|
Inj epidural sgl cerv-thor without img
|
$987.24 |
$987.24 |
$987.24 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,268.82 |
$1,268.82 |
$1,268.82 |
$1,450.84
|
|
Inj hydroxyprogst capoat nos
|
$14.25 |
$14.25 |
$14.25 |
$1,228.59
|
|
Inj intralesional <= 7 lsn(s)
|
$283.29 |
$283.29 |
$283.29 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$197.79 |
$197.79 |
$197.79 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$57.00 |
$57.00 |
$57.00 |
$7,173.90
|
|
Inj progesterone per 50 mg
|
$2.28 |
$2.28 |
$2.28 |
$19.53
|
|
Inj, rimabotulinumtoxinb
|
$17.10 |
$17.10 |
$17.10 |
$1,486.10
|
|
Inj scleros sol mult veins
|
$783.75 |
$783.75 |
$783.75 |
$687.96
|
|
Inj testosterone cypionate
|
$0.57 |
$0.57 |
$0.57 |
$82.58
|
|
Inj triamcinolone ace X-ray 1mg
|
$36.97 |
$36.97 |
$36.97 |
$21.45
|
|
Insert cath pleura without image
|
$3,045.51 |
$3,045.51 |
$3,045.51 |
$2,212.00
|
|
Insert drug delivery implant
|
$140.22 |
$140.22 |
$140.22 |
$285.80
|
|
Insert intrauterine device iud
|
$235.41 |
$235.41 |
$235.41 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$195.51 |
$195.51 |
$195.51 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$249.66 |
$249.66 |
$249.66 |
$273.60
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$5,366.55 |
$5,366.55 |
$5,366.55 |
$2,618.40
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,636.25 |
$2,636.25 |
$2,636.25 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$173.85 |
$173.85 |
$173.85 |
$2,527.91
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$771.21 |
$771.21 |
$771.21 |
$5,470.54
|
|
Insert pessary/other device
|
$140.22 |
$140.22 |
$140.22 |
$278.90
|
|
Insitu hybridization manual
|
$897.75 |
$897.75 |
$897.75 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$318.63 |
$318.63 |
$318.63 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$314.07 |
$314.07 |
$314.07 |
$338.40
|
|
Insole orthotic freedom sz6 6816
|
$202.35 |
$202.35 |
$202.35 |
$68.15
|
|
Ins/rplc spi npg/rcvr pocket
|
$48,484.77 |
$48,484.77 |
$48,484.77 |
$21,097.15
|
|
Instillation anticarcinogenic agent bladder
|
$1,194.72 |
$1,194.72 |
$1,194.72 |
$721.50
|
|
Ins tun cv cath wo subq prt/pm
|
$494.19 |
$494.19 |
$494.19 |
$4,748.00
|
|
Insulin total
|
$41.04 |
$41.04 |
$41.04 |
$67.60
|
|
Interferon alfa-2b inj
|
$46.74 |
$46.74 |
$46.74 |
$559.83
|
|
Interferon beta-1a inj
|
$1,631.91 |
$1,631.91 |
$1,631.91 |
$2,203.14
|
|
Interrog dev eval scrms ip
|
$33.06 |
$33.06 |
$33.06 |
$124.80
|
|
Interrog device eval heart
|
$80.94 |
$80.94 |
$80.94 |
$150.00
|
|
Interrog evl pm/ldls pm ip
|
$35.91 |
$35.91 |
$35.91 |
$127.20
|
|
Intrapul surf admin endo tube
|
$245.10 |
$245.10 |
$245.10 |
$239.52
|
|
Intrinsic factor antibody
|
$95.19 |
$95.19 |
$95.19 |
$59.95
|
|
Intubation endotracheal emergency procedure
|
$565.44 |
$565.44 |
$565.44 |
$617.60
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$12.31 |
$12.31 |
$12.31 |
$203.92
|
|
Iron
|
$41.61 |
$41.61 |
$41.61 |
$70.72
|
|
Iron binding capacity
|
$47.88 |
$47.88 |
$47.88 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$30.42 |
$30.42 |
$30.42 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1.14 |
$1.14 |
$1.14 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$67.26 |
$67.26 |
$67.26 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$123.12 |
$123.12 |
$123.12 |
$154.50
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$193.23 |
$193.23 |
$193.23 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$133.38 |
$133.38 |
$133.38 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$133.38 |
$133.38 |
$133.38 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$433.77 |
$433.77 |
$433.77 |
$460.85
|
|
Jak2 targeted sequence analysis
|
$669.18 |
$669.18 |
$669.18 |
$378.30
|
|
John cunningham antibody
|
$33.63 |
$33.63 |
$33.63 |
$48.57
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$41.04 |
$41.04 |
$41.04 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$3.03 |
$3.03 |
$3.03 |
$29.52
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$593.94 |
$593.94 |
$593.94 |
$668.25
|
|
Knee Arthroscopy (Cartilage Repair)
|
$951.90 |
$951.90 |
$951.90 |
$3,839.54
|
|
Knee arthroscopy/drainage
|
$762.66 |
$762.66 |
$762.66 |
$3,839.54
|
|
Knee Arthroscopy (Meniscus Repair)
|
$1,079.58 |
$1,079.58 |
$1,079.58 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$687.42 |
$687.42 |
$687.42 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$826.50 |
$826.50 |
$826.50 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,020.30 |
$1,020.30 |
$1,020.30 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,033.41 |
$1,033.41 |
$1,033.41 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,039.11 |
$1,039.11 |
$1,039.11 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,254.00 |
$1,254.00 |
$1,254.00 |
$3,839.54
|
|
Knee arthroscopy/surgery
|
$1,671.24 |
$1,671.24 |
$1,671.24 |
$7,807.24
|
|
Knee MRI (with and without contrast)
|
$2,253.21 |
$2,253.21 |
$2,253.21 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,179.11 |
$2,179.11 |
$2,179.11 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,001.27 |
$2,001.27 |
$2,001.27 |
$2,181.10
|
|
Knee X-ray
|
$224.58 |
$224.58 |
$224.58 |
$443.90
|
|
Kras gene addl variants
|
$395.58 |
$395.58 |
$395.58 |
$346.45
|
|
Kras gene variants exon 2
|
$417.24 |
$417.24 |
$417.24 |
$495.00
|
|
Kyleena, 19.5 mg
|
$926.25 |
$926.25 |
$926.25 |
$2,211.85
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$9.55 |
$9.55 |
$9.55 |
$39.72
|
|
Lactate dehydrogenase (ldh)
|
$22.80 |
$22.80 |
$22.80 |
$53.30
|
|
Lactated ringers intravenous solution
|
$4.56 |
$4.56 |
$4.56 |
$48.56
|
|
Lactic acid
|
$53.58 |
$53.58 |
$53.58 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$62.13 |
$62.13 |
$62.13 |
$88.40
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$142.62 |
$142.62 |
$142.62 |
$21,487.67
|
|
Laparo cholecystectomy/explr
|
$1,599.42 |
$1,599.42 |
$1,599.42 |
$6,637.99
|
|
Laparo cholecystectomy/graph
|
$1,379.97 |
$1,379.97 |
$1,379.97 |
$7,220.90
|
|
Laparo partial colectomy 44204
|
$3,053.49 |
$3,053.49 |
$3,053.49 |
$3,790.40
|
|
Laparoscopy biopsy
|
$628.71 |
$628.71 |
$628.71 |
$5,954.23
|
|
Laparoscopy fundoplasty
|
$2,101.02 |
$2,101.02 |
$2,101.02 |
$6,311.00
|
|
Lap close enterostomy with resect 44227
|
$3,320.25 |
$3,320.25 |
$3,320.25 |
$4,097.60
|
|
Lap colectomy/coloproctostomy 44207
|
$3,711.27 |
$3,711.27 |
$3,711.27 |
$4,491.20
|
|
Lap colectomy part w/ileum 44205
|
$2,653.92 |
$2,653.92 |
$2,653.92 |
$3,298.40
|
|
Lap enterectomy 44202
|
$2,697.24 |
$2,697.24 |
$2,697.24 |
$3,404.00
|
|
Lap enterolysis
|
$1,760.73 |
$1,760.73 |
$1,760.73 |
$5,741.00
|
|
Lap ing hernia repair init
|
$713.07 |
$713.07 |
$713.07 |
$5,741.00
|
|
Lap ing hernia repair recur
|
$935.37 |
$935.37 |
$935.37 |
$5,741.00
|
|
Lap mobil splenic fl add-on 44213
|
$415.53 |
$415.53 |
$415.53 |
$622.40
|
|
Lap paraesophag hern repair
|
$3,199.98 |
$3,199.98 |
$3,199.98 |
$8,681.04
|
|
Lap paraesoph her rpr w/mesh
|
$3,620.07 |
$3,620.07 |
$3,620.07 |
$7,826.00
|
|
Lap removal of rectum w/colostomy 45395
|
$3,910.77 |
$3,910.77 |
$3,910.77 |
$4,880.80
|
|
Laps esophgl sphnctr agmntj 43284
|
$1,155.39 |
$1,155.39 |
$1,155.39 |
$10,500.26
|
|
Laps surg prst8ect smpl stot
|
$1,688.34 |
$1,688.34 |
$1,688.34 |
$5,855.00
|
|
Laryngoscopy telescopic
|
$437.76 |
$437.76 |
$437.76 |
$762.30
|
|
Lead capillary
|
$37.05 |
$37.05 |
$37.05 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$992.37 |
$992.37 |
$992.37 |
$1,100.74
|
|
Lens iol ant bicnvx 24.0 multi
|
$295.94 |
$295.94 |
$295.94 |
$1,023.10
|
|
Lens iol ant chamb 10.5
|
$188.10 |
$188.10 |
$188.10 |
$216.48
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$21.27 |
$21.27 |
$21.27 |
$164.09
|
