|
Ivig non-lyophilized, nos
|
$157.60 |
$402.40 |
$548.80 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$52.80 |
$168.00 |
$422.40 |
|
|
IV inj ra drug dx study
|
$513.60 |
$1,228.80 |
$1,713.60 |
|
|
IV Medicine Infusion (additional drug)
|
$71.20 |
$228.60 |
$697.80 |
|
|
IV Medicine Infusion (each additional hour)
|
$85.20 |
$251.40 |
$697.80 |
|
|
IV Medicine Infusion (first hour)
|
$292.80 |
$522.00 |
$1,350.40 |
|
|
IV njx tst vasc flo flap/grf
|
$68.54 |
$68.54 |
$77.48 |
|
|
IV Push Injection (each additional drug)
|
$78.60 |
$147.00 |
$438.00 |
|
|
IV Push Injection (first drug)
|
$144.00 |
$306.60 |
$616.77 |
|
|
Ivp w/nephrotomography
|
$75.60 |
$484.80 |
$716.10 |
|
|
Ivp w/wo kub w/wo tomography
|
$16.64 |
$475.80 |
$1,552.00 |
|
|
Ixabepilone 15 mg intravenous solution
|
$139.20 |
$680.40 |
$16,246.20 |
|
|
Jak2 targeted sequence analysis
|
$156.00 |
$1,227.60 |
$1,266.00 |
|
|
Jaw arthroscopy/surgery
|
$347.53 |
$347.53 |
$392.86 |
|
|
Jaw arthroscopy/surgery
|
$385.25 |
$385.25 |
$435.50 |
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$90.00 |
$340.40 |
$816.80 |
|
|
Jaw (Mandible) X-ray (complete)
|
$108.00 |
$312.00 |
$686.40 |
|
|
Jejunstmy tube plcmt
|
$152.72 |
$3,660.60 |
$5,083.20 |
|
|
John cunningham antibody
|
$37.80 |
$64.80 |
$3,827.20 |
|
|
J-tube placement
|
$90.39 |
$556.80 |
$697.82 |
|
|
Keratoprosthesis
|
$888.72 |
$888.72 |
$1,004.64 |
|
|
Ketamine and metabolite screen - quest
|
$5.00 |
$5.00 |
$753.83 |
|
|
Ketogenic steroids fract
|
$10.58 |
$11.96 |
$262.80 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$28.80 |
$52.80 |
$1,114.80 |
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$3.60 |
$24.60 |
$253.20 |
|
|
Kidney endoscopy
|
$187.91 |
$187.91 |
$212.42 |
|
|
Kidney endoscopy
|
$200.79 |
$226.98 |
$3,964.20 |
|
|
Kidney endoscopy
|
$313.72 |
$313.72 |
$354.64 |
|
|
Kidney endoscopy
|
$455.63 |
$455.63 |
$515.06 |
|
|
Kidney endoscopy & biopsy
|
$218.50 |
$218.50 |
$247.00 |
|
|
Kidney endoscopy & biopsy
|
$360.87 |
$360.87 |
$407.94 |
|
|
Kidney endoscopy & treatment
|
$221.03 |
$221.03 |
$249.86 |
|
|
Kidney endoscopy & treatment
|
$251.85 |
$284.70 |
$3,040.80 |
|
|
Kidney endoscopy & treatment
|
$359.95 |
$359.95 |
$406.90 |
|
|
Kidney endoscopy & treatment
|
$387.55 |
$387.55 |
$438.10 |
|
|
Kidney function study
|
$10.81 |
$1,228.80 |
$1,713.60 |
|
|
Kidney imaging (3d)
|
$682.20 |
$682.20 |
$682.20 |
|
|
Kidney imaging morphology
|
$414.50 |
$1,228.80 |
$2,370.00 |
|
|
Kidney imag w/bld flow multi
|
$491.50 |
$1,574.40 |
$5,354.40 |
|
|
Kidney img w/bldflw sgl without rx
|
$491.50 |
$1,574.40 |
$2,901.00 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$279.50 |
$706.20 |
$1,469.40 |
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$142.80 |
$583.66 |
$1,015.20 |
|
|
Kit case 4.2mm spinejack
|
$7,686.60 |
$7,833.60 |
$12,441.00 |
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$9.60 |
$174.00 |
$489.60 |
|
|
Kit cath f 8f w/glv + wipe ster
|
$5.40 |
$5.40 |
$24.00 |
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$4,863.00 |
$9,505.80 |
$15,094.80 |
|
|
Kit gene analys d816 variant
|
$350.76 |
$1,122.00 |
$1,303.80 |
|
|
Kit hfx iq ipg bundle
|
$32,828.40 |
$56,811.60 |
$56,811.60 |
|
|
Kit ipg optimizer smart
|
$46,800.00 |
$55,402.80 |
$74,319.00 |
|
|
Kit lead specify 5-6-5
|
$2,910.60 |
$12,075.00 |
$54,950.40 |
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$712.20 |
$1,770.60 |
$2,619.00 |
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
|
|
Kit sound processor cochlear osia 2
|
$5,556.60 |
$8,362.80 |
$38,541.00 |
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,621.80 |
$3,676.80 |
$4,897.20 |
|
|
Kit trach suct cls 30.5cm
|
$2.40 |
$2.40 |
$39.00 |
|
|
Knee Arthroscopy (Cartilage Smoothing)
|
$405.49 |
$458.38 |
$2,551.00 |
|
|
Knee arthroscopy/drainage
|
$337.41 |
$337.41 |
$381.42 |
|
|
Knee arthroscopy dx
|
$270.94 |
$306.28 |
$795.60 |
|
|
Knee Arthroscopy (Meniscus Trimming)
|
$353.74 |
$399.88 |
$3,121.75 |
|
|
Knee arthroscopy/surgery
|
$408.94 |
$408.94 |
$462.28 |
|
|
Knee arthroscopy/surgery
|
$605.82 |
$605.82 |
$684.84 |
|
|
Knee arthroscopy/surgery
|
$351.21 |
$397.02 |
$4,183.50 |
|
|
Knee arthroscopy/surgery
|
$350.29 |
$395.98 |
$2,304.00 |
|
|
Knee arthroscopy/surgery
|
$324.76 |
$367.12 |
$2,725.00 |
|
|
Knee arthroscopy/surgery
|
$426.42 |
$482.04 |
$2,393.50 |
|
|
Knee arthroscopy/surgery
|
$432.17 |
$488.54 |
$1,639.20 |
|
|
Knee arthroscopy/surgery
|
$367.08 |
$414.96 |
$1,742.40 |
|
|
Knee arthroscopy/surgery
|
$449.19 |
$507.78 |
$5,152.80 |
|
|
Knee arthroscopy/surgery
|
$546.25 |
$546.25 |
$617.50 |
|
|
Knee arthroscopy/surgery
|
$404.80 |
$457.60 |
$1,705.50 |
|
|
Knee arthroscopy/surgery
|
$416.99 |
$416.99 |
$471.38 |
|
|
Knee arthroscopy/surgery
|
$492.20 |
$492.20 |
$556.40 |
|
|
Knee arthroscopy/surgery
|
$631.81 |
$714.22 |
$10,867.00 |
|
|
Knee arthroscopy/surgery
|
$796.03 |
$899.86 |
$3,067.80 |
|
|
Knee MRI (with and without contrast)
|
$712.50 |
$2,713.80 |
$9,808.20 |
|
|
Knee MRI (with contrast)
|
$645.00 |
$2,713.80 |
$8,004.00 |
|
|
Knee MRI (without contrast)
|
$462.00 |
$2,039.44 |
$6,214.20 |
|
|
Knee orth pos locking joint
|
$1,288.20 |
$1,288.20 |
$1,288.20 |
|
|
Knee X-ray
|
$133.20 |
$424.20 |
$736.80 |
|
|
Knee X-ray (1 to 2 views, both knees)
|
$108.00 |
$262.40 |
$736.00 |
|
|
Knee X-ray (3 views, both knees)
|
$115.80 |
$405.00 |
$686.40 |
|
|
Knee X-ray (standing, both knees)
|
$88.00 |
$238.80 |
$686.40 |
|
|
Kras gene addl variants
|
$167.00 |
$565.18 |
$2,046.60 |
|
|
Kras gene variants exon 2
|
$311.50 |
$697.80 |
$1,561.20 |
|
|
Kyleena, 19.5 mg
|
$1,372.80 |
$2,489.60 |
$4,771.20 |
|
|
Kyphectomy 1-2 segments
|
$1,388.74 |
$1,388.74 |
$1,569.88 |
|
|
Kyphectomy 3 or more
|
$1,598.27 |
$1,598.27 |
$1,806.74 |
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$11.96 |
$13.52 |
$478.20 |
|
|
Lab draw <3 yrs scalp vein 36405
|
$9.43 |
$64.38 |
$83.40 |
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$4.50 |
$7.80 |
$83.20 |
|
|
Labioplasty 56800
|
$163.76 |
$163.76 |
$185.12 |
|
|
Lab pathology consultation
|
$171.00 |
$171.00 |
$171.00 |
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.90 |
$171.00 |
$868.80 |
|
|
Lactate dehydrogenase (ldh)
|
$22.80 |
$36.00 |
$231.60 |
|
|
Lactated ringers intravenous solution
|
$4.83 |
$49.80 |
$240.00 |
|
|
Lactation class
|
$52.80 |
$52.80 |
$52.80 |
|
|
Lactic acid
|
$36.60 |
$75.20 |
$505.80 |
|
|
Lactoferrin fecal qualitative
|
$62.00 |
$109.20 |
$797.40 |
|
|
Lactoferrin fecal quant
|
$65.50 |
$183.60 |
$306.60 |
|
|
Lam facetc/frmt arthrd lum 1
|
$166.52 |
$188.24 |
$7,499.75 |
|
