|
Intraop epicard/endocard/pace/map/ 93631
|
$144.95 |
$144.95 |
$144.95 |
$3,690.00
|
|
Intrauterine transfusion ftl
|
$356.20 |
$356.20 |
$356.20 |
$1,004.25
|
|
Intrinsic factor antibody
|
$44.85 |
$44.85 |
$44.85 |
$59.95
|
|
Intro cath dialysis circuit
|
$1,638.65 |
$1,638.65 |
$1,638.65 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$5,574.40 |
$5,574.40 |
$5,574.40 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$11,976.90 |
$11,976.90 |
$11,976.90 |
$15,625.00
|
|
Intro long gi tube
|
$2,947.10 |
$2,947.10 |
$2,947.10 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$796.25 |
$796.25 |
$796.25 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$578.50 |
$578.50 |
$578.50 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$35.88 |
$35.88 |
$35.88 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$80.24 |
$80.24 |
$80.24 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$24,467.33 |
$24,467.33 |
$24,467.33 |
$52,615.16
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$88.46 |
$88.46 |
$88.46 |
$227.39
|
|
Iron
|
$99.45 |
$99.45 |
$99.45 |
$70.72
|
|
Iron binding capacity
|
$54.60 |
$54.60 |
$54.60 |
$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
|
$195.65 |
$195.65 |
$195.65 |
$154.50
|
|
Ivc venogram s&i
|
$5,811.00 |
$5,811.00 |
$5,811.00 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$247.00 |
$247.00 |
$247.00 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$267.80 |
$267.80 |
$267.80 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$165.10 |
$165.10 |
$165.10 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$505.70 |
$505.70 |
$505.70 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$825.50 |
$825.50 |
$825.50 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$599.95 |
$599.95 |
$599.95 |
$378.30
|
|
Jejunstmy tube plcmt
|
$3,007.55 |
$3,007.55 |
$3,007.55 |
$2,244.82
|
|
Ketamine and metabolite screen - quest
|
$553.80 |
$553.80 |
$553.80 |
$68.15
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$123.50 |
$123.50 |
$123.50 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$23.50 |
$23.50 |
$23.50 |
$30.08
|
|
Kidney img w/bldflw sgl without rx
|
$2,159.95 |
$2,159.95 |
$2,159.95 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$793.00 |
$793.00 |
$793.00 |
$668.25
|
|
Kit gene analys d816 variant
|
$1,094.60 |
$1,094.60 |
$1,094.60 |
$355.00
|
|
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)
|
$4,049.50 |
$4,049.50 |
$4,049.50 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$3,863.60 |
$3,863.60 |
$3,863.60 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,620.50 |
$3,620.50 |
$3,620.50 |
$2,181.10
|
|
Knee X-ray
|
$1,160.90 |
$1,160.90 |
$1,160.90 |
$443.90
|
|
Kras gene variants exon 2
|
$2,672.15 |
$2,672.15 |
$2,672.15 |
$495.00
|
|
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)
|
$29.25 |
$29.25 |
$29.25 |
$53.30
|
|
Lactated ringers intravenous solution
|
$45.04 |
$45.04 |
$45.04 |
$54.11
|
|
Lactic acid
|
$156.00 |
$156.00 |
$156.00 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$262.60 |
$262.60 |
$262.60 |
$88.40
|
|
Lactoferrin fecal quant
|
$674.70 |
$674.70 |
$674.70 |
$106.10
|
|
Laryngoscopy telescopic
|
$1,017.25 |
$1,017.25 |
$1,017.25 |
$762.30
|
|
Lead capillary
|
$11.05 |
$11.05 |
$11.05 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,145.95 |
$1,145.95 |
$1,145.95 |
$1,100.74
|
|
Leishmania antibody
|
$85.80 |
$85.80 |
$85.80 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$91.55 |
$91.55 |
$91.55 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,919.64 |
$1,919.64 |
$1,919.64 |
$3,271.64
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$4,799.28 |
$4,799.28 |
$4,799.28 |
$6,208.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$54.83 |
$54.83 |
$54.83 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$173.55 |
$173.55 |
$173.55 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$53.72 |
$53.72 |
$53.72 |
$66.59
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$223.37 |
$223.37 |
$223.37 |
$319.12
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$49.11 |
$49.11 |
$49.11 |
$49.11
|
|
Lidocaine therapeutic drug level
|
$202.80 |
$202.80 |
$202.80 |
$83.85
|
|
Ligation/biopsy of temporal artery 37609
|
$2,951.00 |
$2,951.00 |
$2,951.00 |
$2,968.00
|
|
Liletta, 52 mg
|
$1,726.84 |
$1,726.84 |
$1,726.84 |
$2,360.29
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$58.63 |
$58.63 |
$58.63 |
$177.90
|
|
Lipase
|
$74.75 |
$74.75 |
$74.75 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$196.95 |
$196.95 |
$196.95 |
$89.52
|
|
Lipoprotein blood quant
|
$94.25 |
$94.25 |
$94.25 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$54.60 |
$54.60 |
$54.60 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$74.10 |
$74.10 |
$74.10 |
$60.00
|
|
Listeria monocytogenes
|
$139.75 |
$139.75 |
$139.75 |
$95.40
|
|
Lithium therapeutic drug level
|
$70.20 |
$70.20 |
$70.20 |
$67.60
|
|
Liver Function Test
|
$24.70 |
$24.70 |
$24.70 |
$110.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$23.34 |
$23.34 |
$23.34 |
$45.56
|
|
Low cost skin substitute app
|
$449.15 |
$449.15 |
$449.15 |
$862.55
|
|
Low cost skin substitute app
|
$583.70 |
$583.70 |
$583.70 |
$2,164.64
|
|
Low cost skin substitute app
|
$646.75 |
$646.75 |
$646.75 |
$933.40
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,157.00 |
$1,157.00 |
$1,157.00 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,052.35 |
$1,052.35 |
$1,052.35 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$958.10 |
$958.10 |
$958.10 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,123.55 |
$2,123.55 |
$2,123.55 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$1,877.85 |
$1,877.85 |
$1,877.85 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,725.10 |
$1,725.10 |
$1,725.10 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$517.40 |
$517.40 |
$517.40 |
$344.00
|
|
Low frequency non-thermal Ultrasound
|
$555.10 |
$555.10 |
$555.10 |
$275.88
|
|
L/s ratio fetal lung
|
$648.05 |
$648.05 |
$648.05 |
$168.00
|
|
Lumbar diskogram s&i
|
$3,103.75 |
$3,103.75 |
$3,103.75 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$468.00 |
$468.00 |
$468.00 |
$298.50
|
|
Lung perfusion imaging
|
$1,190.15 |
$1,190.15 |
$1,190.15 |
$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
|
$40,040.94 |
$40,040.94 |
$40,040.94 |
$29,435.46
|
|
Lymphocyte transformation mitogen
|
$542.10 |
$542.10 |
$542.10 |
$266.20
|
|
Lymph vessel x-ray arm/leg
|
$4,145.70 |
$4,145.70 |
$4,145.70 |
$862.57
|
|
Lymph vessel x-ray arms/legs
|
$5,495.10 |
$5,495.10 |
$5,495.10 |
$2,229.24
|
|
Lymph vessel x-ray trunk
|
$6,958.90 |
$6,958.90 |
$6,958.90 |
$2,542.41
|
|
Lymph vessel x-ray trunk
|
$9,278.75 |
$9,278.75 |
$9,278.75 |
$3,380.00
|
|
Macroscopic exam arthropod
|
$112.45 |
$112.45 |
$112.45 |
$38.58
|
|
Macroscopic exam parasite
|
$98.15 |
$98.15 |
$98.15 |
$38.50
|
|
Magnesium
|
$64.35 |
$64.35 |
$64.35 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$46.93 |
$46.93 |
$46.93 |
$65.49
|
|
Magnetic image bone marrow
|
$1,608.10 |
$1,608.10 |
$1,608.10 |
$1,152.80
|
|
Malaria antibody
|
$27.30 |
$27.30 |
$27.30 |
$38.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$150.80 |
$150.80 |
$150.80 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$150.80 |
$150.80 |
$150.80 |
$178.75
|