|
Ihc/icc per specimen each multiplex antibody stain
|
$1,110.51 |
$1,110.51 |
$1,110.51 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$1,110.51 |
$1,110.51 |
$1,110.51 |
$274.86
|
|
Imatinib 100 mg tab
|
$352.16 |
$352.16 |
$352.16 |
$248.00
|
|
Immobilizer shldr cntor adlt
|
$433.00 |
$433.00 |
$433.00 |
$171.43
|
|
Immobilizer shldr dlx str 24-36in med
|
$200.00 |
$200.00 |
$200.00 |
$102.00
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$10,651.92 |
$10,651.92 |
$10,651.92 |
$3,593.90
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$418.30 |
$418.30 |
$418.30 |
$116.40
|
|
Immunodiffusion nes
|
$698.16 |
$698.16 |
$698.16 |
$53.76
|
|
Immunofluorescence per specimen initial single antibody stain
|
$1,110.51 |
$1,110.51 |
$1,110.51 |
$232.05
|
|
In-111 oxyquinolin per 0.5 mci
|
$26,430.14 |
$26,430.14 |
$26,430.14 |
$2,568.98
|
|
In-111 pentetate dtpa / 0.5 mci
|
$13,885.67 |
$13,885.67 |
$13,885.67 |
$2,550.60
|
|
In-111 pentetreotide
|
$16,111.59 |
$16,111.59 |
$16,111.59 |
$4,944.55
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$18,834.65 |
$18,834.65 |
$18,834.65 |
$2,080.80
|
|
Incobotulinumtoxin a
|
$2,786.99 |
$2,786.99 |
$2,786.99 |
$1,359.43
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$2,181.60 |
$2,181.60 |
$2,181.60 |
$785.83
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$3,213.91 |
$3,213.91 |
$3,213.91 |
$603.75
|
|
Infect ag if ea plyvlnt antsrm
|
$516.54 |
$516.54 |
$516.54 |
$65.10
|
|
Infect ag if influenza a
|
$710.07 |
$710.07 |
$710.07 |
$40.61
|
|
Infect ag if legionella pneumophila
|
$766.65 |
$766.65 |
$766.65 |
$73.46
|
|
Infect ag if pneumocystis carinii
|
$388.52 |
$388.52 |
$388.52 |
$67.46
|
|
Infect ag na chlamydia trachomatis qnt
|
$558.25 |
$558.25 |
$558.25 |
$107.20
|
|
Infect ag na hep b amp
|
$1,732.74 |
$1,732.74 |
$1,732.74 |
$108.44
|
|
Infect ag na influenza r/amp 1st 2 types
|
$884.24 |
$884.24 |
$884.24 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$102.08 |
$102.08 |
$102.08 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$1,650.88 |
$1,650.88 |
$1,650.88 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$6,189.62 |
$6,189.62 |
$6,189.62 |
$855.60
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$544.84 |
$544.84 |
$544.84 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$237.24 |
$237.24 |
$237.24 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$74.79 |
$74.79 |
$74.79 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,296.57 |
$1,296.57 |
$1,296.57 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$308.15 |
$308.15 |
$308.15 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$303.69 |
$303.69 |
$303.69 |
$55.31
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$599.91 |
$599.91 |
$599.91 |
$137.67
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$2,152.43 |
$2,152.43 |
$2,152.43 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$1,753.57 |
$1,753.57 |
$1,753.57 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$421.29 |
$421.29 |
$421.29 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$1,775.93 |
$1,775.93 |
$1,775.93 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$599.91 |
$599.91 |
$599.91 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$67.61 |
$67.61 |
$67.61 |
$100.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$108.21 |
$108.21 |
$108.21 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$1,624.82 |
$1,624.82 |
$1,624.82 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$939.93 |
$939.93 |
$939.93 |
$711.93
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$2,012.62 |
$2,012.62 |
$2,012.62 |
$238.80
|
|
Infectious agent nucleic acid quantification hiv-1
|
$2,852.17 |
$2,852.17 |
$2,852.17 |
$374.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,144.36 |
$1,144.36 |
$1,144.36 |
$293.04
|
|
Inj, acetaminophen (hikma)
|
$250.26 |
$250.26 |
$250.26 |
$68.30
|
|
Inj, artesunate, 1mg
|
$31,681.10 |
$31,681.10 |
$31,681.10 |
$14,460.21
|
|
Inj calcitriol per 0.1 mcg
|
$310.49 |
$310.49 |
$310.49 |
$22.69
|
|
Inj, cefiderocol, 10 mg
|
$1,569.67 |
$1,569.67 |
$1,569.67 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$1,065.47 |
$1,065.47 |
$1,065.47 |
$408.00
|
|
Inj crotalidae im f(ab')2 eq
|
$5,489.88 |
$5,489.88 |
$5,489.88 |
$2,613.60
|
|
Injection, cangrelor
|
$6,048.10 |
$6,048.10 |
$6,048.10 |
$1,889.78
|
|
Injection, isavuconazonium
|
$2,577.54 |
$2,577.54 |
$2,577.54 |
$787.67
|
|
Injection,onabotulinumtoxina
|
$11,423.53 |
$11,423.53 |
$11,423.53 |
$2,241.61
|
|
Injection, pentamidine iseth
|
$1,825.50 |
$1,825.50 |
$1,825.50 |
$464.32
|
|
Inj, etelcalcetide, 0.1 mg
|
$921.26 |
$921.26 |
$921.26 |
$343.35
|
|
Inj pantoprazole(hikma) 40mg
|
$79.46 |
$79.46 |
$79.46 |
$34.61
|
|
Inj testosterone cypionate
|
$168.39 |
$168.39 |
$168.39 |
$62.80
|
|
Inj vasopressin (am reg) 1 u
|
$834.08 |
$834.08 |
$834.08 |
$40.24
|
|
Inj vocal cord bulking agent
|
$21,638.00 |
$21,638.00 |
$21,638.00 |
$1,480.00
|
|
Insertion of catheter vein
|
$6,191.15 |
$6,191.15 |
$6,191.15 |
$836.25
|
|
In situ hybridization per specimen initial single probe stain
|
$348.33 |
$348.33 |
$348.33 |
$326.04
|
|
Ins/rpl pm w/tv ld atrl
|
$47,093.98 |
$47,093.98 |
$47,093.98 |
$12,371.40
|
|
Ins tun intraperit dia cath
|
$24,780.08 |
$24,780.08 |
$24,780.08 |
$4,657.46
|
|
Insulin total
|
$468.92 |
$468.92 |
$468.92 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$24,425.00 |
$24,425.00 |
$24,425.00 |
$8,629.72
|
|
Intracard echo interv w/s&i
|
$5,576.51 |
$5,576.51 |
$5,576.51 |
$3,429.40
|
|
Intracranial complete study
|
$4,361.58 |
$4,361.58 |
$4,361.58 |
$900.50
|
|
Intrapul surf admin endo tube
|
$658.02 |
$658.02 |
$658.02 |
$220.80
|
|
Intraventricular pacing
|
$5,708.52 |
$5,708.52 |
$5,708.52 |
$5,609.50
|
|
Intrinsic factor antibody
|
$686.24 |
$686.24 |
$686.24 |
$66.60
|
|
Intro long gi tube w/mult fluo
|
$1,636.51 |
$1,636.51 |
$1,636.51 |
$449.40
|
|
Ipratropium bromide non-comp
|
$45.34 |
$45.34 |
$45.34 |
$3.75
|
|
Iron binding capacity
|
$346.85 |
$346.85 |
$346.85 |
$63.79
|
|
Iron stain peripheral blood
|
$872.33 |
$872.33 |
$872.33 |
$30.55
|
|
Irradiation of blood product each unit reference
|
$337.02 |
$337.02 |
$337.02 |
$119.83
|
|
Ivc venogram s&i
|
$8,622.19 |
$8,622.19 |
$8,622.19 |
$3,316.95
|
|
IV inj ra drug dx study
|
$2,216.11 |
$2,216.11 |
$2,216.11 |
$549.70
|
|
Ivp w/nephrotomography
|
$2,917.88 |
$2,917.88 |
$2,917.88 |
$790.08
|
|
Ivp w/wo kub w/wo tomography
|
$3,336.46 |
$3,336.46 |
$3,336.46 |
$692.18
|
|
John cunningham antibody
|
$967.60 |
$967.60 |
$967.60 |
$72.60
|
|
Kafo fem fx cast molded to p
|
$10,441.00 |
$10,441.00 |
$10,441.00 |
$3,130.66
|
|
Ketogenic steroids fract
|
$1,597.29 |
$1,597.29 |
$1,597.29 |
$82.74
|
|
Kidney function study
|
$5,103.44 |
$5,103.44 |
$5,103.44 |
$783.86
|
|
Kidney imaging morphology
|
$6,571.04 |
$6,571.04 |
$6,571.04 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$12,567.79 |
$12,567.79 |
$12,567.79 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$5,103.44 |
$5,103.44 |
$5,103.44 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$2,033.62 |
$2,033.62 |
$2,033.62 |
$666.00
|
|
Knee disc/dial lock/adj flex
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$288.41
|
|
Ko rigid without joints pre ots
|
$207.00 |
$207.00 |
$207.00 |
$214.97
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$350.86 |
$350.86 |
$350.86 |
$175.92
|
|
Lactoferrin fecal quant
|
$136.96 |
$136.96 |
$136.96 |
$106.10
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$4,345.74 |
$4,345.74 |
$4,345.74 |
$1,088.26
|
|
Leishmania antibody
|
$285.83 |
$285.83 |
$285.83 |
$68.25
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$236.57 |
$236.57 |
$236.57 |
$163.62
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$10,681.77 |
$10,681.77 |
$10,681.77 |
$9,107.80
|
|
Levalbuterol non-comp con
|
$133.10 |
$133.10 |
$133.10 |
$21.60
|
|
Levalbuterol non-comp unit
|
$120.02 |
$120.02 |
$120.02 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$764.27 |
$764.27 |
$764.27 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$918.47 |
$918.47 |
$918.47 |
$88.92
|