|
Inj, uzedy, 1 mg
|
$2,836.80 |
$2,836.80 |
$2,836.80 |
$24.77
|
|
Inj, vasopressin (baxter)
|
$32.40 |
$32.40 |
$32.40 |
$32.40
|
|
Inj w/fluor eval cv device
|
$330.21 |
$330.21 |
$330.21 |
$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
|
|
Ins cath ren art 1st bi
|
$2,185.65 |
$2,185.65 |
$2,185.65 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$1,742.04 |
$1,742.04 |
$1,742.04 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$2,185.65 |
$2,185.65 |
$2,185.65 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$1,796.85 |
$1,796.85 |
$1,796.85 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$182.34 |
$182.34 |
$182.34 |
$544.00
|
|
Insertion catheter bladder non indwelling
|
$163.26 |
$163.26 |
$163.26 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$176.22 |
$176.22 |
$176.22 |
$273.60
|
|
Insertion of catheter vein
|
$669.60 |
$669.60 |
$669.60 |
$858.05
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,346.58 |
$1,346.58 |
$1,346.58 |
$2,079.43
|
|
Insert/repl sq defib w/eltrd
|
$35,549.10 |
$35,549.10 |
$35,549.10 |
$33,948.20
|
|
Insert sq defib electrode
|
$373.77 |
$373.77 |
$373.77 |
$8,167.68
|
|
Ins icd gen exist sgl lead
|
$35,549.10 |
$35,549.10 |
$35,549.10 |
$24,159.72
|
|
Insitu hybridization manual
|
$354.24 |
$354.24 |
$354.24 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$146.34 |
$146.34 |
$146.34 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$286.74 |
$286.74 |
$286.74 |
$338.40
|
|
Insti hexaminolevulinate hcl
|
$398.52 |
$398.52 |
$398.52 |
$2,359.80
|
|
Insulin total
|
$95.49 |
$95.49 |
$95.49 |
$67.60
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$1,912.68 |
$1,912.68 |
$1,912.68 |
$10,179.63
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$2,755.62 |
$2,755.62 |
$2,755.62 |
$3,160.50
|
|
Intens cardiac rehab no exer
|
$147.51 |
$147.51 |
$147.51 |
$149.00
|
|
Intens cardiac rehab w/exerc
|
$226.98 |
$226.98 |
$226.98 |
$226.98
|
|
Interferon alfa-2b inj
|
$21.24 |
$21.24 |
$21.24 |
$494.64
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$104.31 |
$104.31 |
$104.31 |
$3,853.81
|
|
Interrog evl pm/ldls pm ip
|
$76.95 |
$76.95 |
$76.95 |
$127.20
|
|
Intra-atrial pacing
|
$5,644.35 |
$5,644.35 |
$5,644.35 |
$5,155.51
|
|
Intra-atrial recording
|
$5,644.35 |
$5,644.35 |
$5,644.35 |
$5,707.00
|
|
Intracard echo interv w/s&i
|
$270.18 |
$270.18 |
$270.18 |
$3,982.59
|
|
Intracranial complete study
|
$1,059.93 |
$1,059.93 |
$1,059.93 |
$883.30
|
|
Intracranial limited study
|
$221.58 |
$221.58 |
$221.58 |
$423.52
|
|
Intrapul surf admin endo tube
|
$50.31 |
$50.31 |
$50.31 |
$239.52
|
|
Intraventricular pacing
|
$5,644.35 |
$5,644.35 |
$5,644.35 |
$5,775.22
|
|
Intrinsic factor antibody
|
$132.66 |
$132.66 |
$132.66 |
$59.95
|
|
Intro catheter aorta
|
$225.90 |
$225.90 |
$225.90 |
$1,861.61
|
|
Intro cath svc/ivc
|
$115.74 |
$115.74 |
$115.74 |
$1,350.75
|
|
Intro long gi tube
|
$560.70 |
$560.70 |
$560.70 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$298.35 |
$298.35 |
$298.35 |
$477.85
|
|
Intubation endotracheal emergency procedure
|
$245.79 |
$245.79 |
$245.79 |
$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
|
$2,307.24 |
$2,307.24 |
$2,307.24 |
$153.98
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$9,024.48 |
$9,024.48 |
$9,024.48 |
$52,615.16
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$327.87 |
$327.87 |
$327.87 |
$227.39
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$1,067.90 |
$1,067.90 |
$1,067.90 |
$6,655.71
|
|
Iron
|
$54.99 |
$54.99 |
$54.99 |
$70.72
|
|
Iron binding capacity
|
$61.47 |
$61.47 |
$61.47 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$33.75 |
$33.75 |
$33.75 |
$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
|
$102.15 |
$102.15 |
$102.15 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$126.81 |
$126.81 |
$126.81 |
$154.50
|
|
Ivc venogram s&i
|
$919.26 |
$919.26 |
$919.26 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$145.80 |
$145.80 |
$145.80 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$169.29 |
$169.29 |
$169.29 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$94.68 |
$94.68 |
$94.68 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$315.00 |
$315.00 |
$315.00 |
$460.85
|
|
IV inj ra drug dx study
|
$525.69 |
$525.69 |
$525.69 |
$560.00
|
|
Ivp w/wo kub w/wo tomography
|
$354.51 |
$354.51 |
$354.51 |
$713.05
|
|
Ixabepilone 15 mg intravenous solution
|
$4,714.11 |
$4,714.11 |
$4,714.11 |
$7,216.15
|
|
Jak2 targeted sequence analysis
|
$329.76 |
$329.76 |
$329.76 |
$378.30
|
|
Ketogenic steroids fract
|
$129.15 |
$129.15 |
$129.15 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$167.49 |
$167.49 |
$167.49 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.15 |
$12.15 |
$12.15 |
$30.08
|
|
Kidney imaging morphology
|
$1,026.81 |
$1,026.81 |
$1,026.81 |
$785.00
|
|
Kidney imag w/bld flow multi
|
$1,026.81 |
$1,026.81 |
$1,026.81 |
$1,566.50
|
|
Kidney img w/bldflw sgl without rx
|
$1,180.80 |
$1,180.80 |
$1,180.80 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$317.34 |
$317.34 |
$317.34 |
$668.25
|
|
Kit irrigator stoma cone 7721
|
$30.51 |
$30.51 |
$30.51 |
$7.20
|
|
Kit trach suct cls 30.5cm
|
$10.44 |
$10.44 |
$10.44 |
$28.20
|
|
Knee MRI (with and without contrast)
|
$1,501.02 |
$1,501.02 |
$1,501.02 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$1,252.35 |
$1,252.35 |
$1,252.35 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$1,205.64 |
$1,205.64 |
$1,205.64 |
$2,181.10
|
|
Knee X-ray
|
$461.97 |
$461.97 |
$461.97 |
$443.90
|
|
Kras gene variants exon 2
|
$382.41 |
$382.41 |
$382.41 |
$495.00
|
|
Lactate dehydrogenase (ldh)
|
$105.03 |
$105.03 |
$105.03 |
$53.30
|
|
Lactated ringers intravenous solution
|
$32.49 |
$32.49 |
$32.49 |
$54.11
|
|
Lactic acid
|
$85.14 |
$85.14 |
$85.14 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$52.29 |
$52.29 |
$52.29 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$21,470.76 |
$21,470.76 |
$21,470.76 |
$22,903.90
|
|
Laronidase injection
|
$1,206.27 |
$1,206.27 |
$1,206.27 |
$39.88
|
|
Lead capillary
|
$97.74 |
$97.74 |
$97.74 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,038.60 |
$1,038.60 |
$1,038.60 |
$1,100.74
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$148.77 |
$148.77 |
$148.77 |
$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
|
$75.33 |
$75.33 |
$75.33 |
$89.14
|
|
Levetiracetam therapeutic drug level
|
$355.14 |
$355.14 |
$355.14 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$42.84 |
$42.84 |
$42.84 |
$66.59
|
|
L hrt cath chd nm/abn nt cnj
|
$4,925.61 |
$4,925.61 |
$4,925.61 |
$6,242.85
|
|
Lidocaine therapeutic drug level
|
$133.20 |
$133.20 |
$133.20 |
$83.85
|
|
Limb exercise test
|
$187.56 |
$187.56 |
$187.56 |
$290.40
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$50.85 |
$50.85 |
$50.85 |
$177.90
|
|
Lipase
|
$66.42 |
$66.42 |
$66.42 |
$83.20
|
|
Lipoprotein blood high res frac & quant
|
$188.64 |
$188.64 |
$188.64 |
$89.52
|
|
Lipoprotein direct measurement hdl
|
$62.28 |
$62.28 |
$62.28 |
$55.90
|
|
Lipoprotein direct measurement ldl
|
$31.68 |
$31.68 |
$31.68 |
$60.00
|
|
Lithium therapeutic drug level
|
$80.28 |
$80.28 |
$80.28 |
$67.60
|
|
Liver elastography 91200
|
$33.30 |
$33.30 |
$33.30 |
$291.74
|
|
Liver Function Test
|
$163.35 |
$163.35 |
$163.35 |
$110.50
|
