|
Inj proc ankle arthr
|
$127.68 |
$127.68 |
$127.68 |
$405.31
|
|
Inj proc elbow arthro
|
$127.68 |
$127.68 |
$127.68 |
$419.60
|
|
Inj proc myelogram lumbar
|
$232.96 |
$232.96 |
$232.96 |
$830.50
|
|
Inj proc sialogram
|
$159.68 |
$159.68 |
$159.68 |
$373.00
|
|
Inj progesterone per 50 mg
|
$44.85 |
$44.85 |
$44.85 |
$15.00
|
|
Inj, releuko 1 mcg
|
$277.44 |
$277.44 |
$277.44 |
$473.25
|
|
Inj retro urethrocysto
|
$75.84 |
$75.84 |
$75.84 |
$443.50
|
|
Inj, rimabotulinumtoxinb
|
$692.60 |
$692.60 |
$692.60 |
$746.79
|
|
Inj romidepsin non-lyo 0.1mg
|
$9,592.91 |
$9,592.91 |
$9,592.91 |
$9,892.69
|
|
Inj secretin synthetic human
|
$720.86 |
$720.86 |
$720.86 |
$1,285.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$30,430.20 |
$30,430.20 |
$30,430.20 |
$90,007.62
|
|
Inj teclistamab cqyv 0.5 mg
|
$11,393.68 |
$11,393.68 |
$11,393.68 |
$17,517.56
|
|
Inj testosterone cypionate
|
$17.68 |
$17.68 |
$17.68 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$2,562.82 |
$2,562.82 |
$2,562.82 |
$3,170.16
|
|
Inj, tislelizumab-jsgr
|
$6,078.05 |
$6,078.05 |
$6,078.05 |
$9,764.09
|
|
Inj triamcinolone ace X-ray 1mg
|
$749.75 |
$749.75 |
$749.75 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$2,135.75 |
$2,135.75 |
$2,135.75 |
$3,525.12
|
|
Inj, vegzelma, 10 mg
|
$2,954.98 |
$2,954.98 |
$2,954.98 |
$1,291.28
|
|
Inj w/fluor eval cv device
|
$327.68 |
$327.68 |
$327.68 |
$503.92
|
|
Ins cath ren art 1st bi
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$4,660.00
|
|
Ins cath ren art 2nd+ uni
|
$2,728.96 |
$2,728.96 |
$2,728.96 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$149.44 |
$149.44 |
$149.44 |
$480.28
|
|
Insert cath pleura with image
|
$944.64 |
$944.64 |
$944.64 |
$2,194.40
|
|
Insert cath pleura without image
|
$419.84 |
$419.84 |
$419.84 |
$2,073.18
|
|
Insertion catheter bladder temporary simple
|
$65.28 |
$65.28 |
$65.28 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,146.24 |
$1,146.24 |
$1,146.24 |
$4,782.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,093.12 |
$1,093.12 |
$1,093.12 |
$2,529.45
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,427.52 |
$1,427.52 |
$1,427.52 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$373.44 |
$373.44 |
$373.44 |
$2,505.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$373.44 |
$373.44 |
$373.44 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$522.88 |
$522.88 |
$522.88 |
$2,419.65
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,793.28 |
$2,793.28 |
$2,793.28 |
$7,200.05
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$2,935.68 |
$2,935.68 |
$2,935.68 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$945.28 |
$945.28 |
$945.28 |
$5,223.20
|
|
Insert vad art access left hrt arterial access
|
$1,654.40 |
$1,654.40 |
$1,654.40 |
$4,270.75
|
|
Insitu hybridization auto
|
$78.40 |
$78.40 |
$78.40 |
$377.37
|
|
Insitu hybridization (fish)
|
$208.96 |
$208.96 |
$208.96 |
$481.60
|
|
Insitu hybridization manual
|
$105.60 |
$105.60 |
$105.60 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$104.64 |
$104.64 |
$104.64 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$133.76 |
$133.76 |
$133.76 |
$331.69
|
|
Ins picad w subq port 5yr>
|
$1,346.88 |
$1,346.88 |
$1,346.88 |
$3,985.20
|
|
Ins pq tunnld ip cath w/img
|
$989.44 |
$989.44 |
$989.44 |
$5,377.00
|
|
Instillation anticarcinogenic agent bladder
|
$312.64 |
$312.64 |
$312.64 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$945.28 |
$945.28 |
$945.28 |
$4,202.70
|
|
Insulin total
|
$36.16 |
$36.16 |
$36.16 |
$66.64
|
|
Intens cardiac rehab no exer
|
$84.80 |
$84.80 |
$84.80 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$84.80 |
$84.80 |
$84.80 |
$238.40
|
|
Interdiscal perq aspir dx
|
$641.92 |
$641.92 |
$641.92 |
$1,222.26
|
|
Intro cath dialysis circuit
|
$293.12 |
$293.12 |
$293.12 |
$2,036.94
|
|
Intro cath dialysis circuit w/pta
|
$2,068.16 |
$2,068.16 |
$2,068.16 |
$8,690.50
|
|
Intro catheter aorta
|
$149.76 |
$149.76 |
$149.76 |
$1,654.05
|
|
Intro cath svc/ivc
|
$149.76 |
$149.76 |
$149.76 |
$1,323.27
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$1,007.68 |
$1,007.68 |
$1,007.68 |
$3,409.29
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$1,007.68 |
$1,007.68 |
$1,007.68 |
$1,747.80
|
|
Intubation endotracheal emergency procedure
|
$116.16 |
$116.16 |
$116.16 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$316.07 |
$316.07 |
$316.07 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1,039.43 |
$1,039.43 |
$1,039.43 |
$288.11
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$39,498.87 |
$39,498.87 |
$39,498.87 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$361.30 |
$361.30 |
$361.30 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,329.48 |
$3,329.48 |
$3,329.48 |
$5,517.12
|
|
Iron
|
$20.80 |
$20.80 |
$20.80 |
$72.29
|
|
Iron dextran 50 mg/ml injection solution
|
$69.29 |
$69.29 |
$69.29 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$241.39 |
$241.39 |
$241.39 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$8.00 |
$8.00 |
$8.00 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$28.80 |
$28.80 |
$28.80 |
$144.62
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$4,743.49 |
$4,743.49 |
$4,743.49 |
$8,273.35
|
|
Ivc venogram s&i
|
$1,548.48 |
$1,548.48 |
$1,548.48 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$35.20 |
$35.20 |
$35.20 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$11.84 |
$11.84 |
$11.84 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$23.04 |
$23.04 |
$23.04 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$104.32 |
$104.32 |
$104.32 |
$437.45
|
|
Ivp w/wo kub w/wo tomography
|
$203.20 |
$203.20 |
$203.20 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$6,591.00 |
$6,591.00 |
$6,591.00 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$31.04 |
$31.04 |
$31.04 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$5.36 |
$5.36 |
$5.36 |
$23.77
|
|
Kidney imag w/bld flow multi
|
$266.24 |
$266.24 |
$266.24 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$319.04 |
$319.04 |
$319.04 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$92.80 |
$92.80 |
$92.80 |
$673.36
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$7,520.00 |
$7,520.00 |
$7,520.00 |
$9,482.25
|
|
Kit lead specify 5-6-5
|
$4,857.60 |
$4,857.60 |
$4,857.60 |
$16,965.41
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,176.00 |
$1,176.00 |
$1,176.00 |
$1,667.50
|
|
Knee MRI (with and without contrast)
|
$868.80 |
$868.80 |
$868.80 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$568.64 |
$568.64 |
$568.64 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$496.32 |
$496.32 |
$496.32 |
$2,110.76
|
|
Knee X-ray
|
$134.72 |
$134.72 |
$134.72 |
$425.55
|
|
Ko w/0 joint rigid molded to
|
$360.96 |
$360.96 |
$360.96 |
$1,230.99
|
|
Lactate dehydrogenase (ldh)
|
$19.52 |
$19.52 |
$19.52 |
$55.50
|
|
Lactic acid
|
$34.56 |
$34.56 |
$34.56 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$63.04 |
$63.04 |
$63.04 |
$81.00
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$10,427.94 |
$10,427.94 |
$10,427.94 |
$19,124.00
|
|
Lead capillary
|
$11.20 |
$11.20 |
$11.20 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$840.00 |
$840.00 |
$840.00 |
$3,047.96
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$241.92 |
$241.92 |
$241.92 |
$1,092.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$432.00 |
$432.00 |
$432.00 |
$1,044.75
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$265.20 |
$265.20 |
$265.20 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$14,044.22 |
$14,044.22 |
$14,044.22 |
$6,236.52
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$5,892.70 |
$5,892.70 |
$5,892.70 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$177.16 |
$177.16 |
$177.16 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$11.52 |
$11.52 |
$11.52 |
$88.92
|