|
Graft apligraf 3in 44sqcm-q4101-cost per sq cm
|
$8,925.00 |
$8,925.00 |
$8,925.00 |
$79.30
|
|
Graft fish skin 16mm round marigen 2units-cost per sq cm
|
$5,299.00 |
$5,299.00 |
$5,299.00 |
$1,043.63
|
|
Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm
|
$8,785.00 |
$8,785.00 |
$8,785.00 |
$2,227.50
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$656.00 |
$656.00 |
$656.00 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$156.00 |
$156.00 |
$156.00 |
$31.60
|
|
Haptoglobin quantitative
|
$1,297.75 |
$1,297.75 |
$1,297.75 |
$88.40
|
|
Hbot, full body chamber, 30m
|
$479.75 |
$479.75 |
$479.75 |
$479.75
|
|
Hcg qualitative
|
$2,060.00 |
$2,060.00 |
$2,060.00 |
$77.50
|
|
Hcg quantitative
|
$2,914.75 |
$2,914.75 |
$2,914.75 |
$125.40
|
|
Hc i-131 sodium iodide cap dx per mci
|
$17,750.00 |
$17,750.00 |
$17,750.00 |
$139.60
|
|
Hc pet myocardial imaging metabolic eval single study
|
$7,565.00 |
$7,565.00 |
$7,565.00 |
$3,256.36
|
|
Head CT scan (with and without contrast)
|
$21,662.00 |
$21,662.00 |
$21,662.00 |
$1,881.36
|
|
Head CT scan (with contrast)
|
$20,101.25 |
$20,101.25 |
$20,101.25 |
$1,543.10
|
|
Head CT scan (without contrast)
|
$20,101.25 |
$20,101.25 |
$20,101.25 |
$1,268.90
|
|
Heart infarct image
|
$6,037.25 |
$6,037.25 |
$6,037.25 |
$840.74
|
|
Heinz bodies direct
|
$271.00 |
$271.00 |
$271.00 |
$31.22
|
|
Helicobacter pylori antibody igm
|
$869.75 |
$869.75 |
$869.75 |
$84.80
|
|
Hematocrit
|
$288.00 |
$288.00 |
$288.00 |
$33.57
|
|
Hemoglobin
|
$288.00 |
$288.00 |
$288.00 |
$32.50
|
|
Heparin assay
|
$350.00 |
$350.00 |
$350.00 |
$130.20
|
|
Hepatitis a antibody igm
|
$1,427.50 |
$1,427.50 |
$1,427.50 |
$84.00
|
|
Hepatitis b core antibody igm
|
$288.00 |
$288.00 |
$288.00 |
$86.40
|
|
Hepatitis b core antibody total
|
$645.75 |
$645.75 |
$645.75 |
$83.20
|
|
Hepatitis b surface antibody
|
$1,427.50 |
$1,427.50 |
$1,427.50 |
$82.55
|
|
Hepatitis c antibody
|
$1,437.50 |
$1,437.50 |
$1,437.50 |
$108.00
|
|
Hepatitis c rna dir probe
|
$198.00 |
$198.00 |
$198.00 |
$34.34
|
|
Hepatobiliary system imaging
|
$6,760.50 |
$6,760.50 |
$6,760.50 |
$1,522.95
|
|
Heterophile antibodies screening
|
$2,524.50 |
$2,524.50 |
$2,524.50 |
$74.10
|
|
Hhv-6 dna quant
|
$1,500.50 |
$1,500.50 |
$1,500.50 |
$200.25
|
|
Hip X-ray
|
$317.25 |
$317.25 |
$317.25 |
$290.35
|
|
Histochemical stains add-on
|
$473.75 |
$473.75 |
$473.75 |
$170.00
|
|
Hla class i/ii antibody qual
|
$188.00 |
$188.00 |
$188.00 |
$88.58
|
|
Hla i low res one antigen equiv ea
|
$30.75 |
$30.75 |
$30.75 |
$163.50
|
|
Hla i typing high res 1 allele grp ea
|
$182.25 |
$182.25 |
$182.25 |
$306.80
|
|
Hla typing a b or c
|
$2,361.25 |
$2,361.25 |
$2,361.25 |
$309.40
|
|
Hla typing dr/dq
|
$590.75 |
$590.75 |
$590.75 |
$135.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$450.00 |
$450.00 |
$450.00 |
$68.86
|
|
Homocysteine
|
$1,149.75 |
$1,149.75 |
$1,149.75 |
$107.62
|
|
Homogenization tissue
|
$8.25 |
$8.25 |
$8.25 |
$40.30
|
|
Homovanillic acid (hva)
|
$1,251.50 |
$1,251.50 |
$1,251.50 |
$56.00
|
|
H pylori (c-13) breath
|
$1,177.75 |
$1,177.75 |
$1,177.75 |
$213.00
|
|
Hyaluronidase 150 unit/ml injection solution
|
$2,456.25 |
$2,456.25 |
$2,456.25 |
$161.00
|
|
Hydralazine 20 mg/ml injection solution
|
$214.00 |
$214.00 |
$214.00 |
$54.51
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$361.00 |
$361.00 |
$361.00 |
$73.45
|
|
Hysterosalpingography s&i
|
$5,827.50 |
$5,827.50 |
$5,827.50 |
$585.20
|
|
I-123 sod iodide diag per 100 uci
|
$630.75 |
$630.75 |
$630.75 |
$157.80
|
|
I131 iodide cap, rx
|
$233.75 |
$233.75 |
$233.75 |
$97.90
|
|
Iaadi respiratory synctial virus
|
$1,266.75 |
$1,266.75 |
$1,266.75 |
$42.35
|
|
Ibuprofen injection
|
$104.00 |
$104.00 |
$104.00 |
$90.23
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$4,018.00 |
$4,018.00 |
$4,018.00 |
$918.69
|
|
Idarubicin hcl injection
|
$5,019.00 |
$5,019.00 |
$5,019.00 |
$530.27
|
|
Ifosfamide 1 gram intravenous solution
|
$1,752.00 |
$1,752.00 |
$1,752.00 |
$286.10
|
|
Ihc/icc per specimen each additional single antibody stain
|
$286.50 |
$286.50 |
$286.50 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$944.25 |
$944.25 |
$944.25 |
$342.16
|
|
Immune complex assay
|
$917.75 |
$917.75 |
$917.75 |
$88.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$1,588.00 |
$1,588.00 |
$1,588.00 |
$4,669.36
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$3,238.00 |
$3,238.00 |
$3,238.00 |
$1,681.70
|
|
Immunoassay tumor antigen quantitative ca 125
|
$541.50 |
$541.50 |
$541.50 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$541.50 |
$541.50 |
$541.50 |
$116.40
|
|
Immunodiffusion nes
|
$232.75 |
$232.75 |
$232.75 |
$56.71
|
|
Immunofixation electrophoresis serum
|
$327.50 |
$327.50 |
$327.50 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$304.50 |
$304.50 |
$304.50 |
$161.85
|
|
Implant ureth bulk agent
|
$594.00 |
$594.00 |
$594.00 |
$1,708.88
|
|
In-111 capromab pendet
|
$299.25 |
$299.25 |
$299.25 |
$3,941.34
|
|
In-111 oxyquinolin per 0.5 mci
|
$36,747.25 |
$36,747.25 |
$36,747.25 |
$2,703.60
|
|
In-111 pentetate dtpa / 0.5 mci
|
$7,655.50 |
$7,655.50 |
$7,655.50 |
$2,106.00
|
|
In-111 satumomab pend
|
$21,790.75 |
$21,790.75 |
$21,790.75 |
$3,524.25
|
|
Infect ag genotype na hiv-1 other region
|
$89.25 |
$89.25 |
$89.25 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$2,812.00 |
$2,812.00 |
$2,812.00 |
$558.00
|
|
Infect ag ia optc obs influenza
|
$335.50 |
$335.50 |
$335.50 |
$65.58
|
|
Infect ag if hep delta agent
|
$182.25 |
$182.25 |
$182.25 |
$123.00
|
|
Infect ag if influenza a
|
$44.50 |
$44.50 |
$44.50 |
$40.61
|
|
Infect ag if influenza b
|
$44.50 |
$44.50 |
$44.50 |
$33.60
|
|
Infect ag if legionella pneumophila
|
$1,841.75 |
$1,841.75 |
$1,841.75 |
$75.75
|
|
Infect ag if varicella zoster
|
$778.00 |
$778.00 |
$778.00 |
$66.00
|
|
Infect ag na orthopoxvirus amp prb each
|
$109.00 |
$109.00 |
$109.00 |
$101.00
|
|
Infect ag na resp virus 12-25 targets
|
$1,027.50 |
$1,027.50 |
$1,027.50 |
$847.94
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$1,209.00 |
$1,209.00 |
$1,209.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$354.00 |
$354.00 |
$354.00 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$354.00 |
$354.00 |
$354.00 |
$77.01
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$327.50 |
$327.50 |
$327.50 |
$78.51
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$164.00 |
$164.00 |
$164.00 |
$99.75
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$944.25 |
$944.25 |
$944.25 |
$141.18
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$96.25 |
$96.25 |
$96.25 |
$172.15
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$571.00 |
$571.00 |
$571.00 |
$173.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$255.75 |
$255.75 |
$255.75 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$944.25 |
$944.25 |
$944.25 |
$133.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$67.25 |
$67.25 |
$67.25 |
$102.87
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$3,643.25 |
$3,643.25 |
$3,643.25 |
$272.91
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$471.00 |
$471.00 |
$471.00 |
$76.00
|
|
Initiation & management bipap/cpap initial day
|
$724.75 |
$724.75 |
$724.75 |
$632.37
|
|
Inj, bupivacaine liposome
|
$4,387.14 |
$4,387.14 |
$4,387.14 |
$1,040.36
|
|
Inj calcitriol per 0.1 mcg
|
$151.00 |
$151.00 |
$151.00 |
$31.80
|
|
Inj ceftolozane tazobactam
|
$755.00 |
$755.00 |
$755.00 |
$422.69
|
|
Injection, daratumumab 10 mg
|
$22,000.00 |
$22,000.00 |
$22,000.00 |
$5,536.46
|
|
Injection, fulvestrant
|
$13,109.00 |
$13,109.00 |
$13,109.00 |
$2,728.69
|
|
Injection,onabotulinumtoxina
|
$7,306.00 |
$7,306.00 |
$7,306.00 |
$2,154.07
|
|
Inj hydroxocobalamin IV 25mg
|
$10,981.99 |
$10,981.99 |
$10,981.99 |
$3,180.35
|
|
Inj ivig privigen 500 mg
|
$17,841.00 |
$17,841.00 |
$17,841.00 |
$7,173.90
|
