|
Ins lv lead exist pm/icd
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$12,384.25
|
|
Ins mark abd/pel for right perq
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,070.00
|
|
Ins mark thor for right perq
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,396.35
|
|
Ins picad w subq port 5yr>
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,341.66
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,483.95
|
|
Ins pm gen exist dual lead
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,593.60
|
|
Ins/rplcmt prq eltrd ra pn 1
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$10,237.75
|
|
Ins/rplc spi npg/rcvr pocket
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$21,097.15
|
|
Ins/rpl ldless pm right vent w img & eval
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$11,593.70
|
|
Ins/rpl pm gen exist sgl lead
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$12,384.25
|
|
Ins/rpl prph sac/gstr npg/r
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$22,662.25
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$25,106.90
|
|
Insrt/redo neurostim 1 array
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$23,436.14
|
|
Install spinal shunt 63741
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,839.00
|
|
Inst fibrinolysis agent ini day
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,095.00
|
|
Inst fibrinolysis agent sbsq d
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$898.12
|
|
Instillation anticarcinogenic agent bladder
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$721.50
|
|
Instll rx agnt into rnal tub
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$619.20
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,396.57
|
|
Ins tun cv cath wo subq prt/pm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,657.46
|
|
Inst via cath agent pleurds
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,074.68
|
|
Insulin total
|
$12.57 |
$12.57 |
$12.57 |
$67.60
|
|
Ins vag brachytx device
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$909.35
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$945.16 |
$945.16 |
$945.16 |
$9,970.16
|
|
Integra meshed bil wound mat
|
$248.37 |
$248.37 |
$248.37 |
$25,450.30
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$1,428.41 |
$1,428.41 |
$1,428.41 |
$2,908.50
|
|
Interdental fixation
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,133.48
|
|
Interdental wirg oth/thn fx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,809.68
|
|
Interdiscal perq aspir dx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,222.26
|
|
Interrog evl pm/ldls pm ip
|
$50.30 |
$50.30 |
$50.30 |
$127.20
|
|
Int hrhc lig 1 hroid without img
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,245.23
|
|
Int hrhc lig 2+hroid without img
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,997.10
|
|
Intranasal biopsy 30100
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,850.94
|
|
Intranasal reconstruction
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,421.47
|
|
Intraoral i+d tongue/floor lingual 41000
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,182.15
|
|
Intrauterine transfusion ftl
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,004.25
|
|
Intrinsic factor antibody
|
$16.59 |
$16.59 |
$16.59 |
$59.95
|
|
Intro cath dialysis circuit
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$15,625.00
|
|
Intro cath svc/ivc
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,350.75
|
|
Intro long gi tube
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$91.97 |
$91.97 |
$91.97 |
$477.85
|
|
Intro windpipe wire/tube
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,316.30
|
|
Intubation endotracheal emergency procedure
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$617.60
|
|
Iron
|
$7.12 |
$7.12 |
$7.12 |
$70.72
|
|
Iron binding capacity
|
$9.61 |
$9.61 |
$9.61 |
$63.00
|
|
Iron stain peripheral blood
|
$7.57 |
$7.57 |
$7.57 |
$17.60
|
|
Irrigation implantable venous access device for drug delivery systems
|
$128.57 |
$128.57 |
$128.57 |
$154.50
|
|
Irrigation sphenoid sinus
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$1,752.89
|
|
Irrigation vagina and/or appl medicament tx disease
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$131.88
|
|
Island pedicle flap graft
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,468.80
|
|
Ivc venogram s&i
|
$1,310.33 |
$1,310.33 |
$1,310.33 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$140.39 |
$140.39 |
$140.39 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$71.88 |
$71.88 |
$71.88 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$94.03 |
$94.03 |
$94.03 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$212.66 |
$212.66 |
$212.66 |
$460.85
|
|
IV njx tst vasc flo flap/grf
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$469.93
|
|
Ivp w/nephrotomography
|
$251.89 |
$251.89 |
$251.89 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$219.79 |
$219.79 |
$219.79 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$203.72 |
$203.72 |
$203.72 |
$378.30
|
|
Jaw arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Jaw arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Jejunstmy tube plcmt
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,244.82
|
|
John cunningham antibody
|
$18.58 |
$18.58 |
$18.58 |
$48.57
|
|
Keratoprosthesis
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$9,103.00
|
|
Ketamine and metabolite screen - quest
|
$53.86 |
$53.86 |
$53.86 |
$68.15
|
|
Ketogenic steroids fract
|
$17.02 |
$17.02 |
$17.02 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$8.99 |
$8.99 |
$8.99 |
$56.61
|
|
Kidney endoscopy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,881.00
|
|
Kidney endoscopy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,098.80
|
|
Kidney endoscopy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,817.53
|
|
Kidney endoscopy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,555.79
|
|
Kidney endoscopy & biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,110.00
|
|
Kidney endoscopy & biopsy
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,817.53
|
|
Kidney endoscopy & treatment
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$6,311.00
|
|
Kidney endoscopy & treatment
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,419.00
|
|
Kidney endoscopy & treatment
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$5,339.00
|
|
Kidney endoscopy & treatment
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$4,881.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$186.57 |
$186.57 |
$186.57 |
$668.25
|
|
Kit gene analys d816 variant
|
$137.36 |
$137.36 |
$137.36 |
$355.00
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$71.47 |
$71.47 |
$71.47 |
$234.08
|
|
Kit sound processor cochlear osia 2
|
$3,491.54 |
$3,491.54 |
$3,491.54 |
$10,653.60
|
|
Knee Arthroscopy (Cartilage Repair)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/drainage
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy dx
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,834.77
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$2,974.01
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$5,855.00 |
$5,855.00 |
$5,855.00 |
$3,839.54
|
