|
Injection, fulvestrant
|
$646.27 |
$646.27 |
$646.27 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$5,549.16 |
$5,549.16 |
$5,549.16 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$1,074.40 |
$1,074.40 |
$1,074.40 |
$2,277.65
|
|
Injection, renflexis
|
$713.81 |
$713.81 |
$713.81 |
$1,341.52
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$781.60 |
$781.60 |
$781.60 |
$1,043.20
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$172.00 |
$172.00 |
$172.00 |
$145.60
|
|
Inj. fe derisomaltose 10 mg
|
$3,221.52 |
$3,221.52 |
$3,221.52 |
$3,221.52
|
|
Inj glycopyrrolate, glyrx-pf
|
$60.76 |
$60.76 |
$60.76 |
$11.23
|
|
Inj heparin, pfizer, 1000u
|
$61.04 |
$61.04 |
$61.04 |
$25.30
|
|
Inj. herceptin hylecta, 10mg
|
$5,665.84 |
$5,665.84 |
$5,665.84 |
$8,193.78
|
|
Inj hydroxocobalamin IV 25mg
|
$1,521.86 |
$1,521.86 |
$1,521.86 |
$2,452.32
|
|
Inj, invega hafyera/trinza
|
$15,908.48 |
$15,908.48 |
$15,908.48 |
$32,073.55
|
|
Inj, lidocaine w epinephrine
|
$60.48 |
$60.48 |
$60.48 |
$45.60
|
|
Inj mepivacaine hcl/10 ml
|
$64.49 |
$64.49 |
$64.49 |
$34.34
|
|
Inj multihance
|
$120.00 |
$120.00 |
$120.00 |
$70.54
|
|
Inj octafluoropropane mic,ml
|
$196.00 |
$196.00 |
$196.00 |
$211.40
|
|
Inj ontruzant 10 mg
|
$2,976.40 |
$2,976.40 |
$2,976.40 |
$6,706.27
|
|
Inj pantoprazole(hikma) 40mg
|
$62.10 |
$62.10 |
$62.10 |
$34.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,121.92 |
$3,121.92 |
$3,121.92 |
$6,614.40
|
|
Inj, releuko 1 mcg
|
$119.91 |
$119.91 |
$119.91 |
$475.36
|
|
Inj testosterone cypionate
|
$65.32 |
$65.32 |
$65.32 |
$64.96
|
|
Insertion catheter bladder non indwelling
|
$157.60 |
$157.60 |
$157.60 |
$208.01
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$7,404.80 |
$7,404.80 |
$7,404.80 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,383.20 |
$1,383.20 |
$1,383.20 |
$2,103.75
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,779.20 |
$5,779.20 |
$5,779.20 |
$7,267.20
|
|
In situ hybridization per specimen initial single probe stain
|
$442.40 |
$442.40 |
$442.40 |
$338.40
|
|
Instillation anticarcinogenic agent bladder
|
$942.40 |
$942.40 |
$942.40 |
$638.40
|
|
Insulin total
|
$61.60 |
$61.60 |
$61.60 |
$66.64
|
|
Interferon alfa-2b inj
|
$1,990.80 |
$1,990.80 |
$1,990.80 |
$1,409.92
|
|
Intrauterine transfusion ftl
|
$1,729.60 |
$1,729.60 |
$1,729.60 |
$1,063.50
|
|
Intrinsic factor antibody
|
$56.80 |
$56.80 |
$56.80 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$832.00 |
$832.00 |
$832.00 |
$601.28
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$200.00 |
$200.00 |
$200.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$3.97 |
$3.97 |
$3.97 |
$4.06
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$441.16 |
$441.16 |
$441.16 |
$173.98
|
|
Iron
|
$33.60 |
$33.60 |
$33.60 |
$75.00
|
|
Iron binding capacity
|
$46.40 |
$46.40 |
$46.40 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$86.82 |
$86.82 |
$86.82 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$72.44 |
$72.44 |
$72.44 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$171.20 |
$171.20 |
$171.20 |
$146.11
|
|
IV Fluids (each additional hour)
|
$170.40 |
$170.40 |
$170.40 |
$133.90
|
|
IV Fluids (first hour)
|
$394.40 |
$394.40 |
$394.40 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$240.80 |
$240.80 |
$240.80 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$280.00 |
$280.00 |
$280.00 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$248.00 |
$248.00 |
$248.00 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$504.80 |
$504.80 |
$504.80 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$180.80 |
$180.80 |
$180.80 |
$167.50
|
|
IV Push Injection (first drug)
|
$323.20 |
$323.20 |
$323.20 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$688.00 |
$688.00 |
$688.00 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$284.00 |
$284.00 |
$284.00 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$235.20 |
$235.20 |
$235.20 |
$362.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$48.00 |
$48.00 |
$48.00 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$61.20 |
$61.20 |
$61.20 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,739.20 |
$1,739.20 |
$1,739.20 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$745.60 |
$745.60 |
$745.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$336.00 |
$336.00 |
$336.00 |
$490.75
|
|
Knee MRI (with and without contrast)
|
$4,012.00 |
$4,012.00 |
$4,012.00 |
$3,022.20
|
|
Knee MRI (without contrast)
|
$2,682.40 |
$2,682.40 |
$2,682.40 |
$2,130.88
|
|
Knee X-ray
|
$268.80 |
$268.80 |
$268.80 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$181.60 |
$181.60 |
$181.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$359.20 |
$359.20 |
$359.20 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$262.40 |
$262.40 |
$262.40 |
$251.20
|
|
Kyleena, 19.5 mg
|
$1,009.61 |
$1,009.61 |
$1,009.61 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$64.79 |
$64.79 |
$64.79 |
$33.60
|
|
Lactate dehydrogenase (ldh)
|
$32.80 |
$32.80 |
$32.80 |
$55.50
|
|
Lactated ringers intravenous solution
|
$70.79 |
$70.79 |
$70.79 |
$43.74
|
|
Lactic acid
|
$57.60 |
$57.60 |
$57.60 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$104.80 |
$104.80 |
$104.80 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$10,735.20 |
$10,735.20 |
$10,735.20 |
$19,124.00
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$698.40 |
$698.40 |
$698.40 |
$740.40
|
|
Lavage cannulation maxillary sinus
|
$721.60 |
$721.60 |
$721.60 |
$728.00
|
|
Lead capillary
|
$68.80 |
$68.80 |
$68.80 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,441.60 |
$1,441.60 |
$1,441.60 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,700.00 |
$2,700.00 |
$2,700.00 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$2,235.20 |
$2,235.20 |
$2,235.20 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,322.40 |
$1,322.40 |
$1,322.40 |
$1,092.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$462.40 |
$462.40 |
$462.40 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$320.00 |
$320.00 |
$320.00 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$73.44 |
$73.44 |
$73.44 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$4,396.20 |
$4,396.20 |
$4,396.20 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$16,204.64 |
$16,204.64 |
$16,204.64 |
$8,348.12
|
|
Levalbuterol non-comp unit
|
$7.38 |
$7.38 |
$7.38 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$61.26 |
$61.26 |
$61.26 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$72.00 |
$72.00 |
$72.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$127.12 |
$127.12 |
$127.12 |
$55.69
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$64.85 |
$64.85 |
$64.85 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$154.88 |
$154.88 |
$154.88 |
$39.75
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$212.40 |
$212.40 |
$212.40 |
$121.00
|
|
Lipase
|
$37.60 |
$37.60 |
$37.60 |
$93.58
|
|
Lipoprotein direct measurement hdl
|
$48.00 |
$48.00 |
$48.00 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$66.40 |
$66.40 |
$66.40 |
$61.60
|
|
Lithium therapeutic drug level
|
$39.20 |
$39.20 |
$39.20 |
$69.75
|
|
Liver Function Test
|
$48.00 |
$48.00 |
$48.00 |
$115.44
|
|
Liver imag w/vasclr flow
|
$1,436.00 |
$1,436.00 |
$1,436.00 |
$1,227.60
|
|
Locm 100-199mg/ml iodine,1ml
|
$6.40 |
$6.40 |
$6.40 |
$49.70
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$61.44 |
$61.44 |
$61.44 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,661.60 |
$2,661.60 |
$2,661.60 |
$1,815.45
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$2,495.20 |
$2,495.20 |
$2,495.20 |
$1,468.80
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$4,279.20 |
$4,279.20 |
$4,279.20 |
$3,097.92
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$3,344.00 |
$3,344.00 |
$3,344.00 |
$2,441.25
|