|
Insitu hybridization manual
|
$165.40 |
$165.40 |
$165.40 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$61.80 |
$61.80 |
$61.80 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$61.80 |
$61.80 |
$61.80 |
$326.04
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$473.60 |
$473.60 |
$473.60 |
$1,609.25
|
|
Ins pm gen exist dual lead
|
$13,961.60 |
$13,961.60 |
$13,961.60 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$9,434.60 |
$9,434.60 |
$9,434.60 |
$14,804.40
|
|
Ins/rpl pm gen exist dual lead
|
$7,417.20 |
$7,417.20 |
$7,417.20 |
$11,408.40
|
|
Ins/rpl pm gen exist sgl lead
|
$7,417.20 |
$7,417.20 |
$7,417.20 |
$9,558.78
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$19,764.60 |
$19,764.60 |
$19,764.60 |
$25,807.00
|
|
Instillation anticarcinogenic agent bladder
|
$211.20 |
$211.20 |
$211.20 |
$621.40
|
|
Ins tun cv cath wo subq prt/pm
|
$1,169.80 |
$1,169.80 |
$1,169.80 |
$4,202.70
|
|
Insulin total
|
$38.60 |
$38.60 |
$38.60 |
$66.64
|
|
Intens cardiac rehab no exer
|
$78.00 |
$78.00 |
$78.00 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$78.00 |
$78.00 |
$78.00 |
$238.40
|
|
Intrinsic factor antibody
|
$64.20 |
$64.20 |
$64.20 |
$66.60
|
|
Intro cath dialysis circuit
|
$279.20 |
$279.20 |
$279.20 |
$2,035.00
|
|
Intro catheter aorta
|
$355.20 |
$355.20 |
$355.20 |
$1,654.05
|
|
Intro cath svc/ivc
|
$436.20 |
$436.20 |
$436.20 |
$1,329.90
|
|
Intubation endotracheal emergency procedure
|
$234.60 |
$234.60 |
$234.60 |
$589.60
|
|
Iodine i-123 sod iodide mil
|
$280.59 |
$280.59 |
$280.59 |
$350.74
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$56.25 |
$56.25 |
$56.25 |
$172.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$209.47 |
$209.47 |
$209.47 |
$279.10
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$63.82 |
$63.82 |
$63.82 |
$163.87
|
|
Iron
|
$42.60 |
$42.60 |
$42.60 |
$74.40
|
|
Iron binding capacity
|
$17.80 |
$17.80 |
$17.80 |
$63.79
|
|
Irrigation implantable venous access device for drug delivery systems
|
$72.80 |
$72.80 |
$72.80 |
$142.20
|
|
Ivc venogram s&i
|
$1,574.60 |
$1,574.60 |
$1,574.60 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$80.40 |
$80.40 |
$80.40 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$50.40 |
$50.40 |
$50.40 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$53.20 |
$53.20 |
$53.20 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$153.80 |
$153.80 |
$153.80 |
$439.56
|
|
IV inj ra drug dx study
|
$133.20 |
$133.20 |
$133.20 |
$549.70
|
|
Ivp w/wo kub w/wo tomography
|
$214.40 |
$214.40 |
$214.40 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$129.80 |
$129.80 |
$129.80 |
$379.87
|
|
John cunningham antibody
|
$11.20 |
$11.20 |
$11.20 |
$72.60
|
|
Ketamine and metabolite screen - quest
|
$74.20 |
$74.20 |
$74.20 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$6.00 |
$6.00 |
$6.00 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.67 |
$12.67 |
$12.67 |
$23.50
|
|
Kidney imag w/bld flow multi
|
$526.80 |
$526.80 |
$526.80 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$409.80 |
$409.80 |
$409.80 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$234.80 |
$234.80 |
$234.80 |
$666.00
|
|
Kit gene analys d816 variant
|
$45.80 |
$45.80 |
$45.80 |
$374.61
|
|
Knee MRI (with and without contrast)
|
$1,237.40 |
$1,237.40 |
$1,237.40 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$948.00 |
$948.00 |
$948.00 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$802.40 |
$802.40 |
$802.40 |
$2,169.60
|
|
Knee X-ray
|
$101.20 |
$101.20 |
$101.20 |
$425.55
|
|
Kras gene variants exon 2
|
$221.40 |
$221.40 |
$221.40 |
$486.45
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$30.54 |
$30.54 |
$30.54 |
$32.34
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$763.20 |
$763.20 |
$763.20 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$33.20 |
$33.20 |
$33.20 |
$55.50
|
|
Lactated ringers intravenous solution
|
$340.40 |
$340.40 |
$340.40 |
$45.56
|
|
Lactic acid
|
$39.80 |
$39.80 |
$39.80 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$31.20 |
$31.20 |
$31.20 |
$80.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$3,715.24 |
$3,715.24 |
$3,715.24 |
$19,124.00
|
|
Laryngeal function studies
|
$150.40 |
$150.40 |
$150.40 |
$335.40
|
|
Lead capillary
|
$42.60 |
$42.60 |
$42.60 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$697.60 |
$697.60 |
$697.60 |
$1,088.26
|
|
Leishmania antibody
|
$8.00 |
$8.00 |
$8.00 |
$68.25
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$47.84 |
$47.84 |
$47.84 |
$163.62
|
|
Leuprolide acetate injeciton
|
$990.07 |
$990.07 |
$990.07 |
$1,322.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$33.15 |
$33.15 |
$33.15 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$89.40 |
$89.40 |
$89.40 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$29.56 |
$29.56 |
$29.56 |
$55.60
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$13.50 |
$13.50 |
$13.50 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$18.60 |
$18.60 |
$18.60 |
$89.70
|
|
Lincomycin injection
|
$131.85 |
$131.85 |
$131.85 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$34.65 |
$34.65 |
$34.65 |
$125.66
|
|
Lipase
|
$33.00 |
$33.00 |
$33.00 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$93.80 |
$93.80 |
$93.80 |
$90.35
|
|
Lipoprotein blood quant
|
$63.20 |
$63.20 |
$63.20 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$30.40 |
$30.40 |
$30.40 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$33.20 |
$33.20 |
$33.20 |
$61.60
|
|
Lip surgery procedure
|
$58.60 |
$58.60 |
$58.60 |
$334.50
|
|
Lithium therapeutic drug level
|
$31.40 |
$31.40 |
$31.40 |
$69.42
|
|
Liver ds alys 3 bmrk srm alg
|
$314.00 |
$314.00 |
$314.00 |
$340.00
|
|
Liver Function Test
|
$89.40 |
$89.40 |
$89.40 |
$115.44
|
|
Liver/spleen imag static only
|
$223.60 |
$223.60 |
$223.60 |
$1,123.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$30.12 |
$30.12 |
$30.12 |
$37.20
|
|
Low cost skin substitute app
|
$567.00 |
$567.00 |
$567.00 |
$1,016.16
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$890.20 |
$890.20 |
$890.20 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$691.60 |
$691.60 |
$691.60 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$661.60 |
$661.60 |
$661.60 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$1,076.80 |
$1,076.80 |
$1,076.80 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$948.00 |
$948.00 |
$948.00 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$802.40 |
$802.40 |
$802.40 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$115.40 |
$115.40 |
$115.40 |
$352.32
|
|
Lung Function Test (Spirometry)
|
$83.40 |
$83.40 |
$83.40 |
$295.35
|
|
Lung perfusion imaging
|
$340.00 |
$340.00 |
$340.00 |
$1,075.25
|
|
Lymphatics/lymph node imaging
|
$286.80 |
$286.80 |
$286.80 |
$1,448.00
|
|
Lymphocyte transformation mitogen
|
$40.20 |
$40.20 |
$40.20 |
$266.20
|
|
Macroscopic exam parasite
|
$23.80 |
$23.80 |
$23.80 |
$36.40
|
|
Magnesium
|
$42.60 |
$42.60 |
$42.60 |
$73.00
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$48.97 |
$48.97 |
$48.97 |
$58.70
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$36.00 |
$36.00 |
$36.00 |
$128.40
|
|
Manipulation chest wall initial demonstration/evaluation
|
$56.60 |
$56.60 |
$56.60 |
$152.54
|
|
Mannitol 12.5 gm/50 ml inj
|
$8.40 |
$8.40 |
$8.40 |
$27.81
|
|
Marker biop eviva buckle ss
|
$59.80 |
$59.80 |
$59.80 |
$1,152.48
|
|
Mastoids complete
|
$120.00 |
$120.00 |
$120.00 |
$299.50
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$62.00 |
$62.00 |
$62.00 |
$66.36
|
|
Mayo aathr protein s free
|
$152.20 |
$152.20 |
$152.20 |
$130.08
|