|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,802.16 |
$1,802.16 |
$1,802.16 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$1,434.76 |
$1,434.76 |
$1,434.76 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$151.73 |
$151.73 |
$151.73 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$2,197.80 |
$2,197.80 |
$2,197.80 |
$201.60
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$360.69 |
$360.69 |
$360.69 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$331.95 |
$331.95 |
$331.95 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$2,284.90 |
$2,284.90 |
$2,284.90 |
$711.93
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,319.33 |
$1,319.33 |
$1,319.33 |
$238.80
|
|
Infliximab 100 mg intravenous solution
|
$12,946.17 |
$12,946.17 |
$12,946.17 |
$2,080.86
|
|
Infuse radioactive materials
|
$4,112.83 |
$4,112.83 |
$4,112.83 |
$744.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$679.52 |
$679.52 |
$679.52 |
$293.04
|
|
Inj allopurinol sodium 1 mg
|
$11,757.59 |
$11,757.59 |
$11,757.59 |
$6,968.99
|
|
Inj, artesunate, 1mg
|
$33,132.95 |
$33,132.95 |
$33,132.95 |
$14,460.21
|
|
Inj beta interferon sq 1 mcg
|
$4,795.07 |
$4,795.07 |
$4,795.07 |
$2,856.95
|
|
Inj calcitriol per 0.1 mcg
|
$562.06 |
$562.06 |
$562.06 |
$22.69
|
|
Inj, cefiderocol, 10 mg
|
$1,150.75 |
$1,150.75 |
$1,150.75 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$1,551.42 |
$1,551.42 |
$1,551.42 |
$408.00
|
|
Inj, clevidipine butyrate
|
$3,348.25 |
$3,348.25 |
$3,348.25 |
$4.86
|
|
Inj crotalidae im f(ab')2 eq
|
$5,294.88 |
$5,294.88 |
$5,294.88 |
$2,613.60
|
|
Inj dx for sinogram
|
$2,011.02 |
$2,011.02 |
$2,011.02 |
$413.82
|
|
Injection, caplacizumab-yhdp
|
$46,642.99 |
$46,642.99 |
$46,642.99 |
$16,642.50
|
|
Injection during cath supravalvular aortography
|
$4,940.19 |
$4,940.19 |
$4,940.19 |
$904.17
|
|
Injection, fulvestrant
|
$8,501.59 |
$8,501.59 |
$8,501.59 |
$1,719.16
|
|
Injection glatiramer acetate
|
$1,713.99 |
$1,713.99 |
$1,713.99 |
$830.51
|
|
Injection,onabotulinumtoxina
|
$10,085.22 |
$10,085.22 |
$10,085.22 |
$2,241.61
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$4,940.19 |
$4,940.19 |
$4,940.19 |
$1,237.50
|
|
Inj hrt cath w/s&i sel hrt ang
|
$12,687.90 |
$12,687.90 |
$12,687.90 |
$1,757.00
|
|
Inj hrt cath w/s&i sel left vent
|
$12,687.90 |
$12,687.90 |
$12,687.90 |
$1,071.00
|
|
Inj hrt cath w/s&i sel right vent
|
$12,687.90 |
$12,687.90 |
$12,687.90 |
$947.05
|
|
Inj hydroxocobalamin IV 25mg
|
$5,121.66 |
$5,121.66 |
$5,121.66 |
$2,452.32
|
|
Inj labetalol hcl hikma, 5mg
|
$29.37 |
$29.37 |
$29.37 |
$40.00
|
|
Inj levocarnitine per 1 gm
|
$367.44 |
$367.44 |
$367.44 |
$136.62
|
|
Inj melpha hydroch nos 50 mg
|
$25,959.16 |
$25,959.16 |
$25,959.16 |
$2,375.23
|
|
Inj, micafungin (par pharm)
|
$842.69 |
$842.69 |
$842.69 |
$89.40
|
|
Inj. mycophenolate mofetil
|
$779.26 |
$779.26 |
$779.26 |
$252.66
|
|
Inj, pedmark, 100 mg
|
$945.84 |
$945.84 |
$945.84 |
$123.00
|
|
Inj progesterone per 50 mg
|
$946.52 |
$946.52 |
$946.52 |
$14.93
|
|
Inj secretin synthetic human
|
$7,666.76 |
$7,666.76 |
$7,666.76 |
$1,285.20
|
|
Inj testosterone cypionate
|
$38.24 |
$38.24 |
$38.24 |
$62.80
|
|
Insert cath pleura with image
|
$8,177.49 |
$8,177.49 |
$8,177.49 |
$2,194.40
|
|
Insert hepatic shunt (tips)
|
$84,324.00 |
$84,324.00 |
$84,324.00 |
$8,367.70
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$25,680.69 |
$25,680.69 |
$25,680.69 |
$4,731.80
|
|
Insertion of catheter vein
|
$1,682.42 |
$1,682.42 |
$1,682.42 |
$836.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$32,294.15 |
$32,294.15 |
$32,294.15 |
$12,508.08
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$85,429.63 |
$85,429.63 |
$85,429.63 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$8,371.07 |
$8,371.07 |
$8,371.07 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$11,792.88 |
$11,792.88 |
$11,792.88 |
$2,414.10
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$6,124.94 |
$6,124.94 |
$6,124.94 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$6,804.48 |
$6,804.48 |
$6,804.48 |
$7,342.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$14,099.32 |
$14,099.32 |
$14,099.32 |
$9,397.50
|
|
Insert pm/icd lead dual
|
$6,804.48 |
$6,804.48 |
$6,804.48 |
$7,388.80
|
|
Insert/repl sq defib w/eltrd
|
$219,487.80 |
$219,487.80 |
$219,487.80 |
$33,297.72
|
|
Insert swan-ganz cath
|
$6,491.69 |
$6,491.69 |
$6,491.69 |
$2,210.50
|
|
Insert vad art access left hrt arterial access
|
$34,003.99 |
$34,003.99 |
$34,003.99 |
$4,221.97
|
|
Ins icd gen exist sgl lead
|
$124,643.95 |
$124,643.95 |
$124,643.95 |
$23,742.75
|
|
Insitu hybridization manual
|
$2,061.55 |
$2,061.55 |
$2,061.55 |
$388.20
|
|
Insj perq vad r hrt venous
|
$34,003.99 |
$34,003.99 |
$34,003.99 |
$3,345.87
|
|
Ins lv lead exist pm/icd
|
$8,501.45 |
$8,501.45 |
$8,501.45 |
$12,087.24
|
|
Ins picad w subq port 5yr>
|
$15,182.88 |
$15,182.88 |
$15,182.88 |
$3,912.93
|
|
Ins pq tunnld ip cath w/img
|
$22,418.94 |
$22,418.94 |
$22,418.94 |
$5,377.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$51,071.19 |
$51,071.19 |
$51,071.19 |
$23,369.00
|
|
Ins/rpl pm gen exist dual lead
|
$30,688.99 |
$30,688.99 |
$30,688.99 |
$11,408.40
|
|
Ins/rpl pm gen exist sgl lead
|
$18,600.73 |
$18,600.73 |
$18,600.73 |
$9,558.78
|
|
Ins/rpl pm w/tv ld atrl
|
$18,420.74 |
$18,420.74 |
$18,420.74 |
$12,371.40
|
|
Insulin total
|
$1,029.18 |
$1,029.18 |
$1,029.18 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$37,800.00 |
$37,800.00 |
$37,800.00 |
$8,629.72
|
|
Interdiscal perq aspir dx
|
$2,665.66 |
$2,665.66 |
$2,665.66 |
$1,180.84
|
|
Interferon gamma 1-b inj
|
$4,403.52 |
$4,403.52 |
$4,403.52 |
$9,879.00
|
|
Interrog evl pm/ldls pm ip
|
$321.86 |
$321.86 |
$321.86 |
$124.80
|
|
Intracard echo interv w/s&i
|
$7,171.37 |
$7,171.37 |
$7,171.37 |
$3,429.40
|
|
Intracran angioplsty w/stent
|
$122,580.73 |
$122,580.73 |
$122,580.73 |
$8,440.20
|
|
Intracranial angioplasty
|
$98,064.59 |
$98,064.59 |
$98,064.59 |
$5,099.25
|
|
Intrapul surf admin endo tube
|
$1,105.62 |
$1,105.62 |
$1,105.62 |
$220.80
|
|
Intrinsic factor antibody
|
$987.49 |
$987.49 |
$987.49 |
$66.60
|
|
Intro catheter aorta
|
$6,822.84 |
$6,822.84 |
$6,822.84 |
$1,654.05
|
|
Intro cath svc/ivc
|
$3,193.77 |
$3,193.77 |
$3,193.77 |
$1,329.90
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$3,085.43 |
$3,085.43 |
$3,085.43 |
$3,303.76
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$2,178.18 |
$2,178.18 |
$2,178.18 |
$1,633.03
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$1,699.16 |
$1,699.16 |
$1,699.16 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$43.35 |
$43.35 |
$43.35 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$15,465.92 |
$15,465.92 |
$15,465.92 |
$163.87
|
|
Iron
|
$684.52 |
$684.52 |
$684.52 |
$74.40
|
|
Iron binding capacity
|
$756.66 |
$756.66 |
$756.66 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$806.81 |
$806.81 |
$806.81 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1,315.76 |
$1,315.76 |
$1,315.76 |
$187.06
|
|
Ivp w/wo kub w/wo tomography
|
$2,933.19 |
$2,933.19 |
$2,933.19 |
$692.18
|
|
Ixabepilone 15 mg intravenous solution
|
$53,228.64 |
$53,228.64 |
$53,228.64 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$1,015.32 |
$1,015.32 |
$1,015.32 |
$379.87
|
|
Kafo fem fx cast molded to p
|
$16,729.00 |
$16,729.00 |
$16,729.00 |
$3,130.66
|
|
Kafo fem fx cast thermoplas
|
$17,807.00 |
$17,807.00 |
$17,807.00 |
$2,710.45
|
|
Kafo femoral fx cast rigid
|
$10,686.00 |
$10,686.00 |
$10,686.00 |
$2,138.81
|
|
Ketogenic steroids fract
|
$841.62 |
$841.62 |
$841.62 |
$82.74
|
|
Kidney function study
|
$4,711.24 |
$4,711.24 |
$4,711.24 |
$783.86
|
|
Kidney img w/bldflw sgl without rx
|
$7,484.93 |
$7,484.93 |
$7,484.93 |
$1,427.40
|
|
Knee disc/dial lock/adj flex
|
$3,007.00 |
$3,007.00 |
$3,007.00 |
$288.41
|
|
Knee joint cam lock each joi
|
$1,084.00 |
$1,084.00 |
$1,084.00 |
$287.46
|
|
Ko swedish type pre ots
|
$2,760.00 |
$2,760.00 |
$2,760.00 |
$604.50
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$1,099.49 |
$1,099.49 |
$1,099.49 |
$175.92
|
|
Lactoferrin fecal qualitative
|
$85.18 |
$85.18 |
$85.18 |
$80.40
|
|
Levalbuterol non-comp con
|
$255.86 |
$255.86 |
$255.86 |
$21.60
|
