|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$491.00 |
$491.00 |
$491.00 |
$437.45
|
|
IV njx tst vasc flo flap/grf
|
$4,633.33 |
$4,633.33 |
$4,633.33 |
$476.00
|
|
Jak2 targeted sequence analysis
|
$144.00 |
$144.00 |
$144.00 |
$393.43
|
|
John cunningham antibody
|
$1,536.00 |
$1,536.00 |
$1,536.00 |
$66.31
|
|
Ketamine and metabolite screen - quest
|
$150.00 |
$150.00 |
$150.00 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$44.50 |
$44.50 |
$44.50 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$10.67 |
$10.67 |
$10.67 |
$23.77
|
|
Kidney img w/bldflw sgl without rx
|
$1,009.00 |
$1,009.00 |
$1,009.00 |
$1,425.00
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$438.00 |
$438.00 |
$438.00 |
$673.36
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$57.00 |
$57.00 |
$57.00 |
$174.00
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$4,863.00 |
$4,863.00 |
$4,863.00 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$1,068.00 |
$1,068.00 |
$1,068.00 |
$366.03
|
|
Kit lead specify 5-6-5
|
$4,469.24 |
$4,469.24 |
$4,469.24 |
$16,965.41
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,261.88 |
$1,261.88 |
$1,261.88 |
$1,667.50
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$143.50 |
$143.50 |
$143.50 |
$923.90
|
|
Knee Arthroscopy (Cartilage Repair)
|
$5,644.50 |
$5,644.50 |
$5,644.50 |
$4,499.12
|
|
Knee arthroscopy dx
|
$9,828.00 |
$9,828.00 |
$9,828.00 |
$3,980.03
|
|
Knee Arthroscopy (Meniscus Repair)
|
$4,960.50 |
$4,960.50 |
$4,960.50 |
$5,148.00
|
|
Knee arthroscopy/surgery
|
$2,793.50 |
$2,793.50 |
$2,793.50 |
$4,198.40
|
|
Knee arthroscopy/surgery
|
$7,586.00 |
$7,586.00 |
$7,586.00 |
$4,659.20
|
|
Knee arthroscopy/surgery
|
$4,161.00 |
$4,161.00 |
$4,161.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$4,789.50 |
$4,789.50 |
$4,789.50 |
$4,623.79
|
|
Knee arthroscopy/surgery
|
$10,432.50 |
$10,432.50 |
$10,432.50 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$6,328.50 |
$6,328.50 |
$6,328.50 |
$4,137.60
|
|
Knee arthroscopy/surgery
|
$14,339.00 |
$14,339.00 |
$14,339.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$17,515.00 |
$17,515.00 |
$17,515.00 |
$8,979.74
|
|
Knee MRI (with and without contrast)
|
$1,859.00 |
$1,859.00 |
$1,859.00 |
$3,008.26
|
|
Knee MRI (with contrast)
|
$1,353.50 |
$1,353.50 |
$1,353.50 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,230.00 |
$2,230.00 |
$2,230.00 |
$2,110.76
|
|
Knee X-ray
|
$385.00 |
$385.00 |
$385.00 |
$425.55
|
|
Kras gene addl variants
|
$437.00 |
$437.00 |
$437.00 |
$386.75
|
|
Kras gene variants exon 2
|
$437.00 |
$437.00 |
$437.00 |
$509.00
|
|
Kyleena, 19.5 mg
|
$2,733.00 |
$2,733.00 |
$2,733.00 |
$2,125.00
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$18.23 |
$18.23 |
$18.23 |
$33.60
|
|
Lactate dehydrogenase (ldh)
|
$36.50 |
$36.50 |
$36.50 |
$55.50
|
|
Lactated ringers intravenous solution
|
$187.50 |
$187.50 |
$187.50 |
$44.91
|
|
Lactic acid
|
$338.50 |
$338.50 |
$338.50 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$101.00 |
$101.00 |
$101.00 |
$81.00
|
|
Lactoferrin fecal quant
|
$74.50 |
$74.50 |
$74.50 |
$108.93
|
|
Lam facetc/frmt arthrd lum 1
|
$4,269.70 |
$4,269.70 |
$4,269.70 |
$582.40
|
|
Lam facetec & foramot crv
|
$6,034.67 |
$6,034.67 |
$6,034.67 |
$7,549.13
|
|
Lam facetec & foramot lumbar
|
$14,561.00 |
$14,561.00 |
$14,561.00 |
$8,412.89
|
|
Lam facetec & foramot thrc
|
$15,896.67 |
$15,896.67 |
$15,896.67 |
$8,453.60
|
|
Laminotomy single lumbar
|
$9,637.00 |
$9,637.00 |
$9,637.00 |
$8,453.60
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$19,124.00 |
$19,124.00 |
$19,124.00 |
$19,124.00
|
|
Laparo-asst vag hysterectomy
|
$9,492.00 |
$9,492.00 |
$9,492.00 |
$6,839.00
|
|
Laparo cholecystectomy/graph
|
$15,555.00 |
$15,555.00 |
$15,555.00 |
$8,346.00
|
|
Laparo-myomectomy complex
|
$35,084.00 |
$35,084.00 |
$35,084.00 |
$11,523.76
|
|
Laparo partial nephrectomy
|
$17,358.00 |
$17,358.00 |
$17,358.00 |
$12,320.22
|
|
Laparo proc abdm/per/oment 49329
|
$8,791.94 |
$8,791.94 |
$8,791.94 |
$6,622.75
|
|
Laparo radical nephrectomy
|
$11,202.00 |
$11,202.00 |
$11,202.00 |
$6,360.80
|
|
Laparoscopy aspiration
|
$11,583.00 |
$11,583.00 |
$11,583.00 |
$6,839.00
|
|
Laparoscopy biopsy
|
$4,219.75 |
$4,219.75 |
$4,219.75 |
$6,376.26
|
|
Laparoscopye procstom 43659
|
$25,154.00 |
$25,154.00 |
$25,154.00 |
$6,448.00
|
|
Laparoscopy excise lesions
|
$14,893.67 |
$14,893.67 |
$14,893.67 |
$6,904.15
|
|
Laparoscopy fundoplasty
|
$20,699.00 |
$20,699.00 |
$20,699.00 |
$11,424.40
|
|
Laparoscopy lymph node biop
|
$43,959.70 |
$43,959.70 |
$43,959.70 |
$6,904.15
|
|
Laparoscopy remove adnexa
|
$26,974.50 |
$26,974.50 |
$26,974.50 |
$8,607.55
|
|
Laparoscopy surg colpopexy
|
$21,348.50 |
$21,348.50 |
$21,348.50 |
$10,897.60
|
|
Laparo-vag hyst incl t/o
|
$19,113.75 |
$19,113.75 |
$19,113.75 |
$12,100.40
|
|
Laparo-vag hyst w/t/o compl
|
$25,319.50 |
$25,319.50 |
$25,319.50 |
$8,917.26
|
|
Lap enterolysis
|
$10,888.00 |
$10,888.00 |
$10,888.00 |
$6,376.26
|
|
Lap gastr bypass incl smll i
|
$12,825.26 |
$12,825.26 |
$12,825.26 |
$4,532.00
|
|
Lap gastric bypass/roux-en-y
|
$20,520.00 |
$20,520.00 |
$20,520.00 |
$4,255.20
|
|
Lap ing hernia repair init
|
$17,872.00 |
$17,872.00 |
$17,872.00 |
$8,312.83
|
|
Lap ing hernia repair recur
|
$28,133.00 |
$28,133.00 |
$28,133.00 |
$6,463.42
|
|
Lap paraesophag hern repair
|
$18,699.50 |
$18,699.50 |
$18,699.50 |
$12,260.88
|
|
Lap paraesoph her rpr w/mesh
|
$20,685.50 |
$20,685.50 |
$20,685.50 |
$10,029.60
|
|
Lap rmvl gastr adj all parts
|
$11,086.50 |
$11,086.50 |
$11,086.50 |
$4,502.13
|
|
Lap rmvl gastr adj device
|
$19,047.00 |
$19,047.00 |
$19,047.00 |
$4,502.13
|
|
Lap sleeve gastrectomy
|
$33,760.00 |
$33,760.00 |
$33,760.00 |
$2,733.60
|
|
Largsc w/njx augmentation
|
$2,688.00 |
$2,688.00 |
$2,688.00 |
$3,297.97
|
|
Laryngoscope w/vc inj
|
$2,409.00 |
$2,409.00 |
$2,409.00 |
$4,108.00
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$2,263.00 |
$2,263.00 |
$2,263.00 |
$2,480.71
|
|
Laryngoscopy telescopic
|
$450.00 |
$450.00 |
$450.00 |
$852.80
|
|
Laryngoscopy w/biopsy
|
$2,409.00 |
$2,409.00 |
$2,409.00 |
$4,362.99
|
|
Laryngoscopy w/bx & op scope
|
$6,716.00 |
$6,716.00 |
$6,716.00 |
$4,362.99
|
|
Laryngoscopy w/fb removal
|
$2,264.50 |
$2,264.50 |
$2,264.50 |
$2,854.09
|
|
Laryngoscopy with biopsy
|
$2,655.50 |
$2,655.50 |
$2,655.50 |
$3,297.83
|
|
Larynscop w/tumr exc + scope
|
$8,950.00 |
$8,950.00 |
$8,950.00 |
$5,104.80
|
|
Laser surgery of prostate
|
$3,869.67 |
$3,869.67 |
$3,869.67 |
$6,822.11
|
|
Lateral canthopexy
|
$5,488.00 |
$5,488.00 |
$5,488.00 |
$3,837.72
|
|
Lb with mastopexy 15839
|
$3,220.00 |
$3,220.00 |
$3,220.00 |
$3,386.84
|
|
Lead acuity x4 spiral l 86cm
|
$2,372.50 |
$2,372.50 |
$2,372.50 |
$5,534.00
|
|
Lead capillary
|
$74.50 |
$74.50 |
$74.50 |
$55.25
|
|
Lead ingevity 45cm pfret MRI
|
$1,319.00 |
$1,319.00 |
$1,319.00 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$3,700.50 |
$3,700.50 |
$3,700.50 |
$8,204.74
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$622.00 |
$622.00 |
$622.00 |
$1,092.58
|
|
Leishmania antibody
|
$35.50 |
$35.50 |
$35.50 |
$58.50
|
|
Lens iol ant bicnvx 24.0 multi
|
$75.00 |
$75.00 |
$75.00 |
$1,044.75
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$349.07 |
$349.07 |
$349.07 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$2,196.97 |
$2,196.97 |
$2,196.97 |
$6,236.52
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$10,428.50 |
$10,428.50 |
$10,428.50 |
$9,107.80
|
|
Lev 1 hosp type b ed visit
|
$106.00 |
$106.00 |
$106.00 |
$186.98
|
|
Levalbuterol non-comp unit
|
$2.50 |
$2.50 |
$2.50 |
$6.00
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$58.50 |
$58.50 |
$58.50 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$31.00 |
$31.00 |
$31.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$12.15 |
$12.15 |
$12.15 |
$55.60
|
|
Liberta rc ipg
|
$10,484.12 |
$10,484.12 |
$10,484.12 |
$39,406.68
|
|
Lidocaine injection
|
$60.00 |
$60.00 |
$60.00 |
$44.76
|
