|
Imetelstat 188 mg intravenous solution
|
$31,931.40 |
$31,931.40 |
$31,931.40 |
$20,373.55
|
|
Img rta detcj/mntr ds staff
|
$32.00 |
$32.00 |
$32.00 |
$70.29
|
|
Img rta detc/mntr ds phy/qhp
|
$71.20 |
$71.20 |
$71.20 |
$51.36
|
|
Img rta detc/mntr ds poc aly
|
$120.00 |
$120.00 |
$120.00 |
$71.25
|
|
Immob elbow child sm
|
$25,716.10 |
$25,716.10 |
$25,716.10 |
$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 |
$332.80 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$136.42 |
$136.42 |
$178.40 |
$115.75
|
|
Immobilizer shldr sling med
|
$34.03 |
$34.03 |
$227.84 |
$126.00
|
|
Immt breast prosthesis 19340
|
$4,883.20 |
$4,883.20 |
$85,509.21 |
$4,883.20
|
|
Immune complex assay
|
$61.60 |
$61.60 |
$61.60 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$142.62 |
$142.62 |
$22,553.60 |
$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
|
$81.60 |
$81.60 |
$6,381.00 |
$3,846.15
|
|
Immune globulin ig human im use 90281
|
$92.00 |
$92.00 |
$92.00 |
$92.00
|
|
Immunoassay tumor antigen quantitative ca 125
|
$52.80 |
$52.80 |
$271.70 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$52.80 |
$52.80 |
$195.65 |
$116.50
|
|
Immunoassay tumor qual
|
$56.80 |
$56.80 |
$56.80 |
$66.50
|
|
Immunodiff gel qual ea antigen/ab
|
$26.00 |
$26.00 |
$48.57 |
$48.57
|
|
Immunodiffusion nes
|
$48.57 |
$48.57 |
$48.57 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$48.57 |
$48.57 |
$250.25 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$245.05 |
$245.05 |
$292.13 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$232.05 |
$232.05 |
$292.13 |
$234.27
|
|
Immunoglobulin assay
|
$48.57 |
$48.57 |
$184.60 |
$78.00
|
|
Immunotherapy 2/> injections
|
$40.00 |
$40.00 |
$40.00 |
$40.00
|
|
Impedence cardiogram
|
$55.20 |
$55.20 |
$55.20 |
$152.54
|
|
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
|
|
Implantation iris prosthesis
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$19,332.98
|
|
Implant cartilage 10mm synthetic
|
$4,241.57 |
$4,241.57 |
$4,349.75 |
$8,332.51
|
|
Implant cochlear device
|
$6,016.00 |
$6,016.00 |
$6,016.00 |
$34,229.98
|
|
Implant cochlear osia osi300
|
$6,357.14 |
$6,357.14 |
$6,357.14 |
$16,195.55
|
|
Implant eye drug system
|
$4,228.80 |
$4,228.80 |
$4,228.80 |
$10,009.03
|
|
Implant hormone pellet(s) 11980
|
$504.45 |
$504.45 |
$504.45 |
$315.75
|
|
Implant nerve end
|
$600.80 |
$600.80 |
$600.80 |
$4,760.00
|
|
Implant neuroelectrodes
|
$1,985.60 |
$1,985.60 |
$72,943.01 |
$18,334.40
|
|
Implant neuroelectrodes
|
$6,842.40 |
$6,842.40 |
$6,842.40 |
$13,628.55
|
|
Implant neuroelectrodes
|
$4,554.40 |
$4,554.40 |
$4,554.40 |
$8,836.80
|
|
Implant neuroelectrodes
|
$1,206.00 |
$1,206.00 |
$3,678.40 |
$7,728.86
|
|
Implant neurostim arrays
|
$2,026.40 |
$2,026.40 |
$74,433.58 |
$23,262.40
|
|
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 single ventricular device 33975
|
$3,195.20 |
$3,195.20 |
$4,187.00 |
$5,053.23
|
|
Implant spinal canal cath
|
$2,089.60 |
$2,089.60 |
$2,089.60 |
$7,913.97
|
|
Implant spine infusion pump
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
$17,262.84
|
|
Implant spine infusion pump
|
$1,180.00 |
$1,180.00 |
$15,149.76 |
$17,270.40
|
|
Implant ureth bulk agent
|
$2,100.47 |
$2,100.47 |
$2,115.93 |
$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
|
|
Impl neurostim electr perc
|
$4,620.85 |
$4,620.85 |
$4,646.40 |
$7,672.50
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$1,072.00 |
$1,072.00 |
$137,357.92 |
$1,072.00
|
|
Implnt spinl canal catheter 62350
|
$978.40 |
$978.40 |
$49,540.59 |
$5,095.20
|
|
Impl oi implt skull perq esp
|
$5,209.60 |
$5,209.60 |
$5,209.60 |
$13,525.50
|
|
Impltj ntrstrml crnl rng seg
|
$11,556.80 |
$11,556.80 |
$11,556.80 |
$5,683.61
|
|
Impltj tot rplcmt hrt sys
|
$6,232.00 |
$6,232.00 |
$6,232.00 |
$4,580.80
|
|
Imp neurosti pls gn any type
|
$98,385.69 |
$98,385.69 |
$98,385.69 |
$8,789.19
|
|
Impreg gauze no h20/sal/yard
|
$5.60 |
$5.60 |
$5.60 |
$11.90
|
|
Impres&prep auricular prosth
|
$8,366.40 |
$8,366.40 |
$8,366.40 |
$6,557.24
|
|
Impres&prep def obt prosth
|
$4,369.60 |
$4,369.60 |
$4,369.60 |
$4,558.89
|
|
Impres&prep intrm obt prosth
|
$3,824.80 |
$3,824.80 |
$3,824.80 |
$3,837.72
|
|
Impres&prep mndbl res prosth
|
$4,013.60 |
$4,013.60 |
$4,013.60 |
$6,966.64
|
|
Impres&prep nasal prosth
|
$4,183.20 |
$4,183.20 |
$4,183.20 |
$6,966.64
|
|
Impres&prep oral surg splint
|
$1,751.20 |
$1,751.20 |
$1,751.20 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$11,244.80 |
$11,244.80 |
$11,244.80 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$3,716.80 |
$3,716.80 |
$3,716.80 |
$3,837.72
|
|
Impres&prep paltl lft prosth
|
$3,540.00 |
$3,540.00 |
$3,540.00 |
$3,837.72
|
|
Impres&prep sp aid prosth
|
$4,054.40 |
$4,054.40 |
$4,054.40 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$2,271.20 |
$2,271.20 |
$2,271.20 |
$2,945.12
|
|
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
|
$4,175.58 |
$4,175.58 |
$16,886.35 |
$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
|
$2,931.32 |
$2,931.32 |
$10,776.60 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,584.52 |
$2,584.52 |
$11,163.95 |
$2,598.17
|
|
In-111 pentetreotide
|
$7,526.26 |
$7,526.26 |
$15,327.00 |
$5,294.90
|
|
In-111 satumomab pend
|
$3,524.25 |
$3,524.25 |
$3,524.25 |
$3,113.04
|
|
Inactivated je vacc im
|
$280.80 |
$280.80 |
$280.80 |
$481.34
|
|
Inc deep opng b1 crtx thorax
|
$1,091.20 |
$1,091.20 |
$1,091.20 |
$1,091.20
|
|
Inc dp bone crtx f/arm&/wrst
|
$2,872.00 |
$2,872.00 |
$2,872.00 |
$6,311.00
|
|
Inc dp opn b1 crtx hum/elbw
|
$2,512.00 |
$2,512.00 |
$2,512.00 |
$3,839.54
|
|
Incis 1 vertebral seg cerv
|
$4,297.60 |
$4,297.60 |
$4,297.60 |
$4,297.60
|
|
Incis 1 vertebral seg lumbar
|
$3,628.80 |
$3,628.80 |
$3,628.80 |
$3,628.80
|
|
Incis 1 vertebral seg thorac
|
$3,619.20 |
$3,619.20 |
$3,619.20 |
$3,619.20
|
|
Incis addl spine segment
|
$880.00 |
$880.00 |
$880.00 |
$783.42
|
|
Incise diaphragm nerve
|
$2,102.40 |
$2,102.40 |
$2,102.40 |
$2,310.83
|
|
Incise/drain eyelid lining
|
$598.40 |
$598.40 |
$598.40 |
$1,271.00
|
|
Incise flexor carpi radialis
|
$1,691.20 |
$1,691.20 |
$1,691.20 |
$3,839.54
|
|
Incise hand/finger tendon
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$2,500.80 |
$2,500.80 |
$2,500.80 |
$2,500.80
|
|
Incise hip/thigh nerve
|
$3,086.40 |
$3,086.40 |
$3,086.40 |
$3,086.40
|
|
Incise inner ear
|
$1,043.20 |
$1,043.20 |
$1,043.20 |
$2,186.08
|
|
Incise inner ear nerve
|
$7,489.60 |
$7,489.60 |
$7,489.60 |
$5,289.89
|
|
Incise inner eye adhesions
|
$1,534.40 |
$1,534.40 |
$1,534.40 |
$1,202.90
|
|
Incise inner eye adhesions
|
$2,355.20 |
$2,355.20 |
$2,355.20 |
$2,698.92
|
|
Incise inner eye adhesions
|
$2,940.80 |
$2,940.80 |
$2,940.80 |
$2,940.80
|
|
Incise inner eye adhesions
|
$3,132.80 |
$3,132.80 |
$3,132.80 |
$2,526.64
|
|
Incise inner eye adhesions
|
$3,297.60 |
$3,297.60 |
$3,297.60 |
$4,760.49
|
|
Incise inner eye strands
|
$2,688.00 |
$2,688.00 |
$2,688.00 |
$3,905.20
|
|
Incise nerve back of head
|
$2,344.00 |
$2,344.00 |
$2,344.00 |
$2,685.07
|
|
Incise perq finger tendon 26060
|
$636.80 |
$636.80 |
$636.80 |
$2,211.05
|
