|
Inj., tildrakizumab, 1 mg
|
$47,573.05 |
$47,573.05 |
$47,573.05 |
$31,164.94
|
|
Inj triamcinolone ace X-ray 1mg
|
$2,312.77 |
$2,312.77 |
$2,312.77 |
$21.45
|
|
Inj., triptorelin X-ray 3.75 mg
|
$71,598.03 |
$71,598.03 |
$71,598.03 |
$5,195.68
|
|
Inj, trivisc 1 mg
|
$593.10 |
$593.10 |
$593.10 |
$5.45
|
|
Inj, tyenne, 1 mg
|
$327.47 |
$327.47 |
$327.47 |
$3,525.12
|
|
Inj, uzedy, 1 mg
|
$27,853.88 |
$27,853.88 |
$27,853.88 |
$11,643.18
|
|
Inj, vancomycin hcl (mylan)
|
$63.82 |
$63.82 |
$63.82 |
$89.83
|
|
Inj xipere 1 mg
|
$14,350.00 |
$14,350.00 |
$14,350.00 |
$4,290.00
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$78,991.57 |
$78,991.57 |
$78,991.57 |
$45,841.00
|
|
Ins cerv dilator (sep proc)
|
$456.00 |
$456.00 |
$456.00 |
$544.00
|
|
Insert cath pleura with image
|
$5,105.00 |
$5,105.00 |
$5,105.00 |
$2,239.02
|
|
Insert cath pleura without image
|
$6,175.00 |
$6,175.00 |
$6,175.00 |
$2,212.00
|
|
Insert intrauterine device iud
|
$773.00 |
$773.00 |
$773.00 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$837.00 |
$837.00 |
$837.00 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$837.00 |
$837.00 |
$837.00 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$5,362.00 |
$5,362.00 |
$5,362.00 |
$2,618.40
|
|
Insert pessary/other device
|
$855.00 |
$855.00 |
$855.00 |
$278.90
|
|
Insert uteri tandem/ovoids
|
$10,596.00 |
$10,596.00 |
$10,596.00 |
$3,986.00
|
|
Insitu hybridization (fish)
|
$1,210.00 |
$1,210.00 |
$1,210.00 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$426.00 |
$426.00 |
$426.00 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$560.00 |
$560.00 |
$560.00 |
$338.40
|
|
Insti hexaminolevulinate hcl
|
$3,080.00 |
$3,080.00 |
$3,080.00 |
$2,359.80
|
|
Instill, bupivac and meloxic
|
$69.14 |
$69.14 |
$69.14 |
$786.78
|
|
Instll rx agnt into rnal tub
|
$789.00 |
$789.00 |
$789.00 |
$619.20
|
|
Ins tun cv cath wo subq prt/pm
|
$5,420.00 |
$5,420.00 |
$5,420.00 |
$4,748.00
|
|
Insulin for insulin pump use
|
$0.36 |
$0.36 |
$0.36 |
$107.10
|
|
Insulin total
|
$193.00 |
$193.00 |
$193.00 |
$67.60
|
|
Ins vag brachytx device
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
$909.35
|
|
Intens behave ther cardio dx
|
$91.00 |
$91.00 |
$91.00 |
$38.70
|
|
Interdental fixation
|
$4,113.00 |
$4,113.00 |
$4,113.00 |
$2,133.48
|
|
Interferon alfa-2b inj
|
$1,048.67 |
$1,048.67 |
$1,048.67 |
$559.83
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$28,207.17 |
$28,207.17 |
$28,207.17 |
$5,977.59
|
|
Interrogate subq defib
|
$467.00 |
$467.00 |
$467.00 |
$139.10
|
|
Interrogation vad in person
|
$391.00 |
$391.00 |
$391.00 |
$280.00
|
|
Interrog dev eval scrms ip
|
$92.00 |
$92.00 |
$92.00 |
$124.80
|
|
Interrog evl pm/ldls pm ip
|
$391.00 |
$391.00 |
$391.00 |
$127.20
|
|
Intracranial complete study
|
$2,426.00 |
$2,426.00 |
$2,426.00 |
$883.30
|
|
Intracranial limited study
|
$863.00 |
$863.00 |
$863.00 |
$423.52
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,754.00 |
$1,754.00 |
$1,754.00 |
$1,182.15
|
|
Intrauterine transfusion ftl
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$1,004.25
|
|
Intrinsic factor antibody
|
$25.00 |
$25.00 |
$25.00 |
$59.95
|
|
Intrm oph exam est patient
|
$676.00 |
$676.00 |
$676.00 |
$161.46
|
|
Intro long gi tube w/mult fluo
|
$215.00 |
$215.00 |
$215.00 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$1,385.00 |
$1,385.00 |
$1,385.00 |
$617.60
|
|
Iodine i-123 sod iodide mil
|
$0.04 |
$0.04 |
$0.04 |
$677.98
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.97 |
$0.97 |
$0.97 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.47 |
$0.47 |
$0.47 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$3,046.10 |
$3,046.10 |
$3,046.10 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$2.81 |
$2.81 |
$2.81 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$8.40 |
$8.40 |
$8.40 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$1,017.10 |
$1,017.10 |
$1,017.10 |
$5,837.00
|
|
Iron
|
$118.00 |
$118.00 |
$118.00 |
$70.72
|
|
Iron binding capacity
|
$112.00 |
$112.00 |
$112.00 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$58.07 |
$58.07 |
$58.07 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$24.98 |
$24.98 |
$24.98 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$15.00 |
$15.00 |
$15.00 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$323.00 |
$323.00 |
$323.00 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$554.04 |
$554.04 |
$554.04 |
$8,335.70
|
|
Ivc venogram s&i
|
$16,279.00 |
$16,279.00 |
$16,279.00 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$458.00 |
$458.00 |
$458.00 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$484.00 |
$484.00 |
$484.00 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$366.00 |
$366.00 |
$366.00 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$460.85
|
|
Ivp w/nephrotomography
|
$1,812.00 |
$1,812.00 |
$1,812.00 |
$790.08
|
|
Ixabepilone 15 mg intravenous solution
|
$20,738.13 |
$20,738.13 |
$20,738.13 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$137.00 |
$137.00 |
$137.00 |
$378.30
|
|
John cunningham antibody
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$153.00 |
$153.00 |
$153.00 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$1.55 |
$1.55 |
$1.55 |
$29.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,308.00 |
$1,308.00 |
$1,308.00 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,603.00 |
$1,603.00 |
$1,603.00 |
$668.25
|
|
Kit gene analys d816 variant
|
$790.00 |
$790.00 |
$790.00 |
$355.00
|
|
Knee MRI (with and without contrast)
|
$4,691.00 |
$4,691.00 |
$4,691.00 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$3,262.00 |
$3,262.00 |
$3,262.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,943.00 |
$3,943.00 |
$3,943.00 |
$2,181.10
|
|
Knee X-ray
|
$1,019.00 |
$1,019.00 |
$1,019.00 |
$443.90
|
|
Kras gene addl variants
|
$349.00 |
$349.00 |
$349.00 |
$346.45
|
|
Kras gene variants exon 2
|
$509.00 |
$509.00 |
$509.00 |
$495.00
|
|
Kyleena, 19.5 mg
|
$4,048.77 |
$4,048.77 |
$4,048.77 |
$2,211.85
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$64.00 |
$64.00 |
$64.00 |
$100.75
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$0.33 |
$0.33 |
$0.33 |
$39.72
|
|
Lactate dehydrogenase (ldh)
|
$137.00 |
$137.00 |
$137.00 |
$53.30
|
|
Lactated ringers intravenous solution
|
$0.04 |
$0.04 |
$0.04 |
$48.56
|
|
Lactic acid
|
$169.00 |
$169.00 |
$169.00 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$259.00 |
$259.00 |
$259.00 |
$88.40
|
|
Lactoferrin fecal quant
|
$208.00 |
$208.00 |
$208.00 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$106,540.00 |
$106,540.00 |
$106,540.00 |
$21,487.67
|
|
Lanthanum carbonate oral 5mg
|
$39.29 |
$39.29 |
$39.29 |
$14.41
|
|
Laronidase injection
|
$749.39 |
$749.39 |
$749.39 |
$1,927.01
|
|
Laryngoscopy w/fb removal
|
$12,698.00 |
$12,698.00 |
$12,698.00 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$5,653.00 |
$5,653.00 |
$5,653.00 |
$2,954.40
|
|
Lead capillary
|
$308.00 |
$308.00 |
$308.00 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,058.00 |
$2,058.00 |
$2,058.00 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$79.35 |
$79.35 |
$79.35 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$329.00 |
$329.00 |
$329.00 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$36,780.03 |
$36,780.03 |
$36,780.03 |
$6,694.24
|
|
Leuprolide acetate injeciton
|
$1,824.80 |
$1,824.80 |
$1,824.80 |
$1,346.20
|
|
Levalbuterol non-comp con
|
$17.54 |
$17.54 |
$17.54 |
$20.06
|
|
Levalbuterol non-comp unit
|
$3.05 |
$3.05 |
$3.05 |
$8.13
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.78 |
$0.78 |
$0.78 |
$97.62
|
