|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$4,091.60 |
$4,091.60 |
$4,091.60 |
$10,427.90
|
|
Interferon beta-1b / .25 mg
|
$289.67 |
$289.67 |
$289.67 |
$1,662.71
|
|
Interfyl, 1 mg
|
$5,659.20 |
$5,659.20 |
$5,659.20 |
$4,656.80
|
|
Intraoral i+d tongue/floor lingual 41000
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$1,361.25
|
|
Intrauterine transfusion ftl
|
$589.35 |
$589.35 |
$589.35 |
$1,063.50
|
|
Intrinsic factor antibody
|
$157.80 |
$157.80 |
$157.80 |
$63.15
|
|
Intro cath dialysis circuit
|
$1,545.15 |
$1,545.15 |
$1,545.15 |
$2,053.14
|
|
Intro cath dialysis circuit w/pta
|
$9,720.45 |
$9,720.45 |
$9,720.45 |
$8,761.00
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$11,787.75 |
$11,787.75 |
$11,787.75 |
$15,640.00
|
|
Intro catheter aorta
|
$1,654.05 |
$1,654.05 |
$1,654.05 |
$1,654.05
|
|
Intro long gi tube
|
$669.90 |
$669.90 |
$669.90 |
$954.00
|
|
Intro long gi tube w/mult fluo
|
$383.10 |
$383.10 |
$383.10 |
$465.50
|
|
Intro windpipe wire/tube
|
$1,584.00 |
$1,584.00 |
$1,584.00 |
$2,447.43
|
|
Intubation endotracheal emergency procedure
|
$539.85 |
$539.85 |
$539.85 |
$600.00
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$405.00 |
$405.00 |
$405.00 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$315.00 |
$315.00 |
$315.00 |
$279.10
|
|
Ioxaglate 39.3%-19.6% inj 200 ml
|
$763.50 |
$763.50 |
$763.50 |
$763.50
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$67,577.14 |
$67,577.14 |
$67,577.14 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$77.27 |
$77.27 |
$77.27 |
$174.47
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$5,476.68 |
$5,476.68 |
$5,476.68 |
$5,476.68
|
|
Iron
|
$217.80 |
$217.80 |
$217.80 |
$73.98
|
|
Iron binding capacity
|
$217.80 |
$217.80 |
$217.80 |
$63.84
|
|
Iron dextran 50 mg/ml injection solution
|
$44.75 |
$44.75 |
$44.75 |
$78.46
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$143.26 |
$143.26 |
$143.26 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$223.50 |
$223.50 |
$223.50 |
$116.35
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$394.35 |
$394.35 |
$394.35 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$61.50 |
$61.50 |
$61.50 |
$162.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$59.70 |
$59.70 |
$59.70 |
$154.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$449.55 |
$449.55 |
$449.55 |
$443.20
|
|
IV inj ra drug dx study
|
$510.45 |
$510.45 |
$510.45 |
$549.70
|
|
Ivp w/nephrotomography
|
$622.35 |
$622.35 |
$622.35 |
$764.40
|
|
Ivp w/wo kub w/wo tomography
|
$622.35 |
$622.35 |
$622.35 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$11,501.78 |
$11,501.78 |
$11,501.78 |
$10,695.32
|
|
Jejunstmy tube plcmt
|
$1,138.20 |
$1,138.20 |
$1,138.20 |
$2,174.40
|
|
Kafo dbl solid stirrup band/
|
$2,185.15 |
$2,185.15 |
$2,185.15 |
$2,185.15
|
|
Kafo fem fx cast molded to p
|
$3,130.66 |
$3,130.66 |
$3,130.66 |
$3,130.66
|
|
Kafo fem fx cast semi-rigid
|
$2,130.02 |
$2,130.02 |
$2,130.02 |
$2,130.02
|
|
Kafo femoral fx cast rigid
|
$2,445.29 |
$2,445.29 |
$2,445.29 |
$2,138.81
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$71.10 |
$71.10 |
$71.10 |
$59.00
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$19.68 |
$19.68 |
$19.68 |
$23.77
|
|
Kidney imaging morphology
|
$747.90 |
$747.90 |
$747.90 |
$817.60
|
|
Kidney imag w/bld flow multi
|
$1,570.65 |
$1,570.65 |
$1,570.65 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,320.15 |
$1,320.15 |
$1,320.15 |
$1,433.50
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$742.20 |
$742.20 |
$742.20 |
$668.25
|
|
Kit case 4.2mm spinejack
|
$9,996.00 |
$9,996.00 |
$9,996.00 |
$7,751.14
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$11,280.00 |
$11,280.00 |
$11,280.00 |
$9,482.25
|
|
Kit hfx iq ipg bundle
|
$30,006.00 |
$30,006.00 |
$30,006.00 |
$31,365.00
|
|
Kit ipg optimizer smart
|
$30,006.00 |
$30,006.00 |
$30,006.00 |
$49,011.18
|
|
Kit lead specify 5-6-5
|
$25,500.00 |
$25,500.00 |
$25,500.00 |
$16,625.73
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,783.50 |
$1,783.50 |
$1,783.50 |
$1,617.00
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$142.68 |
$142.68 |
$142.68 |
$923.90
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,908.80 |
$2,908.80 |
$2,908.80 |
$2,264.96
|
|
Kit trach suct cls 30.5cm
|
$39.81 |
$39.81 |
$39.81 |
$35.26
|
|
Knee control condylar pad
|
$12,003.00 |
$12,003.00 |
$12,003.00 |
$175.04
|
|
Knee disc/dial lock/adj flex
|
$288.41 |
$288.41 |
$288.41 |
$288.41
|
|
Knee joint drop lock ea jnt
|
$175.45 |
$175.45 |
$175.45 |
$175.45
|
|
Knee MRI (with and without contrast)
|
$3,700.05 |
$3,700.05 |
$3,700.05 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$3,482.70 |
$3,482.70 |
$3,482.70 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,264.90 |
$3,264.90 |
$3,264.90 |
$2,130.88
|
|
Knee X-ray
|
$425.55 |
$425.55 |
$425.55 |
$425.55
|
|
Ko w adj flex/ext rotat mold
|
$4,285.97 |
$4,285.97 |
$4,285.97 |
$2,418.09
|
|
Kyleena, 19.5 mg
|
$2,345.64 |
$2,345.64 |
$2,345.64 |
$2,152.80
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$28.37 |
$28.37 |
$28.37 |
$33.14
|
|
Lacer molded to patient mode
|
$775.69 |
$775.69 |
$775.69 |
$775.69
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$52.20 |
$52.20 |
$52.20 |
$175.92
|
|
Lactate dehydrogenase (ldh)
|
$201.00 |
$201.00 |
$201.00 |
$55.50
|
|
Lactated ringers intravenous solution
|
$30.00 |
$30.00 |
$30.00 |
$44.91
|
|
Lactic acid
|
$193.65 |
$193.65 |
$193.65 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$118.35 |
$118.35 |
$118.35 |
$82.16
|
|
Laryngeal function studies
|
$410.55 |
$410.55 |
$410.55 |
$335.40
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$3,720.15 |
$3,720.15 |
$3,720.15 |
$2,514.60
|
|
Laryngoscopy telescopic
|
$2,904.90 |
$2,904.90 |
$2,904.90 |
$852.80
|
|
Lead acuity x4 spiral l 86cm
|
$5,292.00 |
$5,292.00 |
$5,292.00 |
$5,617.19
|
|
Lead capillary
|
$17.40 |
$17.40 |
$17.40 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$1,476.00 |
$1,476.00 |
$1,476.00 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$10,944.00 |
$10,944.00 |
$10,944.00 |
$8,202.66
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,251.15 |
$1,251.15 |
$1,251.15 |
$1,090.23
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,616.00 |
$2,616.00 |
$2,616.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$479.70 |
$479.70 |
$479.70 |
$1,041.25
|
|
Lens iol ant chamb 10.5
|
$725.70 |
$725.70 |
$725.70 |
$385.34
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$100.80 |
$100.80 |
$100.80 |
$163.80
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$16,189.23 |
$16,189.23 |
$16,189.23 |
$5,993.33
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$10,189.22 |
$10,189.22 |
$10,189.22 |
$9,107.80
|
|
Leuprolide acetate injeciton
|
$52.51 |
$52.51 |
$52.51 |
$1,322.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$105.30 |
$105.30 |
$105.30 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$146.70 |
$146.70 |
$146.70 |
$83.50
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$46.98 |
$46.98 |
$46.98 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$627.16 |
$627.16 |
$627.16 |
$420.60
|
|
Liberta rc ipg
|
$31,524.00 |
$31,524.00 |
$31,524.00 |
$38,725.40
|
|
Lidocaine injection
|
$44.76 |
$44.76 |
$44.76 |
$44.76
|
|
Lidocaine therapeutic drug level
|
$243.60 |
$243.60 |
$243.60 |
$88.40
|
|
Lift heel adj small gl60404sm
|
$148.39 |
$148.39 |
$148.39 |
$136.66
|
|
Ligate oviduct(s) add-on 58611
|
$1,743.00 |
$1,743.00 |
$1,743.00 |
$800.00
|
|
Liletta, 52 mg
|
$1,100.85 |
$1,100.85 |
$1,100.85 |
$1,453.50
|
|
Limited ankle motion ea jnt
|
$123.05 |
$123.05 |
$123.05 |
$108.64
|
|
Limited motion knee joint
|
$278.92 |
$278.92 |
$278.92 |
$274.07
|
|
Lincomycin injection
|
$64.31 |
$64.31 |
$64.31 |
$64.31
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$83.16 |
$83.16 |
$83.16 |
$123.78
|
|
Lipase
|
$160.50 |
$160.50 |
$160.50 |
$92.88
|
|
Lipoprotein direct measurement hdl
|
$221.10 |
$221.10 |
$221.10 |
$57.50
|