|
Injection, doxercalciferol
|
$58.41 |
$58.41 |
$58.41 |
$30.35
|
|
Injection epidural blood patch or clot
|
$3,486.06 |
$3,486.06 |
$3,486.06 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$553.59 |
$553.59 |
$553.59 |
$441.12
|
|
Injection for bladder x-ray
|
$183.60 |
$183.60 |
$183.60 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$553.59 |
$553.59 |
$553.59 |
$504.00
|
|
Injection, fulvestrant
|
$107.55 |
$107.55 |
$107.55 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$5.22 |
$5.22 |
$5.22 |
$10,366.61
|
|
Injection, isavuconazonium
|
$477.45 |
$477.45 |
$477.45 |
$646.20
|
|
Injection,onabotulinumtoxina
|
$16.56 |
$16.56 |
$16.56 |
$2,154.07
|
|
Injection, peramivir
|
$609.21 |
$609.21 |
$609.21 |
$1,257.68
|
|
Injection radioactive tracer sentinel node (both sides)
|
$531.72 |
$531.72 |
$531.72 |
$717.20
|
|
Injection, renflexis
|
$325.53 |
$325.53 |
$325.53 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$959.13 |
$959.13 |
$959.13 |
$1,160.25
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,647.00 |
$1,647.00 |
$1,647.00 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,647.00 |
$1,647.00 |
$1,647.00 |
$1,758.12
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$108.00 |
$108.00 |
$108.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$90.00 |
$90.00 |
$90.00 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$135.00 |
$135.00 |
$135.00 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$221.22 |
$221.22 |
$221.22 |
$141.60
|
|
Inject sacroiliac joint
|
$267.03 |
$267.03 |
$267.03 |
$1,090.00
|
|
Inj., emapalumab-lzsg, 1 mg
|
$607.86 |
$607.86 |
$607.86 |
$381.64
|
|
Inj., emicizumab-kxwh 0.5 mg
|
$22.23 |
$22.23 |
$22.23 |
$15,669.18
|
|
Inj, factor x, (human), 1iu
|
$4.23 |
$4.23 |
$4.23 |
$9.91
|
|
Inj for ext venography
|
$237.87 |
$237.87 |
$237.87 |
$737.55
|
|
Inj, granisetron, xr, 0.1 mg
|
$92.34 |
$92.34 |
$92.34 |
$5.71
|
|
Inj hydroxyprogst capoat nos
|
$1,495.98 |
$1,495.98 |
$1,495.98 |
$1,495.98
|
|
Inj. inebilizumab-cdon, 1 mg
|
$565.92 |
$565.92 |
$565.92 |
$494.43
|
|
Inj ivig privigen 500 mg
|
$7,891.29 |
$7,891.29 |
$7,891.29 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$15.57 |
$15.57 |
$15.57 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$77.04 |
$77.04 |
$77.04 |
$618.43
|
|
Inj, moxifloxacin 100 mg
|
$44.76 |
$44.76 |
$44.76 |
$190.81
|
|
Inj ogivri 10 mg
|
$38.16 |
$38.16 |
$38.16 |
$3,968.67
|
|
Inj ontruzant 10 mg
|
$39.24 |
$39.24 |
$39.24 |
$34.17
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$1,695.87 |
$1,695.87 |
$1,695.87 |
$6,403.59
|
|
Inj proc ankle arthr
|
$553.59 |
$553.59 |
$553.59 |
$405.31
|
|
Inj proc elbow arthro
|
$553.59 |
$553.59 |
$553.59 |
$453.60
|
|
Inj progesterone per 50 mg
|
$8.91 |
$8.91 |
$8.91 |
$48.51
|
|
Inj retro urethrocysto
|
$394.56 |
$394.56 |
$394.56 |
$551.29
|
|
Inj sulf hexa lipid microsph
|
$39.60 |
$39.60 |
$39.60 |
$315.78
|
|
Inj. tagraxofusp-erzs 10 mcg
|
$47,819.16 |
$47,819.16 |
$47,819.16 |
$92,981.70
|
|
Inj. teprotumumab-trbw 10 mg
|
$147.06 |
$147.06 |
$147.06 |
$47,971.67
|
|
Inj testostero enanthate 1mg
|
$55.89 |
$55.89 |
$55.89 |
$50.85
|
|
Inj testosterone cypionate
|
$80.28 |
$80.28 |
$80.28 |
$77.15
|
|
Inj., tildrakizumab, 1 mg
|
$74.52 |
$74.52 |
$74.52 |
$24,563.40
|
|
Inj, uzedy, 1 mg
|
$2,836.80 |
$2,836.80 |
$2,836.80 |
$24.77
|
|
Inj w/fluor eval cv device
|
$457.56 |
$457.56 |
$457.56 |
$588.90
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$1,712.97 |
$1,712.97 |
$1,712.97 |
$3,429.94
|
|
Insertion catheter bladder non indwelling
|
$78.21 |
$78.21 |
$78.21 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$99.90 |
$99.90 |
$99.90 |
$273.60
|
|
Insitu hybridization manual
|
$366.93 |
$366.93 |
$366.93 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$170.91 |
$170.91 |
$170.91 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$248.58 |
$248.58 |
$248.58 |
$338.40
|
|
Insti hexaminolevulinate hcl
|
$398.52 |
$398.52 |
$398.52 |
$2,359.80
|
|
Insulin total
|
$160.47 |
$160.47 |
$160.47 |
$67.60
|
|
Intens cardiac rehab no exer
|
$103.95 |
$103.95 |
$103.95 |
$149.00
|
|
Intens cardiac rehab w/exerc
|
$401.67 |
$401.67 |
$401.67 |
$226.98
|
|
Interrog evl pm/ldls pm ip
|
$70.20 |
$70.20 |
$70.20 |
$127.20
|
|
Intrinsic factor antibody
|
$76.77 |
$76.77 |
$76.77 |
$59.95
|
|
Intubation endotracheal emergency procedure
|
$233.19 |
$233.19 |
$233.19 |
$617.60
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$1.62 |
$1.62 |
$1.62 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$16.56 |
$16.56 |
$16.56 |
$153.98
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$360.72 |
$360.72 |
$360.72 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$1,067.94 |
$1,067.94 |
$1,067.94 |
$6,655.71
|
|
Iron
|
$33.12 |
$33.12 |
$33.12 |
$70.72
|
|
Iron binding capacity
|
$44.73 |
$44.73 |
$44.73 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$28.62 |
$28.62 |
$28.62 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$5.31 |
$5.31 |
$5.31 |
$198.01
|
|
Irradiation of blood product each unit reference
|
$94.23 |
$94.23 |
$94.23 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$93.69 |
$93.69 |
$93.69 |
$154.50
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$160.20 |
$160.20 |
$160.20 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$86.76 |
$86.76 |
$86.76 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$142.20 |
$142.20 |
$142.20 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$180.00 |
$180.00 |
$180.00 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$312.66 |
$312.66 |
$312.66 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$306.45 |
$306.45 |
$306.45 |
$378.30
|
|
Ketogenic steroids fract
|
$158.22 |
$158.22 |
$158.22 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$155.61 |
$155.61 |
$155.61 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$14.57 |
$14.57 |
$14.57 |
$30.08
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$332.91 |
$332.91 |
$332.91 |
$668.25
|
|
Knee MRI (with and without contrast)
|
$1,313.37 |
$1,313.37 |
$1,313.37 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,110.78 |
$1,110.78 |
$1,110.78 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$776.52 |
$776.52 |
$776.52 |
$2,181.10
|
|
Knee X-ray
|
$248.13 |
$248.13 |
$248.13 |
$443.90
|
|
Kras gene variants exon 2
|
$486.45 |
$486.45 |
$486.45 |
$495.00
|
|
Lactate dehydrogenase (ldh)
|
$147.87 |
$147.87 |
$147.87 |
$53.30
|
|
Lactated ringers intravenous solution
|
$35.73 |
$35.73 |
$35.73 |
$54.11
|
|
Lactic acid
|
$191.79 |
$191.79 |
$191.79 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$48.60 |
$48.60 |
$48.60 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$21,470.76 |
$21,470.76 |
$21,470.76 |
$22,903.90
|
|
Lead capillary
|
$67.68 |
$67.68 |
$67.68 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$610.74 |
$610.74 |
$610.74 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$163.62 |
$163.62 |
$163.62 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$4,313.88 |
$4,313.88 |
$4,313.88 |
$3,271.64
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$12,824.28 |
$12,824.28 |
$12,824.28 |
$6,208.50
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.43 |
$0.43 |
$0.43 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$159.03 |
$159.03 |
$159.03 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$47.07 |
$47.07 |
$47.07 |
$66.59
|
|
Lidocaine therapeutic drug level
|
$214.74 |
$214.74 |
$214.74 |
$83.85
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$67.26 |
$67.26 |
$67.26 |
$177.90
|
|
Lipase
|
$67.68 |
$67.68 |
$67.68 |
$83.20
|