|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$723.24 |
$723.24 |
$723.24 |
$504.00
|
|
Injection, fulvestrant
|
$5,146.11 |
$5,146.11 |
$5,146.11 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$16,749.72 |
$16,749.72 |
$16,749.72 |
$6,830.50
|
|
Injection radioactive tracer sentinel node (both sides)
|
$515.55 |
$515.55 |
$515.55 |
$717.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$864.89 |
$864.89 |
$864.89 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,022.49 |
$1,022.49 |
$1,022.49 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,447.87 |
$2,447.87 |
$2,447.87 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,188.39 |
$1,188.39 |
$1,188.39 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,355.89 |
$2,355.89 |
$2,355.89 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,172.43 |
$1,172.43 |
$1,172.43 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,266.64 |
$2,266.64 |
$2,266.64 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$4,568.45 |
$4,568.45 |
$4,568.45 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$4,372.94 |
$4,372.94 |
$4,372.94 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$4,798.08 |
$4,798.08 |
$4,798.08 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$489.72 |
$489.72 |
$489.72 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$610.68 |
$610.68 |
$610.68 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$309.96 |
$309.96 |
$309.96 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$757.58 |
$757.58 |
$757.58 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$661.19 |
$661.19 |
$661.19 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$232.05 |
$232.05 |
$232.05 |
$141.60
|
|
Inject sacroiliac joint
|
$1,380.02 |
$1,380.02 |
$1,380.02 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$76,529.82 |
$76,529.82 |
$76,529.82 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$2,277.24 |
$2,277.24 |
$2,277.24 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$2,084.25 |
$2,084.25 |
$2,084.25 |
$1,450.84
|
|
Inj, fulvestrant (fresenius)
|
$1,159.51 |
$1,159.51 |
$1,159.51 |
$1,242.20
|
|
Inj, gadopiclenol, 1 ml
|
$297.73 |
$297.73 |
$297.73 |
$70.20
|
|
Inj gemcitabine hcl (accord)
|
$200.33 |
$200.33 |
$200.33 |
$374.24
|
|
Inj glycopyrrolate fres kabi
|
$33.63 |
$33.63 |
$33.63 |
$47.05
|
|
Inj ivig privigen 500 mg
|
$10,347.68 |
$10,347.68 |
$10,347.68 |
$7,173.90
|
|
Inj labetalol hcl hikma, 5mg
|
$54.90 |
$54.90 |
$54.90 |
$25.20
|
|
Inj, lidocaine w epinephrine
|
$320.69 |
$320.69 |
$320.69 |
$43.73
|
|
Inj mepivacaine hcl/10 ml
|
$15.62 |
$15.62 |
$15.62 |
$31.28
|
|
Inj multihance
|
$403.14 |
$403.14 |
$403.14 |
$119.25
|
|
Inj naloxone hydrochloride
|
$121.60 |
$121.60 |
$121.60 |
$95.36
|
|
Inj octafluoropropane mic,ml
|
$155.71 |
$155.71 |
$155.71 |
$169.22
|
|
Inj proc elbow arthro
|
$723.87 |
$723.87 |
$723.87 |
$453.60
|
|
Inj secukinumab intrav 1mg
|
$10,481.11 |
$10,481.11 |
$10,481.11 |
$5,994.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$253,022.14 |
$253,022.14 |
$253,022.14 |
$178,150.09
|
|
Inj testosterone cypionate
|
$107.30 |
$107.30 |
$107.30 |
$82.58
|
|
Inj, tislelizumab-jsgr
|
$32,487.79 |
$32,487.79 |
$32,487.79 |
$103.20
|
|
Inj, vancomycin hcl (mylan)
|
$27.80 |
$27.80 |
$27.80 |
$89.83
|
|
Inj, vancomycin hcl (xellia)
|
$146.45 |
$146.45 |
$146.45 |
$192.59
|
|
Inj, vegzelma, 10 mg
|
$7,940.94 |
$7,940.94 |
$7,940.94 |
$1,444.45
|
|
Inj w/fluor eval cv device
|
$172.31 |
$172.31 |
$172.31 |
$588.90
|
|
Insert cath pleura without image
|
$3,754.59 |
$3,754.59 |
$3,754.59 |
$2,212.00
|
|
Insertion catheter bladder non indwelling
|
$457.49 |
$457.49 |
$457.49 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$357.42 |
$357.42 |
$357.42 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,361.85 |
$1,361.85 |
$1,361.85 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$23,000.00 |
$23,000.00 |
$23,000.00 |
$14,158.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,583.23 |
$3,583.23 |
$3,583.23 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,091.33 |
$4,091.33 |
$4,091.33 |
$2,527.91
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$6,178.73 |
$6,178.73 |
$6,178.73 |
$9,793.46
|
|
Ins/rpl prph sac/gstr npg/r
|
$11,167.59 |
$11,167.59 |
$11,167.59 |
$22,662.25
|
|
Instillation anticarcinogenic agent bladder
|
$971.57 |
$971.57 |
$971.57 |
$721.50
|
|
Instill, bupivac and meloxic
|
$683.88 |
$683.88 |
$683.88 |
$786.78
|
|
Insulin total
|
$99.33 |
$99.33 |
$99.33 |
$67.60
|
|
Interrog evl pm/ldls pm ip
|
$130.00 |
$130.00 |
$130.00 |
$127.20
|
|
Intrinsic factor antibody
|
$101.64 |
$101.64 |
$101.64 |
$59.95
|
|
Intubation endotracheal emergency procedure
|
$1,762.74 |
$1,762.74 |
$1,762.74 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$483.60 |
$483.60 |
$483.60 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$753.66 |
$753.66 |
$753.66 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$36,997.93 |
$36,997.93 |
$36,997.93 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$8.31 |
$8.31 |
$8.31 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$114.64 |
$114.64 |
$114.64 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,024.09 |
$3,024.09 |
$3,024.09 |
$5,837.00
|
|
Iron
|
$93.98 |
$93.98 |
$93.98 |
$70.72
|
|
Iron binding capacity
|
$93.98 |
$93.98 |
$93.98 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$95.90 |
$95.90 |
$95.90 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$255.91 |
$255.91 |
$255.91 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$454.65 |
$454.65 |
$454.65 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$233.21 |
$233.21 |
$233.21 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$11,219.01 |
$11,219.01 |
$11,219.01 |
$8,335.70
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$773.96 |
$773.96 |
$773.96 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$773.96 |
$773.96 |
$773.96 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$773.96 |
$773.96 |
$773.96 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$773.96 |
$773.96 |
$773.96 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$1,352.40 |
$1,352.40 |
$1,352.40 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$749.81 |
$749.81 |
$749.81 |
$378.30
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$118.55 |
$118.55 |
$118.55 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$67.25 |
$67.25 |
$67.25 |
$29.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,490.37 |
$1,490.37 |
$1,490.37 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$4,046.39 |
$4,046.39 |
$4,046.39 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$3,476.76 |
$3,476.76 |
$3,476.76 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,019.80 |
$3,019.80 |
$3,019.80 |
$2,181.10
|
|
Knee X-ray
|
$475.02 |
$475.02 |
$475.02 |
$443.90
|
|
Kras gene variants exon 2
|
$842.00 |
$842.00 |
$842.00 |
$495.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$143.34 |
$143.34 |
$143.34 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$122.49 |
$122.49 |
$122.49 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$85.16 |
$85.16 |
$85.16 |
$53.30
|
|
Lactated ringers intravenous solution
|
$82.70 |
$82.70 |
$82.70 |
$48.56
|
|
Lactic acid
|
$147.74 |
$147.74 |
$147.74 |
$102.90
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$26,459.86 |
$26,459.86 |
$26,459.86 |
$21,487.67
|
|
Lead capillary
|
$79.80 |
$79.80 |
$79.80 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,394.61 |
$1,394.61 |
$1,394.61 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$328.36 |
$328.36 |
$328.36 |
$164.09
|
|
Levalbuterol non-comp con
|
$25.79 |
$25.79 |
$25.79 |
$20.06
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$122.17 |
$122.17 |
$122.17 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$135.35 |
$135.35 |
$135.35 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$76.23 |
$76.23 |
$76.23 |
$64.88
|
