|
I-131 sod iodide sol diag per mci
|
$417.75 |
$417.75 |
$417.75 |
$114.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,149.75 |
$1,149.75 |
$1,149.75 |
$684.45
|
|
Icd cobalt xt dr MRI is1 df1
|
$20,112.30 |
$20,112.30 |
$20,112.30 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$27,933.75 |
$27,933.75 |
$27,933.75 |
$39,070.50
|
|
Icd crtp serena MRI
|
$9,235.69 |
$9,235.69 |
$9,235.69 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$4,621.95 |
$4,621.95 |
$4,621.95 |
$9,264.83
|
|
Ifosfamide 1 gram intravenous solution
|
$494.70 |
$494.70 |
$494.70 |
$246.95
|
|
Ihc/icc per specimen each additional single antibody stain
|
$232.70 |
$232.70 |
$232.70 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$236.60 |
$236.60 |
$236.60 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$629.20 |
$629.20 |
$629.20 |
$277.90
|
|
Ileostomy/jejunostomy non-tube 44310
|
$3,733.00 |
$3,733.00 |
$3,733.00 |
$1,976.40
|
|
Imetelstat 188 mg intravenous solution
|
$31,931.40 |
$31,931.40 |
$31,931.40 |
$20,373.55
|
|
Immob elbow child sm
|
$29.02 |
$29.02 |
$29.02 |
$85.39
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$525.01 |
$525.01 |
$525.01 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$171.43 |
$171.43 |
$171.43 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$136.42 |
$136.42 |
$136.42 |
$118.43
|
|
Immobilizer shldr sling med
|
$34.03 |
$34.03 |
$34.03 |
$126.00
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$10,106.10 |
$10,106.10 |
$10,106.10 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$4,576.15 |
$4,576.15 |
$4,576.15 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$6,381.00 |
$6,381.00 |
$6,381.00 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$215.80 |
$215.80 |
$215.80 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$117.00 |
$117.00 |
$117.00 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$152.10 |
$152.10 |
$152.10 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$231.40 |
$231.40 |
$231.40 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$231.40 |
$231.40 |
$231.40 |
$234.27
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$5,473.00 |
$5,473.00 |
$5,473.00 |
$2,946.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$913.25 |
$913.25 |
$913.25 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$4,241.57 |
$4,241.57 |
$4,241.57 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$6,357.14 |
$6,357.14 |
$6,357.14 |
$16,195.55
|
|
Implant power module patient cable cable 14 volt
|
$2,283.12 |
$2,283.12 |
$2,283.12 |
$3,695.42
|
|
Implant pulse generator remede el
|
$12,314.25 |
$12,314.25 |
$12,314.25 |
$43,752.80
|
|
Implant ureth bulk agent
|
$2,141.57 |
$2,141.57 |
$2,141.57 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$3,704.37 |
$3,704.37 |
$3,704.37 |
$3,974.88
|
|
Impl eye bio-eye 16mm
|
$1,657.55 |
$1,657.55 |
$1,657.55 |
$3,917.20
|
|
In-111 autologous plt stdy dx
|
$1,494.95 |
$1,494.95 |
$1,494.95 |
$6,139.64
|
|
In-111 autol wbc diag per dose
|
$10,776.60 |
$10,776.60 |
$10,776.60 |
$3,493.75
|
|
In-111 capromab pendet
|
$7,024.00 |
$7,024.00 |
$7,024.00 |
$3,141.45
|
|
In-111 ibritumomab tiux dx
|
$7,246.75 |
$7,246.75 |
$7,246.75 |
$4,748.02
|
|
In-111 oxyquinolin per 0.5 mci
|
$10,776.60 |
$10,776.60 |
$10,776.60 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,163.95 |
$11,163.95 |
$11,163.95 |
$2,598.17
|
|
In-111 pentetreotide
|
$15,327.00 |
$15,327.00 |
$15,327.00 |
$5,294.90
|
|
In-111 satumomab pend
|
$3,524.25 |
$3,524.25 |
$3,524.25 |
$3,113.04
|
|
Incise inner ear
|
$1,895.00 |
$1,895.00 |
$1,895.00 |
$2,186.08
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,889.55 |
$1,889.55 |
$1,889.55 |
$2,086.70
|
|
Incision of breast lesion
|
$1,020.00 |
$1,020.00 |
$1,020.00 |
$2,577.85
|
|
Incision of eardrum
|
$858.00 |
$858.00 |
$858.00 |
$552.75
|
|
Incision of foot fascia
|
$25,535.62 |
$25,535.62 |
$25,535.62 |
$4,599.40
|
|
Incision of metatarsal
|
$1,411.00 |
$1,411.00 |
$1,411.00 |
$4,881.00
|
|
Incision of metatarsal
|
$22,201.67 |
$22,201.67 |
$22,201.67 |
$3,786.00
|
|
Incision of tongue fold
|
$1,188.20 |
$1,188.20 |
$1,188.20 |
$1,792.50
|
|
Incisn of toe tndn
|
$934.00 |
$934.00 |
$934.00 |
$2,667.00
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$208.00 |
$208.00 |
$208.00 |
$140.80
|
|
Infect ag na influenza r/amp 1st 2 types
|
$175.50 |
$175.50 |
$175.50 |
$219.70
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$65.00 |
$65.00 |
$65.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$209.30 |
$209.30 |
$209.30 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$63.70 |
$63.70 |
$63.70 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$125.45 |
$125.45 |
$125.45 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$1,121.90 |
$1,121.90 |
$1,121.90 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$235.30 |
$235.30 |
$235.30 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$94.90 |
$94.90 |
$94.90 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$167.05 |
$167.05 |
$167.05 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$833.95 |
$833.95 |
$833.95 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$163.15 |
$163.15 |
$163.15 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$24.05 |
$24.05 |
$24.05 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$928.20 |
$928.20 |
$928.20 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$291.20 |
$291.20 |
$291.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$176.15 |
$176.15 |
$176.15 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$705.90 |
$705.90 |
$705.90 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$813.15 |
$813.15 |
$813.15 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$594.10 |
$594.10 |
$594.10 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$130.00 |
$130.00 |
$130.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$181.35 |
$181.35 |
$181.35 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$138.45 |
$138.45 |
$138.45 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$148.85 |
$148.85 |
$148.85 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$361.40 |
$361.40 |
$361.40 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$445.90 |
$445.90 |
$445.90 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$360.75 |
$360.75 |
$360.75 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$67.60 |
$67.60 |
$67.60 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$137.15 |
$137.15 |
$137.15 |
$217.60
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,325.35 |
$1,325.35 |
$1,325.35 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$798.85 |
$798.85 |
$798.85 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$191.75 |
$191.75 |
$191.75 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$357.50 |
$357.50 |
$357.50 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$319.15 |
$319.15 |
$319.15 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$317.20 |
$317.20 |
$317.20 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$214.50 |
$214.50 |
$214.50 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$503.75 |
$503.75 |
$503.75 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$309.40 |
$309.40 |
$309.40 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$3,222.55 |
$3,222.55 |
$3,222.55 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,379.70 |
$1,379.70 |
$1,379.70 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,739.55 |
$2,739.55 |
$2,739.55 |
$1,537.84
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$431.15 |
$431.15 |
$431.15 |
$111.51
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$344.50 |
$344.50 |
$344.50 |
$296.00
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$878.00 |
$878.00 |
$878.00 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$310.00 |
$310.00 |
$310.00 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$399.00 |
$399.00 |
$399.00 |
$236.80
|
|
Inj alymsys 10 mg
|
$1,199.10 |
$1,199.10 |
$1,199.10 |
$1,280.74
|
|
Injection carpal tunnel therapeutic (both sides)
|
$341.25 |
$341.25 |
$341.25 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$9,893.85 |
$9,893.85 |
$9,893.85 |
$5,324.34
|
|
Injection, doxercalciferol
|
$33,309.61 |
$33,309.61 |
$33,309.61 |
$23.86
|