|
Instillation anticarcinogenic agent bladder
|
$23,367.58 |
$23,367.58 |
$23,367.58 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$8,323.63 |
$8,323.63 |
$8,323.63 |
$4,314.75
|
|
Insulin total
|
$130.00 |
$130.00 |
$130.00 |
$72.15
|
|
Interrog evl pm/ldls pm ip
|
$276.90 |
$276.90 |
$276.90 |
$130.00
|
|
Intranasal biopsy 30100
|
$53.30 |
$53.30 |
$53.30 |
$1,618.86
|
|
Intrapul surf admin endo tube
|
$39.00 |
$39.00 |
$39.00 |
$220.80
|
|
Intrinsic factor antibody
|
$270.40 |
$270.40 |
$270.40 |
$76.77
|
|
Intro cath dialysis circuit
|
$4,926.43 |
$4,926.43 |
$4,926.43 |
$2,161.90
|
|
Intro cath dialysis circuit w/pta
|
$16,543.98 |
$16,543.98 |
$16,543.98 |
$8,761.00
|
|
Intro catheter aorta
|
$20,865.25 |
$20,865.25 |
$20,865.25 |
$1,963.80
|
|
Intro cath svc/ivc
|
$7,419.88 |
$7,419.88 |
$7,419.88 |
$1,942.50
|
|
Intro long gi tube w/mult fluo
|
$154.05 |
$154.05 |
$154.05 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$101,048.09 |
$101,048.09 |
$101,048.09 |
$3,510.75
|
|
Intubation endotracheal emergency procedure
|
$59,342.80 |
$59,342.80 |
$59,342.80 |
$565.00
|
|
Iodine i-123 sod iodide mil
|
$1,741.35 |
$1,741.35 |
$1,741.35 |
$650.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$210.01 |
$210.01 |
$210.01 |
$4.59
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$279.10 |
$279.10 |
$279.10 |
$145.52
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$15,016.03 |
$15,016.03 |
$15,016.03 |
$261.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$35.75 |
$35.75 |
$35.75 |
$254.59
|
|
Iron
|
$78.65 |
$78.65 |
$78.65 |
$67.50
|
|
Iron binding capacity
|
$76.70 |
$76.70 |
$76.70 |
$55.00
|
|
Iron dextran 50 mg/ml injection solution
|
$31.81 |
$31.81 |
$31.81 |
$38.16
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$211.09 |
$211.09 |
$211.09 |
$211.09
|
|
Irradiation of blood product each unit reference
|
$179.40 |
$179.40 |
$179.40 |
$127.49
|
|
Irrigation implantable venous access device for drug delivery systems
|
$134.55 |
$134.55 |
$134.55 |
$149.00
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$7,535.29 |
$7,535.29 |
$7,535.29 |
$82.86
|
|
Ivc venogram s&i
|
$4,737.85 |
$4,737.85 |
$4,737.85 |
$2,975.00
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$314.60 |
$314.60 |
$314.60 |
$186.55
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$273.65 |
$273.65 |
$273.65 |
$153.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$577.20 |
$577.20 |
$577.20 |
$476.50
|
|
Ivp w/nephrotomography
|
$1,194.05 |
$1,194.05 |
$1,194.05 |
$673.90
|
|
Ivp w/wo kub w/wo tomography
|
$759.85 |
$759.85 |
$759.85 |
$687.80
|
|
Jak2 targeted sequence analysis
|
$312.65 |
$312.65 |
$312.65 |
$465.74
|
|
John cunningham antibody
|
$1,181.70 |
$1,181.70 |
$1,181.70 |
$39.65
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$113.75 |
$113.75 |
$113.75 |
$52.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$21.22 |
$21.22 |
$21.22 |
$17.11
|
|
Kidney imag w/bld flow multi
|
$4,008.55 |
$4,008.55 |
$4,008.55 |
$1,319.61
|
|
Kidney img w/bldflw sgl without rx
|
$3,025.75 |
$3,025.75 |
$3,025.75 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,043.25 |
$1,043.25 |
$1,043.25 |
$618.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$22,474.97 |
$22,474.97 |
$22,474.97 |
$3,705.22
|
|
Knee arthroscopy/surgery
|
$21,984.06 |
$21,984.06 |
$21,984.06 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$16,745.84 |
$16,745.84 |
$16,745.84 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$48,944.77 |
$48,944.77 |
$48,944.77 |
$3,743.15
|
|
Knee arthroscopy/surgery
|
$80,006.91 |
$80,006.91 |
$80,006.91 |
$7,907.11
|
|
Knee MRI (with and without contrast)
|
$4,428.45 |
$4,428.45 |
$4,428.45 |
$2,703.85
|
|
Knee MRI (with contrast)
|
$3,494.40 |
$3,494.40 |
$3,494.40 |
$2,315.95
|
|
Knee MRI (without contrast)
|
$3,494.40 |
$3,494.40 |
$3,494.40 |
$2,120.00
|
|
Knee X-ray
|
$828.10 |
$828.10 |
$828.10 |
$387.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$7.15 |
$7.15 |
$7.15 |
$13.00
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$53.23 |
$53.23 |
$53.23 |
$171.00
|
|
Lactate dehydrogenase (ldh)
|
$100.10 |
$100.10 |
$100.10 |
$50.55
|
|
Lactated ringers intravenous solution
|
$130.00 |
$130.00 |
$130.00 |
$46.35
|
|
Lactic acid
|
$257.40 |
$257.40 |
$257.40 |
$85.20
|
|
Lactoferrin fecal qualitative
|
$237.90 |
$237.90 |
$237.90 |
$88.40
|
|
Lam facetc/frmt arthrd lum 1
|
$89,833.69 |
$89,833.69 |
$89,833.69 |
$628.80
|
|
Lam facetec & foramot crv
|
$36,495.48 |
$36,495.48 |
$36,495.48 |
$7,807.24
|
|
Lam facetec & foramot lumbar
|
$27,600.33 |
$27,600.33 |
$27,600.33 |
$7,913.97
|
|
Lam factc/frmt arthrd lum ea
|
$119,389.02 |
$119,389.02 |
$119,389.02 |
$471.20
|
|
Laminotomy single lumbar
|
$34,538.67 |
$34,538.67 |
$34,538.67 |
$7,907.11
|
|
Laparo cholecystectomy/explr
|
$37,953.43 |
$37,953.43 |
$37,953.43 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$20,898.31 |
$20,898.31 |
$20,898.31 |
$6,870.89
|
|
Laparo partial nephrectomy
|
$46,695.27 |
$46,695.27 |
$46,695.27 |
$9,363.13
|
|
Laparoscopy adrenalectomy
|
$35,032.19 |
$35,032.19 |
$35,032.19 |
$5,389.80
|
|
Laparoscopy aspiration
|
$20,147.82 |
$20,147.82 |
$20,147.82 |
$5,922.01
|
|
Laparoscopy biopsy
|
$20,576.29 |
$20,576.29 |
$20,576.29 |
$5,954.23
|
|
Laparoscopy excise lesions
|
$24,457.37 |
$24,457.37 |
$24,457.37 |
$5,747.73
|
|
Laparoscopy fundoplasty
|
$31,288.95 |
$31,288.95 |
$31,288.95 |
$11,191.12
|
|
Laparoscopy lymphadenectomy
|
$54,666.40 |
$54,666.40 |
$54,666.40 |
$11,523.76
|
|
Laparoscopy lymph node biop
|
$42,558.25 |
$42,558.25 |
$42,558.25 |
$6,376.26
|
|
Laparoscopy remove adnexa
|
$23,446.68 |
$23,446.68 |
$23,446.68 |
$6,672.53
|
|
Laparoscopy splenectomy
|
$28,840.49 |
$28,840.49 |
$28,840.49 |
$7,975.19
|
|
Laparoscopy surg colpopexy
|
$44,917.00 |
$44,917.00 |
$44,917.00 |
$9,114.50
|
|
Laparo urethral suspension
|
$44,405.54 |
$44,405.54 |
$44,405.54 |
$6,463.42
|
|
Lap enterolysis
|
$29,247.99 |
$29,247.99 |
$29,247.99 |
$5,868.27
|
|
Lap ing hernia repair init
|
$24,563.59 |
$24,563.59 |
$24,563.59 |
$6,457.82
|
|
Lap ing hernia repair recur
|
$24,917.82 |
$24,917.82 |
$24,917.82 |
$6,376.26
|
|
Lap paraesophag hern repair
|
$33,171.76 |
$33,171.76 |
$33,171.76 |
$8,854.66
|
|
Laps surg prst8ect rpbic rad
|
$46,820.65 |
$46,820.65 |
$46,820.65 |
$11,523.76
|
|
Laps surg prst8ect smpl stot
|
$39,622.84 |
$39,622.84 |
$39,622.84 |
$11,378.21
|
|
Laser surgery of prostate
|
$18,127.72 |
$18,127.72 |
$18,127.72 |
$5,983.74
|
|
Lead capillary
|
$126.75 |
$126.75 |
$126.75 |
$66.32
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,234.35 |
$1,234.35 |
$1,234.35 |
$1,053.00
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$280.12 |
$280.12 |
$280.12 |
$115.27
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$4,411.76 |
$4,411.76 |
$4,411.76 |
$5,001.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$45.50 |
$45.50 |
$45.50 |
$45.50
|
|
Levetiracetam therapeutic drug level
|
$227.50 |
$227.50 |
$227.50 |
$99.45
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$19.50 |
$19.50 |
$19.50 |
$43.61
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$22.75 |
$22.75 |
$22.75 |
$25.89
|
|
Lidocaine therapeutic drug level
|
$65.65 |
$65.65 |
$65.65 |
$82.50
|
|
Lig/band angioaccess av fistula
|
$23,815.17 |
$23,815.17 |
$23,815.17 |
$4,240.23
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$45.82 |
$45.82 |
$45.82 |
$84.28
|
|
Lipase
|
$114.40 |
$114.40 |
$114.40 |
$67.68
|
|
Lipoprotein blood quant
|
$136.50 |
$136.50 |
$136.50 |
$106.43
|
|
Lipoprotein direct measurement hdl
|
$111.15 |
$111.15 |
$111.15 |
$54.60
|
|
Lipoprotein direct measurement ldl
|
$111.15 |
$111.15 |
$111.15 |
$61.60
|
|
Lithium therapeutic drug level
|
$159.90 |
$159.90 |
$159.90 |
$62.40
|
|
Liver elastography 91200
|
$445.25 |
$445.25 |
$445.25 |
$312.00
|
|
Liver Function Test
|
$183.95 |
$183.95 |
$183.95 |
$92.85
|
|
Liver imaging
|
$86,489.96 |
$86,489.96 |
$86,489.96 |
$827.28
|
|
Liver imag w/vasclr flow
|
$1,658.15 |
$1,658.15 |
$1,658.15 |
$913.25
|