|
Inj alymsys 10 mg
|
$1,154.47 |
$1,154.47 |
$1,154.47 |
$1,280.74
|
|
Inj., benralizumab, 1 mg
|
$7,930.42 |
$7,930.42 |
$7,930.42 |
$11,310.00
|
|
Inj cefazolin sodium, hikma
|
$63.90 |
$63.90 |
$63.90 |
$27.38
|
|
Inj, cefepime hcl (b braun)
|
$173.80 |
$173.80 |
$173.80 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$137.88 |
$137.88 |
$137.88 |
$48.30
|
|
Inj crotalidae im f(ab')2 eq
|
$1,943.36 |
$1,943.36 |
$1,943.36 |
$2,613.60
|
|
Inj, daptomycin (hospira)
|
$85.70 |
$85.70 |
$85.70 |
$128.08
|
|
Injection, daratumumab 10 mg
|
$2,731.59 |
$2,731.59 |
$2,731.59 |
$5,324.34
|
|
Injection, fulvestrant
|
$1,568.57 |
$1,568.57 |
$1,568.57 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$5,260.16 |
$5,260.16 |
$5,260.16 |
$6,679.35
|
|
Injection, pentamidine iseth
|
$227.92 |
$227.92 |
$227.92 |
$383.03
|
|
Injection, renflexis
|
$689.86 |
$689.86 |
$689.86 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$520.80 |
$520.80 |
$520.80 |
$1,043.72
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$607.20 |
$607.20 |
$607.20 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$168.00 |
$168.00 |
$168.00 |
$145.60
|
|
Inject sacroiliac joint
|
$1,144.00 |
$1,144.00 |
$1,144.00 |
$1,029.04
|
|
Inj epidural sgl lumb-sacral without img
|
$1,299.20 |
$1,299.20 |
$1,299.20 |
$1,450.84
|
|
Inj. fe derisomaltose 10 mg
|
$3,221.52 |
$3,221.52 |
$3,221.52 |
$3,221.52
|
|
Inj heparin, pfizer, 1000u
|
$61.02 |
$61.02 |
$61.02 |
$25.30
|
|
Inj ivig privigen 500 mg
|
$4,520.16 |
$4,520.16 |
$4,520.16 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$77.04 |
$77.04 |
$77.04 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$13.83 |
$13.83 |
$13.83 |
$45.60
|
|
Inj mepivacaine hcl/10 ml
|
$63.40 |
$63.40 |
$63.40 |
$34.34
|
|
Inj, meropenem (b. braun)
|
$175.96 |
$175.96 |
$175.96 |
$71.14
|
|
Inj, nithiodote, 3mg / 125mg
|
$233.99 |
$233.99 |
$233.99 |
$468.10
|
|
Inj octafluoropropane mic,ml
|
$205.60 |
$205.60 |
$205.60 |
$211.40
|
|
Inj ontruzant 10 mg
|
$2,534.28 |
$2,534.28 |
$2,534.28 |
$6,706.27
|
|
Inj pantoprazole(hikma) 40mg
|
$62.44 |
$62.44 |
$62.44 |
$34.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,121.92 |
$3,121.92 |
$3,121.92 |
$6,614.40
|
|
Inj, releuko 1 mcg
|
$216.71 |
$216.71 |
$216.71 |
$475.36
|
|
Inj testosterone cypionate
|
$65.28 |
$65.28 |
$65.28 |
$64.96
|
|
Insert cath pleura without image
|
$1,418.40 |
$1,418.40 |
$1,418.40 |
$2,099.70
|
|
Insert drug delivery implant
|
$595.20 |
$595.20 |
$595.20 |
$280.00
|
|
Insertion catheter bladder non indwelling
|
$240.00 |
$240.00 |
$240.00 |
$208.01
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,608.00 |
$1,608.00 |
$1,608.00 |
$2,103.75
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$6,675.20 |
$6,675.20 |
$6,675.20 |
$5,236.80
|
|
In situ hybridization per specimen initial single probe stain
|
$483.20 |
$483.20 |
$483.20 |
$338.40
|
|
Instillation anticarcinogenic agent bladder
|
$806.40 |
$806.40 |
$806.40 |
$638.40
|
|
Ins tun intraperit dia cath
|
$5,373.60 |
$5,373.60 |
$5,373.60 |
$4,570.00
|
|
Insulin total
|
$138.40 |
$138.40 |
$138.40 |
$66.64
|
|
Intracranial limited study
|
$700.80 |
$700.80 |
$700.80 |
$467.50
|
|
Intrinsic factor antibody
|
$56.80 |
$56.80 |
$56.80 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$743.20 |
$743.20 |
$743.20 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$20.00 |
$20.00 |
$20.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$100.00 |
$100.00 |
$100.00 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$7,797.00 |
$7,797.00 |
$7,797.00 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$3.40 |
$3.40 |
$3.40 |
$4.06
|
|
Iron
|
$80.80 |
$80.80 |
$80.80 |
$75.00
|
|
Iron binding capacity
|
$90.40 |
$90.40 |
$90.40 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$86.34 |
$86.34 |
$86.34 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$66.40 |
$66.40 |
$66.40 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$172.80 |
$172.80 |
$172.80 |
$146.11
|
|
IV Fluids (each additional hour)
|
$153.60 |
$153.60 |
$153.60 |
$133.90
|
|
IV Fluids (first hour)
|
$370.40 |
$370.40 |
$370.40 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$187.20 |
$187.20 |
$187.20 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$276.00 |
$276.00 |
$276.00 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$181.60 |
$181.60 |
$181.60 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$580.00 |
$580.00 |
$580.00 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$186.40 |
$186.40 |
$186.40 |
$167.50
|
|
IV Push Injection (first drug)
|
$376.00 |
$376.00 |
$376.00 |
$252.76
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$442.40 |
$442.40 |
$442.40 |
$330.05
|
|
Jaw (Mandible) X-ray (complete)
|
$478.40 |
$478.40 |
$478.40 |
$362.05
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$44.80 |
$44.80 |
$44.80 |
$58.56
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$61.93 |
$61.93 |
$61.93 |
$23.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,811.20 |
$1,811.20 |
$1,811.20 |
$1,433.22
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$934.40 |
$934.40 |
$934.40 |
$673.36
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$660.80 |
$660.80 |
$660.80 |
$490.75
|
|
Knee MRI (with and without contrast)
|
$3,798.40 |
$3,798.40 |
$3,798.40 |
$3,022.20
|
|
Knee MRI (with contrast)
|
$3,064.00 |
$3,064.00 |
$3,064.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,968.80 |
$2,968.80 |
$2,968.80 |
$2,130.88
|
|
Knee X-ray
|
$485.60 |
$485.60 |
$485.60 |
$432.18
|
|
Knee X-ray (1 to 2 views, both knees)
|
$331.20 |
$331.20 |
$331.20 |
$290.40
|
|
Knee X-ray (3 views, both knees)
|
$385.60 |
$385.60 |
$385.60 |
$363.60
|
|
Knee X-ray (standing, both knees)
|
$311.20 |
$311.20 |
$311.20 |
$251.20
|
|
Ko elastic w/joints pre ots
|
$426.40 |
$426.40 |
$426.40 |
$137.05
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$61.05 |
$61.05 |
$61.05 |
$33.60
|
|
Lactate dehydrogenase (ldh)
|
$72.80 |
$72.80 |
$72.80 |
$55.50
|
|
Lactated ringers intravenous solution
|
$120.00 |
$120.00 |
$120.00 |
$43.74
|
|
Lactic acid
|
$115.20 |
$115.20 |
$115.20 |
$107.10
|
|
Large Joint Injection or Fluid Draw (both sides)
|
$778.40 |
$778.40 |
$778.40 |
$740.40
|
|
Lead capillary
|
$88.00 |
$88.00 |
$88.00 |
$57.50
|
|
Leg Artery Ultrasound (complete, both legs)
|
$1,398.40 |
$1,398.40 |
$1,398.40 |
$990.00
|
|
Leg CT Scan (with contrast, both legs)
|
$2,017.60 |
$2,017.60 |
$2,017.60 |
$1,585.20
|
|
Leg CT Scan (without contrast, both legs)
|
$1,942.40 |
$1,942.40 |
$1,942.40 |
$1,372.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,610.40 |
$1,610.40 |
$1,610.40 |
$1,092.58
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$65.65 |
$65.65 |
$65.65 |
$163.62
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$1,281.12 |
$1,281.12 |
$1,281.12 |
$6,360.76
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$1,838.88 |
$1,838.88 |
$1,838.88 |
$8,348.12
|
|
Levalbuterol non-comp unit
|
$8.13 |
$8.13 |
$8.13 |
$6.48
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$61.27 |
$61.27 |
$61.27 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$195.20 |
$195.20 |
$195.20 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$110.53 |
$110.53 |
$110.53 |
$55.69
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$191.67 |
$191.67 |
$191.67 |
$420.60
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$60.41 |
$60.41 |
$60.41 |
$46.02
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$137.96 |
$137.96 |
$137.96 |
$39.75
|
|
Liletta, 52 mg
|
$909.11 |
$909.11 |
$909.11 |
$1,514.24
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$257.84 |
$257.84 |
$257.84 |
$121.00
|
|
Lipase
|
$111.20 |
$111.20 |
$111.20 |
$93.58
|
|
Lipoprotein direct measurement hdl
|
$89.60 |
$89.60 |
$89.60 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$92.80 |
$92.80 |
$92.80 |
$61.60
|