|
Inj intralesional <= 7 lsn(s)
|
$303.00 |
$303.00 |
$303.00 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$4,045.80 |
$4,045.80 |
$4,045.80 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$199.20 |
$199.20 |
$199.20 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$0.08 |
$0.08 |
$0.08 |
$45.60
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$108.00 |
$108.00 |
$108.00 |
$794.70
|
|
Inj., meropenem, vaborbactam
|
$2,716.80 |
$2,716.80 |
$2,716.80 |
$556.87
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$691.20 |
$691.20 |
$691.20 |
$8,304.04
|
|
Inj multihance
|
$31.80 |
$31.80 |
$31.80 |
$70.54
|
|
Inj naloxone hydrochloride
|
$21.00 |
$21.00 |
$21.00 |
$83.16
|
|
Inj, nithiodote, 3mg / 125mg
|
$3.60 |
$3.60 |
$3.60 |
$468.10
|
|
Inj., plazomicin, 5 mg
|
$85.80 |
$85.80 |
$85.80 |
$607.16
|
|
Inj proc elbow arthro
|
$580.80 |
$580.80 |
$580.80 |
$432.00
|
|
Inj retro urethrocysto
|
$604.20 |
$604.20 |
$604.20 |
$447.74
|
|
Inj., rolapitant, 0.5 mg
|
$1.80 |
$1.80 |
$1.80 |
$1.80
|
|
Inj scleros sol mult veins
|
$1,016.40 |
$1,016.40 |
$1,016.40 |
$692.90
|
|
Inj scleros sol sgl vein
|
$1,273.80 |
$1,273.80 |
$1,273.80 |
$561.88
|
|
Inj secukinumab intrav 1mg
|
$42.80 |
$42.80 |
$42.80 |
$4,413.21
|
|
Inj sulf hexa lipid microsph
|
$234.60 |
$234.60 |
$234.60 |
$256.14
|
|
Inj. teprotumumab-trbw 10 mg
|
$768.00 |
$768.00 |
$768.00 |
$35,034.78
|
|
Inj testosterone cypionate
|
$0.60 |
$0.60 |
$0.60 |
$64.96
|
|
Inj thrc fascial pln blk bi w/wo image
|
$135.00 |
$135.00 |
$135.00 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$120.00 |
$120.00 |
$120.00 |
$818.00
|
|
Inj, tyenne, 1 mg
|
$12.80 |
$12.80 |
$12.80 |
$3,525.12
|
|
Inj w/fluor eval cv device
|
$996.60 |
$996.60 |
$996.60 |
$504.40
|
|
Ins cath ren art 1st bi
|
$4,954.20 |
$4,954.20 |
$4,954.20 |
$5,974.80
|
|
Insert cath pleura with image
|
$3,525.60 |
$3,525.60 |
$3,525.60 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,335.80 |
$2,335.80 |
$2,335.80 |
$2,099.70
|
|
Insertion catheter bladder non indwelling
|
$231.60 |
$231.60 |
$231.60 |
$208.01
|
|
Insertion intra aortic balloon assist device percutaneous
|
$796.80 |
$796.80 |
$796.80 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$3,606.00 |
$3,606.00 |
$3,606.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,524.00 |
$1,524.00 |
$1,524.00 |
$2,585.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$18,378.00 |
$18,378.00 |
$18,378.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$17,091.00 |
$17,091.00 |
$17,091.00 |
$12,324.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,524.00 |
$1,524.00 |
$1,524.00 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,103.60 |
$2,103.60 |
$2,103.60 |
$2,453.83
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$8,250.60 |
$8,250.60 |
$8,250.60 |
$7,183.68
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,109.60 |
$8,109.60 |
$8,109.60 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,320.00 |
$4,320.00 |
$4,320.00 |
$5,236.80
|
|
Insert swan-ganz cath
|
$2,794.20 |
$2,794.20 |
$2,794.20 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$4,110.00 |
$4,110.00 |
$4,110.00 |
$4,997.60
|
|
Insitu hybridization auto
|
$711.00 |
$711.00 |
$711.00 |
$377.37
|
|
Insitu hybridization manual
|
$388.20 |
$388.20 |
$388.20 |
$401.28
|
|
In situ hybridization per specimen initial single probe stain
|
$109.20 |
$109.20 |
$109.20 |
$338.40
|
|
Ins picad w subq port 5yr>
|
$1,380.00 |
$1,380.00 |
$1,380.00 |
$4,078.00
|
|
Ins pq tunnld ip cath w/img
|
$4,069.20 |
$4,069.20 |
$4,069.20 |
$5,486.00
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$4,444.80 |
$4,444.80 |
$4,444.80 |
$7,826.00
|
|
Ins tun cv cath wo subq prt/pm
|
$4,004.40 |
$4,004.40 |
$4,004.40 |
$4,218.00
|
|
Insulin total
|
$42.00 |
$42.00 |
$42.00 |
$66.64
|
|
Interrogate subq defib
|
$100.20 |
$100.20 |
$100.20 |
$119.60
|
|
Interrog dev eval icpms ip
|
$98.40 |
$98.40 |
$98.40 |
$104.00
|
|
Interrog dev eval scrms ip
|
$181.80 |
$181.80 |
$181.80 |
$124.80
|
|
Interrog device eval heart
|
$243.00 |
$243.00 |
$243.00 |
$162.40
|
|
Interrog evl pm/ldls pm ip
|
$205.20 |
$205.20 |
$205.20 |
$127.20
|
|
Intrinsic factor antibody
|
$49.20 |
$49.20 |
$49.20 |
$65.00
|
|
Intro cath dialysis circuit
|
$3,846.00 |
$3,846.00 |
$3,846.00 |
$2,036.94
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$8,887.20 |
$8,887.20 |
$8,887.20 |
$16,262.40
|
|
Intro catheter aorta
|
$973.20 |
$973.20 |
$973.20 |
$1,678.05
|
|
Intro cath svc/ivc
|
$3,847.80 |
$3,847.80 |
$3,847.80 |
$1,323.27
|
|
Intro long gi tube
|
$864.60 |
$864.60 |
$864.60 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$329.40 |
$329.40 |
$329.40 |
$469.00
|
|
Intubation endotracheal emergency procedure
|
$604.20 |
$604.20 |
$604.20 |
$601.28
|
|
Ionm in operatng room 15 min
|
$191.40 |
$191.40 |
$191.40 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$139.20 |
$139.20 |
$139.20 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$41.40 |
$41.40 |
$41.40 |
$279.10
|
|
Ipratropium bromide non-comp
|
$10.40 |
$10.40 |
$10.40 |
$4.06
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$1,122.40 |
$1,122.40 |
$1,122.40 |
$173.98
|
|
Iron
|
$40.80 |
$40.80 |
$40.80 |
$75.00
|
|
Iron binding capacity
|
$36.60 |
$36.60 |
$36.60 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$72.60 |
$72.60 |
$72.60 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$227.40 |
$227.40 |
$227.40 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$70.20 |
$70.20 |
$70.20 |
$115.20
|
|
Ivc venogram s&i
|
$4,618.80 |
$4,618.80 |
$4,618.80 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$62.40 |
$62.40 |
$62.40 |
$133.90
|
|
IV Fluids (first hour)
|
$231.60 |
$231.60 |
$231.60 |
$390.00
|
|
Ivig non-lyophilized, nos
|
$157.60 |
$157.60 |
$157.60 |
$402.40
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$52.80 |
$52.80 |
$52.80 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$94.80 |
$94.80 |
$94.80 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$85.20 |
$85.20 |
$85.20 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$508.80 |
$508.80 |
$508.80 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$78.60 |
$78.60 |
$78.60 |
$167.50
|
|
IV Push Injection (first drug)
|
$191.40 |
$191.40 |
$191.40 |
$252.76
|
|
Ixabepilone 15 mg intravenous solution
|
$147.60 |
$147.60 |
$147.60 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$1,227.60 |
$1,227.60 |
$1,227.60 |
$405.00
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$215.40 |
$215.40 |
$215.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$292.80 |
$292.80 |
$292.80 |
$362.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$63.60 |
$63.60 |
$63.60 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$24.80 |
$24.80 |
$24.80 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,667.40 |
$1,667.40 |
$1,667.40 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$352.20 |
$352.20 |
$352.20 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$292.80 |
$292.80 |
$292.80 |
$490.75
|
|
Kit gene analys d816 variant
|
$1,229.40 |
$1,229.40 |
$1,229.40 |
$374.61
|
|
Kit lead specify 5-6-5
|
$7,176.60 |
$7,176.60 |
$7,176.60 |
$16,672.10
|
|
Knee MRI (with and without contrast)
|
$3,802.20 |
$3,802.20 |
$3,802.20 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,019.80 |
$3,019.80 |
$3,019.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,796.00 |
$2,796.00 |
$2,796.00 |
$2,130.88
|
|
Knee X-ray
|
$289.20 |
$289.20 |
$289.20 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$215.40 |
$215.40 |
$215.40 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$245.40 |
$245.40 |
$245.40 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$238.80 |
$238.80 |
$238.80 |
$251.20
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$74.40 |
$74.40 |
$74.40 |
$175.92
|
