,346.00
|
|
Laparo proc abdm/per/oment 49329
|
$57,991.71 |
$57,991.71 |
$57,991.71 |
$6,622.75
|
|
Laparoscopy aspiration
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$6,904.15
|
|
Laparoscopy biopsy
|
$56,074.95 |
$56,074.95 |
$56,074.95 |
$6,463.42
|
|
Laparoscopy excise lesions
|
$64,601.91 |
$64,601.91 |
$64,601.91 |
$7,243.60
|
|
Laparoscopy fundoplasty
|
$63,064.05 |
$63,064.05 |
$63,064.05 |
$11,424.40
|
|
Laparoscopy lysis
|
$2,043.00 |
$2,043.00 |
$2,043.00 |
$5,814.32
|
|
Laparoscopy remove adnexa
|
$58,308.84 |
$58,308.84 |
$58,308.84 |
$8,782.80
|
|
Laparoscopy surg colpopexy
|
$70,925.89 |
$70,925.89 |
$70,925.89 |
$10,897.60
|
|
Laparo-vag hyst incl t/o
|
$65,403.65 |
$65,403.65 |
$65,403.65 |
$12,100.40
|
|
Lap enterolysis
|
$46,914.77 |
$46,914.77 |
$46,914.77 |
$6,463.42
|
|
Lap ing hernia repair init
|
$66,845.87 |
$66,845.87 |
$66,845.87 |
$9,605.51
|
|
Lap ing hernia repair recur
|
$63,486.41 |
$63,486.41 |
$63,486.41 |
$6,870.89
|
|
Lap insert tunnel ip cath
|
$40,956.20 |
$40,956.20 |
$40,956.20 |
$6,895.20
|
|
Lap paraesophag hern repair
|
$86,360.67 |
$86,360.67 |
$86,360.67 |
$12,260.88
|
|
Lap paraesoph her rpr w/mesh
|
$79,317.44 |
$79,317.44 |
$79,317.44 |
$10,029.60
|
|
Lap sleeve gastrectomy
|
$78,897.61 |
$78,897.61 |
$78,897.61 |
$2,733.60
|
|
Laps surg prst8ect smpl stot
|
$102,133.08 |
$102,133.08 |
$102,133.08 |
$12,320.22
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$1,879.00 |
$1,879.00 |
$1,879.00 |
$740.40
|
|
Laryngoscopy w/bx & op scope
|
$30,078.05 |
$30,078.05 |
$30,078.05 |
$4,627.00
|
|
Lateral canthopexy
|
$34,657.40 |
$34,657.40 |
$34,657.40 |
$3,837.72
|
|
Lead acuity x4 spiral l 86cm
|
$2,873.32 |
$2,873.32 |
$2,873.32 |
$5,460.00
|
|
Lead capillary
|
$74.10 |
$74.10 |
$74.10 |
$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 Artery Ultrasound (complete, both legs)
|
$1,042.60 |
$1,042.60 |
$1,042.60 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,161.25 |
$2,161.25 |
$2,161.25 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,801.15 |
$1,801.15 |
$1,801.15 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,302.60 |
$1,302.60 |
$1,302.60 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$419.25 |
$419.25 |
$419.25 |
$955.30
|