|
Irradiation of blood product each unit reference
|
$103.90 |
$103.90 |
$103.90 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$202.45 |
$202.45 |
$202.45 |
$146.11
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$13,460.15 |
$13,460.15 |
$13,460.15 |
$8,273.35
|
|
Ivc venogram s&i
|
$144.00 |
$144.00 |
$144.00 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$179.50 |
$179.50 |
$179.50 |
$133.90
|
|
IV Fluids (first hour)
|
$328.00 |
$328.00 |
$328.00 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$179.50 |
$179.50 |
$179.50 |
$162.68
|
|
IV inj ra drug dx study
|
$214.60 |
$214.60 |
$214.60 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$179.50 |
$179.50 |
$179.50 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$179.50 |
$179.50 |
$179.50 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$328.00 |
$328.00 |
$328.00 |
$439.56
|
|
IV njx tst vasc flo flap/grf
|
$634.45 |
$634.45 |
$634.45 |
$476.00
|
|
IV Push Injection (each additional drug)
|
$147.10 |
$147.10 |
$147.10 |
$167.50
|
|
IV Push Injection (first drug)
|
$179.50 |
$179.50 |
$179.50 |
$252.76
|
|
Ivp w/nephrotomography
|
$1,417.10 |
$1,417.10 |
$1,417.10 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$1,538.70 |
$1,538.70 |
$1,538.70 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$15,791.54 |
$15,791.54 |
$15,791.54 |
$10,695.32
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$526.45 |
$526.45 |
$526.45 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$400.85 |
$400.85 |
$400.85 |
$362.05
|
|
John cunningham antibody
|
$27.90 |
$27.90 |
$27.90 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$73.70 |
$73.70 |
$73.70 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$109.38 |
$109.38 |
$109.38 |
$23.52
|
|
Kidney imag w/bld flow multi
|
$733.15 |
$733.15 |
$733.15 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$2,532.05 |
$2,532.05 |
$2,532.05 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$781.50 |
$781.50 |
$781.50 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$642.50 |
$642.50 |
$642.50 |
$490.75
|
|
Kit gene analys d816 variant
|
$1,247.90 |
$1,247.90 |
$1,247.90 |
$374.61
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$265.00 |
$265.00 |
$265.00 |
$1,635.87
|
|
Knee MRI (with and without contrast)
|
$3,657.70 |
$3,657.70 |
$3,657.70 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,915.35 |
$2,915.35 |
$2,915.35 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,352.50 |
$2,352.50 |
$2,352.50 |
$2,130.88
|
|
Knee X-ray
|
$514.30 |
$514.30 |
$514.30 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$332.00 |
$332.00 |
$332.00 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$472.40 |
$472.40 |
$472.40 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$332.00 |
$332.00 |
$332.00 |
$251.20
|
|
Kras gene addl variants
|
$365.20 |
$365.20 |
$365.20 |
$387.20
|
|
Kras gene variants exon 2
|
$365.20 |
$365.20 |
$365.20 |
$536.20
|
|
Kyleena, 19.5 mg
|
$5,289.60 |
$5,289.60 |
$5,289.60 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$93.42 |
$93.42 |
$93.42 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$801.19 |
$801.19 |
$801.19 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$33.75 |
$33.75 |
$33.75 |
$55.50
|
|
Lactated ringers intravenous solution
|
$34.84 |
$34.84 |
$34.84 |
$43.74
|
|
Lactation class
|
$124.20 |
$124.20 |
$124.20 |
$104.96
|
|
Lactic acid
|
$121.45 |
$121.45 |
$121.45 |
$107.10
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$589.85 |
$589.85 |
$589.85 |
$740.40
|
|
Largsc w/rmvl foreign bdy(s)
|
$610.05 |
$610.05 |
$610.05 |
$765.97
|
|
Laryngeal function studies
|
$178.15 |
$178.15 |
$178.15 |
$342.60
|
|
Laryngoscopy telescopic
|
$873.25 |
$873.25 |
$873.25 |
$852.80
|
|
Laryngoscopy w/fb removal
|
$446.75 |
$446.75 |
$446.75 |
$2,854.09
|
|
Lead capillary
|
$75.30 |
$75.30 |
$75.30 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,288.85 |
$1,288.85 |
$1,288.85 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,221.55 |
$2,221.55 |
$2,221.55 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,834.25 |
$1,834.25 |
$1,834.25 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,344.30 |
$1,344.30 |
$1,344.30 |
$1,092.58
|
|
Lens, intraocular (new tech)
|
$175.00 |
$175.00 |
$175.00 |
$589.05
|
|
Lens iol ant bicnvx 24.0 multi
|
$295.00 |
$295.00 |
$295.00 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$150.00 |
$150.00 |
$150.00 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$696.95 |
$696.95 |
$696.95 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$33,648.91 |
$33,648.91 |
$33,648.91 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$14,118.47 |
$14,118.47 |
$14,118.47 |
$8,348.12
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$323.45 |
$323.45 |
$323.45 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$341.10 |
$341.10 |
$341.10 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$182.33 |
$182.33 |
$182.33 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$838.66 |
$838.66 |
$838.66 |
$420.60
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$126.31 |
$126.31 |
$126.31 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$40.65 |
$40.65 |
$40.65 |
$39.75
|
|
Ligation/major artery/extremity 37618
|
$533.10 |
$533.10 |
$533.10 |
$1,567.80
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$266.85 |
$266.85 |
$266.85 |
$121.00
|
|
Lipase
|
$99.90 |
$99.90 |
$99.90 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$97.45 |
$97.45 |
$97.45 |
$87.00
|
|
Lipoprotein blood quant
|
$63.10 |
$63.10 |
$63.10 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$118.75 |
$118.75 |
$118.75 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$98.55 |
$98.55 |
$98.55 |
$61.60
|
|
Lip surgery procedure
|
$3,143.45 |
$3,143.45 |
$3,143.45 |
$334.50
|
|
Lithium therapeutic drug level
|
$136.35 |
$136.35 |
$136.35 |
$69.75
|
|
Liver Function Test
|
$159.35 |
$159.35 |
$159.35 |
$115.44
|
|
Liver/spleen imag static only
|
$2,276.90 |
$2,276.90 |
$2,276.90 |
$1,138.55
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$161.77 |
$161.77 |
$161.77 |
$37.20
|
|
Low cost skin substitute app
|
$305.10 |
$305.10 |
$305.10 |
$933.60
|
|
Low cost skin substitute app
|
$653.30 |
$653.30 |
$653.30 |
$2,164.64
|
|
Low cost skin substitute app
|
$323.95 |
$323.95 |
$323.95 |
$1,012.00
|
|
Low cost skin substitute app
|
$600.00 |
$600.00 |
$600.00 |
$1,016.16
|
|
Low cost skin substitute app
|
$59.45 |
$59.45 |
$59.45 |
$466.80
|
|
Low cost skin substitute app
|
$156.55 |
$156.55 |
$156.55 |
$756.00
|
|
Low cost skin substitute app
|
$65.20 |
$65.20 |
$65.20 |
$408.45
|
|
Low cost skin substitute app
|
$165.95 |
$165.95 |
$165.95 |
$515.00
|
|
Low-Dose Lung Cancer Screening CT Scan
|
$430.50 |
$430.50 |
$430.50 |
$331.50
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,812.75 |
$2,812.75 |
$2,812.75 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,254.00 |
$2,254.00 |
$2,254.00 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,853.10 |
$1,853.10 |
$1,853.10 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$3,382.30 |
$3,382.30 |
$3,382.30 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,775.00 |
$2,775.00 |
$2,775.00 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,440.30 |
$2,440.30 |
$2,440.30 |
$2,080.00
|
|
Lower Back (Lumbar Spine) X-ray
|
$514.30 |
$514.30 |
$514.30 |
$359.20
|
|
Lower Back (Lumbar Spine) X-ray (4 or more views)
|
$577.60 |
$577.60 |
$577.60 |
$505.83
|
|
Lower Back (Lumbar Spine) X-ray (with bending views)
|
$754.45 |
$754.45 |
$754.45 |
$540.60
|
|
Lower Leg (Shin) X-ray (both sides)
|
$332.00 |
$332.00 |
$332.00 |
$338.40
|
|
Lung Function Test Before and After an Inhaler
|
$483.20 |
$483.20 |
$483.20 |
$549.83
|
|
Lung Function Test (Spirometry)
|
$224.05 |
$224.05 |
$224.05 |
$296.91
|
|
Lung perfusion imaging
|
$1,599.35 |
$1,599.35 |
$1,599.35 |
$1,069.25
|