|
Intro cath dialysis circuit w/stent plcmnt
|
$3,786.00 |
$6,311.00 |
$13,355.34 |
|
|
Intro catheter aorta
|
$3,786.00 |
$5,110.00 |
$6,311.00 |
|
|
Intro cath svc/ivc
|
$3,786.00 |
$5,110.00 |
$6,311.00 |
|
|
Intro long gi tube
|
$1,024.64 |
$3,986.00 |
$6,839.00 |
|
|
Intro long gi tube w/mult fluo
|
$91.97 |
$116.47 |
$178.31 |
|
|
Intro windpipe wire/tube
|
$1,884.64 |
$3,986.00 |
$6,839.00 |
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,881.00 |
$5,741.00 |
$6,311.00 |
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$4,881.00 |
$5,741.00 |
$6,311.00 |
|
|
Intubation endotracheal emergency procedure
|
$253.79 |
$3,986.00 |
$6,839.00 |
|
|
Io anal gast n-stim subsq
|
$16.63 |
$65.75 |
$69.95 |
|
|
Iodine i-125 sodium iodide
|
$227.95 |
$230.87 |
$245.64 |
|
|
Io ga n-stim subsq w/reprog
|
$34.55 |
$41.27 |
$43.91 |
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.04 |
$0.04 |
$0.04 |
|
|
Io rad tx deliver by elctrns
|
$8,354.51 |
$8,461.38 |
$9,002.61 |
|
|
Io rad tx delivery by x-ray
|
$8,354.51 |
$8,461.38 |
$9,002.61 |
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$176.88 |
$183.41 |
$183.41 |
|
|
Ip/obs cnsltj new/est low 45
|
$183.00 |
$183.00 |
$183.00 |
|
|
Ip/obs cnsltj new/est mod 60
|
$252.50 |
$252.50 |
$252.50 |
|
|
Ip/obs consltj new/est hi 80
|
$302.50 |
$302.50 |
$302.50 |
|
|
Ip/obs consltj new/est sf 35
|
$121.50 |
$121.50 |
$121.50 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$64.77 |
$65.26 |
$65.26 |
|
|
Iron
|
$6.47 |
$7.12 |
$42.00 |
|
|
Iron binding capacity
|
$8.74 |
$9.61 |
$49.00 |
|
|
Iron dextran 50 mg/ml injection solution
|
$17.67 |
$18.03 |
$18.03 |
|
|
Iron stain peripheral blood
|
$6.88 |
$7.57 |
$7.57 |
|
|
Irradiation of blood product each unit reference
|
$32.28 |
$43.44 |
$49.87 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$48.76 |
$69.95 |
$162.82 |
|
|
Irrigation sphenoid sinus
|
$1,618.86 |
$3,986.00 |
$6,839.00 |
|
|
Irrigation vagina and/or appl medicament tx disease
|
$64.92 |
$3,986.00 |
$6,839.00 |
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$78.05 |
$82.86 |
$82.86 |
|
|
Island pedicle flap graft
|
$1,999.13 |
$3,986.00 |
$6,839.00 |
|
|
IV cipaglucosidase alfa-atga
|
$710.92 |
$720.01 |
$766.07 |
|
|
Ivc venogram s&i
|
$743.81 |
$1,527.44 |
$3,706.68 |
|
|
IV Fluids (each additional hour)
|
$50.43 |
$65.53 |
$128.10 |
|
|
IV Fluids (first hour)
|
$146.39 |
$233.20 |
$254.89 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$43.34 |
$79.58 |
$91.03 |
|
|
IV inj ra drug dx study
|
$439.15 |
$444.77 |
$473.22 |
|
|
IV Medicine Infusion (additional drug)
|
$77.78 |
$123.74 |
$177.79 |
|
|
IV Medicine Infusion (each additional hour)
|
$50.43 |
$94.03 |
$154.21 |
|
|
IV Medicine Infusion (first hour)
|
$200.46 |
$235.43 |
$397.37 |
|
|
IV njx tst vasc flo flap/grf
|
$436.10 |
$3,986.00 |
$6,839.00 |
|
|
IV Push Injection (each additional drug)
|
$50.43 |
$75.46 |
$123.60 |
|
|
IV Push Injection (first drug)
|
$96.10 |
$145.15 |
$248.12 |
|
|
Ivp w/nephrotomography
|
$194.55 |
$197.04 |
$251.89 |
|
|
Ivp w/wo kub w/wo tomography
|
$102.68 |
$197.04 |
$278.34 |
|
|
Ixabepilone 15 mg intravenous solution
|
$134.06 |
$138.67 |
$138.67 |
|
|
Jak2 targeted sequence analysis
|
$185.20 |
$203.72 |
$203.72 |
|
|
Jaw arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Jaw arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$67.08 |
$97.54 |
$115.99 |
|
|
Jaw (Mandible) X-ray (complete)
|
$90.42 |
$117.27 |
$139.42 |
|
|
Jejunstmy tube plcmt
|
$2,073.18 |
$3,986.00 |
$6,839.00 |
|
|
John cunningham antibody
|
$16.89 |
$18.58 |
$18.58 |
|
|
Keratoprosthesis
|
$3,786.00 |
$6,311.00 |
$16,827.95 |
|
|
Ketamine and metabolite screen - quest
|
$37.02 |
$59.52 |
$68.21 |
|
|
Ketogenic steroids fract
|
$15.47 |
$17.02 |
$17.02 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$8.17 |
$8.99 |
$67.50 |
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$0.38 |
$0.39 |
$3.29 |
|
|
Kidney endoscopy
|
$3,786.00 |
$5,626.86 |
$6,839.00 |
|
|
Kidney endoscopy
|
$3,786.00 |
$5,626.86 |
$6,839.00 |
|
|
Kidney endoscopy
|
$3,769.31 |
$4,061.71 |
$6,839.00 |
|
|
Kidney endoscopy
|
$3,786.00 |
$5,626.86 |
$6,839.00 |
|
|
Kidney endoscopy & biopsy
|
$3,786.00 |
$6,311.00 |
$10,890.00 |
|
|
Kidney endoscopy & biopsy
|
$3,769.31 |
$4,061.71 |
$6,839.00 |
|
|
Kidney endoscopy & treatment
|
$3,786.00 |
$6,311.00 |
$10,890.00 |
|
|
Kidney endoscopy & treatment
|
$3,786.00 |
$5,626.86 |
$6,839.00 |
|
|
Kidney endoscopy & treatment
|
$3,786.00 |
$6,311.00 |
$10,890.00 |
|
|
Kidney endoscopy & treatment
|
$3,786.00 |
$5,626.86 |
$6,839.00 |
|
|
Kidney function study
|
$219.38 |
$444.77 |
$473.22 |
|
|
Kidney imaging morphology
|
$209.23 |
$444.77 |
$532.60 |
|
|
Kidney imag w/bld flow multi
|
$392.54 |
$595.79 |
$679.58 |
|
|
Kidney img w/bldflw sgl without rx
|
$241.87 |
$455.32 |
$633.90 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$116.22 |
$186.57 |
$363.00 |
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$116.22 |
$164.71 |
$210.12 |
|
|
Kit gene analys d816 variant
|
$124.87 |
$137.36 |
$137.36 |
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$49.12 |
$57.63 |
$81.22 |
|
|
Kit sound processor cochlear osia 2
|
$2,399.62 |
$2,815.50 |
$3,967.74 |
|
|
Knee Arthroscopy (Cartilage Smoothing)
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/drainage
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy dx
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee Arthroscopy (Meniscus Trimming)
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$1,749.06 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,545.97 |
$3,986.00 |
$6,839.00 |
|
|
Knee arthroscopy/surgery
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Knee arthroscopy/surgery
|
$3,786.00 |
$6,311.00 |
$8,412.89 |
|
|
Knee arthroscopy/surgery
|
$3,786.00 |
$6,311.00 |
$15,152.74 |
|
|
Knee MRI (with and without contrast)
|
$390.30 |
$395.29 |
$420.58 |
|
|
Knee MRI (with contrast)
|
$863.44 |
$874.49 |
$930.42 |
|
|
Knee MRI (without contrast)
|
$264.17 |
$267.55 |
$284.66 |
|
|
Knee X-ray
|
$116.22 |
$117.81 |
$485.00 |
|