|
Img rta detc/mntr ds phy/qhp
|
$129.00 |
$129.00 |
$129.00 |
$46.45
|
|
Immob elbow child sm
|
$43.53 |
$43.53 |
$43.53 |
$78.19
|
|
Immobilizer shldr cntor adlt
|
$800.38 |
$800.38 |
$800.38 |
$154.00
|
|
Immobilizer shldr sling med
|
$605.81 |
$605.81 |
$605.81 |
$34.03
|
|
Immune complex assay
|
$376.15 |
$376.15 |
$560.62 |
$88.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$1,330.00 |
$10,372.35 |
$11,928.45 |
$5,816.40
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$1,300.00 |
$1,300.00 |
$1,300.00 |
$2,854.20
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$26,541.62 |
$26,541.62 |
$30,526.58 |
$5,089.25
|
|
Immunoassay tumor antigen quantitative ca 125
|
$18.46 |
$321.21 |
$321.21 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$18.46 |
$321.21 |
$321.21 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$182.00 |
$184.92 |
$184.92 |
$53.95
|
|
Immunodiffusion nes
|
$15.04 |
$216.87 |
$324.87 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$110.91 |
$110.91 |
$344.82 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$130.62 |
$304.34 |
$1,792.54 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$163.00 |
$3,289.10 |
$3,289.10 |
$250.00
|
|
Immunoglobulin assay
|
$81.91 |
$192.32 |
$192.32 |
$74.00
|
|
Immunology procedure
|
$300.98 |
$300.98 |
$300.98 |
$281.45
|
|
Implant hormone pellet(s) 11980
|
$2,753.67 |
$2,753.67 |
$2,753.67 |
$315.75
|
|
Implant neuroelectrodes
|
$42,186.55 |
$42,186.55 |
$42,186.55 |
$19,287.34
|
|
Implant neuroelectrodes
|
$35,440.80 |
$35,440.80 |
$35,440.80 |
$7,345.58
|
|
Implant neuroelectrodes
|
$38,530.78 |
$38,530.78 |
$38,530.78 |
$7,266.73
|
|
Implant single ventricular device 33975
|
$6,086.90 |
$6,086.90 |
$6,086.90 |
$5,053.23
|
|
Implant spine infusion pump
|
$48,506.85 |
$48,506.85 |
$48,506.85 |
$18,613.91
|
|
Implant tcat pulm vlv perq
|
$52,072.35 |
$52,072.35 |
$52,072.35 |
$18,494.40
|
|
Implant ureth bulk agent
|
$1,930.57 |
$1,930.57 |
$1,930.57 |
$2,003.82
|
|
Impl neurostim electr perc
|
$38,530.78 |
$38,530.78 |
$38,530.78 |
$7,636.00
|
|
In-111 autol wbc diag per dose
|
$17,084.30 |
$17,084.30 |
$17,084.30 |
$3,704.00
|
|
In-111 oxyquinolin per 0.5 mci
|
$9,448.89 |
$9,448.89 |
$20,594.32 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$18,619.12 |
$18,619.12 |
$20,089.03 |
$2,135.29
|
|
In-111 pentetreotide
|
$8,709.24 |
$8,709.24 |
$29,489.82 |
$6,617.05
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$5,186.82 |
$5,186.82 |
$5,186.82 |
$2,261.20
|
|
Incision of achilles tendon
|
$4,955.10 |
$4,955.10 |
$4,955.10 |
$3,306.48
|
|
Incision of breast lesion
|
$16,444.17 |
$16,444.17 |
$16,444.17 |
$3,029.60
|
|
Incision of burn scab initi
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$501.00
|
|
Incision of eardrum
|
$771.72 |
$771.72 |
$771.72 |
$470.73
|
|
Incision of eardrum
|
$30,746.36 |
$30,746.36 |
$30,746.36 |
$3,589.62
|
|
Incision of foot fascia
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$4,499.12
|
|
Incision of foot tendon 28234
|
$4,955.10 |
$4,955.10 |
$5,381.32 |
$2,116.27
|
|
Incision of heel bone
|
$59,420.49 |
$59,420.49 |
$59,420.49 |
$6,004.47
|
|
Incision of metatarsal
|
$31,045.79 |
$31,045.79 |
$31,045.79 |
$3,594.44
|
|
Incision of midfoot bones
|
$59,420.49 |
$59,420.49 |
$59,420.49 |
$6,004.47
|
|
Incision of tendon sheath
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,263.68
|
|
Incision of thigh tendon
|
$9,226.39 |
$9,226.39 |
$9,226.39 |
$4,499.12
|
|
Incision of thigh tendons
|
$9,226.39 |
$9,226.39 |
$9,226.39 |
$4,627.00
|
|
Incision of tibia
|
$59,420.49 |
$59,420.49 |
$59,420.49 |
$5,886.74
|
|
Incision of toe tendons 28011
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,068.30
|
|
Incision of tongue fold
|
$15,514.83 |
$15,514.83 |
$15,514.83 |
$1,865.58
|
|
Incision of urethra
|
$18,806.12 |
$18,806.12 |
$18,806.12 |
$3,549.60
|
|
Incision tendon sheath
|
$16,347.39 |
$16,347.39 |
$16,347.39 |
$2,309.40
|
|
Incisn of toe tndn
|
$7,048.25 |
$7,048.25 |
$7,048.25 |
$2,298.99
|
|
Incisn windpipe
|
$9,451.16 |
$9,451.16 |
$9,986.24 |
$3,837.72
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$689.04 |
$689.04 |
$689.04 |
$876.13
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$245.70 |
$245.70 |
$245.70 |
$137.15
|
|
Infect ag drug suscept pheno predict
|
$652.00 |
$2,011.96 |
$2,011.96 |
$325.00
|
|
Infect ag eia chlamydia trachomatis
|
$422.62 |
$422.62 |
$1,790.50 |
$16.50
|
|
Infect ag eia influenza a or b ea
|
$218.10 |
$218.10 |
$218.10 |
$69.03
|
|
Infect ag genotype na cytomegalovirus
|
$3,973.75 |
$3,973.75 |
$3,973.75 |
$603.41
|
|
Infect ag genotype na dna hepatitis b
|
$3,973.75 |
$3,973.75 |
$3,973.75 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$1,986.95 |
$1,986.95 |
$1,986.95 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$163.50 |
$1,126.00 |
$1,277.79 |
$574.60
|
|
Infect ag ia direct hiv-1 antgn
|
$122.83 |
$122.83 |
$122.83 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$255.45 |
$255.45 |
$1,153.13 |
$66.72
|
|
Infect ag if ea plyvlnt antsrm
|
$273.12 |
$273.12 |
$273.12 |
$37.74
|
|
Infect ag if influenza a
|
$248.04 |
$248.04 |
$595.93 |
$40.61
|
|
Infect ag if influenza b
|
$189.08 |
$189.08 |
$595.93 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$43.60 |
$240.79 |
$273.12 |
$75.79
|
|
Infect ag if nos ea
|
$248.50 |
$248.50 |
$248.50 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$184.92 |
$184.92 |
$422.62 |
$62.29
|
|
Infect ag if varicella zoster
|
$207.13 |
$207.13 |
$422.62 |
$66.00
|
|
Infect ag na hep b amp
|
$541.61 |
$541.61 |
$541.61 |
$108.44
|
|
Infect ag na herpes simplex quant
|
$661.24 |
$661.24 |
$661.24 |
$145.20
|
|
Infect ag na hpv high-risk types
|
$541.61 |
$541.61 |
$541.61 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$195.72 |
$661.24 |
$821.86 |
$227.96
|
|
Infect ag na influenza revr/amp ea type
|
$218.00 |
$218.00 |
$791.97 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$77.00 |
$77.00 |
$211.96 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$6,433.00 |
$6,433.00 |
$6,433.00 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$817.50 |
$860.00 |
$7,542.47 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$402.39 |
$402.39 |
$402.39 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$74.31 |
$74.31 |
$4,717.49 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$228.01 |
$228.01 |
$228.01 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$80.22 |
$119.74 |
$422.62 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$90.80 |
$90.80 |
$461.44 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$100.02 |
$100.02 |
$100.02 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$159.44 |
$159.44 |
$2,509.85 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$130.73 |
$130.73 |
$240.00 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$119.50 |
$119.50 |
$119.50 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$212.46 |
$212.46 |
$212.46 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$199.78 |
$199.78 |
$1,839.81 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$16.35 |
$184.92 |
$424.06 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$541.61 |
$541.61 |
$541.61 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$541.61 |
$541.61 |
$541.61 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$241.23 |
$241.23 |
$241.23 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,458.73 |
$1,458.73 |
$1,458.73 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$190.75 |
$541.61 |
$541.61 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$541.61 |
$541.61 |
$1,425.69 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$97.00 |
$109.00 |
$643.34 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$541.61 |
$541.61 |
$541.61 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.69 |
$100.13 |
$791.97 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$2,201.49 |
$2,201.49 |
$2,201.49 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$2,201.49 |
$2,201.49 |
$2,201.49 |
$248.15
|