|
Intracard echo interv w/s&i
|
$4,013.16 |
$4,013.16 |
$4,013.16 |
$3,982.59
|
|
Intracranial complete study
|
$655.08 |
$655.08 |
$655.08 |
$883.30
|
|
Intracranial limited study
|
$514.10 |
$514.10 |
$514.10 |
$423.52
|
|
Intranasal biopsy 30100
|
$163.77 |
$163.77 |
$163.77 |
$1,850.94
|
|
Intraoral i+d tongue/floor lingual 41000
|
$287.79 |
$287.79 |
$287.79 |
$1,182.15
|
|
Intrapul surf admin endo tube
|
$195.57 |
$195.57 |
$195.57 |
$239.52
|
|
Intraventricular pacing
|
$6,255.59 |
$6,255.59 |
$6,255.59 |
$5,775.22
|
|
Intrinsic factor antibody
|
$84.80 |
$84.80 |
$84.80 |
$59.95
|
|
Intro cath dialysis circuit
|
$2,273.70 |
$2,273.70 |
$2,273.70 |
$2,317.80
|
|
Intro cath dialysis circuit w/pta
|
$8,128.08 |
$8,128.08 |
$8,128.08 |
$8,761.00
|
|
Intro catheter aorta
|
$3,987.19 |
$3,987.19 |
$3,987.19 |
$1,861.61
|
|
Intro cath svc/ivc
|
$4,668.24 |
$4,668.24 |
$4,668.24 |
$1,350.75
|
|
Intro long gi tube
|
$742.53 |
$742.53 |
$742.53 |
$1,036.00
|
|
Intro long gi tube w/mult fluo
|
$366.23 |
$366.23 |
$366.23 |
$477.85
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$6,349.40 |
$6,349.40 |
$6,349.40 |
$3,510.75
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$3,174.70 |
$3,174.70 |
$3,174.70 |
$1,825.16
|
|
Intubation endotracheal emergency procedure
|
$454.74 |
$454.74 |
$454.74 |
$617.60
|
|
Iodine i-123 sod iodide mil
|
$386.37 |
$386.37 |
$386.37 |
$677.98
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$95.93 |
$95.93 |
$95.93 |
$182.21
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$262.37 |
$262.37 |
$262.37 |
$62,692.46
|
|
Ipratropium bromide non-comp
|
$0.22 |
$0.22 |
$0.22 |
$4.77
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$9.32 |
$9.32 |
$9.32 |
$203.92
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$95.67 |
$95.67 |
$95.67 |
$5,837.00
|
|
Iron
|
$53.53 |
$53.53 |
$53.53 |
$70.72
|
|
Iron binding capacity
|
$68.90 |
$68.90 |
$68.90 |
$63.00
|
|
Iron dextran 50 mg/ml injection solution
|
$28.65 |
$28.65 |
$28.65 |
$73.22
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$6.02 |
$6.02 |
$6.02 |
$169.30
|
|
Irradiation of blood product each unit reference
|
$108.65 |
$108.65 |
$108.65 |
$124.24
|
|
Irrigation implantable venous access device for drug delivery systems
|
$170.66 |
$170.66 |
$170.66 |
$154.50
|
|
Irrigation vagina and/or appl medicament tx disease
|
$39.75 |
$39.75 |
$39.75 |
$131.88
|
|
Ivc venogram s&i
|
$1,710.84 |
$1,710.84 |
$1,710.84 |
$3,332.55
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$198.22 |
$198.22 |
$198.22 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$181.26 |
$181.26 |
$181.26 |
$174.40
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$232.14 |
$232.14 |
$232.14 |
$155.00
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$573.99 |
$573.99 |
$573.99 |
$460.85
|
|
Ixabepilone 15 mg intravenous solution
|
$180.29 |
$180.29 |
$180.29 |
$10,695.32
|
|
Jak2 targeted sequence analysis
|
$622.22 |
$622.22 |
$622.22 |
$378.30
|
|
John cunningham antibody
|
$27.03 |
$27.03 |
$27.03 |
$48.57
|
|
Ketogenic steroids fract
|
$49.29 |
$49.29 |
$49.29 |
$79.54
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$68.37 |
$68.37 |
$68.37 |
$56.61
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$4.20 |
$4.20 |
$4.20 |
$29.52
|
|
Kidney img w/bldflw sgl without rx
|
$1,488.24 |
$1,488.24 |
$1,488.24 |
$1,468.04
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$549.61 |
$549.61 |
$549.61 |
$668.25
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$83.21 |
$83.21 |
$83.21 |
$103.20
|
|
Knee arthroscopy dx
|
$385.31 |
$385.31 |
$385.31 |
$3,839.54
|
|
Knee MRI (with and without contrast)
|
$6,520.06 |
$6,520.06 |
$6,520.06 |
$2,950.00
|
|
Knee MRI (with contrast)
|
$2,370.69 |
$2,370.69 |
$2,370.69 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$3,579.09 |
$3,579.09 |
$3,579.09 |
$2,181.10
|
|
Knee X-ray
|
$199.28 |
$199.28 |
$199.28 |
$443.90
|
|
Kras gene addl variants
|
$1,774.97 |
$1,774.97 |
$1,774.97 |
$346.45
|
|
Kras gene variants exon 2
|
$2,457.08 |
$2,457.08 |
$2,457.08 |
$495.00
|
|
Kyleena, 19.5 mg
|
$1,786.62 |
$1,786.62 |
$1,786.62 |
$2,211.85
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$10.20 |
$10.20 |
$10.20 |
$39.72
|
|
Lacosamide 200 mg/20 ml intravenous solution
|
$0.66 |
$0.66 |
$0.66 |
$188.92
|
|
Lactate dehydrogenase (ldh)
|
$55.65 |
$55.65 |
$55.65 |
$53.30
|
|
Lactated ringers intravenous solution
|
$2.65 |
$2.65 |
$2.65 |
$48.56
|
|
Lactic acid
|
$71.55 |
$71.55 |
$71.55 |
$102.90
|
|
Lactoferrin fecal qualitative
|
$100.70 |
$100.70 |
$100.70 |
$88.40
|
|
Lactoferrin fecal quant
|
$42.40 |
$42.40 |
$42.40 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$130.33 |
$130.33 |
$130.33 |
$21,487.67
|
|
Laparo urethral suspension
|
$2,890.62 |
$2,890.62 |
$2,890.62 |
$6,457.82
|
|
Lap esophageal lengthening addl 43283
|
$403.33 |
$403.33 |
$403.33 |
$388.00
|
|
Largsc w/laser dstrj les
|
$368.88 |
$368.88 |
$368.88 |
$4,362.99
|
|
Largsc w/njx augmentation
|
$779.63 |
$779.63 |
$779.63 |
$3,482.74
|
|
Largsc w/ther injection
|
$201.93 |
$201.93 |
$201.93 |
$2,040.67
|
|
Laryngoscope w/vc inj
|
$253.87 |
$253.87 |
$253.87 |
$3,593.25
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$206.17 |
$206.17 |
$206.17 |
$2,480.71
|
|
Laryngoscopy telescopic
|
$161.65 |
$161.65 |
$161.65 |
$762.30
|
|
Laryngoscopy with biopsy
|
$198.22 |
$198.22 |
$198.22 |
$2,954.40
|
|
Laser surgery of prostate
|
$3,227.70 |
$3,227.70 |
$3,227.70 |
$5,631.74
|
|
Laser surgery of prostate
|
$3,835.08 |
$3,835.08 |
$3,835.08 |
$5,741.00
|
|
Laser surg penis lesion(s)
|
$214.12 |
$214.12 |
$214.12 |
$2,164.64
|
|
Lateral canthopexy
|
$1,337.19 |
$1,337.19 |
$1,337.19 |
$3,837.72
|
|
Lavage cannulation maxillary sinus
|
$171.72 |
$171.72 |
$171.72 |
$833.97
|
|
Lead capillary
|
$100.17 |
$100.17 |
$100.17 |
$62.40
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,892.10 |
$1,892.10 |
$1,892.10 |
$1,100.74
|
|
Leishmania antibody
|
$31.27 |
$31.27 |
$31.27 |
$58.50
|
|
Lens iol ant bicnvx 24.0 multi
|
$275.18 |
$275.18 |
$275.18 |
$1,023.10
|
|
Lens iol ant chamb 10.5
|
$174.90 |
$174.90 |
$174.90 |
$216.48
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$13.62 |
$13.62 |
$13.62 |
$164.09
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$828.31 |
$828.31 |
$828.31 |
$5,001.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,589.28 |
$2,589.28 |
$2,589.28 |
$6,694.24
|
|
Levalbuterol non-comp unit
|
$0.06 |
$0.06 |
$0.06 |
$8.13
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.85 |
$0.85 |
$0.85 |
$97.62
|
|
Levetiracetam therapeutic drug level
|
$127.20 |
$127.20 |
$127.20 |
$71.40
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$8.10 |
$8.10 |
$8.10 |
$64.88
|
|
Levonorgestrel implant sys
|
$333.90 |
$333.90 |
$333.90 |
$933.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$187.92 |
$187.92 |
$187.92 |
$420.60
|
|
Lidocaine therapeutic drug level
|
$127.20 |
$127.20 |
$127.20 |
$83.85
|
|
Lift heel adj small gl60404sm
|
$188.15 |
$188.15 |
$188.15 |
$155.52
|
|
Ligation/biopsy of temporal artery 37609
|
$311.11 |
$311.11 |
$311.11 |
$2,968.00
|
|
Ligation vericose vein cluster(s) 1 leg
|
$296.80 |
$296.80 |
$296.80 |
$3,486.86
|
|
Limited visual field xm
|
$56.18 |
$56.18 |
$56.18 |
$79.20
|
|
Lincomycin injection
|
$13.25 |
$13.25 |
$13.25 |
$13.25
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$33.48 |
$33.48 |
$33.48 |
$172.25
|
|
Lipase
|
$58.30 |
$58.30 |
$58.30 |
$83.20
|
|
Lip exc/transverse wedge/w closure 40510
|
$700.66 |
$700.66 |
$700.66 |
$3,780.73
|
|
Lipoprotein blood high res frac & quant
|
$52.47 |
$52.47 |
$52.47 |
$89.52
|
|
Lipoprotein blood quant
|
$334.43 |
$334.43 |
$334.43 |
$103.00
|
|
Lipoprotein direct measurement hdl
|
$67.31 |
$67.31 |
$67.31 |
$55.90
|
