|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,500.00 |
$1,500.00 |
$1,500.00 |
$279.10
|
|
Ipratropium bromide non-comp
|
$1.50 |
$1.50 |
$1.50 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$90.00 |
$90.00 |
$90.00 |
$163.87
|
|
Iron
|
$190.80 |
$190.80 |
$190.80 |
$74.40
|
|
Iron binding capacity
|
$103.20 |
$103.20 |
$103.20 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$90.66 |
$90.66 |
$90.66 |
$187.06
|
|
Ivc venogram s&i
|
$2,537.40 |
$2,537.40 |
$2,537.40 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$565.20 |
$565.20 |
$565.20 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$100.80 |
$100.80 |
$100.80 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$100.80 |
$100.80 |
$100.80 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$565.20 |
$565.20 |
$565.20 |
$439.56
|
|
Ivp w/nephrotomography
|
$1,326.60 |
$1,326.60 |
$1,326.60 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$795.60 |
$795.60 |
$795.60 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$489.60 |
$489.60 |
$489.60 |
$379.87
|
|
John cunningham antibody
|
$132.60 |
$132.60 |
$132.60 |
$72.60
|
|
Kafo dbl solid stirrup band/
|
$2,960.08 |
$2,960.08 |
$2,960.08 |
$2,185.15
|
|
Kafo dbl solid stirrup without j
|
$2,909.53 |
$2,909.53 |
$2,909.53 |
$2,562.92
|
|
Kafo fem fx cast molded to p
|
$4,357.23 |
$4,357.23 |
$4,357.23 |
$3,130.66
|
|
Kafo fem fx cast semi-rigid
|
$3,095.42 |
$3,095.42 |
$3,095.42 |
$2,130.02
|
|
Kafo fem fx cast thermoplas
|
$3,077.02 |
$3,077.02 |
$3,077.02 |
$2,710.45
|
|
Kafo femoral fx cast rigid
|
$3,387.50 |
$3,387.50 |
$3,387.50 |
$2,138.81
|
|
Kafo pla sin up w/wo k/a cus
|
$5,456.71 |
$5,456.71 |
$5,456.71 |
$4,806.65
|
|
Kafo plas sing free knee mol
|
$4,454.44 |
$4,454.44 |
$4,454.44 |
$3,923.78
|
|
Kafo plastic pediatric size
|
$465.34 |
$465.34 |
$465.34 |
$409.90
|
|
Kafo sing fre stirr thi/calf
|
$3,004.86 |
$3,004.86 |
$3,004.86 |
$2,646.89
|
|
Kafo sng/dbl mechanical act
|
$11,006.84 |
$11,006.84 |
$11,006.84 |
$9,695.60
|
|
Kafo sng solid stirrup without j
|
$2,343.76 |
$2,343.76 |
$2,343.76 |
$2,064.55
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$49.20 |
$49.20 |
$49.20 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$33.48 |
$33.48 |
$33.48 |
$23.50
|
|
Kidney imaging morphology
|
$508.20 |
$508.20 |
$508.20 |
$785.00
|
|
Kidney img w/bldflw sgl without rx
|
$2,025.60 |
$2,025.60 |
$2,025.60 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,092.00 |
$1,092.00 |
$1,092.00 |
$666.00
|
|
Kit case 4.2mm spinejack
|
$12,408.04 |
$12,408.04 |
$12,408.04 |
$7,751.14
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$14,001.86 |
$14,001.86 |
$14,001.86 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$655.80 |
$655.80 |
$655.80 |
$374.61
|
|
Kit hfx iq ipg bundle
|
$78,648.77 |
$78,648.77 |
$78,648.77 |
$30,006.00
|
|
Kit ipg optimizer smart
|
$77,457.12 |
$77,457.12 |
$77,457.12 |
$49,011.18
|
|
Kit lead specify 5-6-5
|
$32,770.32 |
$32,770.32 |
$32,770.32 |
$15,639.00
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,189.65 |
$2,189.65 |
$2,189.65 |
$1,543.50
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$40,447.48 |
$40,447.48 |
$40,447.48 |
$740.00
|
|
Kit sound processor cochlear osia 2
|
$35,591.54 |
$35,591.54 |
$35,591.54 |
$10,164.00
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,334.65 |
$2,334.65 |
$2,334.65 |
$2,089.15
|
|
Knee Arthroscopy (Cartilage Repair)
|
$12,252.48 |
$12,252.48 |
$12,252.48 |
$4,304.96
|
|
Knee Arthroscopy (Meniscus Repair)
|
$13,602.77 |
$13,602.77 |
$13,602.77 |
$5,148.00
|
|
Knee arthroscopy/surgery
|
$10,956.36 |
$10,956.36 |
$10,956.36 |
$4,183.50
|
|
Knee arthroscopy/surgery
|
$21,881.70 |
$21,881.70 |
$21,881.70 |
$4,535.82
|
|
Knee arthroscopy/surgery
|
$12,618.90 |
$12,618.90 |
$12,618.90 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$10,549.62 |
$10,549.62 |
$10,549.62 |
$4,499.12
|
|
Knee arthroscopy/surgery
|
$49,948.06 |
$49,948.06 |
$49,948.06 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$16,095.48 |
$16,095.48 |
$16,095.48 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$49,948.06 |
$49,948.06 |
$49,948.06 |
$8,453.60
|
|
Knee control condylar pad
|
$219.38 |
$219.38 |
$219.38 |
$193.25
|
|
Knee control full kneecap
|
$220.28 |
$220.28 |
$220.28 |
$192.00
|
|
Knee disc/dial lock/adj flex
|
$385.05 |
$385.05 |
$385.05 |
$288.41
|
|
Knee jnt ratchet lock ea jnt
|
$385.05 |
$385.05 |
$385.05 |
$289.44
|
|
Knee joint cam lock each joi
|
$326.33 |
$326.33 |
$326.33 |
$287.46
|
|
Knee joint drop lock ea jnt
|
$213.04 |
$213.04 |
$213.04 |
$175.45
|
|
Knee lift loop drop lock rin
|
$315.04 |
$315.04 |
$315.04 |
$242.92
|
|
Knee orth pos locking joint
|
$790.54 |
$790.54 |
$790.54 |
$585.60
|
|
Knee X-ray
|
$676.80 |
$676.80 |
$676.80 |
$425.55
|
|
Ko dbl upright w/air pre cst
|
$1,544.97 |
$1,544.97 |
$1,544.97 |
$1,360.92
|
|
Ko dbl upright w/air pre ots
|
$1,544.97 |
$1,544.97 |
$1,544.97 |
$1,371.41
|
|
Ko derot ant cruciate custom
|
$2,526.02 |
$2,526.02 |
$2,526.02 |
$2,225.10
|
|
Ko elastic w/joints pre ots
|
$216.61 |
$216.61 |
$216.61 |
$147.59
|
|
Ko rigid without joints pre ots
|
$358.36 |
$358.36 |
$358.36 |
$214.97
|
|
Ko single upright prefab ots
|
$2,410.14 |
$2,410.14 |
$2,410.14 |
$928.28
|
|
Ko supracondylar socket mold
|
$3,349.48 |
$3,349.48 |
$3,349.48 |
$2,950.46
|
|
Ko swedish type pre ots
|
$765.25 |
$765.25 |
$765.25 |
$604.50
|
|
Ko w/0 joint rigid molded to
|
$2,147.95 |
$2,147.95 |
$2,147.95 |
$1,230.99
|
|
Ko w adj flex/ext rotat mold
|
$3,142.82 |
$3,142.82 |
$3,142.82 |
$2,768.42
|
|
Kras gene addl variants
|
$397.20 |
$397.20 |
$397.20 |
$384.80
|
|
Kras gene variants exon 2
|
$397.20 |
$397.20 |
$397.20 |
$486.45
|
|
Kyphosis pad
|
$289.45 |
$289.45 |
$289.45 |
$254.97
|
|
Kyphosis pad floating
|
$417.61 |
$417.61 |
$417.61 |
$367.87
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$9.30 |
$9.30 |
$9.30 |
$32.34
|
|
Labioplasty 56800
|
$7,845.84 |
$7,845.84 |
$7,845.84 |
$3,786.00
|
|
Lacer molded to patient mode
|
$986.21 |
$986.21 |
$986.21 |
$775.69
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$101.10 |
$101.10 |
$101.10 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$68.40 |
$68.40 |
$68.40 |
$55.50
|
|
Lactated ringers intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$45.56
|
|
Lactic acid
|
$75.60 |
$75.60 |
$75.60 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$71.40 |
$71.40 |
$71.40 |
$80.40
|
|
Lam facetc/frmt arthrd lum 1
|
$104,275.68 |
$104,275.68 |
$104,275.68 |
$582.40
|
|
Lam facetec & foramot crv
|
$30,858.37 |
$30,858.37 |
$30,858.37 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$40,444.91 |
$40,444.91 |
$40,444.91 |
$7,913.97
|
|
Lam factc/frmt arthrd lum ea
|
$104,275.68 |
$104,275.68 |
$104,275.68 |
$492.80
|
|
Lanthanum carbonate oral 5mg
|
$46.14 |
$46.14 |
$46.14 |
$14.41
|
|
Laparo cholecystectomy/explr
|
$19,674.32 |
$19,674.32 |
$19,674.32 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$13,602.79 |
$13,602.79 |
$13,602.79 |
$8,346.00
|
|
Laparo proc abdm/per/oment 49329
|
$27,404.64 |
$27,404.64 |
$27,404.64 |
$6,622.75
|
|
Laparoscopic myomectomy
|
$45,742.55 |
$45,742.55 |
$45,742.55 |
$6,461.32
|
|
Laparoscopy biopsy
|
$30,581.62 |
$30,581.62 |
$30,581.62 |
$5,954.23
|
|
Laparoscopy excise lesions
|
$19,928.86 |
$19,928.86 |
$19,928.86 |
$6,904.15
|
|
Laparoscopy gastrostomy
|
$10,676.34 |
$10,676.34 |
$10,676.34 |
$6,376.26
|
|
Laparoscopy remove adnexa
|
$20,374.92 |
$20,374.92 |
$20,374.92 |
$8,312.83
|
|
Laparoscopy surg colpopexy
|
$34,983.16 |
$34,983.16 |
$34,983.16 |
$10,897.60
|
|
Laparo-vag hyst incl t/o
|
$24,530.48 |
$24,530.48 |
$24,530.48 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$21,999.38 |
$21,999.38 |
$21,999.38 |
$8,917.26
|
