|
Ins mark abd/pel for right perq
|
$938.79 |
$938.79 |
$938.79 |
$2,393.43
|
|
Ins picad w subq port 5yr>
|
$3,587.41 |
$3,587.41 |
$3,587.41 |
$3,957.62
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,562.21 |
$1,562.21 |
$1,562.21 |
$1,610.00
|
|
Ins pq tunnld ip cath w/img
|
$4,767.76 |
$4,767.76 |
$4,767.76 |
$5,377.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$23,746.69 |
$23,746.69 |
$23,746.69 |
$24,061.80
|
|
Ins/rpl pm gen exist dual lead
|
$10,207.13 |
$10,207.13 |
$10,207.13 |
$11,408.40
|
|
Ins/rpl pm gen exist sgl lead
|
$10,308.39 |
$10,308.39 |
$10,308.39 |
$9,705.00
|
|
Ins/rpl pm w/tv ld atrl
|
$16,695.70 |
$16,695.70 |
$16,695.70 |
$11,742.60
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$34,209.41 |
$34,209.41 |
$34,209.41 |
$25,106.90
|
|
Inst fibrinolysis agent ini day
|
$1,332.85 |
$1,332.85 |
$1,332.85 |
$1,047.78
|
|
Insti hexaminolevulinate hcl
|
$774.09 |
$774.09 |
$774.09 |
$2,224.80
|
|
Instillation anticarcinogenic agent bladder
|
$904.02 |
$904.02 |
$904.02 |
$653.25
|
|
Instill, bupivac and meloxic
|
$12.22 |
$12.22 |
$12.22 |
$687.60
|
|
Instll rx agnt into rnal tub
|
$406.87 |
$406.87 |
$406.87 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$1,426.18 |
$1,426.18 |
$1,426.18 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$3,853.98 |
$3,853.98 |
$3,853.98 |
$4,202.70
|
|
Ins tun intraperit dia cath
|
$3,104.90 |
$3,104.90 |
$3,104.90 |
$4,652.70
|
|
Inst via cath agent pleurds
|
$710.04 |
$710.04 |
$710.04 |
$1,074.68
|
|
Insulin total
|
$18.30 |
$18.30 |
$18.30 |
$66.64
|
|
Ins vag brachytx device
|
$358.07 |
$358.07 |
$358.07 |
$927.55
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$6,231.98 |
$6,231.98 |
$6,231.98 |
$8,683.20
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$151.25 |
$151.25 |
$151.25 |
$3,803.11
|
|
Interdiscal perq aspir dx
|
$433.10 |
$433.10 |
$433.10 |
$1,212.50
|
|
Interrog device eval heart
|
$64.66 |
$64.66 |
$64.66 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$42.70 |
$42.70 |
$42.70 |
$124.80
|
|
Intracranial complete study
|
$616.10 |
$616.10 |
$616.10 |
$882.00
|
|
Intracranial limited study
|
$322.69 |
$322.69 |
$322.69 |
$473.85
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,044.93 |
$1,044.93 |
$1,044.93 |
$1,361.25
|
|
Intrapul surf admin endo tube
|
$117.73 |
$117.73 |
$117.73 |
$221.85
|
|
Intrinsic factor antibody
|
$45.75 |
$45.75 |
$45.75 |
$64.20
|
|
Intro cath dialysis circuit
|
$1,019.31 |
$1,019.31 |
$1,019.31 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$7,280.35 |
$7,280.35 |
$7,280.35 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$10,920.22 |
$10,920.22 |
$10,920.22 |
$15,620.00
|
|
Intro catheter aorta
|
$1,256.60 |
$1,256.60 |
$1,256.60 |
$1,678.05
|
|
Intro cath svc/ivc
|
$1,054.08 |
$1,054.08 |
$1,054.08 |
$1,329.90
|
|
Intro long gi tube w/mult fluo
|
$367.83 |
$367.83 |
$367.83 |
$465.50
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,409.29 |
$3,409.29 |
$3,409.29 |
$3,471.05
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,693.15 |
$2,693.15 |
$2,693.15 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$695.40 |
$695.40 |
$695.40 |
$598.80
|
|
Ionm in operatng room 15 min
|
$57.95 |
$57.95 |
$57.95 |
$191.40
|
|
Ionm remote/>1 pt or per hr
|
$1,155.95 |
$1,155.95 |
$1,155.95 |
$591.36
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$2.47 |
$2.47 |
$2.47 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$356.85 |
$356.85 |
$356.85 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$541.51 |
$541.51 |
$541.51 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$6.03 |
$6.03 |
$6.03 |
$173.40
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$164.64 |
$164.64 |
$164.64 |
$5,476.68
|
|
Iron
|
$40.87 |
$40.87 |
$40.87 |
$74.40
|
|
Iron binding capacity
|
$53.68 |
$53.68 |
$53.68 |
$63.84
|
|
Iron dextran 50 mg/ml injection solution
|
$10.40 |
$10.40 |
$10.40 |
$79.47
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$7.04 |
$7.04 |
$7.04 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$153.11 |
$153.11 |
$153.11 |
$143.76
|
|
Ivc venogram s&i
|
$2,425.97 |
$2,425.97 |
$2,425.97 |
$3,317.44
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$154.94 |
$154.94 |
$154.94 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$90.89 |
$90.89 |
$90.89 |
$158.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$117.73 |
$117.73 |
$117.73 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$612.44 |
$612.44 |
$612.44 |
$444.49
|
|
Ivp w/nephrotomography
|
$940.62 |
$940.62 |
$940.62 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$811.91 |
$811.91 |
$811.91 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$3,543.48 |
$3,543.48 |
$3,543.48 |
$10,695.32
|
|
J-tube placement
|
$336.11 |
$336.11 |
$336.11 |
$467.40
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$40.87 |
$40.87 |
$40.87 |
$60.32
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$2.88 |
$2.88 |
$2.88 |
$23.77
|
|
Kidney imag w/bld flow multi
|
$1,500.60 |
$1,500.60 |
$1,500.60 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,322.48 |
$1,322.48 |
$1,322.48 |
$1,435.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$804.59 |
$804.59 |
$804.59 |
$666.00
|
|
Kit case 4.2mm spinejack
|
$5,144.82 |
$5,144.82 |
$5,144.82 |
$7,751.14
|
|
Kit cath f 8f w/glv + wipe ster
|
$15.41 |
$15.41 |
$15.41 |
$9.80
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$6,450.75 |
$6,450.75 |
$6,450.75 |
$9,482.25
|
|
Kit lead specify 5-6-5
|
$41,470.55 |
$41,470.55 |
$41,470.55 |
$16,405.24
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$663.09 |
$663.09 |
$663.09 |
$1,569.50
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$1,420.54 |
$1,420.54 |
$1,420.54 |
$923.90
|
|
Kit sound processor cochlear osia 2
|
$4,348.08 |
$4,348.08 |
$4,348.08 |
$9,517.95
|
|
Knee MRI (with and without contrast)
|
$2,347.89 |
$2,347.89 |
$2,347.89 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$2,189.90 |
$2,189.90 |
$2,189.90 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,751.92 |
$1,751.92 |
$1,751.92 |
$2,139.80
|
|
Knee X-ray
|
$395.28 |
$395.28 |
$395.28 |
$425.55
|
|
Kras gene variants exon 2
|
$390.40 |
$390.40 |
$390.40 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$3.97 |
$3.97 |
$3.97 |
$33.14
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$2.77 |
$2.77 |
$2.77 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$42.70 |
$42.70 |
$42.70 |
$55.50
|
|
Lactated ringers intravenous solution
|
$0.01 |
$0.01 |
$0.01 |
$44.91
|
|
Lactic acid
|
$81.74 |
$81.74 |
$81.74 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$39.04 |
$39.04 |
$39.04 |
$81.25
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$11,163.00 |
$11,163.00 |
$11,163.00 |
$19,124.00
|
|
Laparo ablate renal mass
|
$5,294.19 |
$5,294.19 |
$5,294.19 |
$12,320.22
|
|
Laps abltj uterine fibroids
|
$9,208.56 |
$9,208.56 |
$9,208.56 |
$12,320.22
|
|
Lead acuity x4 spiral l 86cm
|
$4,117.50 |
$4,117.50 |
$4,117.50 |
$5,617.19
|
|
Lead capillary
|
$90.89 |
$90.89 |
$90.89 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$3,572.16 |
$3,572.16 |
$3,572.16 |
$3,154.46
|
|
Lead tachy durata sj4 58cm
|
$8,260.62 |
$8,260.62 |
$8,260.62 |
$8,202.66
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,265.75 |
$1,265.75 |
$1,265.75 |
$1,090.23
|
|
Lens, intraocular (new tech)
|
$722.85 |
$722.85 |
$722.85 |
$580.65
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$301.95 |
$301.95 |
$301.95 |
$1,012.32
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,517.38 |
$1,517.38 |
$1,517.38 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$532.74 |
$532.74 |
$532.74 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$48.09 |
$48.09 |
$48.09 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$592.74 |
$592.74 |
$592.74 |
$6,163.15
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$3,014.58 |
$3,014.58 |
$3,014.58 |
$9,107.80
|
|
Leuprolide depot cipla 7.5mg
|
$761.05 |
$761.05 |
$761.05 |
$623.81
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$6.41 |
$6.41 |
$6.41 |
$97.62
|