|
Hydration IV infusion initial 31minutes - 1 hour
|
$1,006.33 |
$1,006.33 |
$1,006.33 |
$394.40
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1,565.74 |
$1,565.74 |
$1,565.74 |
$112.22
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$717.05 |
$717.05 |
$717.05 |
$86.47
|
|
Hyoscyamine sulfate inj
|
$2,694.78 |
$2,694.78 |
$2,694.78 |
$215.75
|
|
Hysteroscopy biopsy
|
$22,092.78 |
$22,092.78 |
$22,092.78 |
$4,753.18
|
|
Iaadi respiratory synctial virus
|
$266.32 |
$266.32 |
$266.32 |
$42.48
|
|
Iadna legionella pneumophila amplified probe tq
|
$205.49 |
$205.49 |
$205.49 |
$125.25
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$3,083.52 |
$3,083.52 |
$3,083.52 |
$839.85
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$2,955.91 |
$2,955.91 |
$2,955.91 |
$891.89
|
|
Ihc/icc per specimen each additional single antibody stain
|
$226.47 |
$226.47 |
$226.47 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$2,750.88 |
$2,750.88 |
$2,750.88 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$1,393.74 |
$1,393.74 |
$1,393.74 |
$266.76
|
|
Iliac/fem angio cath insert
|
$583.96 |
$583.96 |
$583.96 |
$1,601.66
|
|
Immune complex assay
|
$483.62 |
$483.62 |
$483.62 |
$88.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$18,724.38 |
$18,724.38 |
$18,724.38 |
$5,617.36
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$47,922.74 |
$47,922.74 |
$47,922.74 |
$5,495.02
|
|
Immunoassay tumor antigen quantitative ca 125
|
$412.98 |
$412.98 |
$412.98 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$412.98 |
$412.98 |
$412.98 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$237.74 |
$237.74 |
$237.74 |
$53.95
|
|
Immunofixation electrophoresis serum
|
$127.63 |
$127.63 |
$127.63 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$357.13 |
$357.13 |
$357.13 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$2,750.88 |
$2,750.88 |
$2,750.88 |
$250.00
|
|
Immunoglobulin assay
|
$247.26 |
$247.26 |
$247.26 |
$74.00
|
|
Immunology procedure
|
$307.13 |
$307.13 |
$307.13 |
$281.45
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$4,519.95 |
$4,519.95 |
$4,519.95 |
$2,261.20
|
|
Infect ag drug suscept pheno predict
|
$2,586.80 |
$2,586.80 |
$2,586.80 |
$325.00
|
|
Infect ag genotype na dna hepatitis b
|
$785.22 |
$785.22 |
$785.22 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$2,554.65 |
$2,554.65 |
$2,554.65 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$785.22 |
$785.22 |
$785.22 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$328.44 |
$328.44 |
$328.44 |
$66.72
|
|
Infect ag if influenza a
|
$318.91 |
$318.91 |
$318.91 |
$40.61
|
|
Infect ag if influenza b
|
$243.11 |
$243.11 |
$243.11 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$309.58 |
$309.58 |
$309.58 |
$75.79
|
|
Infect ag if nos ea
|
$319.50 |
$319.50 |
$319.50 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$237.74 |
$237.74 |
$237.74 |
$62.29
|
|
Infect ag na herpes simplex quant
|
$850.16 |
$850.16 |
$850.16 |
$145.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$392.62 |
$392.62 |
$392.62 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$156.50 |
$156.50 |
$156.50 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$8,271.00 |
$8,271.00 |
$8,271.00 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,490.41 |
$1,490.41 |
$1,490.41 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$79.51 |
$79.51 |
$79.51 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$63.69 |
$63.69 |
$63.69 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$266.32 |
$266.32 |
$266.32 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$229.53 |
$229.53 |
$229.53 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$57.42 |
$57.42 |
$57.42 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$114.87 |
$114.87 |
$114.87 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$205.00 |
$205.00 |
$205.00 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$205.00 |
$205.00 |
$205.00 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$99.04 |
$99.04 |
$99.04 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$337.43 |
$337.43 |
$337.43 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$659.14 |
$659.14 |
$659.14 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$237.74 |
$237.74 |
$237.74 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$821.21 |
$821.21 |
$821.21 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$696.36 |
$696.36 |
$696.36 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$739.62 |
$739.62 |
$739.62 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,401.48 |
$1,401.48 |
$1,401.48 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$696.36 |
$696.36 |
$696.36 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$696.36 |
$696.36 |
$696.36 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$827.14 |
$827.14 |
$827.14 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$696.36 |
$696.36 |
$696.36 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$1,018.25 |
$1,018.25 |
$1,018.25 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$2,830.50 |
$2,830.50 |
$2,830.50 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$2,830.50 |
$2,830.50 |
$2,830.50 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$123.89 |
$123.89 |
$123.89 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$696.36 |
$696.36 |
$696.36 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,401.48 |
$1,401.48 |
$1,401.48 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$2,545.91 |
$2,545.91 |
$2,545.91 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$802.12 |
$802.12 |
$802.12 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$850.16 |
$850.16 |
$850.16 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$850.16 |
$850.16 |
$850.16 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$850.16 |
$850.16 |
$850.16 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$478.61 |
$478.61 |
$478.61 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$2,830.50 |
$2,830.50 |
$2,830.50 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,323.00 |
$1,323.00 |
$1,323.00 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$805.20 |
$805.20 |
$805.20 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$116,493.66 |
$116,493.66 |
$116,493.66 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$26,109.87 |
$26,109.87 |
$26,109.87 |
$9,702.65
|
|
Inj cefazolin sodium, hikma
|
$279.00 |
$279.00 |
$279.00 |
$56.70
|
|
Inj cntr knee arthro incl ct/mri
|
$326.17 |
$326.17 |
$326.17 |
$464.28
|
|
Inj, durolane 1 mg
|
$12,314.18 |
$12,314.18 |
$12,314.18 |
$3,382.31
|
|
Inj dx for sinogram
|
$990.68 |
$990.68 |
$990.68 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,822.35 |
$2,822.35 |
$2,822.35 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$30,788.94 |
$30,788.94 |
$30,788.94 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$314.01 |
$314.01 |
$314.01 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,897.98 |
$2,897.98 |
$2,897.98 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$622.49 |
$622.49 |
$622.49 |
$441.12
|
|
Injection for bladder x-ray
|
$1,709.65 |
$1,709.65 |
$1,709.65 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,505.56 |
$2,505.56 |
$2,505.56 |
$504.00
|
|
Injection for ureter x-ray
|
$2,293.12 |
$2,293.12 |
$2,293.12 |
$444.95
|
|
Injection, fulvestrant
|
$18,776.35 |
$18,776.35 |
$18,776.35 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$82,398.10 |
$82,398.10 |
$82,398.10 |
$10,366.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,874.00 |
$2,874.00 |
$2,874.00 |
$717.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,416.18 |
$1,416.18 |
$1,416.18 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,416.18 |
$1,416.18 |
$1,416.18 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$6,780.46 |
$6,780.46 |
$6,780.46 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$7,472.68 |
$7,472.68 |
$7,472.68 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$8,593.17 |
$8,593.17 |
$8,593.17 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$5,977.71 |
$5,977.71 |
$5,977.71 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$988.28 |
$988.28 |
$988.28 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$988.28 |
$988.28 |
$988.28 |
$670.00
|
