|
Ins mark abd/pel for right perq
|
$4,079.40 |
$4,079.40 |
$4,079.40 |
$2,477.24
|
|
Ins mark thor for right perq
|
$4,211.40 |
$4,211.40 |
$4,211.40 |
$2,503.80
|
|
Ins picad w subq port 5yr>
|
$4,201.80 |
$4,201.80 |
$4,201.80 |
$4,078.00
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$1,992.00 |
$1,992.00 |
$1,992.00 |
$1,690.00
|
|
Ins pm gen w/exist mlt leads
|
$41,511.60 |
$41,511.60 |
$41,511.60 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$11,758.20 |
$11,758.20 |
$11,758.20 |
$5,486.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$24,161.40 |
$24,161.40 |
$24,161.40 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$15,540.60 |
$15,540.60 |
$15,540.60 |
$11,005.50
|
|
Ins/rpl pm gen exist sgl lead
|
$18,185.40 |
$18,185.40 |
$18,185.40 |
$9,428.64
|
|
Ins/rpl pm w/tv ld atrl
|
$25,170.00 |
$25,170.00 |
$25,170.00 |
$11,583.66
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$43,233.60 |
$43,233.60 |
$43,233.60 |
$27,318.11
|
|
Instillation anticarcinogenic agent bladder
|
$587.40 |
$587.40 |
$587.40 |
$638.40
|
|
Ins tun cv cath wo subq prt/pm
|
$6,966.60 |
$6,966.60 |
$6,966.60 |
$5,324.80
|
|
Ins tun cv cath wo subq prt/pm
|
$4,201.80 |
$4,201.80 |
$4,201.80 |
$4,218.00
|
|
Ins tun intraperit dia cath
|
$4,714.20 |
$4,714.20 |
$4,714.20 |
$4,570.00
|
|
Inst via cath agent pleurds
|
$2,146.80 |
$2,146.80 |
$2,146.80 |
$1,074.68
|
|
Insulin total
|
$57.60 |
$57.60 |
$57.60 |
$66.64
|
|
Ins vag brachytx device
|
$1,102.80 |
$1,102.80 |
$1,102.80 |
$950.00
|
|
Interdiscal perq aspir dx
|
$1,930.20 |
$1,930.20 |
$1,930.20 |
$1,222.26
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$4,959.00 |
$4,959.00 |
$4,959.00 |
$10,427.90
|
|
Interstitial brachy inter
|
$415.20 |
$415.20 |
$415.20 |
$1,194.42
|
|
Intra-atrial pacing
|
$15,996.60 |
$15,996.60 |
$15,996.60 |
$4,850.82
|
|
Intra-atrial recording
|
$15,996.60 |
$15,996.60 |
$15,996.60 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$927.00 |
$927.00 |
$927.00 |
$3,436.00
|
|
Intracran angioplsty w/stent
|
$8,322.00 |
$8,322.00 |
$8,322.00 |
$8,145.50
|
|
Intracranial angioplasty
|
$7,600.80 |
$7,600.80 |
$7,600.80 |
$5,181.00
|
|
Intracranial limited study
|
$238.80 |
$238.80 |
$238.80 |
$467.50
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,663.80 |
$1,663.80 |
$1,663.80 |
$1,331.45
|
|
Intrauterine transfusion ftl
|
$846.00 |
$846.00 |
$846.00 |
$1,063.50
|
|
Intraventricular pacing
|
$8,922.00 |
$8,922.00 |
$8,922.00 |
$5,456.17
|
|
Intrinsic factor antibody
|
$85.20 |
$85.20 |
$85.20 |
$65.00
|
|
Intro cath dialysis circuit
|
$2,317.80 |
$2,317.80 |
$2,317.80 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$12,150.60 |
$12,150.60 |
$12,150.60 |
$8,690.50
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$25,053.60 |
$25,053.60 |
$25,053.60 |
$16,262.40
|
|
Intro catheter aorta
|
$4,321.20 |
$4,321.20 |
$4,321.20 |
$1,678.05
|
|
Intro cath svc/ivc
|
$2,403.60 |
$2,403.60 |
$2,403.60 |
$1,323.27
|
|
Intro long gi tube
|
$1,788.00 |
$1,788.00 |
$1,788.00 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$423.60 |
$423.60 |
$423.60 |
$469.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$6,337.80 |
$6,337.80 |
$6,337.80 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$5,288.40 |
$5,288.40 |
$5,288.40 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$463.80 |
$463.80 |
$463.80 |
$601.28
|
|
Iodine i-123 sod iodide mil
|
$753.00 |
$753.00 |
$753.00 |
$386.37
|
|
Ionm in operatng room 15 min
|
$264.00 |
$264.00 |
$264.00 |
$200.78
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$1.20 |
$1.20 |
$1.20 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.60 |
$0.60 |
$0.60 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$511.80 |
$511.80 |
$511.80 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$7.80 |
$7.80 |
$7.80 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$169.80 |
$169.80 |
$169.80 |
$5,517.12
|
|
Iron
|
$32.40 |
$32.40 |
$32.40 |
$75.00
|
|
Iron binding capacity
|
$44.40 |
$44.40 |
$44.40 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$10.20 |
$10.20 |
$10.20 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$7.20 |
$7.20 |
$7.20 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$136.80 |
$136.80 |
$136.80 |
$146.11
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$92.40 |
$92.40 |
$92.40 |
$8,273.35
|
|
Ivc venogram s&i
|
$5,906.40 |
$5,906.40 |
$5,906.40 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$108.00 |
$108.00 |
$108.00 |
$133.90
|
|
IV Fluids (first hour)
|
$522.00 |
$522.00 |
$522.00 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$325.20 |
$325.20 |
$325.20 |
$162.68
|
|
IV inj ra drug dx study
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$171.60 |
$171.60 |
$171.60 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$265.20 |
$265.20 |
$265.20 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$522.00 |
$522.00 |
$522.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$108.00 |
$108.00 |
$108.00 |
$167.50
|
|
IV Push Injection (first drug)
|
$522.00 |
$522.00 |
$522.00 |
$252.76
|
|
Ivp w/wo kub w/wo tomography
|
$427.80 |
$427.80 |
$427.80 |
$713.40
|
|
Ixabepilone 15 mg intravenous solution
|
$3,484.80 |
$3,484.80 |
$3,484.80 |
$10,695.32
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$188.40 |
$188.40 |
$188.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$262.80 |
$262.80 |
$262.80 |
$362.05
|
|
John cunningham antibody
|
$37.80 |
$37.80 |
$37.80 |
$78.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$42.00 |
$42.00 |
$42.00 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$3.60 |
$3.60 |
$3.60 |
$23.52
|
|
Kidney function study
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$935.22
|
|
Kidney imaging morphology
|
$1,228.80 |
$1,228.80 |
$1,228.80 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,574.40 |
$1,574.40 |
$1,574.40 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$394.20 |
$394.20 |
$394.20 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$394.20 |
$394.20 |
$394.20 |
$490.75
|
|
Kit gene analys d816 variant
|
$721.80 |
$721.80 |
$721.80 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$2,713.80 |
$2,713.80 |
$2,713.80 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,656.00 |
$1,656.00 |
$1,656.00 |
$2,130.88
|
|
Knee orth pos locking joint
|
$1,288.20 |
$1,288.20 |
$1,288.20 |
$585.60
|
|
Knee X-ray
|
$262.80 |
$262.80 |
$262.80 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$188.40 |
$188.40 |
$188.40 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$188.40 |
$188.40 |
$188.40 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$188.40 |
$188.40 |
$188.40 |
$251.20
|
|
Kras gene variants exon 2
|
$697.80 |
$697.80 |
$697.80 |
$536.20
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$7.80 |
$7.80 |
$7.80 |
$33.60
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$2.40 |
$2.40 |
$2.40 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$30.60 |
$30.60 |
$30.60 |
$55.50
|
|
Lactic acid
|
$58.80 |
$58.80 |
$58.80 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$99.60 |
$99.60 |
$99.60 |
$82.16
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$18,264.00 |
$18,264.00 |
$18,264.00 |
$19,124.00
|
|
Lanthanum carbonate oral 5mg
|
$7.20 |
$7.20 |
$7.20 |
$14.53
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$453.60 |
$453.60 |
$453.60 |
$740.40
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$2,514.60 |
$2,514.60 |
$2,514.60 |
$2,514.60
|
|
Laryngoscopy w/fb removal
|
$3,505.20 |
$3,505.20 |
$3,505.20 |
$2,854.09
|
|
Lead acuity x4 spiral l 86cm
|
$9,999.00 |
$9,999.00 |
$9,999.00 |
$5,460.00
|
|
Lead capillary
|
$62.40 |
$62.40 |
$62.40 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$2,715.00 |
$2,715.00 |
$2,715.00 |
$2,928.00
|
