|
Immt breast prosthesis 19340
|
$11,238.72 |
$11,238.72 |
$11,238.72 |
$4,883.20
|
|
Immune complex assay
|
$33.63 |
$33.63 |
$33.63 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$65.26 |
$65.26 |
$65.26 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$108.87 |
$108.87 |
$108.87 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$65.39 |
$65.39 |
$65.39 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$28.72 |
$28.72 |
$28.72 |
$132.09
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$28.72 |
$28.72 |
$28.72 |
$116.85
|
|
Immunoassay tumor qual
|
$35.29 |
$35.29 |
$35.29 |
$66.50
|
|
Immunodiff gel qual ea antigen/ab
|
$16.53 |
$16.53 |
$16.53 |
$48.57
|
|
Immunodiffusion nes
|
$19.39 |
$19.39 |
$19.39 |
$52.00
|
|
Immunofixation electrophoresis serum
|
$30.83 |
$30.83 |
$30.83 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$106.19 |
$106.19 |
$106.19 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$234.27 |
$234.27 |
$234.27 |
$238.22
|
|
Immunoglobulin assay
|
$17.19 |
$17.19 |
$17.19 |
$78.00
|
|
Impact tooth remov part bony
|
$888.94 |
$888.94 |
$888.94 |
$1,300.00
|
|
Impedence cardiogram
|
$182.95 |
$182.95 |
$182.95 |
$152.54
|
|
Imp extar knee shck absrb
|
$24,109.66 |
$24,109.66 |
$24,109.66 |
$24,109.66
|
|
Impl absrb msh/prsth dly cls
|
$538.17 |
$538.17 |
$538.17 |
$750.40
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$1,344.92 |
$1,344.92 |
$1,344.92 |
$2,946.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$1,451.36 |
$1,451.36 |
$1,451.36 |
$1,754.00
|
|
Implantation iris prosthesis
|
$22,634.25 |
$22,634.25 |
$22,634.25 |
$19,332.98
|
|
Implant biventricular device 33976
|
$2,214.97 |
$2,214.97 |
$2,214.97 |
$5,053.23
|
|
Implant brain electrodes
|
$1,896.89 |
$1,896.89 |
$1,896.89 |
$1,896.89
|
|
Implant brain electrodes
|
$2,331.47 |
$2,331.47 |
$2,331.47 |
$2,331.47
|
|
Implant brain electrodes
|
$2,410.94 |
$2,410.94 |
$2,410.94 |
$2,410.94
|
|
Implant cochlear device
|
$45,337.91 |
$45,337.91 |
$45,337.91 |
$34,229.98
|
|
Implant cochlear osia osi300
|
$8,083.68 |
$8,083.68 |
$8,083.68 |
$16,195.55
|
|
Implant eye drug system
|
$19,185.84 |
$19,185.84 |
$19,185.84 |
$10,009.03
|
|
Implant hormone pellet(s) 11980
|
$614.27 |
$614.27 |
$614.27 |
$315.75
|
|
Implant nerve end
|
$302.99 |
$302.99 |
$302.99 |
$4,760.00
|
|
Implant neuroelectrde addl
|
$413.38 |
$413.38 |
$413.38 |
$1,158.00
|
|
Implant neuroelectrde addl
|
$727.26 |
$727.26 |
$727.26 |
$727.26
|
|
Implant neuroelectrode
|
$2,308.31 |
$2,308.31 |
$2,308.31 |
$5,925.00
|
|
Implant neuroelectrode
|
$3,442.27 |
$3,442.27 |
$3,442.27 |
$3,442.27
|
|
Implant neuroelectrodes
|
$26,675.88 |
$26,675.88 |
$26,675.88 |
$18,334.40
|
|
Implant neuroelectrodes
|
$15,321.63 |
$15,321.63 |
$15,321.63 |
$13,628.55
|
|
Implant neuroelectrodes
|
$8,763.11 |
$8,763.11 |
$8,763.11 |
$8,836.80
|
|
Implant neuroelectrodes
|
$8,763.11 |
$8,763.11 |
$8,763.11 |
$7,728.86
|
|
Implant neuroelectrodes
|
$1,521.49 |
$1,521.49 |
$1,521.49 |
$1,521.49
|
|
Implant neuroelectrodes
|
$2,378.72 |
$2,378.72 |
$2,378.72 |
$2,378.72
|
|
Implant neurostim arrays
|
$42,430.50 |
$42,430.50 |
$42,430.50 |
$23,262.40
|
|
Implant power module patient cable cable 14 volt
|
$1,318.38 |
$1,318.38 |
$1,318.38 |
$3,695.42
|
|
Implant single ventricular device 33975
|
$1,808.20 |
$1,808.20 |
$1,808.20 |
$5,053.23
|
|
Implant spinal canal cath
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$7,913.97
|
|
Implant spine infusion pump
|
$24,783.48 |
$24,783.48 |
$24,783.48 |
$17,262.84
|
|
Implant spine infusion pump
|
$24,783.48 |
$24,783.48 |
$24,783.48 |
$17,270.40
|
|
Implant tcat pulm vlv perq
|
$1,679.78 |
$1,679.78 |
$1,679.78 |
$13,678.00
|
|
Implant ureter in bowel
|
$1,202.71 |
$1,202.71 |
$1,202.71 |
$1,632.00
|
|
Implant ureth bulk agent
|
$348.97 |
$348.97 |
$348.97 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$2,576.64 |
$2,576.64 |
$2,576.64 |
$3,974.88
|
|
Impl eye bio-eye 16mm
|
$5,704.82 |
$5,704.82 |
$5,704.82 |
$3,917.20
|
|
Impl neurostim electr perc
|
$8,763.11 |
$8,763.11 |
$8,763.11 |
$7,672.50
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$270.87 |
$270.87 |
$270.87 |
$1,072.00
|
|
Implnt spinl canal catheter 62350
|
$12,067.12 |
$12,067.12 |
$12,067.12 |
$5,095.20
|
|
Impl oi implt sk tc esp<100
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$22,958.00
|
|
Impl oi implt sk tc esp>=100
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$15,226.08
|
|
Impl oi implt skull perq esp
|
$17,653.66 |
$17,653.66 |
$17,653.66 |
$13,525.50
|
|
Implt brain chemotx add-on 61517
|
$126.66 |
$126.66 |
$126.66 |
$153.00
|
|
Impltj ntrstrml crnl rng seg
|
$5,683.61 |
$5,683.61 |
$5,683.61 |
$5,683.61
|
|
Impltj tot rplcmt hrt sys
|
$3,558.56 |
$3,558.56 |
$3,558.56 |
$4,580.80
|
|
Imp neurosti pls gn any type
|
$14,560.44 |
$14,560.44 |
$14,560.44 |
$8,789.19
|
|
Imported lipodox inj
|
$412.26 |
$412.26 |
$412.26 |
$528.86
|
|
Impreg gauze no h20/sal/yard
|
$3.75 |
$3.75 |
$3.75 |
$11.90
|
|
Impres&prep auricular prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$6,557.24
|
|
Impres&prep def obt prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$4,558.89
|
|
Impres&prep facial prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$5,028.40
|
|
Impres&prep intrm obt prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,837.72
|
|
Impres&prep mndbl res prosth
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,966.64
|
|
Impres&prep nasal prosth
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$6,966.64
|
|
Impres&prep oral surg splint
|
$622.16 |
$622.16 |
$622.16 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$8,139.99 |
$8,139.99 |
$8,139.99 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,837.72
|
|
Impres&prep paltl lft prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$3,837.72
|
|
Impres&prep sp aid prosth
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$2,945.12
|
|
Imuglucerase injection
|
$59.66 |
$59.66 |
$59.66 |
$3,399.59
|
|
In-111 autol wbc diag per dose
|
$1,522.40 |
$1,522.40 |
$1,522.40 |
$3,493.75
|
|
In-111 capromab pendet
|
$2,387.80 |
$2,387.80 |
$2,387.80 |
$3,141.45
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,147.41 |
$1,147.41 |
$1,147.41 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,028.96 |
$1,028.96 |
$1,028.96 |
$2,598.17
|
|
In-111 pentetreotide
|
$2,761.30 |
$2,761.30 |
$2,761.30 |
$5,294.90
|
|
Inactivated je vacc im
|
$313.00 |
$313.00 |
$313.00 |
$481.34
|
|
Inc deep opng b1 crtx thorax
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$1,091.20
|
|
Inc dp bone crtx f/arm&/wrst
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$6,311.00
|
|
Inc dp opn b1 crtx hum/elbw
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Incis 1 vertebral seg cerv
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$4,297.60
|
|
Incis 1 vertebral seg lumbar
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$3,628.80
|
|
Incis 1 vertebral seg thorac
|
$9,977.57 |
$9,977.57 |
$9,977.57 |
$3,619.20
|
|
Incis addl spine segment
|
$495.32 |
$495.32 |
$495.32 |
$783.42
|
|
Incise bile duct sphincter
|
$1,802.57 |
$1,802.57 |
$1,802.57 |
$1,802.57
|
|
Incise diaphragm nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$2,310.83
|
|
Incise/drain eyelid lining
|
$1,370.74 |
$1,370.74 |
$1,370.74 |
$1,271.00
|
|
Incise flexor carpi radialis
|
$4,499.12 |
$4,499.12 |
$4,499.12 |
$3,839.54
|
|
Incise hand/finger tendon
|
$2,211.05 |
$2,211.05 |
$2,211.05 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$2,500.80
|
|
Incise hip/thigh nerve
|
$2,685.07 |
$2,685.07 |
$2,685.07 |
$3,086.40
|
|
Incise inner ear
|
$2,133.48 |
$2,133.48 |
$2,133.48 |
$2,186.08
|
|
Incise inner ear nerve
|
$4,558.89 |
$4,558.89 |
$4,558.89 |
$5,289.89
|
|
Incise inner ear nerve
|
$2,186.35 |
$2,186.35 |
$2,186.35 |
$2,186.35
|
|
Incise inner eye adhesions
|
$756.27 |
$756.27 |
$756.27 |
$1,202.90
|
