|
Intrauterine transfusion ftl
|
$611.00 |
$611.00 |
$611.00 |
$1,004.25
|
|
Intraventricular pacing
|
$3,019.25 |
$3,019.25 |
$3,019.25 |
$5,775.22
|
|
Intrinsic factor antibody
|
$31.85 |
$31.85 |
$31.85 |
$59.95
|
|
Intro cath dialysis circuit
|
$2,037.75 |
$2,037.75 |
$2,037.75 |
$2,317.80
|
|
Intro catheter aorta
|
$2,720.90 |
$2,720.90 |
$2,720.90 |
$1,861.61
|
|
Intro cath svc/ivc
|
$1,628.90 |
$1,628.90 |
$1,628.90 |
$1,350.75
|
|
Intro long gi tube
|
$1,560.00 |
$1,560.00 |
$1,560.00 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$447.85 |
$447.85 |
$447.85 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,710.15 |
$1,710.15 |
$1,710.15 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$854.75 |
$854.75 |
$854.75 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$585.65 |
$585.65 |
$585.65 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$3.66 |
$3.66 |
$3.66 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$50.05 |
$50.05 |
$50.05 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$0.42 |
$0.42 |
$0.42 |
$52,615.16
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$69.48 |
$69.48 |
$69.48 |
$227.39
|
|
Iron
|
$89.05 |
$89.05 |
$89.05 |
$70.72
|
|
Iron binding capacity
|
$31.85 |
$31.85 |
$31.85 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$49.50 |
$49.50 |
$49.50 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$128.44 |
$128.44 |
$128.44 |
$198.01
|
|
Irrigation implantable venous access device for drug delivery systems
|
$261.95 |
$261.95 |
$261.95 |
$154.50
|
|
Ivc venogram s&i
|
$2,414.75 |
$2,414.75 |
$2,414.75 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$210.60 |
$210.60 |
$210.60 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$229.45 |
$229.45 |
$229.45 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$141.70 |
$141.70 |
$141.70 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$432.90 |
$432.90 |
$432.90 |
$460.85
|
|
IV inj ra drug dx study
|
$511.55 |
$511.55 |
$511.55 |
$560.00
|
|
Ivp w/wo kub w/wo tomography
|
$718.25 |
$718.25 |
$718.25 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$668.85 |
$668.85 |
$668.85 |
$378.30
|
|
Jejunstmy tube plcmt
|
$3,670.55 |
$3,670.55 |
$3,670.55 |
$2,244.82
|
|
Ketamine and metabolite screen - quest
|
$746.85 |
$746.85 |
$746.85 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$92.95 |
$92.95 |
$92.95 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$30.45 |
$30.45 |
$30.45 |
$30.08
|
|
Kidney imaging morphology
|
$1,188.20 |
$1,188.20 |
$1,188.20 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,602.90 |
$1,602.90 |
$1,602.90 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,265.55 |
$1,265.55 |
$1,265.55 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$549.25 |
$549.25 |
$549.25 |
$668.25
|
|
Kit gene analys d816 variant
|
$1,064.05 |
$1,064.05 |
$1,064.05 |
$355.00
|
|
Kit lead specify 5-6-5
|
$1,996.60 |
$1,996.60 |
$1,996.60 |
$17,205.92
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$135.77 |
$135.77 |
$135.77 |
$5,329.23
|
|
Knee MRI (with and without contrast)
|
$3,380.00 |
$3,380.00 |
$3,380.00 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,999.10 |
$2,999.10 |
$2,999.10 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,618.20 |
$2,618.20 |
$2,618.20 |
$2,181.10
|
|
Knee X-ray
|
$586.30 |
$586.30 |
$586.30 |
$443.90
|
|
Kras gene addl variants
|
$597.35 |
$597.35 |
$597.35 |
$346.45
|
|
Kras gene variants exon 2
|
$2,905.50 |
$2,905.50 |
$2,905.50 |
$495.00
|
|
Kyleena, 19.5 mg
|
$2,211.85 |
$2,211.85 |
$2,211.85 |
$2,618.91
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$42.38 |
$42.38 |
$42.38 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$333.03 |
$333.03 |
$333.03 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$16.25 |
$16.25 |
$16.25 |
$53.30
|
|
Lactated ringers intravenous solution
|
$51.80 |
$51.80 |
$51.80 |
$54.11
|
|
Lactic acid
|
$117.00 |
$117.00 |
$117.00 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$203.45 |
$203.45 |
$203.45 |
$88.40
|
|
Lactoferrin fecal quant
|
$404.95 |
$404.95 |
$404.95 |
$106.10
|
|
Laryngoscopy telescopic
|
$1,240.85 |
$1,240.85 |
$1,240.85 |
$762.30
|
|
Lead capillary
|
$8.45 |
$8.45 |
$8.45 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$854.10 |
$854.10 |
$854.10 |
$1,100.74
|
|
Leishmania antibody
|
$61.10 |
$61.10 |
$61.10 |
$58.50
|
|
Lens iol ant bicnvx 24.0 multi
|
$288.39 |
$288.39 |
$288.39 |
$1,546.87
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$69.58 |
$69.58 |
$69.58 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,852.85 |
$2,852.85 |
$2,852.85 |
$3,271.64
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$95.68 |
$95.68 |
$95.68 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$190.45 |
$190.45 |
$190.45 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$51.80 |
$51.80 |
$51.80 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$274.85 |
$274.85 |
$274.85 |
$319.12
|
|
Liberta rc ipg
|
$25,651.39 |
$25,651.39 |
$25,651.39 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$49.11 |
$49.11 |
$49.11 |
$49.11
|
|
Lidocaine therapeutic drug level
|
$123.50 |
$123.50 |
$123.50 |
$83.85
|
|
Ligation/biopsy of temporal artery 37609
|
$2,210.00 |
$2,210.00 |
$2,210.00 |
$2,968.00
|
|
Liletta, 52 mg
|
$1,160.93 |
$1,160.93 |
$1,160.93 |
$2,360.29
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$159.12 |
$159.12 |
$159.12 |
$177.90
|
|
Lipase
|
$44.85 |
$44.85 |
$44.85 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$121.55 |
$121.55 |
$121.55 |
$89.52
|
|
Lipoprotein blood quant
|
$67.60 |
$67.60 |
$67.60 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$31.85 |
$31.85 |
$31.85 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$46.80 |
$46.80 |
$46.80 |
$60.00
|
|
Listeria monocytogenes
|
$108.55 |
$108.55 |
$108.55 |
$95.40
|
|
Lithium therapeutic drug level
|
$42.25 |
$42.25 |
$42.25 |
$67.60
|
|
Liver Function Test
|
$18.85 |
$18.85 |
$18.85 |
$110.50
|
|
Liver imaging
|
$1,396.20 |
$1,396.20 |
$1,396.20 |
$1,241.25
|
|
Liver imag w/vasclr flow
|
$1,396.20 |
$1,396.20 |
$1,396.20 |
$1,255.15
|
|
Liver/spleen imag static only
|
$1,318.85 |
$1,318.85 |
$1,318.85 |
$1,140.78
|
|
Locm 100-199mg/ml iodine,1ml
|
$6.08 |
$6.08 |
$6.08 |
$16.54
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$22.30 |
$22.30 |
$22.30 |
$45.56
|
|
Low cost skin substitute app
|
$380.25 |
$380.25 |
$380.25 |
$862.55
|
|
Low cost skin substitute app
|
$1,137.50 |
$1,137.50 |
$1,137.50 |
$2,164.64
|
|
Low cost skin substitute app
|
$380.25 |
$380.25 |
$380.25 |
$933.40
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,183.00 |
$1,183.00 |
$1,183.00 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,032.20 |
$1,032.20 |
$1,032.20 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$835.25 |
$835.25 |
$835.25 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,924.65 |
$1,924.65 |
$1,924.65 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,634.75 |
$1,634.75 |
$1,634.75 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,311.70 |
$1,311.70 |
$1,311.70 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$245.05 |
$245.05 |
$245.05 |
$344.00
|
|
Low frequency non-thermal Ultrasound
|
$616.85 |
$616.85 |
$616.85 |
$275.88
|
|
L/s ratio fetal lung
|
$395.85 |
$395.85 |
$395.85 |
$168.00
|
|
Lumbar diskogram s&i
|
$1,524.90 |
$1,524.90 |
$1,524.90 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$342.55 |
$342.55 |
$342.55 |
$298.50
|
|
Lung perfusion imaging
|
$702.65 |
$702.65 |
$702.65 |
$1,100.39
|
|
Lurbinectedin 4 mg intravenous solution
|
$22,297.54 |
$22,297.54 |
$22,297.54 |
$21,982.48
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$13,361.30 |
$13,361.30 |
$13,361.30 |
$29,435.46
|