|
Inj teclistamab cqyv 0.5 mg
|
$10,325.52 |
$10,325.52 |
$10,325.52 |
$17,517.56
|
|
Inj testosterone cypionate
|
$16.02 |
$16.02 |
$16.02 |
$64.80
|
|
Inj thiotepa nos 1 mg
|
$2,322.55 |
$2,322.55 |
$2,322.55 |
$3,170.16
|
|
Inj, tislelizumab-jsgr
|
$5,508.24 |
$5,508.24 |
$5,508.24 |
$9,764.09
|
|
Inj triamcinolone ace X-ray 1mg
|
$679.46 |
$679.46 |
$679.46 |
$1,090.75
|
|
Inj, tyenne, 1 mg
|
$1,935.53 |
$1,935.53 |
$1,935.53 |
$3,525.12
|
|
Inj, vegzelma, 10 mg
|
$2,677.95 |
$2,677.95 |
$2,677.95 |
$1,291.28
|
|
Inj w/fluor eval cv device
|
$296.96 |
$296.96 |
$296.96 |
$504.40
|
|
Ins cath ren art 1st bi
|
$1,403.31 |
$1,403.31 |
$1,403.31 |
$5,820.00
|
|
Ins cath ren art 1st uni
|
$1,403.31 |
$1,403.31 |
$1,403.31 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$2,473.12 |
$2,473.12 |
$2,473.12 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$135.43 |
$135.43 |
$135.43 |
$473.90
|
|
Insert cath pleura with image
|
$856.08 |
$856.08 |
$856.08 |
$2,164.52
|
|
Insert cath pleura without image
|
$380.48 |
$380.48 |
$380.48 |
$2,026.58
|
|
Insertion catheter bladder temporary simple
|
$59.16 |
$59.16 |
$59.16 |
$234.40
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,077.56 |
$2,077.56 |
$2,077.56 |
$4,747.60
|
|
Insertion intra aortic balloon assist device percutaneous
|
$990.64 |
$990.64 |
$990.64 |
$2,565.36
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,293.69 |
$1,293.69 |
$1,293.69 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$338.43 |
$338.43 |
$338.43 |
$2,523.30
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$3,415.91 |
$3,415.91 |
$3,415.91 |
$12,843.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$3,415.91 |
$3,415.91 |
$3,415.91 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$1,045.74 |
$1,045.74 |
$1,045.74 |
$10,309.20
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$338.43 |
$338.43 |
$338.43 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$473.86 |
$473.86 |
$473.86 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$8,355.77 |
$8,355.77 |
$8,355.77 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$2,531.41 |
$2,531.41 |
$2,531.41 |
$7,388.80
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,531.41 |
$2,531.41 |
$2,531.41 |
$7,447.01
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$2,660.46 |
$2,660.46 |
$2,660.46 |
$9,390.55
|
|
Insert pm/icd lead dual
|
$2,531.41 |
$2,531.41 |
$2,531.41 |
$7,312.80
|
|
Insert swan-ganz cath
|
$248.24 |
$248.24 |
$248.24 |
$2,327.53
|
|
Insitu hybridization auto
|
$71.05 |
$71.05 |
$71.05 |
$377.37
|
|
Insitu hybridization (fish)
|
$189.37 |
$189.37 |
$189.37 |
$481.60
|
|
Insitu hybridization manual
|
$95.70 |
$95.70 |
$95.70 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$94.83 |
$94.83 |
$94.83 |
$243.00
|
|
In situ hybridization per specimen initial single probe stain
|
$121.22 |
$121.22 |
$121.22 |
$337.20
|
|
Ins lv lead exist pm/icd
|
$4,642.32 |
$4,642.32 |
$4,642.32 |
$12,384.25
|
|
Ins pm gen w/exist mlt leads
|
$6,083.91 |
$6,083.91 |
$6,083.91 |
$14,804.40
|
|
Ins pq tunnld ip cath w/img
|
$896.68 |
$896.68 |
$896.68 |
$5,377.00
|
|
Ins/rpl pm gen exist dual lead
|
$3,415.91 |
$3,415.91 |
$3,415.91 |
$11,412.00
|
|
Ins/rpl pm gen exist sgl lead
|
$2,255.62 |
$2,255.62 |
$2,255.62 |
$9,705.00
|
|
Ins/rpl pm w/tv ld atrl
|
$3,415.91 |
$3,415.91 |
$3,415.91 |
$11,969.00
|
|
Instillation anticarcinogenic agent bladder
|
$283.33 |
$283.33 |
$283.33 |
$653.25
|
|
Ins tun cv cath wo subq prt/pm
|
$856.66 |
$856.66 |
$856.66 |
$4,218.00
|
|
Insulin total
|
$10.44 |
$10.44 |
$10.44 |
$66.64
|
|
Ins vag brachytx device
|
$159.50 |
$159.50 |
$159.50 |
$909.35
|
|
Intens cardiac rehab no exer
|
$76.85 |
$76.85 |
$76.85 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$76.85 |
$76.85 |
$76.85 |
$238.40
|
|
Interdiscal perq aspir dx
|
$581.74 |
$581.74 |
$581.74 |
$1,212.50
|
|
Intrinsic factor antibody
|
$19.43 |
$19.43 |
$19.43 |
$64.20
|
|
Intro cath dialysis circuit
|
$265.64 |
$265.64 |
$265.64 |
$2,043.30
|
|
Intro cath dialysis circuit w/pta
|
$1,874.27 |
$1,874.27 |
$1,874.27 |
$8,690.50
|
|
Intro catheter aorta
|
$135.72 |
$135.72 |
$135.72 |
$1,678.05
|
|
Intro cath svc/ivc
|
$135.72 |
$135.72 |
$135.72 |
$1,346.13
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$913.21 |
$913.21 |
$913.21 |
$3,472.95
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$913.21 |
$913.21 |
$913.21 |
$1,764.10
|
|
Intubation endotracheal emergency procedure
|
$105.27 |
$105.27 |
$105.27 |
$600.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$286.44 |
$286.44 |
$286.44 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$941.98 |
$941.98 |
$941.98 |
$288.11
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$35,795.85 |
$35,795.85 |
$35,795.85 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$327.43 |
$327.43 |
$327.43 |
$171.37
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$3,017.34 |
$3,017.34 |
$3,017.34 |
$5,476.68
|
|
Iron
|
$18.85 |
$18.85 |
$18.85 |
$75.26
|
|
Iron dextran 50 mg/ml injection solution
|
$62.80 |
$62.80 |
$62.80 |
$79.47
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$218.76 |
$218.76 |
$218.76 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$7.25 |
$7.25 |
$7.25 |
$117.60
|
|
Irrigation implantable venous access device for drug delivery systems
|
$26.10 |
$26.10 |
$26.10 |
$143.00
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$4,298.79 |
$4,298.79 |
$4,298.79 |
$8,273.35
|
|
Ivc venogram s&i
|
$1,403.31 |
$1,403.31 |
$1,403.31 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$31.90 |
$31.90 |
$31.90 |
$192.40
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$10.73 |
$10.73 |
$10.73 |
$160.05
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$20.88 |
$20.88 |
$20.88 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$94.54 |
$94.54 |
$94.54 |
$444.49
|
|
IV inj ra drug dx study
|
$177.77 |
$177.77 |
$177.77 |
$549.70
|
|
Ivp w/wo kub w/wo tomography
|
$184.15 |
$184.15 |
$184.15 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$5,973.09 |
$5,973.09 |
$5,973.09 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$227.36 |
$227.36 |
$227.36 |
$404.82
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$23.78 |
$23.78 |
$23.78 |
$60.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$4.86 |
$4.86 |
$4.86 |
$23.66
|
|
Kidney imag w/bld flow multi
|
$241.28 |
$241.28 |
$241.28 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$289.13 |
$289.13 |
$289.13 |
$1,442.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$84.10 |
$84.10 |
$84.10 |
$668.25
|
|
Kit lead specify 5-6-5
|
$1,450.00 |
$1,450.00 |
$1,450.00 |
$16,053.15
|
|
Knee MRI (with and without contrast)
|
$787.35 |
$787.35 |
$787.35 |
$3,021.20
|
|
Knee MRI (with contrast)
|
$515.33 |
$515.33 |
$515.33 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$449.79 |
$449.79 |
$449.79 |
$2,159.09
|
|
Knee X-ray
|
$122.09 |
$122.09 |
$122.09 |
$433.50
|
|
Ko w/0 joint rigid molded to
|
$327.12 |
$327.12 |
$327.12 |
$1,307.71
|
|
Lactate dehydrogenase (ldh)
|
$17.69 |
$17.69 |
$17.69 |
$55.50
|
|
Lactic acid
|
$31.32 |
$31.32 |
$31.32 |
$107.10
|
|
Lactoferrin fecal qualitative
|
$57.13 |
$57.13 |
$57.13 |
$81.25
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$9,450.32 |
$9,450.32 |
$9,450.32 |
$19,124.00
|
|
Lead acuity x4 spiral l 86cm
|
$4,132.50 |
$4,132.50 |
$4,132.50 |
$5,617.19
|
|
Lead capillary
|
$10.15 |
$10.15 |
$10.15 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$1,014.42 |
$1,014.42 |
$1,014.42 |
$3,263.95
|
|
Lead tachy durata sj4 58cm
|
$5,792.75 |
$5,792.75 |
$5,792.75 |
$8,202.66
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$219.24 |
$219.24 |
$219.24 |
$1,092.58
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$174.00 |
$174.00 |
$174.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$391.50 |
$391.50 |
$391.50 |
$1,044.75
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$240.34 |
$240.34 |
$240.34 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$12,727.58 |
$12,727.58 |
$12,727.58 |
$6,163.15
|