|
Inj levocarnitine per 1 gm
|
$408.19 |
$408.19 |
$408.19 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$2,527.56 |
$2,527.56 |
$2,527.56 |
$320.80
|
|
Inj, lidocaine w epinephrine
|
$96.08 |
$96.08 |
$96.08 |
$45.14
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$1,407.60 |
$1,407.60 |
$1,407.60 |
$788.40
|
|
Inj mepivacaine hcl/10 ml
|
$48.00 |
$48.00 |
$48.00 |
$33.86
|
|
Inj meropenem (wg crit care)
|
$345.45 |
$345.45 |
$345.45 |
$77.97
|
|
Inj multihance
|
$240.13 |
$240.13 |
$240.13 |
$70.54
|
|
Inj. mycophenolate mofetil
|
$293.60 |
$293.60 |
$293.60 |
$252.66
|
|
Inj, nithiodote, 3mg / 125mg
|
$3,465.00 |
$3,465.00 |
$3,465.00 |
$472.76
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$123,845.75 |
$123,845.75 |
$123,845.75 |
$1,058.98
|
|
Inj octafluoropropane mic,ml
|
$189.54 |
$189.54 |
$189.54 |
$211.40
|
|
Inj ogivri 10 mg
|
$14,962.79 |
$14,962.79 |
$14,962.79 |
$4,492.28
|
|
Inj ontruzant 10 mg
|
$21,141.53 |
$21,141.53 |
$21,141.53 |
$6,706.27
|
|
Inj proc elbow arthro
|
$775.80 |
$775.80 |
$775.80 |
$433.00
|
|
Inj, releuko 1 mcg
|
$1,389.02 |
$1,389.02 |
$1,389.02 |
$461.20
|
|
Inj retro urethrocysto
|
$1,671.60 |
$1,671.60 |
$1,671.60 |
$450.00
|
|
Inj sulf hexa lipid microsph
|
$1,176.53 |
$1,176.53 |
$1,176.53 |
$256.14
|
|
Inj. teprotumumab-trbw 10 mg
|
$54,056.85 |
$54,056.85 |
$54,056.85 |
$35,034.78
|
|
Inj testosterone cypionate
|
$0.07 |
$0.07 |
$0.07 |
$64.80
|
|
Inj thrc fascial pln blk bi w/wo image
|
$1,407.60 |
$1,407.60 |
$1,407.60 |
$1,025.00
|
|
Inj thrc fascial pln blk uni w/wo image
|
$756.00 |
$756.00 |
$756.00 |
$837.50
|
|
Inj. tigecycline (accord)
|
$287.85 |
$287.85 |
$287.85 |
$182.46
|
|
Inj, tyenne, 1 mg
|
$10,692.86 |
$10,692.86 |
$10,692.86 |
$3,525.12
|
|
Inj vocal cord bulking agent
|
$3,821.27 |
$3,821.27 |
$3,821.27 |
$1,480.00
|
|
Ins cath ren art 1st bi
|
$7,588.80 |
$7,588.80 |
$7,588.80 |
$5,820.00
|
|
Ins cerv dilator (sep proc)
|
$16,736.65 |
$16,736.65 |
$16,736.65 |
$484.90
|
|
Insert and remove bone pin
|
$2,481.60 |
$2,481.60 |
$2,481.60 |
$4,421.00
|
|
Insert cath pleura with image
|
$1,557.00 |
$1,557.00 |
$1,557.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$1,452.00 |
$1,452.00 |
$1,452.00 |
$2,056.00
|
|
Insert drug delivery implant
|
$124.20 |
$124.20 |
$124.20 |
$283.20
|
|
Insert intrauterine device iud
|
$17,584.40 |
$17,584.40 |
$17,584.40 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$118.20 |
$118.20 |
$118.20 |
$205.80
|
|
Insertion catheter bladder temporary simple
|
$133.80 |
$133.80 |
$133.80 |
$235.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$9,093.00 |
$9,093.00 |
$9,093.00 |
$2,565.36
|
|
Insertion intra-aortic circulation dev 33970
|
$9,093.00 |
$9,093.00 |
$9,093.00 |
$866.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,932.80 |
$8,932.80 |
$8,932.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,607.60 |
$2,607.60 |
$2,607.60 |
$2,511.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$20,640.60 |
$20,640.60 |
$20,640.60 |
$12,508.08
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$23,722.20 |
$23,722.20 |
$23,722.20 |
$12,384.25
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$15,638.40 |
$15,638.40 |
$15,638.40 |
$10,285.70
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$6,373.80 |
$6,373.80 |
$6,373.80 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,815.20 |
$5,815.20 |
$5,815.20 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$155,353.73 |
$155,353.73 |
$155,353.73 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$8,140.20 |
$8,140.20 |
$8,140.20 |
$7,216.00
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$11,513.40 |
$11,513.40 |
$11,513.40 |
$7,388.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$11,830.80 |
$11,830.80 |
$11,830.80 |
$9,390.55
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$10,581.81 |
$10,581.81 |
$10,581.81 |
$5,236.80
|
|
Insert multi-comp penis pros
|
$64,626.21 |
$64,626.21 |
$64,626.21 |
$9,495.20
|
|
Insert/repl sq defib w/eltrd
|
$65,328.00 |
$65,328.00 |
$65,328.00 |
$32,052.60
|
|
Insert swan-ganz cath
|
$3,033.60 |
$3,033.60 |
$3,033.60 |
$2,346.51
|
|
Insert vad art access left hrt arterial access
|
$10,623.60 |
$10,623.60 |
$10,623.60 |
$4,504.50
|
|
Insitu hybridization manual
|
$540.00 |
$540.00 |
$540.00 |
$398.51
|
|
In situ hybridization per specimen each additional single probe stain
|
$301.80 |
$301.80 |
$301.80 |
$241.80
|
|
In situ hybridization per specimen initial single probe stain
|
$552.00 |
$552.00 |
$552.00 |
$337.20
|
|
Insj biomechanical device 22853
|
$171,677.97 |
$171,677.97 |
$171,677.97 |
$622.40
|
|
Ins mark abd/pel for right perq
|
$2,620.20 |
$2,620.20 |
$2,620.20 |
$2,393.43
|
|
Insole orthotic freedom sz6 6816
|
$345.73 |
$345.73 |
$345.73 |
$84.00
|
|
Ins pm gen w/exist mlt leads
|
$6,814.80 |
$6,814.80 |
$6,814.80 |
$14,804.40
|
|
Ins/rpl ldless pm right vent w img & eval
|
$42,183.00 |
$42,183.00 |
$42,183.00 |
$24,135.54
|
|
Ins/rpl wireless pulm art sensor incl s&i
|
$6,736.80 |
$6,736.80 |
$6,736.80 |
$25,106.90
|
|
Instillation anticarcinogenic agent bladder
|
$11,651.11 |
$11,651.11 |
$11,651.11 |
$654.02
|
|
Ins tun cv cath wo subq prt/pm
|
$3,001.80 |
$3,001.80 |
$3,001.80 |
$4,218.00
|
|
Insulin total
|
$87.60 |
$87.60 |
$87.60 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$24,018.70 |
$24,018.70 |
$24,018.70 |
$8,683.20
|
|
Integra meshed bil wound mat
|
$78,781.80 |
$78,781.80 |
$78,781.80 |
$9,924.16
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$18,118.52 |
$18,118.52 |
$18,118.52 |
$3,803.11
|
|
Interdental fixation
|
$1,156.80 |
$1,156.80 |
$1,156.80 |
$2,156.00
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$49,235.46 |
$49,235.46 |
$49,235.46 |
$10,427.90
|
|
Interfyl, 1 mg
|
$10,398.00 |
$10,398.00 |
$10,398.00 |
$4,656.80
|
|
Intrapul surf admin endo tube
|
$175.80 |
$175.80 |
$175.80 |
$222.28
|
|
Intrinsic factor antibody
|
$70.20 |
$70.20 |
$70.20 |
$62.70
|
|
Intro cath dialysis circuit
|
$2,281.20 |
$2,281.20 |
$2,281.20 |
$2,037.75
|
|
Intro cath dialysis circuit w/pta
|
$13,118.40 |
$13,118.40 |
$13,118.40 |
$8,717.80
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$16,455.60 |
$16,455.60 |
$16,455.60 |
$15,625.00
|
|
Intro catheter aorta
|
$941.40 |
$941.40 |
$941.40 |
$1,654.05
|
|
Intro long gi tube
|
$960.60 |
$960.60 |
$960.60 |
$957.18
|
|
Intro long gi tube w/mult fluo
|
$696.60 |
$696.60 |
$696.60 |
$464.80
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,666.20 |
$4,666.20 |
$4,666.20 |
$3,436.50
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,745.80 |
$3,745.80 |
$3,745.80 |
$1,801.10
|
|
Intubation endotracheal emergency procedure
|
$995.40 |
$995.40 |
$995.40 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$523.42 |
$523.42 |
$523.42 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$819.72 |
$819.72 |
$819.72 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$108,656.64 |
$108,656.64 |
$108,656.64 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$6.00 |
$6.00 |
$6.00 |
$3.75
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$125.23 |
$125.23 |
$125.23 |
$173.40
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$16,980.30 |
$16,980.30 |
$16,980.30 |
$5,476.68
|
|
Iron
|
$114.60 |
$114.60 |
$114.60 |
$72.29
|
|
Iron binding capacity
|
$78.00 |
$78.00 |
$78.00 |
$63.60
|
|
Iron dextran 50 mg/ml injection solution
|
$90.00 |
$90.00 |
$90.00 |
$78.46
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$177.32 |
$177.32 |
$177.32 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$48.00 |
$48.00 |
$48.00 |
$143.81
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$24,792.72 |
$24,792.72 |
$24,792.72 |
$8,273.35
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$244.80 |
$244.80 |
$244.80 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$223.20 |
$223.20 |
$223.20 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$161.40 |
$161.40 |
$161.40 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$676.20 |
$676.20 |
$676.20 |
$441.75
|
|
Jak2 targeted sequence analysis
|
$676.20 |
$676.20 |
$676.20 |
$408.00
|
|
Kafo dbl solid stirrup band/
|
$5,165.78 |
$5,165.78 |
$5,165.78 |
$2,185.15
|
|
Kafo dbl solid stirrup without j
|
$5,077.55 |
$5,077.55 |
$5,077.55 |
$2,276.79
|
|
Kafo fem fx cast molded to p
|
$7,604.00 |
$7,604.00 |
$7,604.00 |
$3,130.66
|