|
In situ hybridization per specimen each additional single probe stain
|
$324.87 |
$324.87 |
$324.87 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$308.70 |
$308.70 |
$308.70 |
$331.69
|
|
Ins picad w subq port 5yr>
|
$3,063.48 |
$3,063.48 |
$3,063.48 |
$3,985.20
|
|
Ins/rplc spi npg/rcvr pocket
|
$14,586.81 |
$14,586.81 |
$14,586.81 |
$24,061.80
|
|
Insti hexaminolevulinate hcl
|
$3,109.05 |
$3,109.05 |
$3,109.05 |
$2,224.80
|
|
Instillation anticarcinogenic agent bladder
|
$288.61 |
$288.61 |
$288.61 |
$621.40
|
|
Instill, bupivac and meloxic
|
$687.07 |
$687.07 |
$687.07 |
$687.60
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$6,163.22 |
$6,163.22 |
$6,163.22 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$1,193.15 |
$1,193.15 |
$1,193.15 |
$4,202.70
|
|
Insulin total
|
$78.40 |
$78.40 |
$78.40 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$5,006.02 |
$5,006.02 |
$5,006.02 |
$8,629.72
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$121.50 |
$121.50 |
$121.50 |
$3,803.11
|
|
Interdiscal perq aspir dx
|
$350.35 |
$350.35 |
$350.35 |
$1,222.26
|
|
Intranasal biopsy 30100
|
$197.47 |
$197.47 |
$197.47 |
$2,133.48
|
|
Intrinsic factor antibody
|
$46.06 |
$46.06 |
$46.06 |
$63.15
|
|
Intro cath dialysis circuit
|
$644.35 |
$644.35 |
$644.35 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$7,133.42 |
$7,133.42 |
$7,133.42 |
$8,690.50
|
|
Intubation endotracheal emergency procedure
|
$278.81 |
$278.81 |
$278.81 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$198.41 |
$198.41 |
$198.41 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$569.63 |
$569.63 |
$569.63 |
$288.11
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$86,996.37 |
$86,996.37 |
$86,996.37 |
$62,692.46
|
|
Ip/obs cnsltj new/est low 45
|
$122.50 |
$122.50 |
$122.50 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$177.87 |
$177.87 |
$177.87 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$214.13 |
$214.13 |
$214.13 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$79.38 |
$79.38 |
$79.38 |
$134.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$80.45 |
$80.45 |
$80.45 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$6,612.55 |
$6,612.55 |
$6,612.55 |
$5,517.12
|
|
Iron
|
$168.56 |
$168.56 |
$168.56 |
$72.29
|
|
Iron binding capacity
|
$87.22 |
$87.22 |
$87.22 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$83.51 |
$83.51 |
$83.51 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$159.67 |
$159.67 |
$159.67 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$73.50 |
$73.50 |
$73.50 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$90.16 |
$90.16 |
$90.16 |
$144.62
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$85.75 |
$85.75 |
$85.75 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$111.72 |
$111.72 |
$111.72 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$122.99 |
$122.99 |
$122.99 |
$437.45
|
|
Ivp w/nephrotomography
|
$374.36 |
$374.36 |
$374.36 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$368.97 |
$368.97 |
$368.97 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$14,232.01 |
$14,232.01 |
$14,232.01 |
$10,695.32
|
|
Jejunstmy tube plcmt
|
$324.87 |
$324.87 |
$324.87 |
$2,174.40
|
|
Ketogenic steroids fract
|
$57.82 |
$57.82 |
$57.82 |
$82.80
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$90.16 |
$90.16 |
$90.16 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$48.76 |
$48.76 |
$48.76 |
$23.77
|
|
Kidney function study
|
$317.03 |
$317.03 |
$317.03 |
$968.50
|
|
Kidney imaging morphology
|
$353.29 |
$353.29 |
$353.29 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,381.80 |
$1,381.80 |
$1,381.80 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$1,103.48 |
$1,103.48 |
$1,103.48 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$482.65 |
$482.65 |
$482.65 |
$673.36
|
|
Kit case 4.2mm spinejack
|
$4,132.73 |
$4,132.73 |
$4,132.73 |
$7,751.14
|
|
Kit cath f 8f w/glv + wipe ster
|
$12.38 |
$12.38 |
$12.38 |
$9.49
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$5,181.75 |
$5,181.75 |
$5,181.75 |
$9,482.25
|
|
Kit lead specify 5-6-5
|
$33,312.41 |
$33,312.41 |
$33,312.41 |
$16,965.41
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$532.64 |
$532.64 |
$532.64 |
$1,667.50
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$1,141.09 |
$1,141.09 |
$1,141.09 |
$923.90
|
|
Kit sound processor cochlear osia 2
|
$3,492.72 |
$3,492.72 |
$3,492.72 |
$8,425.00
|
|
Knee MRI (with and without contrast)
|
$2,120.23 |
$2,120.23 |
$2,120.23 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,863.96 |
$1,863.96 |
$1,863.96 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,710.10 |
$1,710.10 |
$1,710.10 |
$2,110.76
|
|
Knee X-ray
|
$265.09 |
$265.09 |
$265.09 |
$425.55
|
|
Kras gene variants exon 2
|
$843.29 |
$843.29 |
$843.29 |
$509.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$37.73 |
$37.73 |
$37.73 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$33.32 |
$33.32 |
$33.32 |
$72.80
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$51.99 |
$51.99 |
$51.99 |
$33.60
|
|
Lab pathology consultation
|
$25.97 |
$25.97 |
$25.97 |
$48.44
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$222.02 |
$222.02 |
$222.02 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$68.60 |
$68.60 |
$68.60 |
$55.50
|
|
Lactated ringers intravenous solution
|
$101.31 |
$101.31 |
$101.31 |
$44.91
|
|
Lactic acid
|
$80.36 |
$80.36 |
$80.36 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$57.33 |
$57.33 |
$57.33 |
$81.00
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$22,417.50 |
$22,417.50 |
$22,417.50 |
$19,124.00
|
|
Laparo cholecystectomy/explr
|
$1,472.94 |
$1,472.94 |
$1,472.94 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$949.13 |
$949.13 |
$949.13 |
$8,346.00
|
|
Laparo cholecystoenterostomy
|
$1,023.12 |
$1,023.12 |
$1,023.12 |
$1,108.77
|
|
Laparo drng lymphocele 49323
|
$842.80 |
$842.80 |
$842.80 |
$5,741.00
|
|
Laparo partial colectomy 44204
|
$2,033.01 |
$2,033.01 |
$2,033.01 |
$2,917.80
|
|
Laparoscopy aspiration
|
$497.84 |
$497.84 |
$497.84 |
$6,839.00
|
|
Laparoscopy biopsy
|
$458.15 |
$458.15 |
$458.15 |
$6,376.26
|
|
Laparoscopy splenectomy
|
$1,391.11 |
$1,391.11 |
$1,391.11 |
$10,488.40
|
|
Laparotomy; inject/aspirate liver cyst 47015
|
$1,538.11 |
$1,538.11 |
$1,538.11 |
$1,659.80
|
|
Laparo-vag hyst incl t/o
|
$1,330.35 |
$1,330.35 |
$1,330.35 |
$12,100.40
|
|
Lap colectomy part w/ileum 44205
|
$1,770.37 |
$1,770.37 |
$1,770.37 |
$2,938.32
|
|
Lap enterectomy 44202
|
$1,826.72 |
$1,826.72 |
$1,826.72 |
$2,142.00
|
|
Lap enterolysis
|
$1,212.26 |
$1,212.26 |
$1,212.26 |
$6,376.26
|
|
Lap inc hernia repair 49654
|
$1,113.77 |
$1,113.77 |
$1,113.77 |
$1,932.05
|
|
Lap inc hernia repair recurr 49656
|
$1,208.83 |
$1,208.83 |
$1,208.83 |
$2,072.28
|
|
Lap ing hernia repair init
|
$574.28 |
$574.28 |
$574.28 |
$8,312.83
|
|
Lap ing hernia repair recur
|
$749.21 |
$749.21 |
$749.21 |
$6,463.42
|
|
Lap insert tunnel ip cath
|
$511.07 |
$511.07 |
$511.07 |
$6,895.20
|
|
Lap part colectomy w/stoma 44206
|
$2,304.96 |
$2,304.96 |
$2,304.96 |
$4,307.20
|
|
Lap resect s/intestine addl 44203
|
$313.60 |
$313.60 |
$313.60 |
$516.78
|
|
Lap w/omentopexy add-on 49326
|
$245.00 |
$245.00 |
$245.00 |
$463.20
|
|
Largsc w/rmvl foreign bdy(s)
|
$380.24 |
$380.24 |
$380.24 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$467.46 |
$467.46 |
$467.46 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$642.39 |
$642.39 |
$642.39 |
$2,854.09
|
|
Lateral canthopexy
|
$1,177.96 |
$1,177.96 |
$1,177.96 |
$3,837.72
|
|
Lavage cannulation maxillary sinus
|
$254.31 |
$254.31 |
$254.31 |
$728.00
|
|
Lb with mastopexy 15839
|
$1,733.62 |
$1,733.62 |
$1,733.62 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$3,307.50 |
$3,307.50 |
$3,307.50 |
$5,534.00
|
|
Lead capillary
|
$85.26 |
$85.26 |
$85.26 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$2,869.44 |
$2,869.44 |
$2,869.44 |
$3,047.96
|