|
Inj melpha hydroch nos 50 mg
|
$24,809.59 |
$24,809.59 |
$24,809.59 |
$2,375.23
|
|
Inj mepivacaine hcl/10 ml
|
$48.04 |
$48.04 |
$48.04 |
$33.86
|
|
Inj. mycophenolate mofetil
|
$1,159.71 |
$1,159.71 |
$1,159.71 |
$252.66
|
|
Inj, pedmark, 100 mg
|
$1,076.87 |
$1,076.87 |
$1,076.87 |
$123.00
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$151,904.93 |
$151,904.93 |
$151,904.93 |
$67,538.30
|
|
Inj, tofidence, 1 mg
|
$4,708.43 |
$4,708.43 |
$4,708.43 |
$346.32
|
|
Inj vocal cord bulking agent
|
$23,075.00 |
$23,075.00 |
$23,075.00 |
$1,480.00
|
|
Insertion of cannula(s)
|
$4,888.78 |
$4,888.78 |
$4,888.78 |
$1,989.39
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$6,840.84 |
$6,840.84 |
$6,840.84 |
$2,079.43
|
|
Insitu hybridization auto
|
$151.88 |
$151.88 |
$151.88 |
$371.00
|
|
Insitu hybridization (fish)
|
$420.35 |
$420.35 |
$420.35 |
$481.60
|
|
In situ hybridization per specimen each additional single probe stain
|
$213.25 |
$213.25 |
$213.25 |
$243.60
|
|
In situ hybridization per specimen initial single probe stain
|
$280.75 |
$280.75 |
$280.75 |
$326.04
|
|
Insulin total
|
$635.14 |
$635.14 |
$635.14 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$39,458.00 |
$39,458.00 |
$39,458.00 |
$8,629.72
|
|
Interferon alfa-2b inj
|
$3,389.47 |
$3,389.47 |
$3,389.47 |
$1,409.92
|
|
Interferon beta-1b / .25 mg
|
$4,822.66 |
$4,822.66 |
$4,822.66 |
$1,662.71
|
|
Interferon gamma 1-b inj
|
$51,970.07 |
$51,970.07 |
$51,970.07 |
$9,879.00
|
|
Intra-atrial recording
|
$6,336.53 |
$6,336.53 |
$6,336.53 |
$5,252.30
|
|
Intracard echo interv w/s&i
|
$4,760.69 |
$4,760.69 |
$4,760.69 |
$3,429.40
|
|
Intracranial complete study
|
$3,476.46 |
$3,476.46 |
$3,476.46 |
$900.50
|
|
Intracranial limited study
|
$2,371.41 |
$2,371.41 |
$2,371.41 |
$444.66
|
|
Intraop epicard/endocard/pace/map/ 93631
|
$16,547.04 |
$16,547.04 |
$16,547.04 |
$3,500.60
|
|
Intraventricular pacing
|
$4,872.91 |
$4,872.91 |
$4,872.91 |
$5,609.50
|
|
Intrinsic factor antibody
|
$1,083.12 |
$1,083.12 |
$1,083.12 |
$66.60
|
|
Intro long gi tube w/mult fluo
|
$847.48 |
$847.48 |
$847.48 |
$449.40
|
|
Ipratropium bromide non-comp
|
$34.30 |
$34.30 |
$34.30 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$14,781.03 |
$14,781.03 |
$14,781.03 |
$163.87
|
|
Iron binding capacity
|
$698.05 |
$698.05 |
$698.05 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$747.55 |
$747.55 |
$747.55 |
$80.95
|
|
Iron stain peripheral blood
|
$797.76 |
$797.76 |
$797.76 |
$30.55
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,153.98 |
$1,153.98 |
$1,153.98 |
$187.06
|
|
Ivp w/nephrotomography
|
$1,703.26 |
$1,703.26 |
$1,703.26 |
$790.08
|
|
Ixabepilone 15 mg intravenous solution
|
$64,083.46 |
$64,083.46 |
$64,083.46 |
$10,695.32
|
|
Kafo fem fx cast molded to p
|
$8,611.00 |
$8,611.00 |
$8,611.00 |
$3,130.66
|
|
Kafo fem fx cast thermoplas
|
$9,166.00 |
$9,166.00 |
$9,166.00 |
$2,710.45
|
|
Kafo femoral fx cast rigid
|
$5,501.00 |
$5,501.00 |
$5,501.00 |
$2,138.81
|
|
Ketogenic steroids fract
|
$747.14 |
$747.14 |
$747.14 |
$82.74
|
|
Kidney imag w/bld flow multi
|
$2,232.73 |
$2,232.73 |
$2,232.73 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$2,220.75 |
$2,220.75 |
$2,220.75 |
$1,427.40
|
|
Knee disc/dial lock/adj flex
|
$2,043.00 |
$2,043.00 |
$2,043.00 |
$288.41
|
|
Knee joint cam lock each joi
|
$736.00 |
$736.00 |
$736.00 |
$287.46
|
|
Knee MRI (with and without contrast)
|
$10,136.52 |
$10,136.52 |
$10,136.52 |
$3,034.80
|
|
Knee X-ray
|
$956.88 |
$956.88 |
$956.88 |
$425.55
|
|
Ko swedish type pre ots
|
$1,876.00 |
$1,876.00 |
$1,876.00 |
$604.50
|
|
Kras gene addl variants
|
$297.19 |
$297.19 |
$297.19 |
$384.80
|
|
Kras gene variants exon 2
|
$325.64 |
$325.64 |
$325.64 |
$486.45
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$867.63 |
$867.63 |
$867.63 |
$175.92
|
|
Lactoferrin fecal qualitative
|
$108.93 |
$108.93 |
$108.93 |
$80.40
|
|
Lactoferrin fecal quant
|
$108.93 |
$108.93 |
$108.93 |
$106.10
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$96.22 |
$96.22 |
$96.22 |
$163.62
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$9,189.63 |
$9,189.63 |
$9,189.63 |
$9,107.80
|
|
Levalbuterol non-comp unit
|
$105.78 |
$105.78 |
$105.78 |
$6.00
|
|
Levetiracetam therapeutic drug level
|
$607.53 |
$607.53 |
$607.53 |
$88.92
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$1,155.62 |
$1,155.62 |
$1,155.62 |
$385.62
|
|
Lidocaine injection
|
$385.81 |
$385.81 |
$385.81 |
$44.76
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$360.56 |
$360.56 |
$360.56 |
$39.37
|
|
Lidocaine therapeutic drug level
|
$811.56 |
$811.56 |
$811.56 |
$89.70
|
|
Lig/band angioaccess av fistula
|
$3,057.22 |
$3,057.22 |
$3,057.22 |
$4,676.50
|
|
Limited ankle motion ea jnt
|
$399.00 |
$399.00 |
$399.00 |
$123.05
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$2,861.86 |
$2,861.86 |
$2,861.86 |
$125.66
|
|
Listeria monocytogenes
|
$790.10 |
$790.10 |
$790.10 |
$117.52
|
|
Lithium therapeutic drug level
|
$685.78 |
$685.78 |
$685.78 |
$69.42
|
|
Liver imaging
|
$2,029.02 |
$2,029.02 |
$2,029.02 |
$1,093.50
|
|
Liver imag w/vasclr flow
|
$1,919.85 |
$1,919.85 |
$1,919.85 |
$1,238.65
|
|
Liver/spleen imag static only
|
$2,805.23 |
$2,805.23 |
$2,805.23 |
$1,123.50
|
|
Liver/spleen imag w/vasclr flow
|
$2,528.31 |
$2,528.31 |
$2,528.31 |
$1,067.48
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$9,820.61 |
$9,820.61 |
$9,820.61 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$7,511.20 |
$7,511.20 |
$7,511.20 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$7,789.37 |
$7,789.37 |
$7,789.37 |
$2,096.84
|
|
Low frequency non-thermal Ultrasound
|
$534.65 |
$534.65 |
$534.65 |
$364.00
|
|
Lso full corset
|
$1,086.00 |
$1,086.00 |
$1,086.00 |
$320.92
|
|
Lso sagittal rigid panel cus
|
$3,092.00 |
$3,092.00 |
$3,092.00 |
$3,092.00
|
|
Lso s/c shell/panel prefab
|
$10,391.00 |
$10,391.00 |
$10,391.00 |
$1,332.80
|
|
L/s ratio fetal lung
|
$1,256.48 |
$1,256.48 |
$1,256.48 |
$176.15
|
|
Lung function test (mbc/mvv)
|
$227.49 |
$227.49 |
$227.49 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$802.71 |
$802.71 |
$802.71 |
$295.35
|
|
Lung perfusion imaging
|
$3,261.88 |
$3,261.88 |
$3,261.88 |
$1,075.25
|
|
Lvad shower bag heartmate
|
$15,156.00 |
$15,156.00 |
$15,156.00 |
$887.68
|
|
Lymphatics/lymph node imaging
|
$3,675.95 |
$3,675.95 |
$3,675.95 |
$1,448.00
|
|
Lymphocytotoxicity assay
|
$500.14 |
$500.14 |
$500.14 |
$370.20
|
|
Lymphocytotoxicity assay
|
$556.91 |
$556.91 |
$556.91 |
$96.00
|
|
Lymph vessel x-ray trunk
|
$10,443.63 |
$10,443.63 |
$10,443.63 |
$3,452.15
|
|
Macro exam dissect molec study ea
|
$12.62 |
$12.62 |
$12.62 |
$72.85
|
|
Macroscopic exam parasite
|
$109.16 |
$109.16 |
$109.16 |
$36.40
|
|
Mannitol 12.5 gm/50 ml inj
|
$88.30 |
$88.30 |
$88.30 |
$27.81
|
|
Map tachycard site(s)
|
$8,799.06 |
$8,799.06 |
$8,799.06 |
$3,875.95
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$38.36 |
$38.36 |
$38.36 |
$66.36
|
|
Mayo activated protein c resistance assay
|
$932.77 |
$932.77 |
$932.77 |
$97.50
|
|
Mayo alkaline phosphatase isoenzyme
|
$1,629.29 |
$1,629.29 |
$1,629.29 |
$66.30
|
|
Mayo amikacin trough therapeutic drug level
|
$911.29 |
$911.29 |
$911.29 |
$82.80
|
|
Mayo androstenedione
|
$1,840.99 |
$1,840.99 |
$1,840.99 |
$110.00
|
|
Mayo angiotensin 1 converting enzyme (ace) csf
|
$859.13 |
$859.13 |
$859.13 |
$73.08
|
|
Mayo antithrombin iii antigen
|
$1,888.56 |
$1,888.56 |
$1,888.56 |
$72.35
|
|
Mayo aspergillus fumigatus antibody
|
$633.62 |
$633.62 |
$633.62 |
$67.60
|
|
Mayo avwpr vw factor activity
|
$561.50 |
$561.50 |
$561.50 |
$165.78
|
|
Mayo barbiturates definitive assay confirmation urine
|
$240.88 |
$240.88 |
$240.88 |
$91.50
|
|
Mayo blastomyces antibody immunodiffusion
|
$828.45 |
$828.45 |
$828.45 |
$57.85
|
|
Mayo bordetella pertussis antibody igg
|
$641.28 |
$641.28 |
$641.28 |
$69.00
|
|
Mayo cannabinoids natural definitive assay thc confirmation urine
|
$240.88 |
$240.88 |
$240.88 |
$106.70
|
