|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,006.79 |
$2,006.79 |
$2,006.79 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,589.42 |
$1,589.42 |
$1,589.42 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$807.96 |
$807.96 |
$807.96 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$670.66 |
$670.66 |
$670.66 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$670.66 |
$670.66 |
$670.66 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$94.69 |
$94.69 |
$94.69 |
$145.60
|
|
Inject sacroiliac joint
|
$1,522.96 |
$1,522.96 |
$1,522.96 |
$1,029.04
|
|
Inj, faricimab-svoa, 0.1mg
|
$57.53 |
$57.53 |
$57.53 |
$4,103.29
|
|
Inj, gadopiclenol, 1 ml
|
$6.34 |
$6.34 |
$6.34 |
$37.63
|
|
Inj ivig privigen 500 mg
|
$90.80 |
$90.80 |
$90.80 |
$6,967.29
|
|
Inj, lecanemab-irmb, 1 mg
|
$1.03 |
$1.03 |
$1.03 |
$1,174.88
|
|
Inj mepivacaine hcl/10 ml
|
$5.41 |
$5.41 |
$5.41 |
$34.34
|
|
Inj multihance
|
$3.16 |
$3.16 |
$3.16 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$584.07 |
$584.07 |
$584.07 |
$1,413.35
|
|
Inj proc ankle arthr
|
$257.50 |
$257.50 |
$257.50 |
$405.31
|
|
Inj proc elbow arthro
|
$99.25 |
$99.25 |
$99.25 |
$432.00
|
|
Inj proc myelogram lumbar
|
$462.54 |
$462.54 |
$462.54 |
$838.30
|
|
Inj retro urethrocysto
|
$122.83 |
$122.83 |
$122.83 |
$447.74
|
|
Inj secukinumab intrav 1mg
|
$5.55 |
$5.55 |
$5.55 |
$4,413.21
|
|
Inj. teprotumumab-trbw 10 mg
|
$569.11 |
$569.11 |
$569.11 |
$35,034.78
|
|
Inj testosterone cypionate
|
$0.06 |
$0.06 |
$0.06 |
$64.96
|
|
Inj., tildrakizumab, 1 mg
|
$221.05 |
$221.05 |
$221.05 |
$26,635.60
|
|
Inj w/fluor eval cv device
|
$475.77 |
$475.77 |
$475.77 |
$504.40
|
|
Insert cath pleura without image
|
$4,688.19 |
$4,688.19 |
$4,688.19 |
$2,099.70
|
|
Insert drug delivery implant
|
$286.42 |
$286.42 |
$286.42 |
$280.00
|
|
Insert intrauterine device iud
|
$175.56 |
$175.56 |
$175.56 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$184.45 |
$184.45 |
$184.45 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,754.76 |
$1,754.76 |
$1,754.76 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,643.10 |
$2,643.10 |
$2,643.10 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,269.17 |
$1,269.17 |
$1,269.17 |
$2,453.83
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,886.74 |
$6,886.74 |
$6,886.74 |
$5,236.80
|
|
Insert pessary/other device
|
$425.69 |
$425.69 |
$425.69 |
$278.90
|
|
In situ hybridization per specimen each additional single probe stain
|
$226.30 |
$226.30 |
$226.30 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$291.90 |
$291.90 |
$291.90 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$70.06 |
$70.06 |
$70.06 |
$4,078.00
|
|
Instillation anticarcinogenic agent bladder
|
$1,475.90 |
$1,475.90 |
$1,475.90 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$4,704.03 |
$4,704.03 |
$4,704.03 |
$4,218.00
|
|
Insulin total
|
$139.21 |
$139.21 |
$139.21 |
$66.64
|
|
Interdental fixation
|
$3,431.73 |
$3,431.73 |
$3,431.73 |
$2,133.48
|
|
Interrog dev eval icpms ip
|
$93.91 |
$93.91 |
$93.91 |
$104.00
|
|
Interrog device eval heart
|
$93.91 |
$93.91 |
$93.91 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$93.91 |
$93.91 |
$93.91 |
$127.20
|
|
Intracranial limited study
|
$291.05 |
$291.05 |
$291.05 |
$467.50
|
|
Intraoral i+d tongue/floor lingual 41000
|
$983.79 |
$983.79 |
$983.79 |
$1,331.45
|
|
Intrinsic factor antibody
|
$47.98 |
$47.98 |
$47.98 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$579.00 |
$579.00 |
$579.00 |
$601.28
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.19 |
$0.19 |
$0.19 |
$279.10
|
|
Iron
|
$61.89 |
$61.89 |
$61.89 |
$75.00
|
|
Iron binding capacity
|
$88.37 |
$88.37 |
$88.37 |
$63.91
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$0.51 |
$0.51 |
$0.51 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$141.78 |
$141.78 |
$141.78 |
$146.11
|
|
IV Fluids (each additional hour)
|
$122.03 |
$122.03 |
$122.03 |
$133.90
|
|
IV Fluids (first hour)
|
$351.29 |
$351.29 |
$351.29 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$122.03 |
$122.03 |
$122.03 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$122.03 |
$122.03 |
$122.03 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$210.68 |
$210.68 |
$210.68 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$213.27 |
$213.27 |
$213.27 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$228.91 |
$228.91 |
$228.91 |
$167.50
|
|
IV Push Injection (first drug)
|
$67.69 |
$67.69 |
$67.69 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$476.61 |
$476.61 |
$476.61 |
$713.40
|
|
Jak2 targeted sequence analysis
|
$393.43 |
$393.43 |
$393.43 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$330.16 |
$330.16 |
$330.16 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$339.13 |
$339.13 |
$339.13 |
$362.05
|
|
John cunningham antibody
|
$45.82 |
$45.82 |
$45.82 |
$78.00
|
|
Ketamine and metabolite screen - quest
|
$314.20 |
$314.20 |
$314.20 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$29.85 |
$29.85 |
$29.85 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$0.95 |
$0.95 |
$0.95 |
$23.52
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,000.68 |
$1,000.68 |
$1,000.68 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$740.36 |
$740.36 |
$740.36 |
$490.75
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$58.82 |
$58.82 |
$58.82 |
$174.00
|
|
Kit gene analys d816 variant
|
$321.96 |
$321.96 |
$321.96 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$3,121.77 |
$3,121.77 |
$3,121.77 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,294.38 |
$2,294.38 |
$2,294.38 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,082.27 |
$2,082.27 |
$2,082.27 |
$2,130.88
|
|
Knee X-ray
|
$261.65 |
$261.65 |
$261.65 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$241.52 |
$241.52 |
$241.52 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$219.69 |
$219.69 |
$219.69 |
$363.60
|
|
Kyleena, 19.5 mg
|
$1,611.58 |
$1,611.58 |
$1,611.58 |
$2,125.00
|
|
Lactate dehydrogenase (ldh)
|
$38.30 |
$38.30 |
$38.30 |
$55.50
|
|
Lactated ringers intravenous solution
|
$427.64 |
$427.64 |
$427.64 |
$43.74
|
|
Lactic acid
|
$123.36 |
$123.36 |
$123.36 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$107.17 |
$107.17 |
$107.17 |
$82.16
|
|
Lactoferrin fecal quant
|
$148.77 |
$148.77 |
$148.77 |
$108.93
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$64.64 |
$64.64 |
$64.64 |
$19,124.00
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$670.66 |
$670.66 |
$670.66 |
$740.40
|
|
Lead capillary
|
$91.34 |
$91.34 |
$91.34 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$377.68 |
$377.68 |
$377.68 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$1,489.08 |
$1,489.08 |
$1,489.08 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,181.27 |
$1,181.27 |
$1,181.27 |
$1,372.50
|
|
Legion pneumo dna dir prob
|
$41.54 |
$41.54 |
$41.54 |
$49.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$377.68 |
$377.68 |
$377.68 |
$1,092.58
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,570.26 |
$2,570.26 |
$2,570.26 |
$8,348.12
|
|
Levetiracetam therapeutic drug level
|
$165.70 |
$165.70 |
$165.70 |
$88.92
|
|
Lidocaine therapeutic drug level
|
$28.65 |
$28.65 |
$28.65 |
$87.45
|
|
Lipase
|
$70.70 |
$70.70 |
$70.70 |
$93.58
|
|
Lipoprotein blood quant
|
$66.67 |
$66.67 |
$66.67 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$27.79 |
$27.79 |
$27.79 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$106.07 |
$106.07 |
$106.07 |
$61.60
|
|
Listeria monocytogenes
|
$26.94 |
$26.94 |
$26.94 |
$100.40
|
|
Lithium therapeutic drug level
|
$58.92 |
$58.92 |
$58.92 |
$69.75
|