|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$4,188.15 |
$4,188.15 |
$4,188.15 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$3,278.10 |
$3,278.10 |
$3,278.10 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$888.30 |
$888.30 |
$888.30 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$786.15 |
$786.15 |
$786.15 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$10,273.50 |
$10,273.50 |
$10,273.50 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$4,231.35 |
$4,231.35 |
$4,231.35 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$1,505.25 |
$1,505.25 |
$1,505.25 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$2,506.50 |
$2,506.50 |
$2,506.50 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,295.25 |
$1,295.25 |
$1,295.25 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$1,381.86 |
$1,381.86 |
$1,381.86 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$14,739.90 |
$14,739.90 |
$14,739.90 |
$33,948.20
|
|
Insert sq defib electrode
|
$2,809.65 |
$2,809.65 |
$2,809.65 |
$8,167.68
|
|
Insert swan-ganz cath
|
$7,584.45 |
$7,584.45 |
$7,584.45 |
$2,164.52
|
|
Insert uteri tandem/ovoids
|
$684.30 |
$684.30 |
$684.30 |
$3,986.00
|
|
Insert vad art access left hrt arterial access
|
$1,846.65 |
$1,846.65 |
$1,846.65 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$11,040.60 |
$11,040.60 |
$11,040.60 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$6,620.55 |
$6,620.55 |
$6,620.55 |
$24,159.72
|
|
In situ hybridization per specimen initial single probe stain
|
$211.65 |
$211.65 |
$211.65 |
$338.40
|
|
Insj perq vad r hrt venous
|
$779.36 |
$779.36 |
$779.36 |
$4,981.60
|
|
Ins lv lead exist pm/icd
|
$4,822.80 |
$4,822.80 |
$4,822.80 |
$12,384.25
|
|
Ins picad w subq port 5yr>
|
$2,979.15 |
$2,979.15 |
$2,979.15 |
$4,341.66
|
|
Ins pm gen exist dual lead
|
$7,854.00 |
$7,854.00 |
$7,854.00 |
$24,696.00
|
|
Ins pm gen w/exist mlt leads
|
$7,002.01 |
$7,002.01 |
$7,002.01 |
$15,600.75
|
|
Ins pq tunnld ip cath w/img
|
$589.50 |
$589.50 |
$589.50 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$7,709.85 |
$7,709.85 |
$7,709.85 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$2,002.86 |
$2,002.86 |
$2,002.86 |
$11,593.70
|
|
Ins/rpl pm gen exist sgl lead
|
$2,012.45 |
$2,012.45 |
$2,012.45 |
$9,746.29
|
|
Ins/rpl pm w/tv ld atrl
|
$3,955.50 |
$3,955.50 |
$3,955.50 |
$12,384.25
|
|
Instillation anticarcinogenic agent bladder
|
$988.05 |
$988.05 |
$988.05 |
$721.50
|
|
Ins tun cvad 2 cath w/subq port(s)
|
$410.85 |
$410.85 |
$410.85 |
$6,396.57
|
|
Ins tun cv cath wo subq prt/pm
|
$897.00 |
$897.00 |
$897.00 |
$4,748.00
|
|
Insulin total
|
$52.18 |
$52.18 |
$52.18 |
$67.60
|
|
Ins vag brachytx device
|
$163.80 |
$163.80 |
$163.80 |
$909.35
|
|
Intra-atrial pacing
|
$2,524.79 |
$2,524.79 |
$2,524.79 |
$5,155.51
|
|
Intracard echo interv w/s&i
|
$185.55 |
$185.55 |
$185.55 |
$3,982.59
|
|
Intraventricular pacing
|
$1,198.80 |
$1,198.80 |
$1,198.80 |
$5,775.22
|
|
Intrinsic factor antibody
|
$50.95 |
$50.95 |
$50.95 |
$59.95
|
|
Intro cath dialysis circuit
|
$1,237.35 |
$1,237.35 |
$1,237.35 |
$2,317.80
|
|
Intro catheter aorta
|
$362.40 |
$362.40 |
$362.40 |
$1,861.61
|
|
Intro cath svc/ivc
|
$123.45 |
$123.45 |
$123.45 |
$1,350.75
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$141.00 |
$141.00 |
$141.00 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$126.90 |
$126.90 |
$126.90 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$171.45 |
$171.45 |
$171.45 |
$617.60
|
|
Iodine i-123 sod iodide mil
|
$193.35 |
$193.35 |
$193.35 |
$677.98
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$9.12 |
$9.12 |
$9.12 |
$149.13
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$112.36 |
$112.36 |
$112.36 |
$153.98
|
|
Ipratropium bromide non-comp
|
$7.13 |
$7.13 |
$7.13 |
$7.57
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$399.30 |
$399.30 |
$399.30 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$562.21 |
$562.21 |
$562.21 |
$6,655.71
|
|
Iron
|
$34.80 |
$34.80 |
$34.80 |
$70.72
|
|
Iron binding capacity
|
$49.80 |
$49.80 |
$49.80 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$130.14 |
$130.14 |
$130.14 |
$62.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$200.42 |
$200.42 |
$200.42 |
$198.01
|
|
Irrigation implantable venous access device for drug delivery systems
|
$83.55 |
$83.55 |
$83.55 |
$154.50
|
|
Ivc venogram s&i
|
$1,258.35 |
$1,258.35 |
$1,258.35 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$47.85 |
$47.85 |
$47.85 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$50.70 |
$50.70 |
$50.70 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$44.85 |
$44.85 |
$44.85 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$179.40 |
$179.40 |
$179.40 |
$460.85
|
|
Ivp w/wo kub w/wo tomography
|
$240.60 |
$240.60 |
$240.60 |
$713.05
|
|
Jak2 targeted sequence analysis
|
$191.25 |
$191.25 |
$191.25 |
$378.30
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$22.35 |
$22.35 |
$22.35 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$144.60 |
$144.60 |
$144.60 |
$30.08
|
|
Kidney img w/bldflw sgl without rx
|
$974.70 |
$974.70 |
$974.70 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$545.85 |
$545.85 |
$545.85 |
$668.25
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$7,402.82 |
$7,402.82 |
$7,402.82 |
$9,384.04
|
|
Kit ipg optimizer smart
|
$40,950.00 |
$40,950.00 |
$40,950.00 |
$46,737.60
|
|
Kit lead specify 5-6-5
|
$7,910.13 |
$7,910.13 |
$7,910.13 |
$17,205.92
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$702.93 |
$702.93 |
$702.93 |
$1,357.69
|
|
Knee MRI (with and without contrast)
|
$2,608.50 |
$2,608.50 |
$2,608.50 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,241.30 |
$2,241.30 |
$2,241.30 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,606.80 |
$1,606.80 |
$1,606.80 |
$2,181.10
|
|
Knee X-ray
|
$223.50 |
$223.50 |
$223.50 |
$443.90
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$23.52 |
$23.52 |
$23.52 |
$42.38
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$188.92 |
$188.92 |
$188.92 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$42.75 |
$42.75 |
$42.75 |
$53.30
|
|
Lactated ringers intravenous solution
|
$47.66 |
$47.66 |
$47.66 |
$54.11
|
|
Lactic acid
|
$53.25 |
$53.25 |
$53.25 |
$102.90
|
|
Lactoferrin fecal quant
|
$39.75 |
$39.75 |
$39.75 |
$106.10
|
|
Lead acuity x4 spiral l 86cm
|
$9,747.68 |
$9,747.68 |
$9,747.68 |
$5,831.00
|
|
Lead capillary
|
$23.40 |
$23.40 |
$23.40 |
$62.40
|
|
Lead ingevity 45cm pfret MRI
|
$2,027.19 |
$2,027.19 |
$2,027.19 |
$3,842.56
|
|
Lead tachy durata sj4 58cm
|
$2,835.16 |
$2,835.16 |
$2,835.16 |
$6,551.30
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$622.50 |
$622.50 |
$622.50 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$297.73 |
$297.73 |
$297.73 |
$146.32
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$38,606.44 |
$38,606.44 |
$38,606.44 |
$3,271.64
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$201.87 |
$201.87 |
$201.87 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$68.70 |
$68.70 |
$68.70 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$97.03 |
$97.03 |
$97.03 |
$66.59
|
|
Liberta rc ipg
|
$15,561.63 |
$15,561.63 |
$15,561.63 |
$39,406.68
|
|
Lidocaine (pf) 4 mg/ml (0.4 %) in 5 % dextrose intravenous solution
|
$30.08 |
$30.08 |
$30.08 |
$49.11
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$318.12 |
$318.12 |
$318.12 |
$177.90
|
|
Lipase
|
$43.20 |
$43.20 |
$43.20 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$47.85 |
$47.85 |
$47.85 |
$89.52
|
|
Lipoprotein blood quant
|
$44.70 |
$44.70 |
$44.70 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$24.48 |
$24.48 |
$24.48 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$22.35 |
$22.35 |
$22.35 |
$60.00
|
|
Lithium therapeutic drug level
|
$54.00 |
$54.00 |
$54.00 |
$67.60
|
|
Lithotripsy transluminal coronary percutaneous
|
$2,570.85 |
$2,570.85 |
$2,570.85 |
$4,371.12
|
|
Liver Function Test
|
$115.20 |
$115.20 |
$115.20 |
$110.50
|