|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$2.46 |
$2.46 |
$9.75 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$392.73 |
$392.73 |
$392.73 |
$62,692.46
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$150.41 |
$150.41 |
$150.41 |
$5,476.68
|
|
Iron
|
$39.60 |
$39.60 |
$82.50 |
$74.40
|
|
Iron binding capacity
|
$62.04 |
$62.04 |
$72.50 |
$63.79
|
|
Iron dextran 50 mg/ml injection solution
|
$43.14 |
$43.14 |
$43.14 |
$80.95
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$1.00 |
$1.00 |
$3.07 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$65.00 |
$65.00 |
$88.44 |
$119.83
|
|
Irrigation implantable venous access device for drug delivery systems
|
$112.50 |
$112.50 |
$127.38 |
$142.20
|
|
Ivc venogram s&i
|
$2,095.00 |
$2,095.00 |
$3,635.28 |
$3,316.95
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$115.00 |
$115.00 |
$145.86 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$115.00 |
$115.00 |
$207.24 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$115.00 |
$115.00 |
$143.88 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$280.00 |
$280.00 |
$439.56 |
$439.56
|
|
Ivp w/wo kub w/wo tomography
|
$747.78 |
$747.78 |
$747.78 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$421.74 |
$421.74 |
$475.00 |
$379.87
|
|
John cunningham antibody
|
$65.00 |
$65.00 |
$1,585.32 |
$72.60
|
|
Ketamine and metabolite screen - quest
|
$44.88 |
$44.88 |
$225.00 |
$72.14
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$44.22 |
$44.22 |
$47.50 |
$60.20
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$32.34 |
$32.34 |
$41.88 |
$23.50
|
|
Kidney endoscopy
|
$1,665.00 |
$1,665.00 |
$5,871.36 |
$5,728.00
|
|
Kidney function study
|
$1,595.00 |
$1,595.00 |
$1,595.00 |
$783.86
|
|
Kidney imag w/bld flow multi
|
$2,525.00 |
$2,525.00 |
$2,525.00 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,595.00 |
$1,595.00 |
$1,682.34 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$525.00 |
$525.00 |
$566.28 |
$666.00
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$7,614.00 |
$7,614.00 |
$7,614.00 |
$9,482.25
|
|
Kit gene analys d816 variant
|
$382.50 |
$382.50 |
$683.10 |
$374.61
|
|
Kit lead specify 5-6-5
|
$6,861.06 |
$6,861.06 |
$6,861.06 |
$15,639.00
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,990.00 |
$1,990.00 |
$1,990.00 |
$1,543.50
|
|
Knee MRI (with and without contrast)
|
$2,669.70 |
$2,669.70 |
$3,265.00 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$2,210.00 |
$2,210.00 |
$2,542.32 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,110.00 |
$2,110.00 |
$2,420.88 |
$2,169.60
|
|
Knee X-ray
|
$363.00 |
$363.00 |
$675.00 |
$425.55
|
|
Ko single upright pre cst
|
$127.60 |
$127.60 |
$127.60 |
$988.40
|
|
Kras gene addl variants
|
$875.00 |
$875.00 |
$875.00 |
$384.80
|
|
Kras gene variants exon 2
|
$260.00 |
$260.00 |
$931.26 |
$486.45
|
|
Lab draw < 3 yrs fem/jugular 36400
|
$70.00 |
$70.00 |
$157.08 |
$109.20
|
|
Lab draw <3 yrs scalp vein 36405
|
$41.58 |
$41.58 |
$70.00 |
$72.80
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$38.97 |
$38.97 |
$38.97 |
$32.34
|
|
Lactate dehydrogenase (ldh)
|
$47.50 |
$47.50 |
$67.32 |
$55.50
|
|
Lactated ringers intravenous solution
|
$69.96 |
$69.96 |
$117.13 |
$45.56
|
|
Lactic acid
|
$65.00 |
$65.00 |
$72.60 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$75.00 |
$75.00 |
$75.00 |
$80.40
|
|
Lactoferrin fecal quant
|
$114.18 |
$114.18 |
$114.18 |
$106.10
|
|
Lanreotide 120 mg/0.5 ml subcutaneous syringe
|
$147.07 |
$147.07 |
$147.07 |
$19,124.00
|
|
Largsc w/rmvl foreign bdy(s)
|
$766.92 |
$766.92 |
$766.92 |
$765.97
|
|
Laryngoscopic sensory vid
|
$405.00 |
$405.00 |
$405.00 |
$336.00
|
|
Lead capillary
|
$57.50 |
$57.50 |
$72.60 |
$57.50
|
|
Lead ingevity 45cm pfret MRI
|
$564.46 |
$564.46 |
$564.46 |
$3,047.96
|
|
Lead tachy durata sj4 58cm
|
$3,783.50 |
$3,783.50 |
$3,783.50 |
$8,000.00
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,015.00 |
$1,015.00 |
$1,058.64 |
$1,088.26
|
|
Lens iol 23.0 d 1.5 cyl eyhance toric
|
$200.00 |
$200.00 |
$200.00 |
$1,050.40
|
|
Lens iol ant bicnvx 24.0 multi
|
$1,636.78 |
$1,636.78 |
$1,636.78 |
$1,065.00
|
|
Leucovorin calcium 100 mg solution for injection (1 mg rounding)
|
$17.39 |
$17.39 |
$28.91 |
$163.62
|
|
Leukacyte transfusion
|
$1,306.14 |
$1,306.14 |
$1,306.14 |
$202.78
|
|
Leuprolide 30 mg (4 month) intramuscular syringe kit
|
$398.16 |
$398.16 |
$398.16 |
$7,052.00
|
|
Leuprolide 3.75 mg intramuscular syringe kit
|
$2,996.48 |
$2,996.48 |
$2,996.48 |
$9,107.80
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$1.02 |
$1.02 |
$1.02 |
$95.68
|
|
Levetiracetam therapeutic drug level
|
$77.22 |
$77.22 |
$100.00 |
$88.92
|
|
Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback
|
$35.57 |
$35.57 |
$35.57 |
$55.60
|
|
Levothyroxine 100 mcg intravenous powder for solution
|
$34.70 |
$34.70 |
$34.70 |
$385.62
|
|
Lidocaine (pf) 10 mg/ml (1 %) injection solution
|
$2.16 |
$2.16 |
$2.16 |
$46.02
|
|
Lidocaine therapeutic drug level
|
$155.76 |
$155.76 |
$155.76 |
$89.70
|
|
Ligation/biopsy of temporal artery 37609
|
$3,385.00 |
$3,385.00 |
$3,385.00 |
$3,322.80
|
|
Ligation/divis of long saph vein 37700
|
$4,255.00 |
$4,255.00 |
$4,255.00 |
$4,026.79
|
|
Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback
|
$80.67 |
$80.67 |
$80.67 |
$125.66
|
|
Lipase
|
$105.00 |
$105.00 |
$143.88 |
$93.58
|
|
Lipoprotein blood high res frac & quant
|
$147.84 |
$147.84 |
$147.84 |
$90.35
|
|
Lipoprotein blood quant
|
$137.50 |
$137.50 |
$217.80 |
$102.05
|
|
Lipoprotein direct measurement hdl
|
$54.12 |
$54.12 |
$54.12 |
$57.50
|
|
Lipoprotein direct measurement ldl
|
$62.70 |
$62.70 |
$67.50 |
$61.60
|
|
Lithium therapeutic drug level
|
$39.60 |
$39.60 |
$62.50 |
$69.42
|
|
Liver Function Test
|
$68.64 |
$68.64 |
$140.00 |
$115.44
|
|
Liver imaging
|
$1,255.00 |
$1,255.00 |
$1,961.52 |
$1,093.50
|
|
Liver/spleen imag static only
|
$951.06 |
$951.06 |
$1,380.00 |
$1,123.50
|
|
Lmtd oph exam general anes
|
$3,275.00 |
$3,275.00 |
$3,275.00 |
$2,590.36
|
|
Lorazepam 2 mg/ml injection (wrapper)
|
$32.34 |
$32.34 |
$39.15 |
$37.20
|
|
Low cost skin substitute app
|
$776.16 |
$776.16 |
$776.16 |
$909.35
|
|
Low cost skin substitute app
|
$1,032.90 |
$1,032.90 |
$1,032.90 |
$2,164.64
|
|
Low cost skin substitute app
|
$780.78 |
$780.78 |
$780.78 |
$933.60
|
|
Low cost skin substitute app
|
$865.26 |
$865.26 |
$865.26 |
$1,016.16
|
|
Low cost skin substitute app
|
$341.22 |
$341.22 |
$341.22 |
$429.50
|
|
Low cost skin substitute app
|
$616.44 |
$616.44 |
$616.44 |
$659.75
|
|
Low cost skin substitute app
|
$306.24 |
$306.24 |
$306.24 |
$349.44
|
|
Low cost skin substitute app
|
$801.24 |
$801.24 |
$801.24 |
$515.00
|
|
Lower Back (Lumbar Spine) CT scan (with and without contrast)
|
$1,818.96 |
$1,818.96 |
$2,305.00 |
$1,958.19
|
|
Lower Back (Lumbar Spine) CT scan (with contrast)
|
$1,562.88 |
$1,562.88 |
$1,570.00 |
$1,829.25
|
|
Lower Back (Lumbar Spine) CT scan (without contrast)
|
$1,359.60 |
$1,359.60 |
$1,470.00 |
$1,504.05
|
|
Lower Back (Lumbar Spine) MRI (with and without contrast)
|
$2,700.06 |
$2,700.06 |
$3,265.00 |
$3,111.17
|
|
Lower Back (Lumbar Spine) MRI (with contrast)
|
$2,210.00 |
$2,210.00 |
$2,571.36 |
$2,445.30
|
|
Lower Back (Lumbar Spine) MRI (without contrast)
|
$2,110.00 |
$2,110.00 |
$2,337.72 |
$2,096.84
|
|
Lower Back (Lumbar Spine) X-ray
|
$297.50 |
$297.50 |
$363.66 |
$352.32
|
|
Lumbar diskogram s&i
|
$1,940.00 |
$1,940.00 |
$2,484.90 |
$2,358.23
|
|
Lung function test (mbc/mvv)
|
$115.00 |
$115.00 |
$115.00 |
$180.16
|
|
Lung Function Test (Spirometry)
|
$265.00 |
$265.00 |
$363.00 |
$295.35
|
|
Lung perfusion imaging
|
$1,095.00 |
$1,095.00 |
$1,226.28 |
$1,075.25
|
|
Lurbinectedin 4 mg intravenous solution
|
$447.49 |
$447.49 |
$447.49 |
$20,101.00
|
|
Luspatercept-aamt 25 mg subcutaneous solution
|
$89.14 |
$89.14 |
$89.14 |
$21,867.91
|
|
Lutetium lu 177 vipivotide
|
$357.50 |
$357.50 |
$357.50 |
$332.80
|
|
Lymphatics/lymph node imaging
|
$1,385.00 |
$1,385.00 |
$1,463.22 |
$1,448.00
|
