|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$179.02 |
$179.02 |
$179.02 |
$120.72
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$334.42 |
$334.42 |
$334.42 |
$294.92
|
|
Hydromorphone injection
|
$242.55 |
$242.55 |
$242.55 |
$85.79
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$166.77 |
$166.77 |
$166.77 |
$72.65
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$91.00 |
$91.00 |
$91.00 |
$73.45
|
|
#hypersens-actinomyces ab
|
$74.20 |
$74.20 |
$74.20 |
$32.40
|
|
Hyperthermia ext gen supfc
|
$6,412.00 |
$6,412.00 |
$6,412.00 |
$943.00
|
|
Hysterosalpingography s&i
|
$1,134.70 |
$1,134.70 |
$1,134.70 |
$663.50
|
|
Hysteroscopy ablation
|
$23,947.33 |
$23,947.33 |
$23,947.33 |
$5,865.75
|
|
Hysteroscopy biopsy
|
$20,583.09 |
$20,583.09 |
$20,583.09 |
$5,117.50
|
|
Hysteroscopy dx sep proc
|
$15,834.99 |
$15,834.99 |
$15,834.99 |
$3,997.50
|
|
Hysteroscopy lysis
|
$25,944.46 |
$25,944.46 |
$25,944.46 |
$5,468.70
|
|
Hysteroscopy remove fb
|
$16,578.81 |
$16,578.81 |
$16,578.81 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$24,719.55 |
$24,719.55 |
$24,719.55 |
$5,417.29
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$186.20 |
$186.20 |
$186.20 |
$352.24
|
|
I-123 iobenguane diag
|
$8,227.80 |
$8,227.80 |
$8,227.80 |
$5,170.70
|
|
I-123 ioflupane diag
|
$10,017.70 |
$10,017.70 |
$10,017.70 |
$4,077.15
|
|
I-123 sod iodide diag per 100 uci
|
$361.20 |
$361.20 |
$361.20 |
$144.24
|
|
I131 iodide cap, rx
|
$250.60 |
$250.60 |
$250.60 |
$71.70
|
|
I131 iodide sol, rx
|
$254.80 |
$254.80 |
$254.80 |
$42.01
|
|
I131 max 100uci
|
$177.10 |
$177.10 |
$177.10 |
$53.39
|
|
I-131 sod iodide sol diag per mci
|
$693.00 |
$693.00 |
$693.00 |
$33.60
|
|
Iaadi respiratory synctial virus
|
$399.00 |
$399.00 |
$399.00 |
$54.98
|
|
Iadna legionella pneumophila amplified probe tq
|
$142.80 |
$142.80 |
$142.80 |
$109.00
|
|
Ia infect ag ab qual/semiquant sgl step
|
$70.70 |
$70.70 |
$70.70 |
$50.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$3,857.70 |
$3,857.70 |
$3,857.70 |
$684.45
|
|
Ibmfs seq alys pnl 30 genes
|
$5,656.70 |
$5,656.70 |
$5,656.70 |
$2,828.00
|
|
Icd cobalt xt dr MRI is1 df1
|
$107,171.30 |
$107,171.30 |
$107,171.30 |
$34,681.07
|
|
Icd crtd cobalt hf MRI is1 df1
|
$126,569.16 |
$126,569.16 |
$126,569.16 |
$41,418.00
|
|
Icd crtp serena MRI
|
$32,211.27 |
$32,211.27 |
$32,211.27 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$28,448.68 |
$28,448.68 |
$28,448.68 |
$9,267.72
|
|
I&d frarm&/wrst deep absc/hematoma
|
$2,965.20 |
$2,965.20 |
$2,965.20 |
$3,839.54
|
|
Idh1 common variants
|
$1,414.70 |
$1,414.70 |
$1,414.70 |
$412.10
|
|
Idh2 common variants
|
$1,414.70 |
$1,414.70 |
$1,414.70 |
$486.00
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$19,817.78 |
$19,817.78 |
$19,817.78 |
$3,245.23
|
|
I&d lacrimal sac
|
$4,734.80 |
$4,734.80 |
$4,734.80 |
$2,732.50
|
|
Ifnl3 gene
|
$169.40 |
$169.40 |
$169.40 |
$147.20
|
|
Ifosfamide 1 gram intravenous solution
|
$1,614.55 |
$1,614.55 |
$1,614.55 |
$246.95
|
|
Igh gene rearrang dir probe
|
$777.70 |
$777.70 |
$777.70 |
$111.50
|
|
Igh gene rearrange amp meth
|
$1,927.80 |
$1,927.80 |
$1,927.80 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$791.00 |
$791.00 |
$791.00 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$848.40 |
$848.40 |
$848.40 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$15,920.32 |
$15,920.32 |
$15,920.32 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$16,588.27 |
$16,588.27 |
$16,588.27 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$13,541.11 |
$13,541.11 |
$13,541.11 |
$272.30
|
|
Ikbkap gene
|
$2,557.80 |
$2,557.80 |
$2,557.80 |
$173.49
|
|
Iliac/fem angio cath insert
|
$3,850.00 |
$3,850.00 |
$3,850.00 |
$1,856.01
|
|
Iliac revasc add-on 37222
|
$7,244.30 |
$7,244.30 |
$7,244.30 |
$6,082.65
|
|
Imetelstat 188 mg intravenous solution
|
$28,682.67 |
$28,682.67 |
$28,682.67 |
$20,373.55
|
|
Immob elbow child sm
|
$126.70 |
$126.70 |
$126.70 |
$85.39
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$252.70 |
$252.70 |
$252.70 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$732.90 |
$732.90 |
$732.90 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$440.50 |
$440.50 |
$440.50 |
$114.60
|
|
Immune complex assay
|
$285.60 |
$285.60 |
$285.60 |
$100.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$18,087.30 |
$18,087.30 |
$18,087.30 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$4,285.75 |
$4,285.75 |
$4,285.75 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$6,974.97 |
$6,974.97 |
$6,974.97 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$352.80 |
$352.80 |
$352.80 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$237.30 |
$237.30 |
$237.30 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$61.60 |
$61.60 |
$61.60 |
$48.38
|
|
Immunodiffusion nes
|
$113.40 |
$113.40 |
$113.40 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$310.80 |
$310.80 |
$310.80 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$8,189.30 |
$8,189.30 |
$8,189.30 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$8,189.30 |
$8,189.30 |
$8,189.30 |
$231.40
|
|
Immunoglobulin assay
|
$228.20 |
$228.20 |
$228.20 |
$75.88
|
|
Immunology procedure
|
$4,613.70 |
$4,613.70 |
$4,613.70 |
$142.56
|
|
Implant cartilage 10mm synthetic
|
$6,035.53 |
$6,035.53 |
$6,035.53 |
$8,184.00
|
|
Implant cochlear device
|
$200,428.98 |
$200,428.98 |
$200,428.98 |
$34,229.98
|
|
Implant cochlear osia osi300
|
$14,572.62 |
$14,572.62 |
$14,572.62 |
$16,200.89
|
|
Implant neuroelectrodes
|
$8,836.80 |
$8,836.80 |
$8,836.80 |
$8,763.11
|
|
Implant neuroelectrodes
|
$86,186.39 |
$86,186.39 |
$86,186.39 |
$7,766.27
|
|
Implant spine infusion pump
|
$114,431.97 |
$114,431.97 |
$114,431.97 |
$17,262.84
|
|
Implant spine infusion pump
|
$82,508.38 |
$82,508.38 |
$82,508.38 |
$17,270.40
|
|
Implant tcat pulm vlv perq
|
$8,855.00 |
$8,855.00 |
$8,855.00 |
$9,812.40
|
|
Implant ureth bulk agent
|
$5,492.35 |
$5,492.35 |
$5,492.35 |
$2,168.00
|
|
Impl neurostim electr perc
|
$199,493.55 |
$199,493.55 |
$199,493.55 |
$7,672.50
|
|
Impl oi implt sk tc esp<100
|
$16,752.80 |
$16,752.80 |
$16,752.80 |
$22,958.00
|
|
Impl oi implt skull perq esp
|
$149,234.60 |
$149,234.60 |
$149,234.60 |
$13,525.50
|
|
In-111 autol wbc diag per dose
|
$6,117.30 |
$6,117.30 |
$6,117.30 |
$3,523.65
|
|
In-111 pentetate dtpa / 0.5 mci
|
$7,731.50 |
$7,731.50 |
$7,731.50 |
$2,598.17
|
|
In-111 pentetreotide
|
$10,985.80 |
$10,985.80 |
$10,985.80 |
$5,201.00
|
|
Incise inner eye adhesions
|
$13,628.15 |
$13,628.15 |
$13,628.15 |
$2,698.92
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$5,876.50 |
$5,876.50 |
$5,876.50 |
$2,056.93
|
|
Incision of anal sphincter
|
$16,579.96 |
$16,579.96 |
$16,579.96 |
$3,245.23
|
|
Incision of rectal abscess
|
$19,317.31 |
$19,317.31 |
$19,317.31 |
$3,245.23
|
|
Incision of spinal nerve 64772
|
$41,389.19 |
$41,389.19 |
$41,389.19 |
$2,310.83
|
|
Incision of tendon & muscle
|
$6,385.40 |
$6,385.40 |
$6,385.40 |
$5,624.45
|
|
Incision of tongue fold
|
$7,393.11 |
$7,393.11 |
$7,393.11 |
$1,792.50
|
|
Incisn of toe tndn
|
$3,136.70 |
$3,136.70 |
$3,136.70 |
$2,627.96
|
|
Incisn windpipe
|
$4,520.60 |
$4,520.60 |
$4,520.60 |
$3,810.50
|
|
Induced abortion d&c
|
$6,291.60 |
$6,291.60 |
$6,291.60 |
$3,762.53
|
|
Infect ag drug suscept pheno predict
|
$1,103.90 |
$1,103.90 |
$1,103.90 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$1,247.40 |
$1,247.40 |
$1,247.40 |
$661.80
|
|
Infect ag genotype na dna hepatitis b
|
$1,098.30 |
$1,098.30 |
$1,098.30 |
$405.30
|
|
Infect ag genotype na hiv-1 other region
|
$1,179.50 |
$1,179.50 |
$1,179.50 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,261.40 |
$1,261.40 |
$1,261.40 |
$603.75
|
|
Infect ag if legionella pneumophila
|
$224.00 |
$224.00 |
$224.00 |
$72.58
|
|
Infect ag if nos ea
|
$135.80 |
$135.80 |
$135.80 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$203.00 |
$203.00 |
$203.00 |
$66.00
|
|
Infect ag if varicella zoster
|
$70.70 |
$70.70 |
$70.70 |
$70.70
|
