|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$515.20 |
$515.20 |
$515.20 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$178.40 |
$178.40 |
$178.40 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$178.40 |
$178.40 |
$178.40 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$178.40 |
$178.40 |
$178.40 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$354.40 |
$354.40 |
$354.40 |
$374.00
|
|
Infliximab-axxq 100 mg intravenous solution
|
$3,409.60 |
$3,409.60 |
$3,409.60 |
$1,062.00
|
|
Initiation & management bipap/cpap initial day
|
$1,171.20 |
$1,171.20 |
$1,171.20 |
$576.00
|
|
Inj, bupivacaine liposome
|
$1,586.20 |
$1,586.20 |
$1,586.20 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$71.20 |
$71.20 |
$71.20 |
$28.08
|
|
Inj ceftolozane tazobactam
|
$1,151.80 |
$1,151.80 |
$1,151.80 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$839.20 |
$839.20 |
$839.20 |
$436.80
|
|
Inj dx for sinogram
|
$124.00 |
$124.00 |
$124.00 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$260.00 |
$260.00 |
$260.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$872.80 |
$872.80 |
$872.80 |
$495.84
|
|
Injection, cangrelor
|
$6,600.40 |
$6,600.40 |
$6,600.40 |
$1,889.78
|
|
Injection, doxercalciferol
|
$38.40 |
$38.40 |
$38.40 |
$23.86
|
|
Injection epidural blood patch or clot
|
$500.80 |
$500.80 |
$500.80 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$839.20 |
$839.20 |
$839.20 |
$428.40
|
|
Injection for bladder x-ray
|
$653.60 |
$653.60 |
$653.60 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$933.60 |
$933.60 |
$933.60 |
$494.65
|
|
Injection for ureter x-ray
|
$963.20 |
$963.20 |
$963.20 |
$515.21
|
|
Injection,onabotulinumtoxina
|
$4,536.20 |
$4,536.20 |
$4,536.20 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$381.60 |
$381.60 |
$381.60 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$350.40 |
$350.40 |
$350.40 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$966.40 |
$966.40 |
$966.40 |
$1,023.50
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$548.80 |
$548.80 |
$548.80 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$548.80 |
$548.80 |
$548.80 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$147.20 |
$147.20 |
$147.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$147.20 |
$147.20 |
$147.20 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$113.60 |
$113.60 |
$113.60 |
$135.60
|
|
Inj for ext venography
|
$443.20 |
$443.20 |
$443.20 |
$649.95
|
|
Inj ivig privigen 500 mg
|
$4,981.20 |
$4,981.20 |
$4,981.20 |
$6,967.29
|
|
Inj, lidocaine w epinephrine
|
$79.40 |
$79.40 |
$79.40 |
$47.52
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$88.80 |
$88.80 |
$88.80 |
$784.00
|
|
Inj mepivacaine hcl/10 ml
|
$87.00 |
$87.00 |
$87.00 |
$33.86
|
|
Inj multihance
|
$12.00 |
$12.00 |
$12.00 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,308.80 |
$1,308.80 |
$1,308.80 |
$1,413.35
|
|
Inj proc elbow arthro
|
$872.80 |
$872.80 |
$872.80 |
$419.60
|
|
Inj proc myelogram lumbar
|
$4,736.80 |
$4,736.80 |
$4,736.80 |
$830.50
|
|
Inj retro urethrocysto
|
$285.60 |
$285.60 |
$285.60 |
$443.50
|
|
Inj w/fluor eval cv device
|
$567.20 |
$567.20 |
$567.20 |
$503.92
|
|
Ins cerv dilator (sep proc)
|
$476.80 |
$476.80 |
$476.80 |
$480.28
|
|
Insert cath pleura with image
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,116.80 |
$1,116.80 |
$1,116.80 |
$2,073.18
|
|
Insert drug delivery implant
|
$192.80 |
$192.80 |
$192.80 |
$280.00
|
|
Insertion catheter bladder non indwelling
|
$150.40 |
$150.40 |
$150.40 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$310.40 |
$310.40 |
$310.40 |
$232.25
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,252.80 |
$8,252.80 |
$8,252.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,904.00 |
$1,904.00 |
$1,904.00 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$6,147.20 |
$6,147.20 |
$6,147.20 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$5,941.60 |
$5,941.60 |
$5,941.60 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$549.60 |
$549.60 |
$549.60 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,868.80 |
$1,868.80 |
$1,868.80 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,651.20 |
$15,651.20 |
$15,651.20 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,131.20 |
$4,131.20 |
$4,131.20 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$12,016.00 |
$12,016.00 |
$12,016.00 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$5,018.40 |
$5,018.40 |
$5,018.40 |
$9,332.50
|
|
In situ hybridization per specimen each additional single probe stain
|
$491.20 |
$491.20 |
$491.20 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$511.20 |
$511.20 |
$511.20 |
$331.69
|
|
Ins/rpl ldless pm right vent w img & eval
|
$5,640.80 |
$5,640.80 |
$5,640.80 |
$24,135.54
|
|
Instillation anticarcinogenic agent bladder
|
$608.00 |
$608.00 |
$608.00 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$2,836.00 |
$2,836.00 |
$2,836.00 |
$4,202.70
|
|
Insulin total
|
$47.20 |
$47.20 |
$47.20 |
$66.64
|
|
Interdiscal perq aspir dx
|
$1,187.20 |
$1,187.20 |
$1,187.20 |
$1,222.26
|
|
Intrinsic factor antibody
|
$62.40 |
$62.40 |
$62.40 |
$63.15
|
|
Intubation endotracheal emergency procedure
|
$1,075.20 |
$1,075.20 |
$1,075.20 |
$598.80
|
|
Iodine i-123 sod iodide mil
|
$1,230.40 |
$1,230.40 |
$1,230.40 |
$371.18
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$5.60 |
$5.60 |
$5.60 |
$288.11
|
|
Iron
|
$20.00 |
$20.00 |
$20.00 |
$72.29
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$994.60 |
$994.60 |
$994.60 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$100.00 |
$100.00 |
$100.00 |
$144.62
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$71.20 |
$71.20 |
$71.20 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$71.20 |
$71.20 |
$71.20 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$154.40 |
$154.40 |
$154.40 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$448.00 |
$448.00 |
$448.00 |
$437.45
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$33.60 |
$33.60 |
$33.60 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$33.60 |
$33.60 |
$33.60 |
$23.77
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$772.80 |
$772.80 |
$772.80 |
$673.36
|
|
Knee MRI (with and without contrast)
|
$712.50 |
$712.50 |
$712.50 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$645.00 |
$645.00 |
$645.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$462.00 |
$462.00 |
$462.00 |
$2,110.76
|
|
Knee X-ray
|
$442.40 |
$442.40 |
$442.40 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$83.20 |
$83.20 |
$83.20 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$868.80 |
$868.80 |
$868.80 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$25.00 |
$25.00 |
$25.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$30.40 |
$30.40 |
$30.40 |
$44.91
|
|
Lactic acid
|
$75.20 |
$75.20 |
$75.20 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$82.40 |
$82.40 |
$82.40 |
$81.00
|
|
Lead capillary
|
$50.40 |
$50.40 |
$50.40 |
$55.25
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$869.60 |
$869.60 |
$869.60 |
$1,092.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$691.36 |
$691.36 |
$691.36 |
$1,044.75
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$502.00 |
$502.00 |
$502.00 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$3,509.20 |
$3,509.20 |
$3,509.20 |
$6,236.52
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$19.40 |
$19.40 |
$19.40 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$55.20 |
$55.20 |
$55.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$136.40 |
$136.40 |
$136.40 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$621.00 |
$621.00 |
$621.00 |
$420.60
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$91.20 |
$91.20 |
$91.20 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$105.80 |
$105.80 |
$105.80 |
$40.54
|
