|
Inj, abilify maintena, 1 mg
|
$3,561.72 |
$3,561.72 |
$3,561.72 |
$5,355.30
|
|
Inj, bezlotoxumab, 10 mg
|
$4,659.94 |
$4,659.94 |
$4,659.94 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$1,087.43 |
$1,087.43 |
$1,087.43 |
$699.38
|
|
Inj cefazolin sodium, baxter
|
$36.96 |
$36.96 |
$36.96 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$61.77 |
$61.77 |
$61.77 |
$27.38
|
|
Inj, clindamycin (baxter)
|
$68.20 |
$68.20 |
$68.20 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$172.50 |
$172.50 |
$172.50 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$1,650.58 |
$1,650.58 |
$1,650.58 |
$742.72
|
|
Inj, cyclophosphamd, sandoz
|
$687.17 |
$687.17 |
$687.17 |
$735.20
|
|
Inj dx for sinogram
|
$172.50 |
$172.50 |
$172.50 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$172.50 |
$172.50 |
$172.50 |
$503.50
|
|
Injection epidural blood patch or clot
|
$94.95 |
$94.95 |
$94.95 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$223.60 |
$223.60 |
$223.60 |
$436.00
|
|
Injection for bladder x-ray
|
$224.65 |
$224.65 |
$224.65 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$172.50 |
$172.50 |
$172.50 |
$497.76
|
|
Injection,onabotulinumtoxina
|
$792.19 |
$792.19 |
$792.19 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$143.05 |
$143.05 |
$143.05 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$184.60 |
$184.60 |
$184.60 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$164.40 |
$164.40 |
$164.40 |
$1,043.72
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$855.90 |
$855.90 |
$855.90 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$855.90 |
$855.90 |
$855.90 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$73.55 |
$73.55 |
$73.55 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$111.00 |
$111.00 |
$111.00 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$64.15 |
$64.15 |
$64.15 |
$145.60
|
|
Inj epidural sgl cerv-thor without img
|
$855.90 |
$855.90 |
$855.90 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$855.90 |
$855.90 |
$855.90 |
$1,450.84
|
|
Inj for ext venography
|
$172.50 |
$172.50 |
$172.50 |
$628.80
|
|
Inj for mammo ductogram
|
$119.00 |
$119.00 |
$119.00 |
$397.80
|
|
Inj herzuma 10 mg
|
$4,815.69 |
$4,815.69 |
$4,815.69 |
$7,775.46
|
|
Inj, invega hafyera/trinza
|
$26,211.17 |
$26,211.17 |
$26,211.17 |
$32,073.55
|
|
Inj ivig privigen 500 mg
|
$9,235.52 |
$9,235.52 |
$9,235.52 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$225.26 |
$225.26 |
$225.26 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$64.83 |
$64.83 |
$64.83 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$855.90 |
$855.90 |
$855.90 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$19.70 |
$19.70 |
$19.70 |
$34.34
|
|
Inj, meropenem (b. braun)
|
$173.31 |
$173.31 |
$173.31 |
$71.14
|
|
Inj meropenem (wg crit care)
|
$190.64 |
$190.64 |
$190.64 |
$82.42
|
|
Inj, moxifloxacin 100 mg
|
$60.19 |
$60.19 |
$60.19 |
$101.31
|
|
Inj naloxone hydrochloride
|
$191.22 |
$191.22 |
$191.22 |
$83.16
|
|
Inj, nithiodote, 3mg / 125mg
|
$766.05 |
$766.05 |
$766.05 |
$468.10
|
|
Inj ontruzant 10 mg
|
$4,548.40 |
$4,548.40 |
$4,548.40 |
$6,706.27
|
|
Inj thrc fascial pln blk bi w/wo image
|
$837.10 |
$837.10 |
$837.10 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$837.10 |
$837.10 |
$837.10 |
$818.00
|
|
Inj, vancomycin hcl (mylan)
|
$68.21 |
$68.21 |
$68.21 |
$72.33
|
|
Inj w/fluor eval cv device
|
$534.80 |
$534.80 |
$534.80 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$288.80 |
$288.80 |
$288.80 |
$490.73
|
|
Insertion catheter bladder non indwelling
|
$58.00 |
$58.00 |
$58.00 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$301.50 |
$301.50 |
$301.50 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,658.15 |
$2,658.15 |
$2,658.15 |
$2,103.75
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$252.70 |
$252.70 |
$252.70 |
$7,183.68
|
|
Insert swan-ganz cath
|
$173.85 |
$173.85 |
$173.85 |
$2,164.52
|
|
In situ hybridization per specimen each additional single probe stain
|
$334.00 |
$334.00 |
$334.00 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$428.40 |
$428.40 |
$428.40 |
$338.40
|
|
Inst fibrinolysis agent sbsq d
|
$714.65 |
$714.65 |
$714.65 |
$997.05
|
|
Ins tun cv cath wo subq prt/pm
|
$3,906.75 |
$3,906.75 |
$3,906.75 |
$4,218.00
|
|
Insulin total
|
$200.75 |
$200.75 |
$200.75 |
$66.64
|
|
Interrog evl pm/ldls pm ip
|
$78.00 |
$78.00 |
$78.00 |
$127.20
|
|
Intranasal biopsy 30100
|
$3,777.95 |
$3,777.95 |
$3,777.95 |
$2,265.00
|
|
Intraoral i+d tongue/floor lingual 41000
|
$273.00 |
$273.00 |
$273.00 |
$1,331.45
|
|
Intrinsic factor antibody
|
$389.00 |
$389.00 |
$389.00 |
$65.00
|
|
Intro long gi tube w/mult fluo
|
$3,743.50 |
$3,743.50 |
$3,743.50 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$283.45 |
$283.45 |
$283.45 |
$601.28
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$417.60 |
$417.60 |
$417.60 |
$279.10
|
|
Ip/obs cnsltj new/est low 45
|
$360.80 |
$360.80 |
$360.80 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$518.45 |
$518.45 |
$518.45 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$618.05 |
$618.05 |
$618.05 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$237.10 |
$237.10 |
$237.10 |
$134.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$109.44 |
$109.44 |
$109.44 |
$173.98
|
|
Iron
|
$141.00 |
$141.00 |
$141.00 |
$75.00
|
|
Iron binding capacity
|
$183.60 |
$183.60 |
$183.60 |
$63.91
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$365.39 |
$365.39 |
$365.39 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$119.75 |
$119.75 |
$119.75 |
$115.20
|
|
Irrigation implantable venous access device for drug delivery systems
|
$374.40 |
$374.40 |
$374.40 |
$146.11
|
|
IV Fluids (each additional hour)
|
$129.75 |
$129.75 |
$129.75 |
$133.90
|
|
IV Fluids (first hour)
|
$408.65 |
$408.65 |
$408.65 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$64.15 |
$64.15 |
$64.15 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$129.75 |
$129.75 |
$129.75 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$129.75 |
$129.75 |
$129.75 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$565.60 |
$565.60 |
$565.60 |
$439.56
|
|
IV njx tst vasc flo flap/grf
|
$997.60 |
$997.60 |
$997.60 |
$476.00
|
|
IV Push Injection (each additional drug)
|
$464.20 |
$464.20 |
$464.20 |
$167.50
|
|
IV Push Injection (first drug)
|
$565.60 |
$565.60 |
$565.60 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$1,342.75 |
$1,342.75 |
$1,342.75 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$725.30 |
$725.30 |
$725.30 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$801.10 |
$801.10 |
$801.10 |
$362.05
|
|
John cunningham antibody
|
$43.90 |
$43.90 |
$43.90 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$226.15 |
$226.15 |
$226.15 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$40.13 |
$40.13 |
$40.13 |
$23.52
|
|
Kidney imag w/bld flow multi
|
$3,037.85 |
$3,037.85 |
$3,037.85 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,637.95 |
$1,637.95 |
$1,637.95 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,165.75 |
$1,165.75 |
$1,165.75 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$758.60 |
$758.60 |
$758.60 |
$490.75
|
|
Kit gene analys d816 variant
|
$738.25 |
$738.25 |
$738.25 |
$374.61
|
|
Kit lead specify 5-6-5
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
$16,672.10
|
|
Knee MRI (with and without contrast)
|
$3,301.70 |
$3,301.70 |
$3,301.70 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,330.40 |
$2,330.40 |
$2,330.40 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,139.80 |
$2,139.80 |
$2,139.80 |
$2,130.88
|
|
Knee X-ray
|
$565.60 |
$565.60 |
$565.60 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$384.60 |
$384.60 |
$384.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$480.40 |
$480.40 |
$480.40 |
$363.60
|