|
Hyaluronidase 150 unit/ml injection solution
|
$154.70 |
$154.70 |
$154.70 |
$126.37
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$236.10 |
$236.10 |
$236.10 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$14.05 |
$14.05 |
$14.05 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$243.25 |
$243.25 |
$243.25 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$185.75 |
$185.75 |
$185.75 |
$112.66
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$105.00 |
$105.00 |
$105.00 |
$72.65
|
|
Hydroxyzine pamoate 25 mg capsule
|
$1.00 |
$1.00 |
$1.00 |
$1.28
|
|
Hysteroscopy ablation
|
$20,991.69 |
$20,991.69 |
$20,991.69 |
$5,865.75
|
|
Hysteroscopy biopsy
|
$19,888.91 |
$19,888.91 |
$19,888.91 |
$5,419.00
|
|
Hysteroscopy remove fb
|
$16,636.25 |
$16,636.25 |
$16,636.25 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$20,265.91 |
$20,265.91 |
$20,265.91 |
$5,463.96
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$273.00 |
$273.00 |
$273.00 |
$352.24
|
|
I-123 iobenguane diag
|
$24,445.60 |
$24,445.60 |
$24,445.60 |
$5,170.70
|
|
I-123 ioflupane diag
|
$12,340.00 |
$12,340.00 |
$12,340.00 |
$4,158.00
|
|
I-123 sod iodide diag per 100 uci
|
$412.50 |
$412.50 |
$412.50 |
$147.46
|
|
I-131 iobenguane sulf diag mibg
|
$6,709.35 |
$6,709.35 |
$6,709.35 |
$3,638.48
|
|
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
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$2,574.70 |
$2,574.70 |
$2,574.70 |
$980.94
|
|
Icd cobalt xt dr MRI is1 df1
|
$30,942.00 |
$30,942.00 |
$30,942.00 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$42,975.00 |
$42,975.00 |
$42,975.00 |
$39,070.50
|
|
Icd crtp serena MRI
|
$14,208.75 |
$14,208.75 |
$14,208.75 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$7,110.69 |
$7,110.69 |
$7,110.69 |
$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
|
$41,637.31 |
$41,637.31 |
$41,637.31 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$444.00 |
$444.00 |
$444.00 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$41,637.31 |
$41,637.31 |
$41,637.31 |
$277.90
|
|
Imetelstat 188 mg intravenous solution
|
$31,931.40 |
$31,931.40 |
$31,931.40 |
$20,373.55
|
|
Immob elbow child sm
|
$44.65 |
$44.65 |
$44.65 |
$85.39
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$807.71 |
$807.71 |
$807.71 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$263.74 |
$263.74 |
$263.74 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$209.88 |
$209.88 |
$209.88 |
$118.43
|
|
Immobilizer shldr sling med
|
$52.36 |
$52.36 |
$52.36 |
$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
|
$418.00 |
$418.00 |
$418.00 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$301.00 |
$301.00 |
$301.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$36.00 |
$36.00 |
$36.00 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$385.00 |
$385.00 |
$385.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$377.00 |
$377.00 |
$377.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$357.00 |
$357.00 |
$357.00 |
$234.27
|
|
Immunoglobulin assay
|
$284.00 |
$284.00 |
$284.00 |
$78.00
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$8,420.00 |
$8,420.00 |
$8,420.00 |
$2,946.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$1,405.00 |
$1,405.00 |
$1,405.00 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$6,525.50 |
$6,525.50 |
$6,525.50 |
$8,332.51
|
|
Implant cochlear device
|
$78,755.54 |
$78,755.54 |
$78,755.54 |
$34,229.98
|
|
Implant cochlear osia osi300
|
$48,020.46 |
$48,020.46 |
$48,020.46 |
$16,195.55
|
|
Implant power module patient cable cable 14 volt
|
$3,512.50 |
$3,512.50 |
$3,512.50 |
$3,695.42
|
|
Implant pulse generator remede el
|
$18,945.00 |
$18,945.00 |
$18,945.00 |
$43,752.80
|
|
Implant ureth bulk agent
|
$3,231.50 |
$3,231.50 |
$3,231.50 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$5,699.03 |
$5,699.03 |
$5,699.03 |
$3,974.88
|
|
Impl eye bio-eye 16mm
|
$2,550.08 |
$2,550.08 |
$2,550.08 |
$3,917.20
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$73,098.62 |
$73,098.62 |
$73,098.62 |
$1,072.00
|
|
Impl oi implt sk tc esp<100
|
$47,069.05 |
$47,069.05 |
$47,069.05 |
$22,958.00
|
|
Impl oi implt skull perq esp
|
$52,423.57 |
$52,423.57 |
$52,423.57 |
$13,525.50
|
|
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
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$14,575.00 |
$14,575.00 |
$14,575.00 |
$2,086.70
|
|
Incision of breast lesion
|
$23,042.80 |
$23,042.80 |
$23,042.80 |
$2,577.85
|
|
Incision of midfoot bones
|
$104,104.65 |
$104,104.65 |
$104,104.65 |
$6,004.47
|
|
Incision of tibia
|
$112,432.88 |
$112,432.88 |
$112,432.88 |
$6,311.00
|
|
Incision tendon sheath
|
$12,020.25 |
$12,020.25 |
$12,020.25 |
$3,073.20
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$211.00 |
$211.00 |
$211.00 |
$140.80
|
|
Infect ag drug suscept pheno predict
|
$737.00 |
$737.00 |
$737.00 |
$325.00
|
|
Infect ag genotype na dna hepatitis b
|
$772.00 |
$772.00 |
$772.00 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$608.00 |
$608.00 |
$608.00 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$525.00 |
$525.00 |
$525.00 |
$603.83
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$84.00 |
$84.00 |
$84.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$86.00 |
$86.00 |
$86.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$333.00 |
$333.00 |
$333.00 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$286.00 |
$286.00 |
$286.00 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$285.00 |
$285.00 |
$285.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$211.00 |
$211.00 |
$211.00 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$250.00 |
$250.00 |
$250.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$273.00 |
$273.00 |
$273.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$293.00 |
$293.00 |
$293.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$416.00 |
$416.00 |
$416.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$291.00 |
$291.00 |
$291.00 |
$98.58
|
|
Infectious agent nucleic acid amplified probe
|
$145.00 |
$145.00 |
$145.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$511.00 |
$511.00 |
$511.00 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$372.00 |
$372.00 |
$372.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,205.00 |
$1,205.00 |
$1,205.00 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$415.00 |
$415.00 |
$415.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$374.00 |
$374.00 |
$374.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$279.00 |
$279.00 |
$279.00 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$342.00 |
$342.00 |
$342.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$200.00 |
$200.00 |
$200.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$556.00 |
$556.00 |
$556.00 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$2,551.00 |
$2,551.00 |
$2,551.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$184.00 |
$184.00 |
$184.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$53.00 |
$53.00 |
$53.00 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$211.00 |
$211.00 |
$211.00 |
$217.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$323.00 |
$323.00 |
$323.00 |
$195.60
|
