|
Ihc/icc per specimen initial single antibody stain
|
$543.96 |
$543.96 |
$543.96 |
$274.86
|
|
Immune complex assay
|
$289.33 |
$289.33 |
$289.33 |
$109.20
|
|
Immunoassay tumor antigen quantitative ca 125
|
$1,014.41 |
$1,014.41 |
$1,014.41 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$528.09 |
$528.09 |
$528.09 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$244.03 |
$244.03 |
$244.03 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$1,368.00 |
$1,368.00 |
$1,368.00 |
$138.60
|
|
Immunofluorescence per specimen initial single antibody stain
|
$404.58 |
$404.58 |
$404.58 |
$232.05
|
|
In-111 oxyquinolin per 0.5 mci
|
$5,132.99 |
$5,132.99 |
$5,132.99 |
$2,568.98
|
|
In-111 pentetreotide
|
$15,243.60 |
$15,243.60 |
$15,243.60 |
$4,944.55
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$933.12 |
$933.12 |
$933.12 |
$785.83
|
|
Infect ag drug suscept pheno predict
|
$303.45 |
$303.45 |
$303.45 |
$320.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$303.45 |
$303.45 |
$303.45 |
$603.75
|
|
Infect ag if legionella pneumophila
|
$1,053.78 |
$1,053.78 |
$1,053.78 |
$73.46
|
|
Infect ag if pneumocystis carinii
|
$610.04 |
$610.04 |
$610.04 |
$67.46
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$303.45 |
$303.45 |
$303.45 |
$855.60
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$303.45 |
$303.45 |
$303.45 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$610.04 |
$610.04 |
$610.04 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$256.98 |
$256.98 |
$256.98 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$771.76 |
$771.76 |
$771.76 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$790.34 |
$790.34 |
$790.34 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$175.32 |
$175.32 |
$175.32 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$1,081.43 |
$1,081.43 |
$1,081.43 |
$97.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$324.61 |
$324.61 |
$324.61 |
$137.67
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$144.00 |
$144.00 |
$144.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$245.63 |
$245.63 |
$245.63 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$2,018.00 |
$2,018.00 |
$2,018.00 |
$201.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$52.52 |
$52.52 |
$52.52 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$187.19 |
$187.19 |
$187.19 |
$105.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$375.00 |
$375.00 |
$375.00 |
$250.50
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$1,789.20 |
$1,789.20 |
$1,789.20 |
$184.80
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$886.20 |
$886.20 |
$886.20 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,901.00 |
$1,901.00 |
$1,901.00 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,737.71 |
$1,737.71 |
$1,737.71 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$536.59 |
$536.59 |
$536.59 |
$2,080.86
|
|
Initiation & management bipap/cpap initial day
|
$1,279.68 |
$1,279.68 |
$1,279.68 |
$576.00
|
|
Inj, biorphen, 20 micrograms
|
$46.95 |
$46.95 |
$46.95 |
$17.12
|
|
Inj cefazolin sodium, hikma
|
$70.75 |
$70.75 |
$70.75 |
$29.10
|
|
Inj, cefiderocol, 10 mg
|
$2,059.86 |
$2,059.86 |
$2,059.86 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$1,353.90 |
$1,353.90 |
$1,353.90 |
$408.00
|
|
Inj crotalidae im f(ab')2 eq
|
$3,651.62 |
$3,651.62 |
$3,651.62 |
$2,613.60
|
|
Injection, cangrelor
|
$2,335.50 |
$2,335.50 |
$2,335.50 |
$1,889.78
|
|
Injection,onabotulinumtoxina
|
$6,810.00 |
$6,810.00 |
$6,810.00 |
$2,241.61
|
|
Inj., eravacycline, 1 mg
|
$582.66 |
$582.66 |
$582.66 |
$206.64
|
|
Inj, gadopiclenol, 1 ml
|
$958.50 |
$958.50 |
$958.50 |
$66.94
|
|
Inj hydroxocobalamin IV 25mg
|
$2,441.28 |
$2,441.28 |
$2,441.28 |
$2,452.32
|
|
Inj levocarnitine per 1 gm
|
$848.86 |
$848.86 |
$848.86 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$713.00 |
$713.00 |
$713.00 |
$363.97
|
|
Inj mepivacaine hcl/10 ml
|
$81.04 |
$81.04 |
$81.04 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$251.50 |
$251.50 |
$251.50 |
$77.97
|
|
Inj. mycophenolate mofetil
|
$730.75 |
$730.75 |
$730.75 |
$252.66
|
|
Inj vocal cord bulking agent
|
$4,758.00 |
$4,758.00 |
$4,758.00 |
$1,480.00
|
|
Insitu hybridization auto
|
$596.28 |
$596.28 |
$596.28 |
$371.00
|
|
Insitu hybridization manual
|
$596.28 |
$596.28 |
$596.28 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$481.00 |
$481.00 |
$481.00 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$543.96 |
$543.96 |
$543.96 |
$326.04
|
|
Insulin total
|
$768.60 |
$768.60 |
$768.60 |
$66.64
|
|
Integra meshed bil wound mat
|
$696.00 |
$696.00 |
$696.00 |
$9,924.00
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$150.64 |
$150.64 |
$150.64 |
$10,427.90
|
|
Intrapul surf admin endo tube
|
$1,559.26 |
$1,559.26 |
$1,559.26 |
$220.80
|
|
Intrinsic factor antibody
|
$467.90 |
$467.90 |
$467.90 |
$66.60
|
|
Ipratropium bromide non-comp
|
$38.44 |
$38.44 |
$38.44 |
$3.75
|
|
Iron
|
$146.42 |
$146.42 |
$146.42 |
$74.40
|
|
Iron binding capacity
|
$249.92 |
$249.92 |
$249.92 |
$63.79
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,495.72 |
$1,495.72 |
$1,495.72 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$343.68 |
$343.68 |
$343.68 |
$119.83
|
|
Ivc venogram s&i
|
$3,317.44 |
$3,317.44 |
$3,317.44 |
$3,316.95
|
|
IV inj ra drug dx study
|
$1,488.05 |
$1,488.05 |
$1,488.05 |
$549.70
|
|
Ivp w/nephrotomography
|
$1,262.19 |
$1,262.19 |
$1,262.19 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$1,406.13 |
$1,406.13 |
$1,406.13 |
$692.18
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$183.49 |
$183.49 |
$183.49 |
$60.20
|
|
Kidney function study
|
$1,633.73 |
$1,633.73 |
$1,633.73 |
$783.86
|
|
Kidney imag w/bld flow multi
|
$4,825.72 |
$4,825.72 |
$4,825.72 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$4,825.72 |
$4,825.72 |
$4,825.72 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,375.32 |
$1,375.32 |
$1,375.32 |
$666.00
|
|
Kras gene addl variants
|
$805.14 |
$805.14 |
$805.14 |
$384.80
|
|
Kras gene variants exon 2
|
$805.14 |
$805.14 |
$805.14 |
$486.45
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$935.33 |
$935.33 |
$935.33 |
$175.92
|
|
Lactic acid
|
$577.46 |
$577.46 |
$577.46 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$557.86 |
$557.86 |
$557.86 |
$80.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,810.10 |
$1,810.10 |
$1,810.10 |
$1,088.26
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$1,010.74 |
$1,010.74 |
$1,010.74 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$230.52 |
$230.52 |
$230.52 |
$88.92
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$73.44 |
$73.44 |
$73.44 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$433.99 |
$433.99 |
$433.99 |
$89.70
|
|
Liletta, 52 mg
|
$2,173.50 |
$2,173.50 |
$2,173.50 |
$1,453.50
|
|
Lipase
|
$222.89 |
$222.89 |
$222.89 |
$93.58
|
|
Lithium therapeutic drug level
|
$629.81 |
$629.81 |
$629.81 |
$69.42
|
|
Liver Function Test
|
$1,714.18 |
$1,714.18 |
$1,714.18 |
$115.44
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$21.74 |
$21.74 |
$21.74 |
$37.20
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$4,419.07 |
$4,419.07 |
$4,419.07 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$3,895.85 |
$3,895.85 |
$3,895.85 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$3,250.31 |
$3,250.31 |
$3,250.31 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$6,224.13 |
$6,224.13 |
$6,224.13 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$5,106.42 |
$5,106.42 |
$5,106.42 |
$2,445.30
|
|
Lower Back (Lumbar Spine) X-ray
|
$622.18 |
$622.18 |
$622.18 |
$352.32
|
|
Lumbar diskogram s&i
|
$6,998.37 |
$6,998.37 |
$6,998.37 |
$2,358.23
|
|
Lung Function Test (Spirometry)
|
$1,325.51 |
$1,325.51 |
$1,325.51 |
$295.35
|
|
Lung perfusion imaging
|
$4,307.23 |
$4,307.23 |
$4,307.23 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$4,999.03 |
$4,999.03 |
$4,999.03 |
$1,448.00
|
|
Macroscopic exam parasite
|
$200.56 |
$200.56 |
$200.56 |
$36.40
|