|
Intranasal reconstruction
|
$4,496.00 |
$4,496.00 |
$4,496.00 |
|
|
Intraoral i+d tongue/floor lingual 41000
|
$287.79 |
$287.79 |
$1,466.40 |
|
|
Intrapul surf admin endo tube
|
$92.40 |
$205.00 |
$721.57 |
|
|
Intrauterine transfusion ftl
|
$1,075.00 |
$1,075.00 |
$2,058.96 |
|
|
Intraventricular pacing
|
$4,191.55 |
$6,857.95 |
$20,216.07 |
|
|
Intrinsic factor antibody
|
$24.20 |
$95.00 |
$193.97 |
|
|
Intrm oph exam est patient
|
$107.50 |
$107.50 |
$107.50 |
|
|
Intro cath dialysis circuit
|
$672.10 |
$1,145.00 |
$6,424.47 |
|
|
Intro cath dialysis circuit w/pta
|
$4,592.50 |
$8,190.00 |
$16,799.51 |
|
|
Intro cath dialysis circuit w/stent plcmnt
|
$6,494.40 |
$16,275.00 |
$31,013.39 |
|
|
Intro catheter aorta
|
$469.70 |
$1,060.00 |
$3,987.19 |
|
|
Intro cath svc/ivc
|
$590.15 |
$880.00 |
$4,668.24 |
|
|
Intro long gi tube
|
$200.75 |
$457.50 |
$4,987.31 |
|
|
Intro long gi tube w/mult fluo
|
$169.60 |
$317.50 |
$1,070.30 |
|
|
Intro windpipe wire/tube
|
$1,505.00 |
$1,505.00 |
$1,505.00 |
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$966.72 |
$2,902.81 |
$6,349.40 |
|
|
Intrvasc Ultrasound noncoronary addl vessel
|
$483.36 |
$2,090.00 |
$3,210.90 |
|
|
Intubation endotracheal emergency procedure
|
$302.50 |
$454.74 |
$1,094.94 |
|
|
Iodine i-123 sod iodide mil
|
$307.50 |
$307.50 |
$960.36 |
|
|
Ionm in operatng room 15 min
|
$37.95 |
$159.88 |
$297.86 |
|
|
Ionm remote/>1 pt or per hr
|
$277.20 |
$591.36 |
$1,165.30 |
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$2.40 |
$8.88 |
$492.98 |
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$0.33 |
$2.64 |
$768.29 |
|
|
Io rad tx delivery by x-ray
|
$2,300.00 |
$2,300.00 |
$2,300.00 |
|
|
Ioxaglate 39.3%-19.6% inj 200 ml
|
$2.40 |
$2.40 |
$2.40 |
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$228.12 |
$341.15 |
$35,025.80 |
|
|
Ip/obs cnsltj new/est low 45
|
$226.29 |
$242.82 |
$678.30 |
|
|
Ip/obs cnsltj new/est mod 60
|
$326.61 |
$340.29 |
$964.60 |
|
|
Ip/obs consltj new/est hi 80
|
$395.01 |
$409.83 |
$1,020.48 |
|
|
Ip/obs consltj new/est sf 35
|
$147.63 |
$153.33 |
$496.56 |
|
|
Ipratropium bromide comp
|
$0.02 |
$0.02 |
$0.02 |
|
|
Ipratropium bromide non-comp
|
$0.22 |
$13.60 |
$15.48 |
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$9.32 |
$13.96 |
$3,791.56 |
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$95.67 |
$115.89 |
$3,093.33 |
|
|
Iron
|
$25.97 |
$67.50 |
$144.06 |
|
|
Iron binding capacity
|
$15.40 |
$72.50 |
$152.28 |
|
|
Iron dextran 50 mg/ml injection solution
|
$28.65 |
$30.46 |
$88.53 |
|
|
Iron stain peripheral blood
|
$16.53 |
$16.53 |
$16.53 |
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$0.79 |
$1.14 |
$156.96 |
|
|
Irradiation of blood product each unit reference
|
$43.99 |
$65.00 |
$146.53 |
|
|
Irrigation implantable venous access device for drug delivery systems
|
$71.50 |
$112.50 |
$260.79 |
|
|
Irrigation sphenoid sinus
|
$472.80 |
$472.80 |
$472.80 |
|
|
Irrigation vagina and/or appl medicament tx disease
|
$39.75 |
$39.75 |
$39.75 |
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$10,621.76 |
$10,621.76 |
$10,621.76 |
|
|
Island pedicle flap graft
|
$2,996.80 |
$2,996.80 |
$2,996.80 |
|
|
Ivc venogram s&i
|
$1,674.80 |
$2,095.00 |
$6,442.64 |
|
|
IV Fluids (each additional hour)
|
$78.09 |
$143.88 |
$232.14 |
|
|
IV Fluids (first hour)
|
$187.50 |
$293.70 |
$614.52 |
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$84.93 |
$147.50 |
$604.40 |
|
|
IV inj ra drug dx study
|
$273.35 |
$647.52 |
$1,319.70 |
|
|
IV Medicine Infusion (additional drug)
|
$85.80 |
$145.86 |
$270.73 |
|
|
IV Medicine Infusion (each additional hour)
|
$84.93 |
$143.88 |
$232.14 |
|
|
IV Medicine Infusion (first hour)
|
$235.00 |
$337.50 |
$623.15 |
|
|
IV njx tst vasc flo flap/grf
|
$460.68 |
$460.68 |
$1,315.00 |
|
|
IV Push Injection (each additional drug)
|
$72.50 |
$136.18 |
$213.40 |
|
|
IV Push Injection (first drug)
|
$72.50 |
$182.85 |
$614.52 |
|
|
Ivp w/nephrotomography
|
$469.15 |
$469.15 |
$1,610.40 |
|
|
Ivp w/wo kub w/wo tomography
|
$437.80 |
$670.00 |
$2,220.25 |
|
|
Ixabepilone 15 mg intravenous solution
|
$124.69 |
$124.69 |
$189.96 |
|
|
Jak2 targeted sequence analysis
|
$297.00 |
$475.00 |
$1,339.96 |
|
|
Jaw arthroscopy/surgery
|
$9,062.40 |
$9,062.40 |
$9,062.40 |
|
|
Jaw Joint (TMJ) X-ray (both sides, open and closed)
|
$51.30 |
$315.48 |
$727.10 |
|
|
Jaw (Mandible) X-ray (complete)
|
$60.99 |
$391.38 |
$615.45 |
|
|
Jejunstmy tube plcmt
|
$1,050.40 |
$1,179.20 |
$1,179.20 |
|
|
John cunningham antibody
|
$22.80 |
$65.00 |
$1,585.32 |
|
|
J-tube placement
|
$2,253.60 |
$2,253.60 |
$2,253.60 |
|
|
Kafo fem fx cast molded to p
|
$4,095.31 |
$4,095.31 |
$4,404.39 |
|
|
Ketamine and metabolite screen - quest
|
$44.88 |
$225.00 |
$400.40 |
|
|
Ketogenic steroids fract
|
$49.29 |
$49.29 |
$49.29 |
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$24.20 |
$47.50 |
$155.88 |
|
|
Ketorolac (Toradol) Pain Shot, 15 mg
|
$3.03 |
$23.04 |
$76.00 |
|
|
Kidney endoscopy
|
$1,665.00 |
$1,665.00 |
$5,871.36 |
|
|
Kidney function study
|
$1,595.00 |
$1,595.00 |
$1,595.00 |
|
|
Kidney imaging morphology
|
$459.80 |
$1,170.18 |
$1,295.00 |
|
|
Kidney imag w/bld flow multi
|
$1,296.35 |
$2,231.55 |
$3,643.75 |
|
|
Kidney img w/bldflw sgl without rx
|
$524.15 |
$1,595.00 |
$1,898.05 |
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$410.97 |
$565.00 |
$1,495.12 |
|
|
Kidney (Retroperitoneal) Ultrasound (limited)
|
$225.72 |
$463.10 |
$1,415.87 |
|
|
Kit cast tcc 3in w/2reg boots total contact cast
|
$60.72 |
$83.21 |
$86.40 |
|
|
Kit cath ivl 2.5x40mm 135cm shockwave s4
|
$2,956.25 |
$7,614.00 |
$13,160.00 |
|
|
Kit gene analys d816 variant
|
$382.50 |
$382.50 |
$687.50 |
|
|
Kit hfx iq ipg bundle
|
$33,749.63 |
$33,749.63 |
$53,608.50 |
|
|
Kit ipg optimizer smart
|
$72,150.00 |
$72,150.00 |
$72,150.00 |
|
|
Kit lead specify 5-6-5
|
$1,412.98 |
$10,037.47 |
$22,776.88 |
|
|
Kit montgmry thyrplasty impl f 5 implants 1meas dev inst set
|
$1,176.18 |
$1,722.01 |
$2,026.94 |
|
|
Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm
|
$47.50 |
$47.50 |
$47.50 |
|
|
Kit sound processor cochlear osia 2
|
$4,780.80 |
$4,780.80 |
$4,780.80 |
|
|
Kit tissue closure sealant adhesive air leak progel 4 ml pleura
|
$1,509.41 |
$1,509.41 |
$3,390.66 |
|
|
Knee Arthroscopy (Cartilage Smoothing)
|
$951.90 |
$951.90 |
$8,013.60 |
|
|
Knee arthroscopy/drainage
|
$762.66 |
$762.66 |
$5,035.20 |
|
|
Knee arthroscopy dx
|
$385.31 |
$385.31 |
$7,492.00 |
|
|
Knee Arthroscopy (Meniscus Trimming)
|
$1,079.58 |
$1,079.58 |
$8,683.20 |
|
|
Knee arthroscopy/surgery
|
$687.42 |
$687.42 |
$6,718.40 |
|
|
Knee arthroscopy/surgery
|
$826.50 |
$826.50 |
$6,603.20 |
|
|
Knee arthroscopy/surgery
|
$6,932.80 |
$6,932.80 |
$6,932.80 |
|
|
Knee arthroscopy/surgery
|
$1,020.30 |
$1,020.30 |
$8,316.80 |
|
|
Knee arthroscopy/surgery
|
$1,033.41 |
$1,033.41 |
$8,743.20 |
|
|
Knee arthroscopy/surgery
|
$1,039.11 |
$1,039.11 |
$10,013.60 |
|
|
Knee arthroscopy/surgery
|
$1,254.00 |
$1,254.00 |
$4,794.40 |
|
|
Knee arthroscopy/surgery
|
$7,436.80 |
$7,436.80 |
$7,436.80 |
|
