|
Intranasal biopsy 30100
|
$1,845.90 |
$1,845.90 |
$1,845.90 |
$1,850.94
|
|
Intraoral i+d tongue/floor lingual 41000
|
$607.74 |
$607.74 |
$607.74 |
$1,182.15
|
|
Intro long gi tube
|
$1,097.88 |
$1,097.88 |
$1,097.88 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$111.72 |
$111.72 |
$111.72 |
$477.85
|
|
Intro windpipe wire/tube
|
$2,126.04 |
$2,126.04 |
$2,126.04 |
$2,316.30
|
|
Intubation endotracheal emergency procedure
|
$328.44 |
$328.44 |
$328.44 |
$617.60
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$37.80 |
$37.80 |
$37.80 |
$153.98
|
|
Ipratropium bromide non-comp
|
$4.62 |
$4.62 |
$4.62 |
$7.57
|
|
Iron
|
$34.86 |
$34.86 |
$34.86 |
$70.72
|
|
Iron binding capacity
|
$47.04 |
$47.04 |
$47.04 |
$63.00
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$92.78 |
$92.78 |
$92.78 |
$198.01
|
|
Irrigation implantable venous access device for drug delivery systems
|
$66.36 |
$66.36 |
$66.36 |
$154.50
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$280.14 |
$280.14 |
$280.14 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$118.86 |
$118.86 |
$118.86 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$286.02 |
$286.02 |
$286.02 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$345.66 |
$345.66 |
$345.66 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$311.22 |
$311.22 |
$311.22 |
$713.05
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$56.70 |
$56.70 |
$56.70 |
$30.08
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$270.06 |
$270.06 |
$270.06 |
$668.25
|
|
Kit cath f 8f w/glv + wipe ster
|
$12.34 |
$12.34 |
$12.34 |
$8.68
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$9,159.36 |
$9,159.36 |
$9,159.36 |
$9,384.04
|
|
Kit hfx iq ipg bundle
|
$27,909.00 |
$27,909.00 |
$27,909.00 |
$28,974.93
|
|
Kit ipg optimizer smart
|
$46,737.60 |
$46,737.60 |
$46,737.60 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$34,886.25 |
$34,886.25 |
$34,886.25 |
$17,205.92
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$2,021.99 |
$2,021.99 |
$2,021.99 |
$1,357.69
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$5,628.61 |
$5,628.61 |
$5,628.61 |
$5,329.23
|
|
Kit sound processor cochlear osia 2
|
$10,895.93 |
$10,895.93 |
$10,895.93 |
$10,444.90
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$2,725.63 |
$2,725.63 |
$2,725.63 |
$2,087.65
|
|
Knee MRI (with and without contrast)
|
$1,661.94 |
$1,661.94 |
$1,661.94 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,619.94 |
$1,619.94 |
$1,619.94 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,012.62 |
$1,012.62 |
$1,012.62 |
$2,181.10
|
|
Knee X-ray
|
$197.82 |
$197.82 |
$197.82 |
$443.90
|
|
Kyleena, 19.5 mg
|
$1,322.16 |
$1,322.16 |
$1,322.16 |
$2,618.91
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$120.96 |
$120.96 |
$120.96 |
$100.75
|
|
Lab draw <3 yrs scalp vein 36405
|
$120.96 |
$120.96 |
$120.96 |
$58.40
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$56.70 |
$56.70 |
$56.70 |
$42.38
|
|
Lactate dehydrogenase (ldh)
|
$32.34 |
$32.34 |
$32.34 |
$53.30
|
|
Lactated ringers intravenous solution
|
$46.85 |
$46.85 |
$46.85 |
$54.11
|
|
Lactic acid
|
$62.16 |
$62.16 |
$62.16 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$105.84 |
$105.84 |
$105.84 |
$88.40
|
|
Laparo cholecystectomy/graph
|
$6,932.10 |
$6,932.10 |
$6,932.10 |
$7,220.90
|
|
Largsc w/removal lesion
|
$4,361.70 |
$4,361.70 |
$4,361.70 |
$4,341.97
|
|
Largsc w/rmvl foreign bdy(s)
|
$459.48 |
$459.48 |
$459.48 |
$765.97
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$1,848.84 |
$1,848.84 |
$1,848.84 |
$2,480.71
|
|
Laryngoscopy w/fb removal
|
$1,848.84 |
$1,848.84 |
$1,848.84 |
$3,390.75
|
|
Laryngoscopy with biopsy
|
$2,039.94 |
$2,039.94 |
$2,039.94 |
$2,954.40
|
|
Laryngoscopy w/w/o tracheoscopy aspiration
|
$435.96 |
$435.96 |
$435.96 |
$660.10
|
|
Lateral canthopexy
|
$3,783.78 |
$3,783.78 |
$3,783.78 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$3,435.60 |
$3,435.60 |
$3,435.60 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$3,934.60 |
$3,934.60 |
$3,934.60 |
$5,831.00
|
|
Lead capillary
|
$25.20 |
$25.20 |
$25.20 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$4,851.42 |
$4,851.42 |
$4,851.42 |
$3,842.56
|
|
Lead tachy durata sj4 58cm
|
$5,601.96 |
$5,601.96 |
$5,601.96 |
$6,551.30
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$570.36 |
$570.36 |
$570.36 |
$1,100.74
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$2,716.35 |
$2,716.35 |
$2,716.35 |
$1,690.58
|
|
Lens iol ant bicnvx 24.0 multi
|
$2,716.35 |
$2,716.35 |
$2,716.35 |
$1,546.87
|
|
Lens iol ant chamb 10.5
|
$377.71 |
$377.71 |
$377.71 |
$234.81
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$210.00 |
$210.00 |
$210.00 |
$3,271.64
|
|
Levalbuterol non-comp unit
|
$13.94 |
$13.94 |
$13.94 |
$11.90
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$56.70 |
$56.70 |
$56.70 |
$89.14
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$69.30 |
$69.30 |
$69.30 |
$66.59
|
|
Liberta rc ipg
|
$41,854.20 |
$41,854.20 |
$41,854.20 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$48.53 |
$48.53 |
$48.53 |
$49.11
|
|
Ligation/biopsy of temporal artery 37609
|
$1,994.16 |
$1,994.16 |
$1,994.16 |
$2,968.00
|
|
Ligation/major artery/extremity 37618
|
$105.00 |
$105.00 |
$105.00 |
$1,567.80
|
|
Ligation major artery neck
|
$3,445.26 |
$3,445.26 |
$3,445.26 |
$3,724.63
|
|
Lincomycin injection
|
$186.82 |
$186.82 |
$186.82 |
$13.25
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$135.14 |
$135.14 |
$135.14 |
$177.90
|
|
Lipase
|
$36.96 |
$36.96 |
$36.96 |
$83.20
|
|
Lipoprotein direct measurement hdl
|
$44.10 |
$44.10 |
$44.10 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$56.70 |
$56.70 |
$56.70 |
$60.00
|
|
Lithium therapeutic drug level
|
$11.76 |
$11.76 |
$11.76 |
$67.60
|
|
Liver Function Test
|
$84.84 |
$84.84 |
$84.84 |
$110.50
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$57.96 |
$57.96 |
$57.96 |
$45.56
|
|
Low cost skin substitute app
|
$772.80 |
$772.80 |
$772.80 |
$862.55
|
|
Low cost skin substitute app
|
$2,295.30 |
$2,295.30 |
$2,295.30 |
$2,164.64
|
|
Low cost skin substitute app
|
$772.80 |
$772.80 |
$772.80 |
$933.40
|
|
Low cost skin substitute app
|
$772.80 |
$772.80 |
$772.80 |
$868.70
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$2,149.98 |
$2,149.98 |
$2,149.98 |
$1,921.40
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$2,101.68 |
$2,101.68 |
$2,101.68 |
$1,844.70
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$509.88 |
$509.88 |
$509.88 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,066.82 |
$2,066.82 |
$2,066.82 |
$2,995.20
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,024.82 |
$2,024.82 |
$2,024.82 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$1,012.62 |
$1,012.62 |
$1,012.62 |
$2,060.27
|
|
Lower Back (Lumbar Spine) X-ray
|
$197.82 |
$197.82 |
$197.82 |
$344.00
|
|
Lung Function Test (Spirometry)
|
$283.92 |
$283.92 |
$283.92 |
$298.50
|
|
Lvad shower bag heartmate
|
$1,583.97 |
$1,583.97 |
$1,583.97 |
$1,090.58
|
|
Lymphatics/lymph node imaging
|
$417.06 |
$417.06 |
$417.06 |
$1,543.75
|
|
Lysis penil circumic lesion
|
$147.00 |
$147.00 |
$147.00 |
$4,173.43
|
|
Magnesium
|
$36.12 |
$36.12 |
$36.12 |
$71.50
|
|
Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback
|
$69.30 |
$69.30 |
$69.30 |
$65.49
|
|
Makena, 10 mg
|
$1,011.78 |
$1,011.78 |
$1,011.78 |
$22.86
|
|
Mammosite ced
|
$5,386.50 |
$5,386.50 |
$5,386.50 |
$5,100.00
|
|
Manipulate wrist w/anesthes
|
$1,907.64 |
$1,907.64 |
$1,907.64 |
$2,084.80
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$91.14 |
$91.14 |
$91.14 |
$144.00
|
|
Manipulation chest wall initial demonstration/evaluation
|
$196.98 |
$196.98 |
$196.98 |
$178.75
|
|
Mapping io sentinel lymph node
|
$118.44 |
$118.44 |
$118.44 |
$468.21
|
|
Marker biop eviva buckle ss
|
$5,682.67 |
$5,682.67 |
$5,682.67 |
$1,213.20
|
|
Marker lymphatic sentimag magtrace 10 vial
|
$2,533.17 |
$2,533.17 |
$2,533.17 |
$1,753.29
|
|
Mastoids complete
|
$197.82 |
$197.82 |
$197.82 |
$271.95
|