|
Inst via cath agent pleurds
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,074.68
|
|
Insulin total
|
$12.57 |
$12.57 |
$12.57 |
$67.60
|
|
Ins vag brachytx device
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$909.35
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$850.99 |
$850.99 |
$850.99 |
$10,179.63
|
|
Integra meshed bil wound mat
|
$223.62 |
$223.62 |
$223.62 |
$24,354.93
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$1,286.10 |
$1,286.10 |
$1,286.10 |
$3,160.50
|
|
Interdental fixation
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,133.48
|
|
Interdental wirg oth/thn fx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,809.68
|
|
Interdiscal perq aspir dx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,222.26
|
|
Int hrhc lig 1 hroid without img
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,245.23
|
|
Int hrhc lig 2+hroid without img
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,997.10
|
|
Intracran angioplsty w/stent
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$11,364.78
|
|
Intracranial angioplasty
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$7,149.60
|
|
Intracranial complete study
|
$206.68 |
$206.68 |
$206.68 |
$883.30
|
|
Intracranial limited study
|
$134.35 |
$134.35 |
$134.35 |
$423.52
|
|
Intranasal biopsy 30100
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,850.94
|
|
Intranasal reconstruction
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,421.47
|
|
Intraoral i+d tongue/floor lingual 41000
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$76.38 |
$76.38 |
$76.38 |
$239.52
|
|
Intrauterine transfusion ftl
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,004.25
|
|
Intrinsic factor antibody
|
$16.59 |
$16.59 |
$16.59 |
$59.95
|
|
Intro cath dialysis circuit
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$15,625.00
|
|
Intro catheter aorta
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,861.61
|
|
Intro cath svc/ivc
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,350.75
|
|
Intro long gi tube
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$131.48 |
$131.48 |
$131.48 |
$477.85
|
|
Intro windpipe wire/tube
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,316.30
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$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
|
$63.88 |
$63.88 |
$63.88 |
$154.50
|
|
Irrigation sphenoid sinus
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$1,752.89
|
|
Irrigation vagina and/or appl medicament tx disease
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$131.88
|
|
Island pedicle flap graft
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,468.80
|
|
Ivc venogram s&i
|
$974.45 |
$974.45 |
$974.45 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$127.59 |
$127.59 |
$127.59 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$56.78 |
$56.78 |
$56.78 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$109.85 |
$109.85 |
$109.85 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$262.62 |
$262.62 |
$262.62 |
$460.85
|
|
IV njx tst vasc flo flap/grf
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$469.93
|
|
Ivp w/wo kub w/wo tomography
|
$134.52 |
$134.52 |
$134.52 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$203.72 |
$203.72 |
$203.72 |
$378.30
|
|
Jaw arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Jaw arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Jejunstmy tube plcmt
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,244.82
|
|
John cunningham antibody
|
$18.58 |
$18.58 |
$18.58 |
$48.57
|
|
Keratoprosthesis
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$9,103.00
|
|
Ketamine and metabolite screen - quest
|
$48.50 |
$48.50 |
$48.50 |
$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
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,881.00
|
|
Kidney endoscopy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,098.80
|
|
Kidney endoscopy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,817.53
|
|
Kidney endoscopy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,555.79
|
|
Kidney endoscopy & biopsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,110.00
|
|
Kidney endoscopy & biopsy
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,817.53
|
|
Kidney endoscopy & treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,311.00
|
|
Kidney endoscopy & treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,419.00
|
|
Kidney endoscopy & treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,339.00
|
|
Kidney endoscopy & treatment
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,881.00
|
|
Kidney imag w/bld flow multi
|
$514.26 |
$514.26 |
$514.26 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$316.87 |
$316.87 |
$316.87 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$215.98 |
$215.98 |
$215.98 |
$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
|
$64.35 |
$64.35 |
$64.35 |
$5,329.23
|
|
Kit sound processor cochlear osia 2
|
$3,143.69 |
$3,143.69 |
$3,143.69 |
$10,444.90
|
|
Knee Arthroscopy (Cartilage Repair)
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/drainage
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy dx
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,834.77
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$2,974.01
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$4,137.60
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,594.44
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$5,419.00
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$7,807.24
|
|
Knee arthroscopy/surgery
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$10,477.98
|
|
Kras gene addl variants
|
$212.58 |
$212.58 |
$212.58 |
$346.45
|
|
Kras gene variants exon 2
|
$212.58 |
$212.58 |
$212.58 |
$495.00
|
|
Labioplasty 56800
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$3,762.53
|
|
Lactate dehydrogenase (ldh)
|
$6.64 |
$6.64 |
$6.64 |
$53.30
|
|
Lactic acid
|
$12.73 |
$12.73 |
$12.73 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$21.67 |
$21.67 |
$21.67 |
$88.40
|
|
Lactoferrin fecal quant
|
$21.59 |
$21.59 |
$21.59 |
$106.10
|
|
Lam facetec & foramot crv
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$7,807.24
|
|
Lam facetec & foramot lumbar
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$7,907.11
|
|
Lam facetec & foramot thrc
|
$6,311.00 |
$6,311.00 |
$6,311.00 |
$6,839.00
|
