|
Infectious agent nucleic acid quantification hepatitis c
|
$313.95 |
$313.95 |
$313.95 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$372.45 |
$372.45 |
$372.45 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$313.30 |
$313.30 |
$313.30 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,042.11 |
$1,042.11 |
$1,042.11 |
$178.95
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$552.50 |
$552.50 |
$552.50 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$188.50 |
$188.50 |
$188.50 |
$244.00
|
|
Initial nursing facility care/day 45 minutes
|
$252.20 |
$252.20 |
$252.20 |
$333.60
|
|
Initial nursing facility care/day low severity 99304
|
$130.65 |
$130.65 |
$130.65 |
$162.40
|
|
Initiation & management bipap/cpap initial day
|
$639.60 |
$639.60 |
$639.60 |
$608.40
|
|
Inj, bupivacaine liposome
|
$506.12 |
$506.12 |
$506.12 |
$3.22
|
|
Inj cefazolin sodium, hikma
|
$26.53 |
$26.53 |
$26.53 |
$66.38
|
|
Inj ceftolozane tazobactam
|
$579.20 |
$579.20 |
$579.20 |
$248.93
|
|
Injection carpal tunnel therapeutic (both sides)
|
$196.95 |
$196.95 |
$196.95 |
$441.60
|
|
Injection epidural blood patch or clot
|
$625.30 |
$625.30 |
$625.30 |
$1,470.60
|
|
Injection, inclisiran, 1 mg
|
$7,300.18 |
$7,300.18 |
$7,300.18 |
$12.72
|
|
Injection, renflexis
|
$1,648.31 |
$1,648.31 |
$1,648.31 |
$632.98
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$263.25 |
$263.25 |
$263.25 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,040.36 |
$2,040.36 |
$2,040.36 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,172.89 |
$3,172.89 |
$3,172.89 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,194.64 |
$2,194.64 |
$2,194.64 |
$1,985.61
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,122.19 |
$3,122.19 |
$3,122.19 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,122.19 |
$3,122.19 |
$3,122.19 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,840.16 |
$1,840.16 |
$1,840.16 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,879.16 |
$1,879.16 |
$1,879.16 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$147.55 |
$147.55 |
$147.55 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$152.10 |
$152.10 |
$152.10 |
$517.24
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$128.05 |
$128.05 |
$128.05 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$128.05 |
$128.05 |
$128.05 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$128.05 |
$128.05 |
$128.05 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$89.70 |
$89.70 |
$89.70 |
$130.19
|
|
Inject sacroiliac joint
|
$447.20 |
$447.20 |
$447.20 |
$1,028.95
|
|
Inj meropenem (wg crit care)
|
$90.67 |
$90.67 |
$90.67 |
$20.78
|
|
Inj multihance
|
$85.75 |
$85.75 |
$85.75 |
$86.40
|
|
Inj progesterone per 50 mg
|
$90.67 |
$90.67 |
$90.67 |
$35.00
|
|
Inj testosterone cypionate
|
$119.21 |
$119.21 |
$119.21 |
$78.79
|
|
Inj, vasopressin (baxter)
|
$226.69 |
$226.69 |
$226.69 |
$2.94
|
|
Ins cerv dilator (sep proc)
|
$282.10 |
$282.10 |
$282.10 |
$557.60
|
|
Insertion catheter bladder non indwelling
|
$133.90 |
$133.90 |
$133.90 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$2,240.28 |
$2,240.28 |
$2,240.28 |
$245.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$529.75 |
$529.75 |
$529.75 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,306.50 |
$1,306.50 |
$1,306.50 |
$2,079.43
|
|
In situ hybridization per specimen each additional single probe stain
|
$4,162.98 |
$4,162.98 |
$4,162.98 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$4,162.98 |
$4,162.98 |
$4,162.98 |
$364.00
|
|
Insulin total
|
$78.65 |
$78.65 |
$78.65 |
$72.15
|
|
Intrinsic factor antibody
|
$89.05 |
$89.05 |
$89.05 |
$76.77
|
|
Intubation endotracheal emergency procedure
|
$555.10 |
$555.10 |
$555.10 |
$565.00
|
|
Iron
|
$75.40 |
$75.40 |
$75.40 |
$67.50
|
|
Iron binding capacity
|
$75.40 |
$75.40 |
$75.40 |
$55.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$181.08 |
$181.08 |
$181.08 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$83.20 |
$83.20 |
$83.20 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$143.00 |
$143.00 |
$143.00 |
$149.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$191.10 |
$191.10 |
$191.10 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$191.10 |
$191.10 |
$191.10 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$191.10 |
$191.10 |
$191.10 |
$476.50
|
|
Ivp w/nephrotomography
|
$878.15 |
$878.15 |
$878.15 |
$673.90
|
|
John cunningham antibody
|
$945.75 |
$945.75 |
$945.75 |
$39.65
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$73.45 |
$73.45 |
$73.45 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$11.31 |
$11.31 |
$11.31 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$1,370.85 |
$1,370.85 |
$1,370.85 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$1,467.70 |
$1,467.70 |
$1,467.70 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$679.25 |
$679.25 |
$679.25 |
$618.54
|
|
Knee MRI (with and without contrast)
|
$2,624.05 |
$2,624.05 |
$2,624.05 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$2,332.85 |
$2,332.85 |
$2,332.85 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$3,027.70 |
$3,027.70 |
$3,027.70 |
$2,120.00
|
|
Knee X-ray
|
$482.30 |
$482.30 |
$482.30 |
$387.20
|
|
Kras gene addl variants
|
$317.20 |
$317.20 |
$317.20 |
$366.56
|
|
Kras gene variants exon 2
|
$557.05 |
$557.05 |
$557.05 |
$495.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$42.25 |
$42.25 |
$42.25 |
$102.70
|
|
Lactate dehydrogenase (ldh)
|
$69.55 |
$69.55 |
$69.55 |
$50.55
|
|
Lactated ringers intravenous solution
|
$68.25 |
$68.25 |
$68.25 |
$46.35
|
|
Lactic acid
|
$185.90 |
$185.90 |
$185.90 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$102.70 |
$102.70 |
$102.70 |
$88.40
|
|
Laparo cholecystectomy/explr
|
$2,413.45 |
$2,413.45 |
$2,413.45 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$11,186.99 |
$11,186.99 |
$11,186.99 |
$6,870.89
|
|
Laparoscopy biopsy
|
$1,172.60 |
$1,172.60 |
$1,172.60 |
$5,954.23
|
|
Lap ing hernia repair init
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$6,457.82
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$648.05 |
$648.05 |
$648.05 |
$2,480.71
|
|
Lead capillary
|
$78.65 |
$78.65 |
$78.65 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$955.50 |
$955.50 |
$955.50 |
$1,053.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$11.76 |
$11.76 |
$11.76 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$111.15 |
$111.15 |
$111.15 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$40.35 |
$40.35 |
$40.35 |
$43.61
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$319.12 |
$319.12 |
$319.12 |
$343.13
|
|
Lidocaine therapeutic drug level
|
$89.70 |
$89.70 |
$89.70 |
$82.50
|
|
Lift heel adj small gl60404sm
|
$11.70 |
$11.70 |
$11.70 |
$188.15
|
|
Ligation/biopsy of temporal artery 37609
|
$687.05 |
$687.05 |
$687.05 |
$3,679.25
|
|
Limited visual field xm
|
$77.35 |
$77.35 |
$77.35 |
$79.20
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$42.62 |
$42.62 |
$42.62 |
$84.28
|
|
Lipase
|
$105.95 |
$105.95 |
$105.95 |
$67.68
|
|
Lipoprotein blood high res frac & quant
|
$68.90 |
$68.90 |
$68.90 |
$90.60
|
|
Lipoprotein direct measurement hdl
|
$55.25 |
$55.25 |
$55.25 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$65.65 |
$65.65 |
$65.65 |
$61.60
|
|
Lithium therapeutic drug level
|
$91.65 |
$91.65 |
$91.65 |
$62.40
|
|
Liver Function Test
|
$161.20 |
$161.20 |
$161.20 |
$92.85
|
|
Liver imaging
|
$980.20 |
$980.20 |
$980.20 |
$827.28
|
|
Liver imag w/vasclr flow
|
$1,027.00 |
$1,027.00 |
$1,027.00 |
$913.25
|
|
Liver/spleen imag static only
|
$1,149.85 |
$1,149.85 |
$1,149.85 |
$1,135.20
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$13.01 |
$13.01 |
$13.01 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,050.75 |
$2,050.75 |
$2,050.75 |
$1,731.00
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,191.15 |
$2,191.15 |
$2,191.15 |
$1,705.08
|
