|
Inj w/fluor eval cv device
|
$113.40 |
$113.40 |
$113.40 |
$463.40
|
|
Ins cerv dilator (sep proc)
|
$273.78 |
$273.78 |
$273.78 |
$488.35
|
|
Insert and remove bone pin
|
$355.86 |
$355.86 |
$355.86 |
$4,421.00
|
|
Insert cath pleura with image
|
$505.44 |
$505.44 |
$505.44 |
$2,194.40
|
|
Insert cath pleura without image
|
$318.06 |
$318.06 |
$318.06 |
$2,019.00
|
|
Insert drug delivery implant
|
$210.06 |
$210.06 |
$210.06 |
$280.00
|
|
Insert intrauterine device iud
|
$162.54 |
$162.54 |
$162.54 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$92.34 |
$92.34 |
$92.34 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$167.67 |
$167.67 |
$167.67 |
$229.32
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$517.05 |
$517.05 |
$517.05 |
$4,731.80
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$397.44 |
$397.44 |
$397.44 |
$2,511.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$291.06 |
$291.06 |
$291.06 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$261.90 |
$261.90 |
$261.90 |
$2,414.10
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$405.27 |
$405.27 |
$405.27 |
$7,513.67
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$927.45 |
$927.45 |
$927.45 |
$5,236.80
|
|
Insert pessary/other device
|
$154.44 |
$154.44 |
$154.44 |
$273.54
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$204.66 |
$204.66 |
$204.66 |
$1,609.25
|
|
Ins pq tunnld ip cath w/img
|
$410.94 |
$410.94 |
$410.94 |
$5,377.00
|
|
Instillation anticarcinogenic agent bladder
|
$244.89 |
$244.89 |
$244.89 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$1,935.90 |
$1,935.90 |
$1,935.90 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$598.05 |
$598.05 |
$598.05 |
$4,202.70
|
|
Ins tun intraperit dia cath
|
$645.84 |
$645.84 |
$645.84 |
$4,657.46
|
|
Interrog evl pm/ldls pm ip
|
$54.00 |
$54.00 |
$54.00 |
$124.80
|
|
Int hrhc lig 1 hroid without img
|
$722.52 |
$722.52 |
$722.52 |
$3,316.74
|
|
Int hrhc lig 2+hroid without img
|
$804.06 |
$804.06 |
$804.06 |
$3,229.60
|
|
Intranasal biopsy 30100
|
$291.60 |
$291.60 |
$291.60 |
$2,199.10
|
|
Intubation endotracheal emergency procedure
|
$382.05 |
$382.05 |
$382.05 |
$589.60
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$37,551.75 |
$37,551.75 |
$37,551.75 |
$62,692.46
|
|
Ip/obs cnsltj new/est low 45
|
$235.44 |
$235.44 |
$235.44 |
$174.20
|
|
Ip/obs cnsltj new/est mod 60
|
$340.74 |
$340.74 |
$340.74 |
$284.45
|
|
Ip/obs consltj new/est hi 80
|
$468.72 |
$468.72 |
$468.72 |
$332.80
|
|
Ip/obs consltj new/est sf 35
|
$112.32 |
$112.32 |
$112.32 |
$134.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$209.96 |
$209.96 |
$209.96 |
$163.87
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$47.52 |
$47.52 |
$47.52 |
$5,476.68
|
|
Iron dextran 50 mg/ml injection solution
|
$65.23 |
$65.23 |
$65.23 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$113.64 |
$113.64 |
$113.64 |
$187.06
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$37.80 |
$37.80 |
$37.80 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$117.72 |
$117.72 |
$117.72 |
$439.56
|
|
IV njx tst vasc flo flap/grf
|
$240.03 |
$240.03 |
$240.03 |
$476.00
|
|
Ivp w/nephrotomography
|
$86.40 |
$86.40 |
$86.40 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$86.94 |
$86.94 |
$86.94 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$78.84 |
$78.84 |
$78.84 |
$10,695.32
|
|
J-tube placement
|
$301.05 |
$301.05 |
$301.05 |
$462.00
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$21.06 |
$21.06 |
$21.06 |
$23.50
|
|
Kidney imaging morphology
|
$77.76 |
$77.76 |
$77.76 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$243.54 |
$243.54 |
$243.54 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$164.16 |
$164.16 |
$164.16 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$130.14 |
$130.14 |
$130.14 |
$666.00
|
|
Knee Arthroscopy (Cartilage Repair)
|
$1,313.82 |
$1,313.82 |
$1,313.82 |
$4,304.96
|
|
Knee arthroscopy/drainage
|
$1,094.04 |
$1,094.04 |
$1,094.04 |
$3,839.54
|
|
Knee arthroscopy dx
|
$1,321.92 |
$1,321.92 |
$1,321.92 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$1,489.32 |
$1,489.32 |
$1,489.32 |
$5,148.00
|
|
Knee arthroscopy/surgery
|
$1,135.08 |
$1,135.08 |
$1,135.08 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,053.54 |
$1,053.54 |
$1,053.54 |
$4,535.82
|
|
Knee arthroscopy/surgery
|
$1,379.70 |
$1,379.70 |
$1,379.70 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,398.06 |
$1,398.06 |
$1,398.06 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,431.81 |
$1,431.81 |
$1,431.81 |
$4,499.12
|
|
Knee arthroscopy/surgery
|
$1,452.06 |
$1,452.06 |
$1,452.06 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,934.01 |
$1,934.01 |
$1,934.01 |
$3,986.00
|
|
Knee arthroscopy/surgery
|
$2,071.44 |
$2,071.44 |
$2,071.44 |
$8,453.60
|
|
Knee MRI (with and without contrast)
|
$549.72 |
$549.72 |
$549.72 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$287.82 |
$287.82 |
$287.82 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$441.99 |
$441.99 |
$441.99 |
$2,169.60
|
|
Knee X-ray
|
$173.34 |
$173.34 |
$173.34 |
$425.55
|
|
Kyleena, 19.5 mg
|
$589.68 |
$589.68 |
$589.68 |
$2,125.00
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$49.14 |
$49.14 |
$49.14 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$39.69 |
$39.69 |
$39.69 |
$72.80
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$23.70 |
$23.70 |
$23.70 |
$32.34
|
|
Lactated ringers intravenous solution
|
$21.20 |
$21.20 |
$21.20 |
$45.56
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$60.48 |
$60.48 |
$60.48 |
$19,124.00
|
|
Laparo-asst vag hysterectomy
|
$1,891.89 |
$1,891.89 |
$1,891.89 |
$6,463.42
|
|
Laparo cholecystectomy/graph
|
$1,596.78 |
$1,596.78 |
$1,596.78 |
$8,346.00
|
|
Laparo partial colectomy 44204
|
$3,524.58 |
$3,524.58 |
$3,524.58 |
$2,917.80
|
|
Laparo radical nephrectomy
|
$3,072.60 |
$3,072.60 |
$3,072.60 |
$6,360.80
|
|
Laparoscopic myomectomy
|
$1,925.91 |
$1,925.91 |
$1,925.91 |
$6,461.32
|
|
Laparoscopic nephrectomy
|
$2,681.37 |
$2,681.37 |
$2,681.37 |
$5,686.20
|
|
Laparoscopy aspiration
|
$1,567.08 |
$1,567.08 |
$1,567.08 |
$6,457.82
|
|
Laparoscopy biopsy
|
$730.62 |
$730.62 |
$730.62 |
$5,954.23
|
|
Laparoscopy excise lesions
|
$1,514.16 |
$1,514.16 |
$1,514.16 |
$6,904.15
|
|
Laparoscopy lysis
|
$1,446.93 |
$1,446.93 |
$1,446.93 |
$5,057.88
|
|
Laparoscopy remove adnexa
|
$2,770.20 |
$2,770.20 |
$2,770.20 |
$8,312.83
|
|
Laparoscopy tubal block 58671
|
$773.82 |
$773.82 |
$773.82 |
$5,166.25
|
|
Laparo-vag hyst incl t/o
|
$2,104.65 |
$2,104.65 |
$2,104.65 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$2,833.38 |
$2,833.38 |
$2,833.38 |
$8,917.26
|
|
Lap colectomy part w/ileum 44205
|
$2,854.17 |
$2,854.17 |
$2,854.17 |
$2,938.32
|
|
Lap enterolysis
|
$1,950.75 |
$1,950.75 |
$1,950.75 |
$6,161.68
|
|
Lap ing hernia repair recur
|
$1,760.40 |
$1,760.40 |
$1,760.40 |
$6,376.26
|
|
Lap mobil splenic fl add-on 44213
|
$380.70 |
$380.70 |
$380.70 |
$622.40
|
|
Lap rmvl gastr adj device
|
$1,950.48 |
$1,950.48 |
$1,950.48 |
$4,502.13
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$332.64 |
$332.64 |
$332.64 |
$2,480.71
|
|
Laryngoscopy w/biopsy
|
$393.12 |
$393.12 |
$393.12 |
$4,362.99
|
|
Laryngoscopy w/bx & op scope
|
$476.01 |
$476.01 |
$476.01 |
$4,362.99
|
|
Laryngoscopy w/exc of tumor
|
$511.38 |
$511.38 |
$511.38 |
$5,110.00
|
|
Laryngoscopy w/fb removal
|
$430.38 |
$430.38 |
$430.38 |
$3,055.20
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$231.66 |
$231.66 |
$231.66 |
$754.32
|
|
Larynscop w/tumr exc + scope
|
$543.78 |
$543.78 |
$543.78 |
$4,363.27
|
|
Laser surgery of prostate
|
$1,448.82 |
$1,448.82 |
$1,448.82 |
$6,015.75
|
|
Lat retinacular release open
|
$973.08 |
$973.08 |
$973.08 |
$3,839.54
|
|
Lavh >250 gms 58553
|
$2,313.90 |
$2,313.90 |
$2,313.90 |
$6,839.00
|
|
Lb with mastopexy 15839
|
$1,548.18 |
$1,548.18 |
$1,548.18 |
$3,435.60
|