|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$432.50 |
$432.50 |
$863.58 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$217.50 |
$217.50 |
$435.02 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$215.22 |
$215.22 |
$245.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$498.00 |
$498.00 |
$997.38 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$364.75 |
$364.75 |
$729.76 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$539.42 |
$539.42 |
$539.42 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$377.45 |
$377.45 |
$377.45 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$350.25 |
$350.25 |
$699.11 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$85.15 |
$85.15 |
$85.15 |
$55.31
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$601.50 |
$601.50 |
$1,206.77 |
$139.68
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$785.00 |
$785.00 |
$785.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$785.00 |
$785.00 |
$1,570.07 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$601.50 |
$601.50 |
$1,206.77 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$97.72 |
$97.72 |
$97.72 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$97.72 |
$97.72 |
$97.72 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$232.58 |
$232.58 |
$232.58 |
$108.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,042.92 |
$1,042.92 |
$1,042.92 |
$727.50
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$852.98 |
$852.98 |
$852.98 |
$239.50
|
|
Infliximab 100 mg intravenous solution
|
$3,926.41 |
$3,926.41 |
$3,926.41 |
$2,080.86
|
|
Influenza dna amp prob addl
|
$787.25 |
$787.25 |
$1,710.72 |
$64.26
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$706.87 |
$706.87 |
$706.87 |
$293.25
|
|
Inj allopurinol sodium 1 mg
|
$5,236.81 |
$5,236.81 |
$5,236.81 |
$6,968.99
|
|
Inj ceftolozane tazobactam
|
$168.07 |
$168.07 |
$168.07 |
$380.80
|
|
Inj crotalidae im f(ab')2 eq
|
$2,667.53 |
$2,667.53 |
$2,667.53 |
$2,613.60
|
|
Injection, caplacizumab-yhdp
|
$25,550.00 |
$25,550.00 |
$25,550.00 |
$16,375.33
|
|
Injection, doxercalciferol
|
$96.00 |
$96.00 |
$96.00 |
$23.86
|
|
Injection, fulvestrant
|
$245.93 |
$245.93 |
$2,901.82 |
$1,817.65
|
|
Injection, isavuconazonium
|
$961.59 |
$961.59 |
$961.59 |
$787.67
|
|
Injection, pentamidine iseth
|
$207.78 |
$207.78 |
$207.78 |
$429.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$354.00 |
$354.00 |
$354.00 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$354.00 |
$354.00 |
$354.00 |
$249.32
|
|
Inj fluphenazine hcl 1.25 mg
|
$261.24 |
$261.24 |
$261.24 |
$39.54
|
|
Inj, fulvestrant (teva)
|
$151.15 |
$151.15 |
$151.15 |
$136.50
|
|
Inj human fibrinogen con nos
|
$3.92 |
$3.92 |
$3.92 |
$3.95
|
|
Inj hydroxocobalamin IV 25mg
|
$3,166.31 |
$3,166.31 |
$3,166.31 |
$2,452.32
|
|
Inj imip 4 cilas 4 releb 2mg
|
$936.25 |
$936.25 |
$936.25 |
$739.77
|
|
Inj levocarnitine per 1 gm
|
$111.84 |
$111.84 |
$111.84 |
$136.62
|
|
Inj levoleucovorin nos 0.5mg
|
$600.00 |
$600.00 |
$600.00 |
$109.92
|
|
Inj melpha hydroch nos 50 mg
|
$466.90 |
$466.90 |
$466.90 |
$1,791.90
|
|
Inj multihance
|
$5.13 |
$5.13 |
$5.13 |
$73.49
|
|
Inj. mycophenolate mofetil
|
$149.03 |
$149.03 |
$149.03 |
$252.66
|
|
Inj octafluoropropane mic,ml
|
$1,530.25 |
$1,530.25 |
$1,995.00 |
$211.40
|
|
Inj, pedmark, 100 mg
|
$173.00 |
$173.00 |
$173.00 |
$132.57
|
|
Inj progesterone per 50 mg
|
$119.75 |
$119.75 |
$179.25 |
$15.00
|
|
Inj secretin synthetic human
|
$415.00 |
$415.00 |
$415.00 |
$1,285.20
|
|
Inj ustekinumab-stba, 1 mg
|
$1,022.11 |
$1,022.11 |
$1,022.11 |
$16.36
|
|
Inj vocal cord bulking agent
|
$5,931.00 |
$5,931.00 |
$5,931.00 |
$1,480.00
|
|
Insertion of catheter vein
|
$4,066.71 |
$4,066.71 |
$4,066.71 |
$836.25
|
|
Insitu hybridization auto
|
$571.75 |
$571.75 |
$1,249.10 |
$377.37
|
|
Insitu hybridization manual
|
$866.50 |
$866.50 |
$1,893.18 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$387.66 |
$387.66 |
$387.66 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$806.46 |
$806.46 |
$806.46 |
$331.69
|
|
Insulin tolerance panel
|
$314.75 |
$314.75 |
$622.44 |
$258.40
|
|
Insulin total
|
$188.79 |
$188.79 |
$596.25 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$3,161.62 |
$3,161.62 |
$3,161.62 |
$8,629.72
|
|
Interrogate subq defib
|
$285.43 |
$285.43 |
$285.43 |
$119.60
|
|
Interrog dev eval scrms ip
|
$326.40 |
$326.40 |
$326.40 |
$124.80
|
|
Interrog device eval heart
|
$550.75 |
$550.75 |
$550.75 |
$162.40
|
|
Intra-atrial recording
|
$25,856.57 |
$25,856.57 |
$25,856.57 |
$5,252.30
|
|
Intrinsic factor antibody
|
$445.79 |
$445.79 |
$445.79 |
$63.15
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$14.50 |
$14.50 |
$14.50 |
$288.11
|
|
Iron
|
$229.25 |
$229.25 |
$229.25 |
$72.29
|
|
Iron binding capacity
|
$48.25 |
$48.25 |
$517.70 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$101.50 |
$101.50 |
$101.50 |
$81.70
|
|
Iron stain peripheral blood
|
$109.50 |
$109.50 |
$215.22 |
$30.55
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$110.51 |
$110.51 |
$171.88 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$245.22 |
$245.22 |
$245.22 |
$114.40
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$596.25 |
$596.25 |
$596.25 |
$437.45
|
|
Ixabepilone 15 mg intravenous solution
|
$222.75 |
$222.75 |
$222.75 |
$10,695.32
|
|
Kafo femoral fx cast rigid
|
$8,958.00 |
$8,958.00 |
$8,958.00 |
$2,162.01
|
|
Kafo sing fre stirr thi/calf
|
$8,012.00 |
$8,012.00 |
$8,012.00 |
$2,351.38
|
|
Kafo sng solid stirrup without j
|
$7,801.00 |
$7,801.00 |
$7,801.00 |
$1,834.11
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,207.00 |
$1,207.00 |
$1,207.00 |
$673.36
|
|
Knee control full kneecap
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$192.00
|
|
Knee lift loop drop lock rin
|
$1,372.00 |
$1,372.00 |
$1,372.00 |
$222.00
|
|
Knee orth pos locking joint
|
$1,090.00 |
$1,090.00 |
$1,090.00 |
$585.60
|
|
Kras gene addl variants
|
$3,389.50 |
$3,389.50 |
$3,389.50 |
$386.75
|
|
Kras gene variants exon 2
|
$1,087.10 |
$1,087.10 |
$1,087.10 |
$509.00
|
|
Lacer molded to patient mode
|
$4,016.00 |
$4,016.00 |
$4,016.00 |
$775.69
|
|
Lactated ringers intravenous solution
|
$138.25 |
$138.25 |
$138.25 |
$44.91
|
|
Lactoferrin fecal qualitative
|
$255.75 |
$255.75 |
$555.29 |
$81.00
|
|
Laryngeal function studies
|
$1,327.28 |
$1,327.28 |
$1,327.28 |
$335.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$3,149.00 |
$3,149.00 |
$3,149.00 |
$1,092.58
|
|
Lev 1 hosp type b ed visit
|
$3,122.91 |
$3,122.91 |
$3,122.91 |
$186.98
|
|
Lev 2 hosp type b ed visit
|
$3,902.40 |
$3,902.40 |
$3,902.40 |
$359.65
|
|
Lev 3 hosp type b ed visit
|
$4,555.71 |
$4,555.71 |
$4,555.71 |
$598.15
|
|
Lev 4 hosp type b ed visit
|
$5,202.81 |
$5,202.81 |
$5,202.81 |
$915.40
|
|
Lev 5 hosp type b ed visit
|
$5,851.79 |
$5,851.79 |
$5,851.79 |
$1,542.68
|
|
Levalbuterol non-comp unit
|
$8.74 |
$8.74 |
$8.74 |
$6.00
|
|
Levetiracetam therapeutic drug level
|
$734.54 |
$734.54 |
$734.54 |
$88.92
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$5.00 |
$5.00 |
$5.00 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$320.75 |
$320.75 |
$643.04 |
$87.45
|
|
Lift heel adjustable med
|
$572.00 |
$572.00 |
$572.00 |
$64.68
|
|
Lipase
|
$98.00 |
$98.00 |
$435.02 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$348.75 |
$348.75 |
$757.27 |
$86.42
|
|
Lipoprotein direct measurement hdl
|
$310.75 |
$310.75 |
$622.44 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$390.00 |
$390.00 |
$390.00 |
$61.60
|
|
Lithium therapeutic drug level
|
$210.75 |
$210.75 |
$413.55 |
$69.42
|
|
Liver Function Test
|
$68.00 |
$68.00 |
$1,134.30 |
$115.44
|
|
Liver imaging
|
$4,712.83 |
$4,712.83 |
$4,712.83 |
$1,143.00
|