|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$546.45 |
$546.45 |
$546.45 |
$121.31
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$96.00 |
$96.00 |
$96.00 |
$294.92
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$124.18 |
$124.18 |
$124.18 |
$72.65
|
|
Hydroxyzine pamoate 25 mg capsule
|
$0.64 |
$0.64 |
$0.64 |
$1.28
|
|
Hysterosalpingography s&i
|
$722.50 |
$722.50 |
$722.50 |
$651.85
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$422.96 |
$422.96 |
$422.96 |
$352.24
|
|
I-123 iobenguane diag
|
$5,163.50 |
$5,163.50 |
$5,163.50 |
$5,229.62
|
|
I-123 ioflupane diag
|
$3,591.50 |
$3,591.50 |
$3,591.50 |
$3,923.52
|
|
I-123 sod iodide diag per 100 uci
|
$227.71 |
$227.71 |
$227.71 |
$141.90
|
|
I131 iodide cap, rx
|
$6,861.02 |
$6,861.02 |
$6,861.02 |
$71.70
|
|
Iaadi respiratory synctial virus
|
$65.00 |
$65.00 |
$65.00 |
$49.40
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$492.16 |
$492.16 |
$492.16 |
$684.45
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$464.54 |
$464.54 |
$464.54 |
$980.94
|
|
Icatibant injection
|
$1,515.38 |
$1,515.38 |
$1,515.38 |
$8,695.05
|
|
Icd cobalt xt dr MRI is1 df1
|
$37,548.52 |
$37,548.52 |
$37,548.52 |
$34,858.40
|
|
Icd crtd cobalt hf MRI is1 df1
|
$56,786.40 |
$56,786.40 |
$56,786.40 |
$39,070.50
|
|
Icd crtp serena MRI
|
$19,320.00 |
$19,320.00 |
$19,320.00 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$10,030.00 |
$10,030.00 |
$10,030.00 |
$9,297.68
|
|
Icut allergy test drug/bug
|
$49.50 |
$49.50 |
$49.50 |
$70.29
|
|
Idarubicin hcl injection
|
$258.28 |
$258.28 |
$258.28 |
$447.02
|
|
Ifosfamide 1 gram intravenous solution
|
$246.95 |
$246.95 |
$246.95 |
$246.95
|
|
Ihc/icc per specimen each additional single antibody stain
|
$265.50 |
$265.50 |
$265.50 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$265.50 |
$265.50 |
$265.50 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$285.50 |
$285.50 |
$285.50 |
$272.30
|
|
Immobilizer shldr cntor adlt
|
$226.12 |
$226.12 |
$226.12 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$281.97 |
$281.97 |
$281.97 |
$115.00
|
|
Immune complex assay
|
$180.00 |
$180.00 |
$180.00 |
$106.14
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$5,930.00 |
$5,930.00 |
$5,930.00 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$3,809.32 |
$3,809.32 |
$3,809.32 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$6,977.00 |
$6,977.00 |
$6,977.00 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$156.00 |
$156.00 |
$156.00 |
$130.39
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$143.00 |
$143.00 |
$143.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$36.50 |
$36.50 |
$36.50 |
$48.36
|
|
Immunofixation electrophoresis serum
|
$153.00 |
$153.00 |
$153.00 |
$140.70
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$125.00 |
$125.00 |
$125.00 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$215.50 |
$215.50 |
$215.50 |
$234.27
|
|
Immunoglobulin assay
|
$319.50 |
$319.50 |
$319.50 |
$74.15
|
|
Implant cochlear osia osi300
|
$35,580.73 |
$35,580.73 |
$35,580.73 |
$17,423.06
|
|
Implant pulse generator remede el
|
$68,750.00 |
$68,750.00 |
$68,750.00 |
$46,034.74
|
|
Implant ureth bulk agent
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$2,141.57
|
|
In-111 oxyquinolin per 0.5 mci
|
$29.84 |
$29.84 |
$29.84 |
$2,601.60
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,598.17 |
$2,598.17 |
$2,598.17 |
$2,598.17
|
|
In-111 pentetreotide
|
$4,394.56 |
$4,394.56 |
$4,394.56 |
$5,201.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,019.50 |
$1,019.50 |
$1,019.50 |
$2,080.80
|
|
Incobotulinumtoxin a
|
$2,578.00 |
$2,578.00 |
$2,578.00 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$295.00 |
$295.00 |
$295.00 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$342.00 |
$342.00 |
$342.00 |
$346.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$517.50 |
$517.50 |
$517.50 |
$603.75
|
|
Infect ag if ea plyvlnt antsrm
|
$77.50 |
$77.50 |
$77.50 |
$55.80
|
|
Infect ag if influenza a
|
$45.50 |
$45.50 |
$45.50 |
$42.12
|
|
Infect ag if influenza b
|
$49.00 |
$49.00 |
$49.00 |
$40.52
|
|
Infect ag if pneumocystis carinii
|
$82.00 |
$82.00 |
$82.00 |
$67.19
|
|
Infect ag na herpes simplex quant
|
$232.00 |
$232.00 |
$232.00 |
$168.50
|
|
Infect ag na influenza r/amp 1st 2 types
|
$217.50 |
$217.50 |
$217.50 |
$217.88
|
|
Infect ag na orthopoxvirus amp prb each
|
$142.00 |
$142.00 |
$142.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$78.50 |
$78.50 |
$78.50 |
$81.90
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$79.50 |
$79.50 |
$79.50 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$84.50 |
$84.50 |
$84.50 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$131.50 |
$131.50 |
$131.50 |
$95.34
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$60.50 |
$60.50 |
$60.50 |
$80.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$94.50 |
$94.50 |
$94.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$74.00 |
$74.00 |
$74.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$326.00 |
$326.00 |
$326.00 |
$129.68
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$126.50 |
$126.50 |
$126.50 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$68.00 |
$68.00 |
$68.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$115.50 |
$115.50 |
$115.50 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$79.00 |
$79.00 |
$79.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$130.00 |
$130.00 |
$130.00 |
$166.40
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$871.00 |
$871.00 |
$871.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$157.50 |
$157.50 |
$157.50 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$115.50 |
$115.50 |
$115.50 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$199.00 |
$199.00 |
$199.00 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$94.50 |
$94.50 |
$94.50 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$179.50 |
$179.50 |
$179.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$180.50 |
$180.50 |
$180.50 |
$217.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$221.00 |
$221.00 |
$221.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$88.00 |
$88.00 |
$88.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$95.00 |
$95.00 |
$95.00 |
$108.21
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$252.00 |
$252.00 |
$252.00 |
$211.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$603.00 |
$603.00 |
$603.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$51.50 |
$51.50 |
$51.50 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$411.50 |
$411.50 |
$411.50 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$276.50 |
$276.50 |
$276.50 |
$285.60
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$262.50 |
$262.50 |
$262.50 |
$237.70
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$241.50 |
$241.50 |
$241.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$376.50 |
$376.50 |
$376.50 |
$373.60
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$239.00 |
$239.00 |
$239.00 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,986.92 |
$1,986.92 |
$1,986.92 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,226.50 |
$1,226.50 |
$1,226.50 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,128.50 |
$1,128.50 |
$1,128.50 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$232.00 |
$232.00 |
$232.00 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$412.50 |
$412.50 |
$412.50 |
$570.00
|
|
Inj, abilify asimtufii, 1 mg
|
$12,633.78 |
$12,633.78 |
$12,633.78 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$4,761.56 |
$4,761.56 |
$4,761.56 |
$5,168.00
|
|
Inj, acetaminophen (hikma)
|
$81.30 |
$81.30 |
$81.30 |
$56.70
|
|
Inj. acthar gel to 40 units
|
$0.01 |
$0.01 |
$0.01 |
$7,918.32
|
|
Inj allopurinol sodium 1 mg
|
$3,419.02 |
$3,419.02 |
$3,419.02 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$5,026.08 |
$5,026.08 |
$5,026.08 |
$1,280.74
|
|
Inj andexxa, 10 mg
|
$3,875.00 |
$3,875.00 |
$3,875.00 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$13,099.42 |
$13,099.42 |
$13,099.42 |
$9,878.82
|
