|
Ihc/icc per specimen initial single antibody stain
|
$890.85 |
$890.85 |
$890.85 |
$265.60
|
|
Immunoassay tumor antigen quantitative ca 125
|
$783.17 |
$783.17 |
$783.17 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$763.58 |
$763.58 |
$763.58 |
$111.07
|
|
Immunodiff gel qual ea antigen/ab
|
$620.95 |
$620.95 |
$620.95 |
$53.95
|
|
Implant ureth bulk agent
|
$9,837.00 |
$9,837.00 |
$9,837.00 |
$1,524.80
|
|
In-111 autol wbc diag per dose
|
$6,228.06 |
$6,228.06 |
$6,228.06 |
$3,704.00
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$926.09 |
$926.09 |
$926.09 |
$1,099.05
|
|
Infect ag ia optc obs influenza
|
$1,166.37 |
$1,166.37 |
$1,166.37 |
$65.58
|
|
Infect ag if legionella pneumophila
|
$1,704.79 |
$1,704.79 |
$1,704.79 |
$75.79
|
|
Infect ag na chlamydia trachomatis qnt
|
$458.71 |
$458.71 |
$458.71 |
$58.82
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$283.90 |
$283.90 |
$283.90 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$783.17 |
$783.17 |
$783.17 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$783.17 |
$783.17 |
$783.17 |
$76.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$959.37 |
$959.37 |
$959.37 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$748.21 |
$748.21 |
$748.21 |
$56.78
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$2,510.34 |
$2,510.34 |
$2,510.34 |
$173.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$70.39 |
$70.39 |
$70.39 |
$100.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$76.98 |
$76.98 |
$76.98 |
$97.50
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,322.99 |
$1,322.99 |
$1,322.99 |
$228.38
|
|
Initiation & management bipap/cpap initial day
|
$8,976.24 |
$8,976.24 |
$8,976.24 |
$627.00
|
|
Inj, bupivacaine liposome
|
$2,795.94 |
$2,795.94 |
$2,795.94 |
$1,040.36
|
|
Inj, cefiderocol, 10 mg
|
$675.27 |
$675.27 |
$675.27 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$542.27 |
$542.27 |
$542.27 |
$333.00
|
|
Inj crotalidae im f(ab')2 eq
|
$4,558.95 |
$4,558.95 |
$4,558.95 |
$2,735.85
|
|
Injection, cangrelor
|
$2,966.55 |
$2,966.55 |
$2,966.55 |
$2,161.85
|
|
Injection epidural blood patch or clot
|
$3,712.55 |
$3,712.55 |
$3,712.55 |
$1,447.86
|
|
Injection,onabotulinumtoxina
|
$1,612.48 |
$1,612.48 |
$1,612.48 |
$2,154.07
|
|
Inj hydroxocobalamin IV 25mg
|
$2,252.07 |
$2,252.07 |
$2,252.07 |
$3,180.35
|
|
Inj levocarnitine per 1 gm
|
$854.39 |
$854.39 |
$854.39 |
$122.28
|
|
Inj., meropenem, vaborbactam
|
$1,007.81 |
$1,007.81 |
$1,007.81 |
$618.43
|
|
Inj multihance
|
$3.96 |
$3.96 |
$3.96 |
$120.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$4,717.26 |
$4,717.26 |
$4,717.26 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$638.28 |
$638.28 |
$638.28 |
$653.00
|
|
Inj w/fluor eval cv device
|
$1,766.90 |
$1,766.90 |
$1,766.90 |
$593.60
|
|
Ins cath ren art 1st bi
|
$6,983.05 |
$6,983.05 |
$6,983.05 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$5,720.59 |
$5,720.59 |
$5,720.59 |
$4,628.00
|
|
Ins cath ren art 2nd+ bi
|
$18,979.92 |
$18,979.92 |
$18,979.92 |
$5,349.00
|
|
Ins cath ren art 2nd+ uni
|
$6,983.05 |
$6,983.05 |
$6,983.05 |
$5,528.94
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$22,063.32 |
$22,063.32 |
$22,063.32 |
$4,782.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,284.90 |
$4,284.90 |
$4,284.90 |
$6,832.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$8,666.79 |
$8,666.79 |
$8,666.79 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$85,513.56 |
$85,513.56 |
$85,513.56 |
$13,588.90
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$85,513.56 |
$85,513.56 |
$85,513.56 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$8,354.98 |
$8,354.98 |
$8,354.98 |
$2,079.43
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$277,297.16 |
$277,297.16 |
$277,297.16 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$63,369.86 |
$63,369.86 |
$63,369.86 |
$7,216.00
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$56,579.44 |
$56,579.44 |
$56,579.44 |
$7,504.00
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$56,123.51 |
$56,123.51 |
$56,123.51 |
$9,746.29
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$7,827.00 |
$7,827.00 |
$7,827.00 |
$5,423.04
|
|
Insert pm/icd lead dual
|
$56,579.44 |
$56,579.44 |
$56,579.44 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$247,587.01 |
$247,587.01 |
$247,587.01 |
$33,948.20
|
|
Insert vad art access left hrt arterial access
|
$25,308.86 |
$25,308.86 |
$25,308.86 |
$5,135.65
|
|
Ins icd gen exist mlt leads
|
$227,143.68 |
$227,143.68 |
$227,143.68 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$163,696.22 |
$163,696.22 |
$163,696.22 |
$24,844.79
|
|
Ins lv lead exist pm/icd
|
$70,046.64 |
$70,046.64 |
$70,046.64 |
$12,384.25
|
|
Ins pm gen exist dual lead
|
$163,696.22 |
$163,696.22 |
$163,696.22 |
$24,696.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$24,265.35 |
$24,265.35 |
$24,265.35 |
$24,135.54
|
|
Ins/rpl pm w/tv ld atrl
|
$70,046.64 |
$70,046.64 |
$70,046.64 |
$12,384.25
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$22,833.82 |
$22,833.82 |
$22,833.82 |
$25,106.90
|
|
Instill, bupivac and meloxic
|
$864.54 |
$864.54 |
$864.54 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$13,374.35 |
$13,374.35 |
$13,374.35 |
$4,341.66
|
|
Insulin total
|
$861.48 |
$861.48 |
$861.48 |
$67.50
|
|
Integra meshed bil wound mat
|
$1,350.00 |
$1,350.00 |
$1,350.00 |
$8,521.10
|
|
Interdiscal perq aspir dx
|
$4,343.10 |
$4,343.10 |
$4,343.10 |
$1,222.26
|
|
Intro cath dialysis circuit
|
$10,224.42 |
$10,224.42 |
$10,224.42 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$14,859.94 |
$14,859.94 |
$14,859.94 |
$8,683.70
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$14,859.94 |
$14,859.94 |
$14,859.94 |
$15,762.09
|
|
Iodine i-123 sod iodide mil
|
$338.68 |
$338.68 |
$338.68 |
$688.38
|
|
Iron
|
$980.36 |
$980.36 |
$980.36 |
$72.15
|
|
Iron binding capacity
|
$1,359.35 |
$1,359.35 |
$1,359.35 |
$61.47
|
|
Irrigation implantable venous access device for drug delivery systems
|
$635.69 |
$635.69 |
$635.69 |
$153.75
|
|
Ivc venogram s&i
|
$7,473.61 |
$7,473.61 |
$7,473.61 |
$3,258.00
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$523.04 |
$523.04 |
$523.04 |
$52.80
|
|
Kidney img w/bldflw sgl without rx
|
$7,842.55 |
$7,842.55 |
$7,842.55 |
$1,468.04
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$476.13 |
$476.13 |
$476.13 |
$207.29
|
|
Lactic acid
|
$1,050.29 |
$1,050.29 |
$1,050.29 |
$100.65
|
|
Lead capillary
|
$696.46 |
$696.46 |
$696.46 |
$62.40
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$718.16 |
$718.16 |
$718.16 |
$120.34
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$24,475.08 |
$24,475.08 |
$24,475.08 |
$4,799.28
|
|
Levetiracetam therapeutic drug level
|
$1,492.21 |
$1,492.21 |
$1,492.21 |
$74.92
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$51.84 |
$51.84 |
$51.84 |
$35.62
|
|
Lig/band angioaccess av fistula
|
$15,132.93 |
$15,132.93 |
$15,132.93 |
$4,240.23
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$1,547.42 |
$1,547.42 |
$1,547.42 |
$130.49
|
|
Lipase
|
$1,110.42 |
$1,110.42 |
$1,110.42 |
$81.25
|
|
Lithium therapeutic drug level
|
$1,124.41 |
$1,124.41 |
$1,124.41 |
$66.43
|
|
Liver Function Test
|
$1,390.12 |
$1,390.12 |
$1,390.12 |
$111.13
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$425.88 |
$425.88 |
$425.88 |
$37.37
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$18,152.95 |
$18,152.95 |
$18,152.95 |
$2,893.15
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$13,106.54 |
$13,106.54 |
$13,106.54 |
$2,441.25
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$13,110.77 |
$13,110.77 |
$13,110.77 |
$2,013.08
|
|
Lung Function Test (Spirometry)
|
$1,901.08 |
$1,901.08 |
$1,901.08 |
$295.35
|
|
Lung perfusion imaging
|
$8,325.40 |
$8,325.40 |
$8,325.40 |
$1,082.75
|
|
Magnesium
|
$1,110.42 |
$1,110.42 |
$1,110.42 |
$72.57
|
|
Manipulation chest wall demonstration/evaluation subsequent
|
$670.96 |
$670.96 |
$670.96 |
$136.64
|
|
Manipulation chest wall initial demonstration/evaluation
|
$955.86 |
$955.86 |
$955.86 |
$163.15
|
|
Mannitol 12.5 gm/50 ml inj
|
$224.85 |
$224.85 |
$224.85 |
$40.12
|
|
Mayo a1app alpha 1 antitrypsin phenotype
|
$904.83 |
$904.83 |
$904.83 |
$71.78
|
|
Mayo aathr protein s free
|
$1,184.53 |
$1,184.53 |
$1,184.53 |
$134.55
|
|
Mayo activated protein c resistance assay
|
$791.55 |
$791.55 |
$791.55 |
$100.10
|
|
Mayo alkaline phosphatase isoenzyme
|
$946.79 |
$946.79 |
$946.79 |
$66.30
|