|
Hysteroscopy dx sep proc
|
$9,029.40 |
$9,029.40 |
$9,029.40 |
$3,997.50
|
|
Hysteroscopy remove fb
|
$9,070.54 |
$9,070.54 |
$9,070.54 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$23,810.21 |
$23,810.21 |
$23,810.21 |
$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
|
$109.20 |
$109.20 |
$109.20 |
$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
|
$391.65 |
$391.65 |
$391.65 |
$684.45
|
|
Ibmfs seq alys pnl 30 genes
|
$5,656.70 |
$5,656.70 |
$5,656.70 |
$2,828.00
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$500.15 |
$500.15 |
$500.15 |
$975.45
|
|
Icd cobalt xt dr MRI is1 df1
|
$127,363.91 |
$127,363.91 |
$127,363.91 |
$34,681.07
|
|
Icd crtd cobalt hf MRI is1 df1
|
$152,542.06 |
$152,542.06 |
$152,542.06 |
$41,418.00
|
|
Icd crtp serena MRI
|
$72,888.99 |
$72,888.99 |
$72,888.99 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$90,468.28 |
$90,468.28 |
$90,468.28 |
$9,267.72
|
|
Idarubicin hcl injection
|
$387.80 |
$387.80 |
$387.80 |
$447.02
|
|
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 lacrimal sac
|
$4,734.80 |
$4,734.80 |
$4,734.80 |
$2,732.50
|
|
I & d vag hematoma non-ob 57023
|
$83,057.93 |
$83,057.93 |
$83,057.93 |
$3,444.42
|
|
Ifosfamide 1 gram intravenous solution
|
$465.15 |
$465.15 |
$465.15 |
$246.95
|
|
Igh gene rearrang dir probe
|
$777.70 |
$777.70 |
$777.70 |
$111.50
|
|
Igh gene rearrange amp meth
|
$891.10 |
$891.10 |
$891.10 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$1,285.90 |
$1,285.90 |
$1,285.90 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$16,150.86 |
$16,150.86 |
$16,150.86 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$27,252.73 |
$27,252.73 |
$27,252.73 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$12,386.29 |
$12,386.29 |
$12,386.29 |
$272.30
|
|
Ikbkap gene
|
$1,662.50 |
$1,662.50 |
$1,662.50 |
$173.49
|
|
Ileostomy/jejunostomy non-tube 44310
|
$92,056.12 |
$92,056.12 |
$92,056.12 |
$1,976.40
|
|
Iliac/fem angio cath insert
|
$3,850.00 |
$3,850.00 |
$3,850.00 |
$1,856.01
|
|
Iliac revasc add-on 37222
|
$6,631.10 |
$6,631.10 |
$6,631.10 |
$6,082.65
|
|
Imetelstat 188 mg intravenous solution
|
$60,754.40 |
$60,754.40 |
$60,754.40 |
$20,373.55
|
|
Immob elbow child sm
|
$126.70 |
$126.70 |
$126.70 |
$85.39
|
|
Immobilizer shldr cntor adlt
|
$790.16 |
$790.16 |
$790.16 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$1,036.84 |
$1,036.84 |
$1,036.84 |
$114.60
|
|
Immune complex assay
|
$168.00 |
$168.00 |
$168.00 |
$100.80
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$30,371.07 |
$30,371.07 |
$30,371.07 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$8,937.07 |
$8,937.07 |
$8,937.07 |
$2,900.11
|
|
Immunoassay tumor antigen quantitative ca 125
|
$330.40 |
$330.40 |
$330.40 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$381.50 |
$381.50 |
$381.50 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$138.60 |
$138.60 |
$138.60 |
$48.38
|
|
Immunodiffusion nes
|
$107.80 |
$107.80 |
$107.80 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$364.70 |
$364.70 |
$364.70 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$15,514.45 |
$15,514.45 |
$15,514.45 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$15,514.45 |
$15,514.45 |
$15,514.45 |
$231.40
|
|
Immunoglobulin assay
|
$109.90 |
$109.90 |
$109.90 |
$75.88
|
|
Immunology procedure
|
$2,226.70 |
$2,226.70 |
$2,226.70 |
$142.56
|
|
Implant cartilage 10mm synthetic
|
$118,371.71 |
$118,371.71 |
$118,371.71 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$56,469.78 |
$56,469.78 |
$56,469.78 |
$16,200.89
|
|
Implant nerve end
|
$50,094.07 |
$50,094.07 |
$50,094.07 |
$2,152.40
|
|
Implant neuroelectrodes
|
$204,414.19 |
$204,414.19 |
$204,414.19 |
$18,334.40
|
|
Implant neuroelectrodes
|
$63,121.80 |
$63,121.80 |
$63,121.80 |
$8,763.11
|
|
Implant neuroelectrodes
|
$46,189.13 |
$46,189.13 |
$46,189.13 |
$7,766.27
|
|
Implant spine infusion pump
|
$128,081.94 |
$128,081.94 |
$128,081.94 |
$17,270.40
|
|
Implant tcat pulm vlv perq
|
$8,855.00 |
$8,855.00 |
$8,855.00 |
$9,812.40
|
|
Implant ureth bulk agent
|
$6,684.38 |
$6,684.38 |
$6,684.38 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$24,858.98 |
$24,858.98 |
$24,858.98 |
$3,974.88
|
|
Impl neurostim electr perc
|
$43,488.30 |
$43,488.30 |
$43,488.30 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$128,081.94 |
$128,081.94 |
$128,081.94 |
$5,095.20
|
|
Impl oi implt skull perq esp
|
$51,028.13 |
$51,028.13 |
$51,028.13 |
$13,525.50
|
|
Implt neurostim elctr each
|
$368.28 |
$368.28 |
$368.28 |
$4,579.99
|
|
Imp neurosti pls gn any type
|
$181,071.60 |
$181,071.60 |
$181,071.60 |
$8,789.19
|
|
Imuglucerase injection
|
$9,883.82 |
$9,883.82 |
$9,883.82 |
$3,399.59
|
|
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 tear duct opening 68440
|
$15,604.00 |
$15,604.00 |
$15,604.00 |
$507.20
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,915.10 |
$3,915.10 |
$3,915.10 |
$2,056.93
|
|
Incision of anal sphincter
|
$10,627.84 |
$10,627.84 |
$10,627.84 |
$3,245.23
|
|
Incision of breast lesion
|
$3,588.90 |
$3,588.90 |
$3,588.90 |
$2,560.80
|
|
Incision of eardrum
|
$9,672.33 |
$9,672.33 |
$9,672.33 |
$3,827.50
|
|
Incision of eye
|
$21,477.11 |
$21,477.11 |
$21,477.11 |
$4,190.40
|
|
Incision of eyelid
|
$10,402.34 |
$10,402.34 |
$10,402.34 |
$1,488.50
|
|
Incision of rectal abscess
|
$14,327.42 |
$14,327.42 |
$14,327.42 |
$3,245.23
|
|
Incision of spinal nerve 64772
|
$44,268.29 |
$44,268.29 |
$44,268.29 |
$2,310.83
|
|
Incision of tendon & muscle
|
$6,385.40 |
$6,385.40 |
$6,385.40 |
$5,624.45
|
|
Incision of tongue fold
|
$7,635.03 |
$7,635.03 |
$7,635.03 |
$1,792.50
|
|
Incisn of toe tndn
|
$3,136.70 |
$3,136.70 |
$3,136.70 |
$2,627.96
|
|
Incisn windpipe
|
$2,802.80 |
$2,802.80 |
$2,802.80 |
$3,810.50
|
|
Induced abortion d&c
|
$11,721.97 |
$11,721.97 |
$11,721.97 |
$3,762.53
|
|
Induced abortion dilat&evac
|
$18,631.06 |
$18,631.06 |
$18,631.06 |
$4,446.00
|
|
Infect ag drug suscept pheno predict
|
$1,327.90 |
$1,327.90 |
$1,327.90 |
$323.20
|
|
Infect ag genotype na cytomegalovirus
|
$2,170.00 |
$2,170.00 |
$2,170.00 |
$661.80
|
|
Infect ag genotype na dna hepatitis b
|
$482.30 |
$482.30 |
$482.30 |
$405.30
|
|
Infect ag genotype na hiv-1 other region
|
$589.40 |
$589.40 |
$589.40 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,166.20 |
$1,166.20 |
$1,166.20 |
$603.75
|
|
Infect ag if nos ea
|
$135.80 |
$135.80 |
$135.80 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$79.80 |
$79.80 |
$79.80 |
$66.00
|
|
Infect ag if varicella zoster
|
$70.70 |
$70.70 |
$70.70 |
$70.70
|
|
Infect ag na hep b amp
|
$173.60 |
$173.60 |
$173.60 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$254.10 |
$254.10 |
$254.10 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$245.70 |
$245.70 |
$245.70 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$283.50 |
$283.50 |
$283.50 |
$219.70
|
