|
Ins/rpl pm gen exist dual lead
|
$11,777.36 |
$11,777.36 |
$11,777.36 |
$11,583.66
|
|
Ins/rpl pm gen exist sgl lead
|
$10,119.76 |
$10,119.76 |
$10,119.76 |
$9,824.59
|
|
Ins/rpl pm w/tv ld atrl
|
$12,442.08 |
$12,442.08 |
$12,442.08 |
$12,442.95
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$9,089.36 |
$9,089.36 |
$9,089.36 |
$6,396.57
|
|
Ins tun cv cath wo subq prt/pm
|
$2,904.72 |
$2,904.72 |
$2,904.72 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$2,904.72 |
$2,904.72 |
$2,904.72 |
$4,314.75
|
|
Ins tun intraperit dia cath
|
$703.36 |
$703.36 |
$703.36 |
$4,657.46
|
|
Insulin total
|
$25.76 |
$25.76 |
$25.76 |
$72.15
|
|
Ins vag brachytx device
|
$434.56 |
$434.56 |
$434.56 |
$909.35
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$1,154.72 |
$1,154.72 |
$1,154.72 |
$9,463.86
|
|
Interdiscal perq aspir dx
|
$596.96 |
$596.96 |
$596.96 |
$1,222.26
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$88.03 |
$88.03 |
$88.03 |
$104.31
|
|
Interrogate subq defib
|
$112.56 |
$112.56 |
$112.56 |
$148.00
|
|
Interrog dev eval icpms ip
|
$50.96 |
$50.96 |
$50.96 |
$108.80
|
|
Interrog device eval heart
|
$124.32 |
$124.32 |
$124.32 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$124.32 |
$124.32 |
$124.32 |
$130.00
|
|
Interstitial brachy inter
|
$176.96 |
$176.96 |
$176.96 |
$1,348.20
|
|
Intracard echo interv w/s&i
|
$3,176.32 |
$3,176.32 |
$3,176.32 |
$4,328.45
|
|
Intracran angioplsty w/stent
|
$6,587.84 |
$6,587.84 |
$6,587.84 |
$9,045.05
|
|
Intracranial angioplasty
|
$3,723.44 |
$3,723.44 |
$3,723.44 |
$7,578.00
|
|
Intracranial complete study
|
$544.88 |
$544.88 |
$544.88 |
$903.50
|
|
Intracranial limited study
|
$364.56 |
$364.56 |
$364.56 |
$398.34
|
|
Intrapul surf admin endo tube
|
$327.60 |
$327.60 |
$327.60 |
$220.80
|
|
Intraventricular pacing
|
$4,309.20 |
$4,309.20 |
$4,309.20 |
$5,625.00
|
|
Intrinsic factor antibody
|
$17.92 |
$17.92 |
$17.92 |
$76.77
|
|
Intro cath dialysis circuit
|
$281.12 |
$281.12 |
$281.12 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$12,046.16 |
$12,046.16 |
$12,046.16 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$40,103.84 |
$40,103.84 |
$40,103.84 |
$18,260.50
|
|
Intro catheter aorta
|
$4,447.52 |
$4,447.52 |
$4,447.52 |
$1,963.80
|
|
Intro cath svc/ivc
|
$1,865.36 |
$1,865.36 |
$1,865.36 |
$1,942.50
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$5,123.44 |
$5,123.44 |
$5,123.44 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,696.24 |
$1,696.24 |
$1,696.24 |
$1,633.03
|
|
Iodine i-123 sod iodide mil
|
$246.96 |
$246.96 |
$246.96 |
$650.00
|
|
Ionm in operatng room 15 min
|
$73.92 |
$73.92 |
$73.92 |
$238.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$25.86 |
$25.86 |
$25.86 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$24.36 |
$24.36 |
$24.36 |
$145.52
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$74.60 |
$74.60 |
$74.60 |
$254.59
|
|
Iron
|
$19.04 |
$19.04 |
$19.04 |
$67.50
|
|
Iron binding capacity
|
$28.56 |
$28.56 |
$28.56 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$22.14 |
$22.14 |
$22.14 |
$38.16
|
|
Irradiation of blood product each unit reference
|
$53.76 |
$53.76 |
$53.76 |
$127.49
|
|
Ivc venogram s&i
|
$974.40 |
$974.40 |
$974.40 |
$2,975.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$91.28 |
$91.28 |
$91.28 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$87.36 |
$87.36 |
$87.36 |
$170.94
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$94.64 |
$94.64 |
$94.64 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$171.36 |
$171.36 |
$171.36 |
$476.50
|
|
IV inj ra drug dx study
|
$472.64 |
$472.64 |
$472.64 |
$473.22
|
|
Ivp w/wo kub w/wo tomography
|
$231.28 |
$231.28 |
$231.28 |
$687.80
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$9.52 |
$9.52 |
$9.52 |
$52.50
|
|
Kidney img w/bldflw sgl without rx
|
$554.40 |
$554.40 |
$554.40 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$509.04 |
$509.04 |
$509.04 |
$618.54
|
|
Kit hfx iq ipg bundle
|
$19,867.68 |
$19,867.68 |
$19,867.68 |
$56,811.60
|
|
Kit lead specify 5-6-5
|
$7,208.88 |
$7,208.88 |
$7,208.88 |
$13,784.80
|
|
Kit sound processor cochlear osia 2
|
$10,164.00 |
$10,164.00 |
$10,164.00 |
$22,008.58
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,136.24 |
$1,136.24 |
$1,136.24 |
$2,836.08
|
|
Kit trach suct cls 30.5cm
|
$26.32 |
$26.32 |
$26.32 |
$28.20
|
|
Knee MRI (with and without contrast)
|
$2,328.48 |
$2,328.48 |
$2,328.48 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$2,196.88 |
$2,196.88 |
$2,196.88 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$2,158.80 |
$2,158.80 |
$2,158.80 |
$2,120.00
|
|
Knee X-ray
|
$206.64 |
$206.64 |
$206.64 |
$387.20
|
|
Kras gene addl variants
|
$32.68 |
$32.68 |
$32.68 |
$366.56
|
|
Kras gene variants exon 2
|
$32.68 |
$32.68 |
$32.68 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$144.48 |
$144.48 |
$144.48 |
$102.70
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.26 |
$0.26 |
$0.26 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$19.04 |
$19.04 |
$19.04 |
$50.55
|
|
Lactic acid
|
$57.68 |
$57.68 |
$57.68 |
$85.20
|
|
Lactoferrin fecal quant
|
$22.96 |
$22.96 |
$22.96 |
$106.10
|
|
Lap revision perm ip cath
|
$5,864.32 |
$5,864.32 |
$5,864.32 |
$6,376.26
|
|
Lap w/omentopexy add-on 49326
|
$884.80 |
$884.80 |
$884.80 |
$463.20
|
|
Lead acuity x4 spiral l 86cm
|
$14,560.00 |
$14,560.00 |
$14,560.00 |
$4,863.24
|
|
Lead capillary
|
$19.60 |
$19.60 |
$19.60 |
$66.32
|
|
Lead ingevity 45cm pfret MRI
|
$1,461.60 |
$1,461.60 |
$1,461.60 |
$4,132.20
|
|
Lead tachy durata sj4 58cm
|
$6,328.00 |
$6,328.00 |
$6,328.00 |
$13,488.75
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$489.44 |
$489.44 |
$489.44 |
$1,053.00
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$831.60 |
$831.60 |
$831.60 |
$609.00
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,170.40 |
$1,170.40 |
$1,170.40 |
$1,136.25
|
|
Lens iol ant chamb 10.5
|
$162.96 |
$162.96 |
$162.96 |
$191.25
|
|
Leukocyte phagocytosis
|
$49.28 |
$49.28 |
$49.28 |
$92.88
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$488.37 |
$488.37 |
$488.37 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$476.58 |
$476.58 |
$476.58 |
$4,308.91
|
|
Levetiracetam therapeutic drug level
|
$21.84 |
$21.84 |
$21.84 |
$99.45
|
|
Liberta rc ipg
|
$20,160.00 |
$20,160.00 |
$20,160.00 |
$48,321.00
|
|
Lidocaine therapeutic drug level
|
$29.68 |
$29.68 |
$29.68 |
$82.50
|
|
Ligation of inf vena cava
|
$4,975.04 |
$4,975.04 |
$4,975.04 |
$5,983.35
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$27.12 |
$27.12 |
$27.12 |
$84.28
|
|
Lipase
|
$39.76 |
$39.76 |
$39.76 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$30.46 |
$30.46 |
$30.46 |
$90.60
|
|
Lipoprotein blood quant
|
$39.76 |
$39.76 |
$39.76 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$42.00 |
$42.00 |
$42.00 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$16.24 |
$16.24 |
$16.24 |
$61.60
|
|
Lithium therapeutic drug level
|
$33.04 |
$33.04 |
$33.04 |
$62.40
|
|
Liver elastography 91200
|
$219.52 |
$219.52 |
$219.52 |
$312.00
|
|
Liver Function Test
|
$16.24 |
$16.24 |
$16.24 |
$92.85
|
|
Liver/spleen imag static only
|
$660.24 |
$660.24 |
$660.24 |
$1,135.20
|
|
Liver/spleen imag w/vasclr flow
|
$468.16 |
$468.16 |
$468.16 |
$727.35
|
|
Locm 100-199mg/ml iodine,1ml
|
$2.80 |
$2.80 |
$2.80 |
$2.57
|
|
Low cost skin substitute app
|
$1,036.56 |
$1,036.56 |
$1,036.56 |
$879.60
|
|
Low cost skin substitute app
|
$5,169.92 |
$5,169.92 |
$5,169.92 |
$2,147.57
|
|
Low cost skin substitute app
|
$1,036.56 |
$1,036.56 |
$1,036.56 |
$879.60
|
|
Low cost skin substitute app
|
$3,414.32 |
$3,414.32 |
$3,414.32 |
$1,214.40
|
