|
Iliac revasc add-on 37222
|
$1,775.40 |
$8,969.01 |
$34,365.68 |
|
|
Imatinib 100 mg tab
|
$207.25 |
$207.25 |
$514.08 |
|
|
Imbrication/diaphragm/transthor/transabd 39545
|
$1,645.80 |
$2,181.60 |
$2,649.00 |
|
|
Imetelstat 188 mg intravenous solution
|
$86.77 |
$31,931.40 |
$31,931.40 |
|
|
Img rta detcj/mntr ds staff
|
$32.00 |
$32.00 |
$32.00 |
|
|
Img rta detc/mntr ds phy/qhp
|
$71.20 |
$71.20 |
$71.20 |
|
|
Img rta detc/mntr ds poc aly
|
$120.00 |
$120.00 |
$120.00 |
|
|
Immob elbow child sm
|
$23.22 |
$29.02 |
$25,716.10 |
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$525.01 |
$525.01 |
$807.71 |
|
|
Immobilizer shldr cntor adlt
|
$6.60 |
$171.43 |
$43,475.64 |
|
|
Immobilizer shldr dlx str 24-36in med
|
$28.73 |
$136.42 |
$61,857.41 |
|
|
Immobilizer shldr sling med
|
$27.23 |
$34.03 |
$227.84 |
|
|
Immt breast prosthesis 19340
|
$1,728.60 |
$4,883.20 |
$85,509.21 |
|
|
Immune complex assay
|
$61.60 |
$61.60 |
$227.22 |
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$136.74 |
$9,307.69 |
$22,553.60 |
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$183.36 |
$4,576.15 |
$4,576.15 |
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$81.60 |
$4,725.00 |
$6,381.00 |
|
|
Immune globulin ig human im use 90281
|
$34.80 |
$92.00 |
$92.00 |
|
|
Immunoassay tumor antigen quantitative ca 125
|
$52.80 |
$131.95 |
$54,110.19 |
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$52.80 |
$104.65 |
$301.00 |
|
|
Immunoassay tumor qual
|
$56.80 |
$56.80 |
$56.80 |
|
|
Immunodiff gel qual ea antigen/ab
|
$21.60 |
$48.57 |
$187.20 |
|
|
Immunodiffusion nes
|
$48.57 |
$48.57 |
$216.30 |
|
|
Immunoelectrophoresis assay
|
$285.00 |
$285.00 |
$285.00 |
|
|
Immunofixation electrophoresis serum
|
$48.57 |
$155.35 |
$385.00 |
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$76.05 |
$292.13 |
$377.00 |
|
|
Immunofluorescence per specimen initial single antibody stain
|
$28.60 |
$267.60 |
$357.00 |
|
|
Immunoglobulin assay
|
$48.57 |
$48.57 |
$284.00 |
|
|
Immunology procedure
|
$653.40 |
$653.40 |
$686.40 |
|
|
Immunotherapy 2/> injections
|
$40.00 |
$40.00 |
$52.00 |
|
|
Impact tooth remov part bony
|
$37,061.95 |
$37,061.95 |
$43,785.95 |
|
|
Impedence cardiogram
|
$55.20 |
$55.20 |
$154.20 |
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$5,200.00 |
$5,473.00 |
$8,420.00 |
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$913.25 |
$913.25 |
$1,405.00 |
|
|
Implantation iris prosthesis
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
|
|
Implant biventricular device 33976
|
$3,280.80 |
$3,444.60 |
$3,444.60 |
|
|
Implant cartilage 10mm synthetic
|
$966.60 |
$4,241.57 |
$53,412.30 |
|
|
Implant cochlear device
|
$6,016.00 |
$6,016.00 |
$78,755.54 |
|
|
Implant cochlear osia osi300
|
$1,315.20 |
$6,357.14 |
$76,267.30 |
|
|
Implant eye drug system
|
$4,228.80 |
$4,228.80 |
$4,228.80 |
|
|
Implant hormone pellet(s) 11980
|
$190.20 |
$233.60 |
$504.45 |
|
|
Implant nerve end
|
$600.80 |
$600.80 |
$600.80 |
|
|
Implant neuroelectrodes
|
$1,985.60 |
$1,985.60 |
$72,943.01 |
|
|
Implant neuroelectrodes
|
$6,842.40 |
$6,842.40 |
$6,842.40 |
|
|
Implant neuroelectrodes
|
$4,554.40 |
$4,554.40 |
$15,209.13 |
|
|
Implant neuroelectrodes
|
$1,206.00 |
$3,678.40 |
$3,678.40 |
|
|
Implant neurostim arrays
|
$2,026.40 |
$2,026.40 |
$74,433.58 |
|
|
Implant open hernia repair w/mesh 49568
|
$339.84 |
$531.00 |
$557.40 |
|
|
Implant power module patient cable cable 14 volt
|
$1,625.00 |
$2,283.12 |
$3,512.50 |
|
|
Implant pulse generator remede el
|
$143.20 |
$12,314.25 |
$18,945.00 |
|
|
Implant single ventricular device 33975
|
$2,539.80 |
$3,195.20 |
$14,352.24 |
|
|
Implant spinal canal cath
|
$2,089.60 |
$2,089.60 |
$2,089.60 |
|
|
Implant spine infusion pump
|
$1,010.40 |
$1,010.40 |
$1,010.40 |
|
|
Implant spine infusion pump
|
$777.60 |
$936.80 |
$23,274.55 |
|
|
Implant ureth bulk agent
|
$280.00 |
$2,100.47 |
$3,291.72 |
|
|
Impl ear abutment ba300 9mm
|
$3,519.59 |
$3,704.37 |
$5,699.03 |
|
|
Impl eye bio-eye 16mm
|
$1,474.69 |
$1,657.55 |
$2,550.08 |
|
|
Impl neurostim electr perc
|
$2,535.60 |
$11,605.33 |
$56,786.95 |
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$204.00 |
$1,072.00 |
$137,357.92 |
|
|
Implnt spinl canal catheter 62350
|
$726.60 |
$978.40 |
$49,540.59 |
|
|
Impl oi implt sk tc esp<100
|
$47,069.05 |
$47,069.05 |
$47,069.05 |
|
|
Impl oi implt skull perq esp
|
$5,209.60 |
$5,209.60 |
$76,267.30 |
|
|
Implt brain chemotx add-on 61517
|
$153.00 |
$160.80 |
$160.80 |
|
|
Impltj ntrstrml crnl rng seg
|
$11,556.80 |
$11,556.80 |
$11,556.80 |
|
|
Impltj tot rplcmt hrt sys
|
$6,232.00 |
$6,232.00 |
$6,232.00 |
|
|
Imp neurosti pls gn any type
|
$98,385.69 |
$98,385.69 |
$98,385.69 |
|
|
Impreg gauze no h20/sal/yard
|
$5.60 |
$5.60 |
$9.60 |
|
|
Impres&prep auricular prosth
|
$8,366.40 |
$8,366.40 |
$8,366.40 |
|
|
Impres&prep def obt prosth
|
$4,369.60 |
$4,369.60 |
$4,369.60 |
|
|
Impres&prep intrm obt prosth
|
$3,824.80 |
$3,824.80 |
$3,824.80 |
|
|
Impres&prep mndbl res prosth
|
$4,013.60 |
$4,013.60 |
$4,013.60 |
|
|
Impres&prep nasal prosth
|
$4,183.20 |
$4,183.20 |
$4,183.20 |
|
|
Impres&prep oral surg splint
|
$1,751.20 |
$1,751.20 |
$1,751.20 |
|
|
Impres&prep orbital prosth
|
$11,244.80 |
$11,244.80 |
$11,244.80 |
|
|
Impres&prep paltl aug prosth
|
$3,716.80 |
$3,716.80 |
$3,716.80 |
|
|
Impres&prep paltl lft prosth
|
$3,540.00 |
$3,540.00 |
$3,540.00 |
|
|
Impres&prep sp aid prosth
|
$4,054.40 |
$4,054.40 |
$4,054.40 |
|
|
Impres&prep surg obt prosth
|
$2,271.20 |
$2,271.20 |
$2,271.20 |
|
|
Imuglucerase injection
|
$68.85 |
$68.85 |
$68.85 |
|
|
In-111 autologous plt stdy dx
|
$1,494.95 |
$1,494.95 |
$1,494.95 |
|
|
In-111 autol wbc diag per dose
|
$1,642.80 |
$5,974.15 |
$16,886.35 |
|
|
In-111 capromab pendet
|
$3,819.84 |
$7,024.00 |
$7,024.00 |
|
|
In-111 ibritumomab tiux dx
|
$3,093.00 |
$7,246.75 |
$7,246.75 |
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,207.08 |
$4,312.32 |
$10,776.60 |
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,159.16 |
$11,163.95 |
$11,163.95 |
|
|
In-111 pentetreotide
|
$2,763.60 |
$10,976.74 |
$15,327.00 |
|
|
In-111 satumomab pend
|
$1,380.00 |
$3,524.25 |
$3,524.25 |
|
|
Inactivated je vacc im
|
$280.80 |
$280.80 |
$280.80 |
|
|
Inc deep opng b1 crtx thorax
|
$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 |
|
|
Inc dp opn b1 crtx hum/elbw
|
$2,512.00 |
$2,512.00 |
$2,512.00 |
|
|
Incis 1 vertebral seg cerv
|
$4,297.60 |
$4,297.60 |
$4,297.60 |
|
|
Incis 1 vertebral seg lumbar
|
$2,073.60 |
$3,628.80 |
$3,628.80 |
|
|
Incis 1 vertebral seg thorac
|
$3,619.20 |
$3,619.20 |
$3,619.20 |
|
|
Incis addl spine segment
|
$880.00 |
$880.00 |
$880.00 |
|
|
Incise bile duct sphincter
|
$1,640.16 |
$1,640.16 |
$1,674.33 |
|
|
Incise diaphragm nerve
|
$2,102.40 |
$2,102.40 |
$2,102.40 |
|
|
Incise/drain eyelid lining
|
$598.40 |
$598.40 |
$2,175.71 |
|
|
Incise flexor carpi radialis
|
$1,691.20 |
$1,691.20 |
$1,691.20 |
|
|
Incise hand/finger tendon
|
$1,013.60 |
$1,013.60 |
$1,013.60 |
|
