|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$372.59 |
$372.59 |
$372.59 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,433.52 |
$3,433.52 |
$3,433.52 |
$5,517.12
|
|
Iron
|
$55.77 |
$55.77 |
$55.77 |
$72.29
|
|
Iron binding capacity
|
$29.04 |
$29.04 |
$29.04 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$71.46 |
$71.46 |
$71.46 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$248.93 |
$248.93 |
$248.93 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$8.25 |
$8.25 |
$8.25 |
$114.40
|
|
Irrigation implantable venous access device for drug delivery systems
|
$29.70 |
$29.70 |
$29.70 |
$144.62
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$4,891.72 |
$4,891.72 |
$4,891.72 |
$8,273.35
|
|
Ivc venogram s&i
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$36.30 |
$36.30 |
$36.30 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$12.21 |
$12.21 |
$12.21 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$23.76 |
$23.76 |
$23.76 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$107.58 |
$107.58 |
$107.58 |
$437.45
|
|
Ivp w/wo kub w/wo tomography
|
$209.55 |
$209.55 |
$209.55 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$6,796.96 |
$6,796.96 |
$6,796.96 |
$10,695.32
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$32.01 |
$32.01 |
$32.01 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$5.53 |
$5.53 |
$5.53 |
$23.77
|
|
Kidney function study
|
$202.29 |
$202.29 |
$202.29 |
$968.50
|
|
Kidney imag w/bld flow multi
|
$274.56 |
$274.56 |
$274.56 |
$1,557.41
|
|
Kidney img w/bldflw sgl without rx
|
$329.01 |
$329.01 |
$329.01 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$95.70 |
$95.70 |
$95.70 |
$673.36
|
|
Kit case 4.2mm spinejack
|
$6,370.58 |
$6,370.58 |
$6,370.58 |
$7,751.14
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$7,755.00 |
$7,755.00 |
$7,755.00 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$260.37 |
$260.37 |
$260.37 |
$366.03
|
|
Kit hfx iq ipg bundle
|
$33,825.00 |
$33,825.00 |
$33,825.00 |
$34,160.00
|
|
Kit lead specify 5-6-5
|
$11,279.40 |
$11,279.40 |
$11,279.40 |
$16,965.41
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,212.75 |
$1,212.75 |
$1,212.75 |
$1,667.50
|
|
Knee MRI (with and without contrast)
|
$895.95 |
$895.95 |
$895.95 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$586.41 |
$586.41 |
$586.41 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$511.83 |
$511.83 |
$511.83 |
$2,110.76
|
|
Knee X-ray
|
$138.93 |
$138.93 |
$138.93 |
$425.55
|
|
Ko w/0 joint rigid molded to
|
$372.24 |
$372.24 |
$372.24 |
$1,230.99
|
|
Lactate dehydrogenase (ldh)
|
$20.13 |
$20.13 |
$20.13 |
$55.50
|
|
Lactic acid
|
$35.64 |
$35.64 |
$35.64 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$65.01 |
$65.01 |
$65.01 |
$81.00
|
|
Lactoferrin fecal quant
|
$112.20 |
$112.20 |
$112.20 |
$108.93
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$10,753.81 |
$10,753.81 |
$10,753.81 |
$19,124.00
|
|
Lead acuity x4 spiral l 86cm
|
$4,702.50 |
$4,702.50 |
$4,702.50 |
$5,534.00
|
|
Lead capillary
|
$11.55 |
$11.55 |
$11.55 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$1,154.34 |
$1,154.34 |
$1,154.34 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$6,591.75 |
$6,591.75 |
$6,591.75 |
$8,204.74
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$249.48 |
$249.48 |
$249.48 |
$1,092.58
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$273.49 |
$273.49 |
$273.49 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$14,483.10 |
$14,483.10 |
$14,483.10 |
$6,236.52
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$6,076.85 |
$6,076.85 |
$6,076.85 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$182.70 |
$182.70 |
$182.70 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$11.88 |
$11.88 |
$11.88 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$593.71 |
$593.71 |
$593.71 |
$420.60
|
|
Liberta rc ipg
|
$32,175.00 |
$32,175.00 |
$32,175.00 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$19.99 |
$19.99 |
$19.99 |
$40.54
|
|
Lidocaine therapeutic drug level
|
$33.66 |
$33.66 |
$33.66 |
$87.45
|
|
Liletta, 52 mg
|
$1,047.86 |
$1,047.86 |
$1,047.86 |
$1,514.24
|
|
Lincomycin injection
|
$48.91 |
$48.91 |
$48.91 |
$64.31
|
|
Lipase
|
$22.77 |
$22.77 |
$22.77 |
$91.65
|
|
Lipoprotein blood high res frac & quant
|
$13.86 |
$13.86 |
$13.86 |
$86.42
|
|
Lipoprotein blood quant
|
$39.60 |
$39.60 |
$39.60 |
$97.53
|
|
Lipoprotein direct measurement hdl
|
$27.06 |
$27.06 |
$27.06 |
$57.50
|
|
Lithium therapeutic drug level
|
$22.11 |
$22.11 |
$22.11 |
$69.42
|
|
Lithotripsy transluminal coronary percutaneous
|
$1,879.68 |
$1,879.68 |
$1,879.68 |
$4,113.20
|
|
Liver Function Test
|
$39.60 |
$39.60 |
$39.60 |
$115.44
|
|
Liver imaging
|
$503.58 |
$503.58 |
$503.58 |
$1,143.00
|
|
Liver imag w/vasclr flow
|
$416.46 |
$416.46 |
$416.46 |
$1,227.60
|
|
Liver/spleen imag static only
|
$254.76 |
$254.76 |
$254.76 |
$1,123.50
|
|
Liver/spleen imag w/vasclr flow
|
$202.29 |
$202.29 |
$202.29 |
$1,069.20
|
|
Locm 100-199mg/ml iodine,1ml
|
$120.60 |
$120.60 |
$120.60 |
$48.19
|
|
Loncastuximab tesirine-lpyl 10 mg intravenous solution
|
$31,851.75 |
$31,851.75 |
$31,851.75 |
$61,208.69
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$14.46 |
$14.46 |
$14.46 |
$37.37
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$897.93 |
$897.93 |
$897.93 |
$1,909.80
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$598.62 |
$598.62 |
$598.62 |
$1,804.80
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$598.62 |
$598.62 |
$598.62 |
$1,470.00
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$953.70 |
$953.70 |
$953.70 |
$3,070.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$775.50 |
$775.50 |
$775.50 |
$2,065.69
|
|
Lower Back (Lumbar Spine) X-ray
|
$82.83 |
$82.83 |
$82.83 |
$356.16
|
|
Lung function test (mbc/mvv)
|
$43.89 |
$43.89 |
$43.89 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$109.23 |
$109.23 |
$109.23 |
$295.35
|
|
Lung perfusion imaging
|
$235.95 |
$235.95 |
$235.95 |
$1,059.97
|
|
Lurbinectedin 4 mg intravenous solution
|
$9,278.28 |
$9,278.28 |
$9,278.28 |
$19,182.33
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$13,877.35 |
$13,877.35 |
$13,877.35 |
$22,210.87
|
|
Lymphatics/lymph node imaging
|
$285.12 |
$285.12 |
$285.12 |
$1,463.22
|
|
Lymphocyte transformation mitogen
|
$203.94 |
$203.94 |
$203.94 |
$271.88
|
|
Lymph vessel x-ray trunk
|
$1,596.87 |
$1,596.87 |
$1,596.87 |
$3,380.00
|
|
Macroscopic exam arthropod
|
$31.35 |
$31.35 |
$31.35 |
$38.58
|
|
Macroscopic exam parasite
|
$31.35 |
$31.35 |
$31.35 |
$36.55
|
|
Magnesium
|
$44.22 |
$44.22 |
$44.22 |
$72.50
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$67.32 |
$67.32 |
$67.32 |
$131.16
|
|
Manipulation chest wall initial demonstration/evaluation
|
$67.32 |
$67.32 |
$67.32 |
$160.80
|
|
Mapping functional cort/subcort ea add'l hr
|
$231.00 |
$231.00 |
$231.00 |
$636.50
|
|
Map tachycard site(s)
|
$1,189.98 |
$1,189.98 |
$1,189.98 |
$4,082.82
|
|
Marker biop eviva buckle ss
|
$329.37 |
$329.37 |
$329.37 |
$1,451.30
|
|
Mastoids complete
|
$114.51 |
$114.51 |
$114.51 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$25.08 |
$25.08 |
$25.08 |
$65.00
|
|
Mayo aathr protein s free
|
$34.65 |
$34.65 |
$34.65 |
$130.00
|
|
Mayo activated protein c resistance assay
|
$39.93 |
$39.93 |
$39.93 |
$97.50
|
|
Mayo adalimumab (humira) therapeutic drug level
|
$25.41 |
$25.41 |
$25.41 |
$172.90
|
|
Mayo alkaline phosphatase isoenzyme
|
$16.50 |
$16.50 |
$16.50 |
$66.30
|
|
Mayo alpha 1 antitrypsin
|
$12.21 |
$12.21 |
$12.21 |
$87.10
|
|
Mayo amikacin trough therapeutic drug level
|
$49.17 |
$49.17 |
$49.17 |
$81.81
|
|
Mayo analysis gene calr common variants exon 9
|
$80.19 |
$80.19 |
$80.19 |
$467.61
|