|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,040.48 |
$3,040.48 |
$3,040.48 |
$2,618.40
|
|
Insertion of catheter vein
|
$1,255.78 |
$1,255.78 |
$1,255.78 |
$1,749.80
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$48,540.91 |
$48,540.91 |
$48,540.91 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$53,318.08 |
$53,318.08 |
$53,318.08 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$51,009.34 |
$51,009.34 |
$51,009.34 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$8,831.16 |
$8,831.16 |
$8,831.16 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,865.12 |
$5,865.12 |
$5,865.12 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$53,318.08 |
$53,318.08 |
$53,318.08 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$13,775.22 |
$13,775.22 |
$13,775.22 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$25,556.89 |
$25,556.89 |
$25,556.89 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$13,985.67 |
$13,985.67 |
$13,985.67 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$16,275.88 |
$16,275.88 |
$16,275.88 |
$5,470.54
|
|
Insert picvad cath
|
$15,205.47 |
$15,205.47 |
$15,205.47 |
$4,490.00
|
|
Insert pm/icd lead dual
|
$13,775.22 |
$13,775.22 |
$13,775.22 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$53,318.08 |
$53,318.08 |
$53,318.08 |
$33,948.20
|
|
Insert swan-ganz cath
|
$5,996.24 |
$5,996.24 |
$5,996.24 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$5,124.75 |
$5,124.75 |
$5,124.75 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$51,505.62 |
$51,505.62 |
$51,505.62 |
$31,286.77
|
|
In situ hybridization per specimen each additional single probe stain
|
$395.62 |
$395.62 |
$395.62 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$507.71 |
$507.71 |
$507.71 |
$338.40
|
|
Ins mark abd/pel for right perq
|
$3,111.72 |
$3,111.72 |
$3,111.72 |
$2,070.00
|
|
Ins mark thor for right perq
|
$3,830.52 |
$3,830.52 |
$3,830.52 |
$2,396.35
|
|
Ins pq tunnld ip cath w/img
|
$14,497.04 |
$14,497.04 |
$14,497.04 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$80,748.25 |
$80,748.25 |
$80,748.25 |
$24,135.54
|
|
Ins/rpl pm w/tv ld atrl
|
$53,317.96 |
$53,317.96 |
$53,317.96 |
$12,384.25
|
|
Instillation anticarcinogenic agent bladder
|
$1,228.64 |
$1,228.64 |
$1,228.64 |
$721.50
|
|
Instill, bupivac and meloxic
|
$488.05 |
$488.05 |
$488.05 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$26,035.39 |
$26,035.39 |
$26,035.39 |
$5,888.85
|
|
Ins tun cv cath wo subq prt/pm
|
$13,195.21 |
$13,195.21 |
$13,195.21 |
$4,748.00
|
|
Ins tun intraperit dia cath
|
$19,307.42 |
$19,307.42 |
$19,307.42 |
$4,657.46
|
|
Insulin total
|
$96.05 |
$96.05 |
$96.05 |
$67.60
|
|
Intra-atrial recording
|
$19,878.97 |
$19,878.97 |
$19,878.97 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$3,546.13 |
$3,546.13 |
$3,546.13 |
$3,982.59
|
|
Intrapul surf admin endo tube
|
$1,310.19 |
$1,310.19 |
$1,310.19 |
$239.52
|
|
Intraventricular pacing
|
$705.98 |
$705.98 |
$705.98 |
$5,775.22
|
|
Intrinsic factor antibody
|
$256.21 |
$256.21 |
$256.21 |
$59.95
|
|
Intro cath dialysis circuit
|
$4,646.36 |
$4,646.36 |
$4,646.36 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$34,102.35 |
$34,102.35 |
$34,102.35 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$39,088.21 |
$39,088.21 |
$39,088.21 |
$15,625.00
|
|
Intro catheter aorta
|
$1,971.95 |
$1,971.95 |
$1,971.95 |
$1,861.61
|
|
Intro cath svc/ivc
|
$987.27 |
$987.27 |
$987.27 |
$1,350.75
|
|
Intro long gi tube w/mult fluo
|
$2,538.41 |
$2,538.41 |
$2,538.41 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,110.46 |
$4,110.46 |
$4,110.46 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,647.53 |
$2,647.53 |
$2,647.53 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$1,511.16 |
$1,511.16 |
$1,511.16 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$484.01 |
$484.01 |
$484.01 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$754.30 |
$754.30 |
$754.30 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$51,535.10 |
$51,535.10 |
$51,535.10 |
$52,615.16
|
|
Ipratropium bromide non-comp
|
$5.86 |
$5.86 |
$5.86 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$291.99 |
$291.99 |
$291.99 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$4,357.82 |
$4,357.82 |
$4,357.82 |
$6,655.71
|
|
Iron
|
$186.79 |
$186.79 |
$186.79 |
$70.72
|
|
Iron binding capacity
|
$179.37 |
$179.37 |
$179.37 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$73.22 |
$73.22 |
$73.22 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$220.15 |
$220.15 |
$220.15 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$589.93 |
$589.93 |
$589.93 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$255.84 |
$255.84 |
$255.84 |
$154.50
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$15,616.46 |
$15,616.46 |
$15,616.46 |
$13,419.80
|
|
Ivc venogram s&i
|
$2,287.48 |
$2,287.48 |
$2,287.48 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$783.06 |
$783.06 |
$783.06 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$261.75 |
$261.75 |
$261.75 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$304.13 |
$304.13 |
$304.13 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$900.62 |
$900.62 |
$900.62 |
$460.85
|
|
Ivp w/nephrotomography
|
$1,931.38 |
$1,931.38 |
$1,931.38 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$2,129.83 |
$2,129.83 |
$2,129.83 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$1,314.56 |
$1,314.56 |
$1,314.56 |
$378.30
|
|
John cunningham antibody
|
$203.24 |
$203.24 |
$203.24 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$101.16 |
$101.16 |
$101.16 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$52.38 |
$52.38 |
$52.38 |
$30.08
|
|
Kidney imag w/bld flow multi
|
$3,791.85 |
$3,791.85 |
$3,791.85 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$2,173.05 |
$2,173.05 |
$2,173.05 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,224.94 |
$1,224.94 |
$1,224.94 |
$668.25
|
|
Knee Arthroscopy (Meniscus Repair)
|
$21,427.02 |
$21,427.02 |
$21,427.02 |
$3,839.54
|
|
Knee MRI (with and without contrast)
|
$4,842.61 |
$4,842.61 |
$4,842.61 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$4,639.91 |
$4,639.91 |
$4,639.91 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$4,237.94 |
$4,237.94 |
$4,237.94 |
$2,181.10
|
|
Knee X-ray
|
$738.51 |
$738.51 |
$738.51 |
$443.90
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$124.00 |
$124.00 |
$124.00 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$106.19 |
$106.19 |
$106.19 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$188.58 |
$188.58 |
$188.58 |
$53.30
|
|
Lactated ringers intravenous solution
|
$83.93 |
$83.93 |
$83.93 |
$54.11
|
|
Lactic acid
|
$298.69 |
$298.69 |
$298.69 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$355.95 |
$355.95 |
$355.95 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$18,741.65 |
$18,741.65 |
$18,741.65 |
$22,903.90
|
|
Laparoscopy remove adnexa
|
$36,351.80 |
$36,351.80 |
$36,351.80 |
$6,904.15
|
|
Lead capillary
|
$227.77 |
$227.77 |
$227.77 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$2,918.62 |
$2,918.62 |
$2,918.62 |
$1,100.74
|
|
Leishmania antibody
|
$131.76 |
$131.76 |
$131.76 |
$58.50
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$733.10 |
$733.10 |
$733.10 |
$146.32
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$161.02 |
$161.02 |
$161.02 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$524.62 |
$524.62 |
$524.62 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$97.86 |
$97.86 |
$97.86 |
$66.59
|
|
Lidocaine therapeutic drug level
|
$283.83 |
$283.83 |
$283.83 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$147.23 |
$147.23 |
$147.23 |
$177.90
|
|
Lipase
|
$337.22 |
$337.22 |
$337.22 |
$83.20
|
|
Lipoprotein blood quant
|
$410.69 |
$410.69 |
$410.69 |
$103.00
|
|
Lipoprotein direct measurement ldl
|
$269.07 |
$269.07 |
$269.07 |
$60.00
|
|
Lithium therapeutic drug level
|
$161.70 |
$161.70 |
$161.70 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$16,838.49 |
$16,838.49 |
$16,838.49 |
$4,371.12
|
|
Liver Function Test
|
$703.20 |
$703.20 |
$703.20 |
$110.50
|