|
Intro cath svc/ivc
|
$2,576.80 |
$2,576.80 |
$2,576.80 |
$1,323.27
|
|
Intro long gi tube
|
$1,149.60 |
$1,149.60 |
$1,149.60 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$668.00 |
$668.00 |
$668.00 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,695.20 |
$4,695.20 |
$4,695.20 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,960.80 |
$3,960.80 |
$3,960.80 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$761.60 |
$761.60 |
$761.60 |
$601.28
|
|
Iodine i-123 sod iodide mil
|
$658.40 |
$658.40 |
$658.40 |
$386.37
|
|
Ionm in operatng room 15 min
|
$124.80 |
$124.80 |
$124.80 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$312.51 |
$312.51 |
$312.51 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,915.20 |
$1,915.20 |
$1,915.20 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$13,885.20 |
$13,885.20 |
$13,885.20 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$1.20 |
$1.20 |
$1.20 |
$4.06
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$40.34 |
$40.34 |
$40.34 |
$173.98
|
|
Iron dextran 50 mg/ml injection solution
|
$109.10 |
$109.10 |
$109.10 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$50.16 |
$50.16 |
$50.16 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$167.20 |
$167.20 |
$167.20 |
$146.11
|
|
Ivc venogram s&i
|
$3,001.60 |
$3,001.60 |
$3,001.60 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$213.60 |
$213.60 |
$213.60 |
$133.90
|
|
IV Fluids (first hour)
|
$476.80 |
$476.80 |
$476.80 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$252.80 |
$252.80 |
$252.80 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$290.40 |
$290.40 |
$290.40 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$216.80 |
$216.80 |
$216.80 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$556.00 |
$556.00 |
$556.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$212.80 |
$212.80 |
$212.80 |
$167.50
|
|
IV Push Injection (first drug)
|
$416.00 |
$416.00 |
$416.00 |
$252.76
|
|
Ivp w/nephrotomography
|
$912.80 |
$912.80 |
$912.80 |
$748.15
|
|
Ivp w/wo kub w/wo tomography
|
$795.20 |
$795.20 |
$795.20 |
$713.40
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$410.40 |
$410.40 |
$410.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$319.20 |
$319.20 |
$319.20 |
$362.05
|
|
Jejunstmy tube plcmt
|
$2,384.80 |
$2,384.80 |
$2,384.80 |
$2,174.40
|
|
Kafo fem fx cast semi-rigid
|
$938.59 |
$938.59 |
$938.59 |
$2,130.02
|
|
Kafo femoral fx cast rigid
|
$5,600.00 |
$5,600.00 |
$5,600.00 |
$2,148.69
|
|
Kerecis marigen shld sq cm
|
$1,416.96 |
$1,416.96 |
$1,416.96 |
$1.00
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$16.80 |
$16.80 |
$16.80 |
$23.52
|
|
Kidney endoscopy
|
$5,118.40 |
$5,118.40 |
$5,118.40 |
$5,728.00
|
|
Kidney function study
|
$360.80 |
$360.80 |
$360.80 |
$935.22
|
|
Kidney imaging morphology
|
$922.40 |
$922.40 |
$922.40 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$2,119.20 |
$2,119.20 |
$2,119.20 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,824.80 |
$1,824.80 |
$1,824.80 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$893.60 |
$893.60 |
$893.60 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$693.60 |
$693.60 |
$693.60 |
$490.75
|
|
Kit case 4.2mm spinejack
|
$8,663.20 |
$8,663.20 |
$8,663.20 |
$7,177.60
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$9,776.00 |
$9,776.00 |
$9,776.00 |
$9,423.50
|
|
Kit hfx iq ipg bundle
|
$49,121.28 |
$49,121.28 |
$49,121.28 |
$33,859.00
|
|
Kit lead specify 5-6-5
|
$17,318.88 |
$17,318.88 |
$17,318.88 |
$16,672.10
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,116.80 |
$2,116.80 |
$2,116.80 |
$1,635.87
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$328.24 |
$328.24 |
$328.24 |
$360.12
|
|
Kit sound processor cochlear osia 2
|
$23,808.00 |
$23,808.00 |
$23,808.00 |
$8,425.00
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,823.48 |
$2,823.48 |
$2,823.48 |
$2,254.50
|
|
Knee joint cam lock each joi
|
$612.72 |
$612.72 |
$612.72 |
$260.22
|
|
Knee MRI (with and without contrast)
|
$3,838.40 |
$3,838.40 |
$3,838.40 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,288.80 |
$3,288.80 |
$3,288.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,904.00 |
$2,904.00 |
$2,904.00 |
$2,130.88
|
|
Knee X-ray
|
$457.60 |
$457.60 |
$457.60 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$413.60 |
$413.60 |
$413.60 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$413.60 |
$413.60 |
$413.60 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$401.60 |
$401.60 |
$401.60 |
$251.20
|
|
Ko elastic w/joints pre ots
|
$1,343.97 |
$1,343.97 |
$1,343.97 |
$137.05
|
|
Ko single upright pre cst
|
$1,198.35 |
$1,198.35 |
$1,198.35 |
$988.40
|
|
Ko w/0 joint rigid molded to
|
$548.11 |
$548.11 |
$548.11 |
$1,230.99
|
|
Ko w adj flex/ext rotat mold
|
$1,081.69 |
$1,081.69 |
$1,081.69 |
$2,418.09
|
|
Kyleena, 19.5 mg
|
$2,540.66 |
$2,540.66 |
$2,540.66 |
$2,125.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$146.40 |
$146.40 |
$146.40 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$136.80 |
$136.80 |
$136.80 |
$70.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$38.98 |
$38.98 |
$38.98 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$41.20 |
$41.20 |
$41.20 |
$175.92
|
|
Lap revise gastr adj device
|
$5,103.20 |
$5,103.20 |
$5,103.20 |
$3,131.20
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$1,138.40 |
$1,138.40 |
$1,138.40 |
$740.40
|
|
Largsc w/rmvl foreign bdy(s)
|
$1,732.00 |
$1,732.00 |
$1,732.00 |
$765.97
|
|
Laryngoscopy and dilation
|
$394.40 |
$394.40 |
$394.40 |
$4,745.55
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$3,894.40 |
$3,894.40 |
$3,894.40 |
$2,514.60
|
|
Laryngoscopy w/fb removal
|
$4,634.40 |
$4,634.40 |
$4,634.40 |
$2,854.09
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$3,156.00 |
$3,156.00 |
$3,156.00 |
$981.40
|
|
Lead acuity x4 spiral l 86cm
|
$10,154.56 |
$10,154.56 |
$10,154.56 |
$5,460.00
|
|
Lead ingevity 45cm pfret MRI
|
$6,760.00 |
$6,760.00 |
$6,760.00 |
$2,928.00
|
|
Lead tachy durata sj4 58cm
|
$13,893.12 |
$13,893.12 |
$13,893.12 |
$8,202.66
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,300.80 |
$1,300.80 |
$1,300.80 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,397.60 |
$2,397.60 |
$2,397.60 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,832.00 |
$1,832.00 |
$1,832.00 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,382.40 |
$1,382.40 |
$1,382.40 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,560.00 |
$2,560.00 |
$2,560.00 |
$955.30
|
|
Lens iol ant bicnvx 24.0 multi
|
$2,273.60 |
$2,273.60 |
$2,273.60 |
$1,065.00
|
|
Lens iol ant chamb 10.5
|
$540.00 |
$540.00 |
$540.00 |
$377.71
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$252.13 |
$252.13 |
$252.13 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,227.23 |
$1,227.23 |
$1,227.23 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$18,463.95 |
$18,463.95 |
$18,463.95 |
$8,348.12
|
|
Levalbuterol non-comp unit
|
$19.44 |
$19.44 |
$19.44 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$152.01 |
$152.01 |
$152.01 |
$97.62
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$36.55 |
$36.55 |
$36.55 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$343.90 |
$343.90 |
$343.90 |
$420.60
|
|
L hrt cath chd nm/abn nt cnj
|
$9,144.80 |
$9,144.80 |
$9,144.80 |
$6,104.00
|
|
Liberta rc ipg
|
$57,822.72 |
$57,822.72 |
$57,822.72 |
$39,189.70
|
|
Lidocaine injection
|
$16.80 |
$16.80 |
$16.80 |
$44.76
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$19.69 |
$19.69 |
$19.69 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$17.40 |
$17.40 |
$17.40 |
$39.75
|
|
Lift heel adj small gl60404sm
|
$38.56 |
$38.56 |
$38.56 |
$133.50
|
|
Ligate leg veins open
|
$4,760.80 |
$4,760.80 |
$4,760.80 |
$3,724.63
|
|
Ligate/strip short leg vein
|
$5,322.40 |
$5,322.40 |
$5,322.40 |
$3,724.63
|
|
Ligation/biopsy of temporal artery 37609
|
$3,614.40 |
$3,614.40 |
$3,614.40 |
$3,322.80
|
|
Ligation/divis of long saph vein 37700
|
$4,874.40 |
$4,874.40 |
$4,874.40 |
$4,255.00
|