|
Ins icd gen exist mlt leads
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins icd gen exist sgl lead
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insitu hybridization auto
|
$267.60 |
$267.60 |
$267.60 |
|
|
Insitu hybridization manual
|
$243.60 |
$243.60 |
$243.60 |
|
|
In situ hybridization per specimen each additional single probe stain
|
$243.60 |
$243.60 |
$243.60 |
|
|
In situ hybridization per specimen initial single probe stain
|
$243.60 |
$243.60 |
$243.60 |
|
|
Ins lv lead exist pm/icd
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins picad w subq port 5yr>
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins pm gen exist dual lead
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins pm gen w/exist mlt leads
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins pq tunnld ip cath w/img
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins/rpl ldless pm right vent w img & eval
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins/rpl pm gen exist dual lead
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins/rpl pm gen exist sgl lead
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins/rpl pm w/tv ld atrl
|
$0.60 |
$0.60 |
$0.60 |
|
|
Instillation anticarcinogenic agent bladder
|
$117.00 |
$117.00 |
$117.00 |
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins tun cv cath wo subq prt/pm
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins tun cv cath wo subq prt/pm
|
$0.60 |
$0.60 |
$0.60 |
|
|
Ins tun intraperit dia cath
|
$0.60 |
$0.60 |
$0.60 |
|
|
Insulin total
|
$24.00 |
$24.00 |
$24.00 |
|
|
Interferon alfa-2b inj
|
$1,585.20 |
$1,585.20 |
$1,585.20 |
|
|
Interrog evl pm/ldls pm ip
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intra-atrial pacing
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intra-atrial recording
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intracard echo interv w/s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intraventricular pacing
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intrinsic factor antibody
|
$56.40 |
$56.40 |
$56.40 |
|
|
Intro cath dialysis circuit
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intro cath dialysis circuit w/pta
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intro catheter aorta
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intro cath svc/ivc
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$0.60 |
$0.60 |
$0.60 |
|
|
Intubation endotracheal emergency procedure
|
$39.60 |
$39.60 |
$39.60 |
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$61.20 |
$61.20 |
$61.20 |
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$200.40 |
$200.40 |
$200.40 |
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$78.00 |
$78.00 |
$78.00 |
|
|
Iron
|
$9.60 |
$9.60 |
$9.60 |
|
|
Iron binding capacity
|
$19.20 |
$19.20 |
$19.20 |
|
|
Iron dextran 50 mg/ml injection solution
|
$38.40 |
$38.40 |
$38.40 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$35.40 |
$35.40 |
$35.40 |
|
|
Irradiation of blood product each unit reference
|
$129.60 |
$129.60 |
$129.60 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$87.60 |
$87.60 |
$87.60 |
|
|
Ivc venogram s&i
|
$0.60 |
$0.60 |
$0.60 |
|
|
IV Fluids (each additional hour)
|
$703.20 |
$703.20 |
$703.20 |
|
|
IV Fluids (first hour)
|
$234.00 |
$234.00 |
$234.00 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$117.00 |
$117.00 |
$117.00 |
|
|
IV Medicine Infusion (additional drug)
|
$204.60 |
$204.60 |
$204.60 |
|
|
IV Medicine Infusion (each additional hour)
|
$937.80 |
$937.80 |
$937.80 |
|
|
IV Medicine Infusion (first hour)
|
$527.40 |
$527.40 |
$527.40 |
|
|
IV Push Injection (each additional drug)
|
$117.00 |
$117.00 |
$117.00 |
|
|
IV Push Injection (first drug)
|
$292.80 |
$292.80 |
$292.80 |
|
|
Ixabepilone 15 mg intravenous solution
|
$1,650.60 |
$1,650.60 |
$1,650.60 |
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$178.80 |
$178.80 |
$178.80 |
|
|
Jaw (Mandible) X-ray (complete)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$21.00 |
$21.00 |
$21.00 |
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$1.20 |
$1.20 |
$1.20 |
|
|
Kidney img w/bldflw sgl without rx
|
$198.00 |
$198.00 |
$198.00 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$393.00 |
$393.00 |
$393.00 |
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$142.80 |
$142.80 |
$142.80 |
|
|
Kit lead specify 5-6-5
|
$8,840.40 |
$8,840.40 |
$8,840.40 |
|
|
Kit monitr cath camino icp w/integratd licox bolt fitting
|
$448.20 |
$448.20 |
$448.20 |
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,122.00 |
$1,122.00 |
$1,122.00 |
|
|
Knee MRI (with and without contrast)
|
$601.20 |
$601.20 |
$601.20 |
|
|
Knee MRI (with contrast)
|
$495.00 |
$495.00 |
$495.00 |
|
|
Knee MRI (without contrast)
|
$276.60 |
$276.60 |
$276.60 |
|
|
Knee X-ray
|
$142.80 |
$142.80 |
$142.80 |
|
|
Knee X-ray (1 to 2 views, both knees)
|
$106.80 |
$106.80 |
$106.80 |
|
|
Knee X-ray (3 views, both knees)
|
$124.80 |
$124.80 |
$124.80 |
|
|
Knee X-ray (standing, both knees)
|
$142.80 |
$142.80 |
$142.80 |
|
|
Kras gene addl variants
|
$243.60 |
$243.60 |
$243.60 |
|
|
Kras gene variants exon 2
|
$389.40 |
$389.40 |
$389.40 |
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$63.60 |
$63.60 |
$63.60 |
|
|
Lactate dehydrogenase (ldh)
|
$6.00 |
$6.00 |
$6.00 |
|
|
Lactated ringers intravenous solution
|
$1.20 |
$1.20 |
$1.20 |
|
|
Lactic acid
|
$32.40 |
$32.40 |
$32.40 |
|
|
Lactoferrin fecal qualitative
|
$40.20 |
$40.20 |
$40.20 |
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$11,474.40 |
$11,474.40 |
$11,474.40 |
|
|
Lanthanum carbonate oral 5mg
|
$6.60 |
$6.60 |
$6.60 |
|
|
Lead acuity x4 spiral l 86cm
|
$2,570.40 |
$2,570.40 |
$2,570.40 |
|
|
Lead capillary
|
$40.20 |
$40.20 |
$40.20 |
|
|
Lead ingevity 45cm pfret MRI
|
$4,174.20 |
$4,174.20 |
$4,174.20 |
|
|
Lead tachy durata sj4 58cm
|
$4,950.00 |
$4,950.00 |
$4,950.00 |
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,108.20 |
$1,108.20 |
$1,108.20 |
|
|
Leg CT Scan (with contrast, both legs)
|
$140.40 |
$140.40 |
$140.40 |
|
|
Leg CT Scan (without contrast, both legs)
|
$107.40 |
$107.40 |
$107.40 |
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$822.00 |
$822.00 |
$822.00 |
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,993.80 |
$1,993.80 |
$1,993.80 |
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$4.80 |
$4.80 |
$4.80 |
|
|
Leukacyte transfusion
|
$974.40 |
$974.40 |
$974.40 |
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$6,209.40 |
$6,209.40 |
$6,209.40 |
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$4,876.80 |
$4,876.80 |
$4,876.80 |
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$13.20 |
$13.20 |
$13.20 |
|
|
Levetiracetam therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$2.40 |
$2.40 |
$2.40 |
|
|
Liberta rc ipg
|
$32,526.00 |
$32,526.00 |
$32,526.00 |
|
|
Lidocaine therapeutic drug level
|
$24.00 |
$24.00 |
$24.00 |
|