|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1,239.15 |
$1,239.15 |
$1,239.15 |
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$22.07 |
$22.07 |
$22.07 |
|
|
Hydromorphone injection
|
$216.73 |
$216.73 |
$216.73 |
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$56.04 |
$505.68 |
$569.33 |
|
|
Hydroxyzine pamoate 25 mg capsule
|
$21.36 |
$22.96 |
$48.25 |
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$278.66 |
$1,001.11 |
$1,627.47 |
|
|
Hyoscyamine sulfate inj
|
$2,130.22 |
$2,130.22 |
$2,130.22 |
|
|
Hyperbaric oxygen therapy
|
$1,179.02 |
$1,179.02 |
$1,179.02 |
|
|
#hypersens-actinomyces ab
|
$19.88 |
$19.88 |
$19.88 |
|
|
Hysterosalpingography s&i
|
$238.05 |
$2,084.80 |
$5,525.85 |
|
|
Hysteroscopy ablation
|
$13,509.49 |
$13,509.49 |
$13,509.49 |
|
|
Hysteroscopy biopsy
|
$8,240.86 |
$8,240.86 |
$8,240.86 |
|
|
I-123 iobenguane diag
|
$3,116.42 |
$16,135.25 |
$39,345.75 |
|
|
I-123 ioflupane diag
|
$2,639.52 |
$2,849.84 |
$23,029.42 |
|
|
I-123 sod iodide diag per 100 uci
|
$84.26 |
$370.75 |
$4,380.00 |
|
|
I125 iothalamate, dx
|
$3,576.00 |
$3,576.00 |
$3,576.00 |
|
|
I-131 iobenguane sulf diag mibg
|
$15,012.27 |
$15,012.27 |
$15,012.27 |
|
|
I131 iodide cap, rx
|
$20.94 |
$303.00 |
$2,296.00 |
|
|
I131 max 100uci
|
$237.66 |
$237.66 |
$4,132.12 |
|
|
Iaadi respiratory synctial virus
|
$8.70 |
$77.39 |
$190.79 |
|
|
Iadna legionella pneumophila amplified probe tq
|
$15.37 |
$418.61 |
$2,909.74 |
|
|
Ia nfct ab sarscov2 covid19
|
$25.16 |
$36.31 |
$100.50 |
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$466.30 |
$2,437.03 |
$11,833.36 |
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$2,318.96 |
$2,336.32 |
$9,092.88 |
|
|
Icatibant injection
|
$20,092.00 |
$29,461.00 |
$29,461.00 |
|
|
Icd cobalt xt dr MRI is1 df1
|
$34,953.46 |
$38,501.37 |
$91,876.36 |
|
|
Icd crtd cobalt hf MRI is1 df1
|
$25,753.21 |
$25,753.21 |
$65,614.54 |
|
|
Icd crtp serena MRI
|
$11,651.86 |
$12,834.57 |
$30,627.32 |
|
|
Icd reliance df4 ib 64cm
|
$12,188.83 |
$13,240.16 |
$17,576.89 |
|
|
Idarubicin hcl injection
|
$8.15 |
$4,122.72 |
$5,178.76 |
|
|
I&d/bursa/foot 28001
|
$4,370.59 |
$4,370.59 |
$4,370.59 |
|
|
I&d frarm&/wrst deep absc/hematoma
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Idh1 common variants
|
$80.62 |
$511.97 |
$1,331.25 |
|
|
Idh2 common variants
|
$123.43 |
$511.97 |
$1,331.25 |
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$7,529.14 |
$7,529.14 |
$7,529.14 |
|
|
Ifnl3 gene
|
$30.72 |
$68.07 |
$139.67 |
|
|
Ifosfamide 1 gram intravenous solution
|
$420.26 |
$1,287.50 |
$6,042.00 |
|
|
Igh@/bcl2 translocation alys
|
$979.21 |
$979.21 |
$979.21 |
|
|
Igh gene rearrang dir probe
|
$2,839.75 |
$2,839.75 |
$2,839.75 |
|
|
Igh gene rearrange amp meth
|
$82.57 |
$1,948.00 |
$2,999.73 |
|
|
Igh@ var region somatic mutation analy
|
$122.88 |
$919.07 |
$5,022.38 |
|
|
Igk rearrangeabn clonal pop
|
$72.14 |
$293.17 |
$7,097.00 |
|
|
Ihc/icc per specimen each additional single antibody stain
|
$84.39 |
$403.16 |
$1,735.16 |
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$332.11 |
$756.05 |
$2,951.20 |
|
|
Ihc/icc per specimen initial single antibody stain
|
$169.59 |
$651.00 |
$2,283.57 |
|
|
Iiv3 vacc no prsv 0.25 ml im
|
$48.56 |
$137.00 |
$197.12 |
|
|
Ikbkap gene
|
$1,050.00 |
$1,050.00 |
$2,839.75 |
|
|
Iliac/fem angio cath insert
|
$1,660.53 |
$5,332.92 |
$5,332.92 |
|
|
Iliac revasc add-on 37222
|
$5,110.97 |
$13,488.62 |
$13,488.62 |
|
|
Iloprost non-comp unit dose
|
$1,465.43 |
$1,465.43 |
$1,465.43 |
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$567.76 |
$567.76 |
$567.76 |
|
|
Immobilizer shldr cntor adlt
|
$290.43 |
$290.43 |
$290.43 |
|
|
Immobilizer shldr dlx str 24-36in med
|
$179.00 |
$232.12 |
$232.12 |
|
|
Immobilizer shldr sling med
|
$208.98 |
$208.98 |
$208.98 |
|
|
Immune complex assay
|
$13.69 |
$296.96 |
$1,304.62 |
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$14.98 |
$4,733.76 |
$7,906.35 |
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$384.74 |
$559.59 |
$7,490.00 |
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$12,089.74 |
$12,089.74 |
$12,089.74 |
|
|
Immunoassay tumor antigen quantitative ca 125
|
$11.65 |
$333.24 |
$2,087.21 |
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$11.65 |
$333.24 |
$2,087.21 |
|
|
Immunoassay tumor qual
|
$831.31 |
$831.31 |
$1,242.51 |
|
|
Immunodiff gel qual ea antigen/ab
|
$10.36 |
$189.97 |
$189.97 |
|
|
Immunodiffusion nes
|
$10.18 |
$223.32 |
$1,539.00 |
|
|
Immunofixation electrophoresis serum
|
$26.27 |
$357.17 |
$2,350.11 |
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$93.18 |
$313.70 |
$1,735.16 |
|
|
Immunofluorescence per specimen initial single antibody stain
|
$169.59 |
$587.00 |
$2,207.93 |
|
|
Immunoglobulin assay
|
$43.66 |
$277.13 |
$2,938.00 |
|
|
Immunology procedure
|
$225.03 |
$225.03 |
$2,136.75 |
|
|
Implant cartilage 10mm synthetic
|
$44,905.62 |
$51,554.74 |
$79,432.91 |
|
|
Implant cochlear osia osi300
|
$22,751.20 |
$24,713.57 |
$70,043.00 |
|
|
Implant hormone pellet(s) 11980
|
$1,100.47 |
$1,100.47 |
$1,100.47 |
|
|
Implant neuroelectrodes
|
$62,708.67 |
$62,708.67 |
$62,708.67 |
|
|
Implant neuroelectrodes
|
$2,296.23 |
$17,945.15 |
$17,945.15 |
|
|
Implant neuroelectrodes
|
$3,201.86 |
$3,201.86 |
$3,201.86 |
|
|
Implant pulse generator remede el
|
$56,875.78 |
$56,875.78 |
$56,875.78 |
|
|
Implant single ventricular device 33975
|
$5,507.21 |
$5,507.21 |
$5,507.21 |
|
|
Implant spine infusion pump
|
$3,040.89 |
$88,012.27 |
$88,012.27 |
|
|
Implant tcat pulm vlv perq
|
$46,722.62 |
$46,722.62 |
$46,722.62 |
|
|
Implant ureth bulk agent
|
$1,240.43 |
$2,264.96 |
$12,454.00 |
|
|
Impl ear abutment ba300 9mm
|
$4,128.58 |
$4,128.58 |
$9,082.00 |
|
|
Impl neurostim electr perc
|
$2,356.12 |
$25,489.32 |
$25,489.32 |
|
|
Implnt spinl canal catheter 62350
|
$3,084.23 |
$3,084.23 |
$3,499.12 |
|
|
Imported lipodox inj
|
$9,652.00 |
$9,652.00 |
$9,652.00 |
|
|
Imuglucerase injection
|
$454.04 |
$7,991.05 |
$12,259.52 |
|
|
In-111 autol wbc diag per dose
|
$1,759.87 |
$17,788.75 |
$21,431.05 |
|
|
In-111 ibritumomab tiux dx
|
$29,258.75 |
$46,975.00 |
$53,019.42 |
|
|
In-111 oxyquinolin per 0.5 mci
|
$726.93 |
$946.33 |
$23,574.79 |
|
|
In-111 pentetate dtpa / 0.5 mci
|
$936.23 |
$5,465.76 |
$53,151.00 |
|
|
In-111 pentetreotide
|
$1,482.41 |
$15,997.50 |
$32,810.45 |
|
|
In-111 satumomab pend
|
$14,672.57 |
$14,672.57 |
$14,672.57 |
|
|
Incise tendon(s) & muscle(s)
|
$20,180.27 |
$20,180.27 |
$20,180.27 |
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$272.63 |
$5,534.27 |
$5,534.27 |
|
|
Incision of achilles tendon
|
$5,916.21 |
$5,916.21 |
$5,916.21 |
|
|
Incision of ankle bone
|
$8,675.77 |
$8,675.77 |
$8,675.77 |
|
|
Incision of breast lesion
|
$4,705.79 |
$4,705.79 |
$4,705.79 |
|
|
Incision of burn scab initi
|
$1,087.35 |
$1,087.35 |
$1,087.35 |
|
|
Incision of foot fascia
|
$7,546.32 |
$7,546.32 |
$7,546.32 |
|
|
Incision of foot tendon 28234
|
$9,949.50 |
$9,949.50 |
$9,949.50 |
|
|
Incision of heel bone
|
$19,279.01 |
$19,279.01 |
$19,279.01 |
|
|
Incision of hip tendon
|
$5,905.07 |
$5,905.07 |
$5,905.07 |
|
