|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$106.10 |
$106.10 |
$106.10 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$112.66 |
$112.66 |
$112.66 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$837.12 |
$837.12 |
$837.12 |
$294.92
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$34.77 |
$34.77 |
$34.77 |
$72.65
|
|
Hysterosalpingography s&i
|
$642.40 |
$642.40 |
$642.40 |
$669.12
|
|
Hysteroscopy ablation
|
$7,251.20 |
$7,251.20 |
$7,251.20 |
$5,865.75
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$422.59 |
$422.59 |
$422.59 |
$352.24
|
|
I-123 sod iodide diag per 100 uci
|
$224.80 |
$224.80 |
$224.80 |
$147.46
|
|
I131 iodide cap, rx
|
$140.00 |
$140.00 |
$140.00 |
$71.70
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,003.72 |
$1,003.72 |
$1,003.72 |
$980.94
|
|
Idh1 common variants
|
$471.20 |
$471.20 |
$471.20 |
$415.35
|
|
Idh2 common variants
|
$721.60 |
$721.60 |
$721.60 |
$486.00
|
|
Ifosfamide 1 gram intravenous solution
|
$301.36 |
$301.36 |
$301.36 |
$246.95
|
|
Igh gene rearrange amp meth
|
$464.00 |
$464.00 |
$464.00 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$718.40 |
$718.40 |
$718.40 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$404.80 |
$404.80 |
$404.80 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$173.60 |
$173.60 |
$173.60 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$558.40 |
$558.40 |
$558.40 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$265.60 |
$265.60 |
$265.60 |
$277.90
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$3,953.07 |
$3,953.07 |
$3,953.07 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$101.60 |
$101.60 |
$101.60 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$101.60 |
$101.60 |
$101.60 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$90.40 |
$90.40 |
$90.40 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$192.00 |
$192.00 |
$192.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$215.20 |
$215.20 |
$215.20 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$288.00 |
$288.00 |
$288.00 |
$234.27
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,926.40 |
$1,926.40 |
$1,926.40 |
$2,086.70
|
|
Incision of burn scab initi
|
$590.40 |
$590.40 |
$590.40 |
$494.40
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$154.40 |
$154.40 |
$154.40 |
$140.80
|
|
Infect ag ia optc obs influenza
|
$70.40 |
$70.40 |
$70.40 |
$72.93
|
|
Infect ag na hep b amp
|
$87.20 |
$87.20 |
$87.20 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$131.20 |
$131.20 |
$131.20 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$248.80 |
$248.80 |
$248.80 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$144.00 |
$144.00 |
$144.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$52.00 |
$52.00 |
$52.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$89.60 |
$89.60 |
$89.60 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$158.40 |
$158.40 |
$158.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$139.20 |
$139.20 |
$139.20 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$68.80 |
$68.80 |
$68.80 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$67.20 |
$67.20 |
$67.20 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$89.60 |
$89.60 |
$89.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$164.00 |
$164.00 |
$164.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$130.40 |
$130.40 |
$130.40 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$90.40 |
$90.40 |
$90.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$304.00 |
$304.00 |
$304.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$173.60 |
$173.60 |
$173.60 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$132.80 |
$132.80 |
$132.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,633.60 |
$1,633.60 |
$1,633.60 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$152.80 |
$152.80 |
$152.80 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$136.00 |
$136.00 |
$136.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$319.20 |
$319.20 |
$319.20 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$211.20 |
$211.20 |
$211.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$124.80 |
$124.80 |
$124.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$349.60 |
$349.60 |
$349.60 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$460.80 |
$460.80 |
$460.80 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$105.60 |
$105.60 |
$105.60 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$120.80 |
$120.80 |
$120.80 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$384.80 |
$384.80 |
$384.80 |
$217.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$211.20 |
$211.20 |
$211.20 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,227.20 |
$1,227.20 |
$1,227.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$312.80 |
$312.80 |
$312.80 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$717.60 |
$717.60 |
$717.60 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$275.20 |
$275.20 |
$275.20 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$100.00 |
$100.00 |
$100.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$120.80 |
$120.80 |
$120.80 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$522.40 |
$522.40 |
$522.40 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$348.00 |
$348.00 |
$348.00 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$2,086.58 |
$2,086.58 |
$2,086.58 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,079.04 |
$1,079.04 |
$1,079.04 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,161.24 |
$1,161.24 |
$1,161.24 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$239.20 |
$239.20 |
$239.20 |
$296.00
|
|
Inj, abilify maintena, 1 mg
|
$4,069.32 |
$4,069.32 |
$4,069.32 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$74.64 |
$74.64 |
$74.64 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$75.68 |
$75.68 |
$75.68 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$43.28 |
$43.28 |
$43.28 |
$56.70
|
|
Inj alymsys 10 mg
|
$2,167.04 |
$2,167.04 |
$2,167.04 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$8,006.57 |
$8,006.57 |
$8,006.57 |
$10,052.58
|
|
Inj, aponvie, 1 mg
|
$112.05 |
$112.05 |
$112.05 |
$3.36
|
|
Inj., aristada initio, 1 mg
|
$3,854.61 |
$3,854.61 |
$3,854.61 |
$4,052.45
|
|
Inj, bortezomib freseniuskab
|
$1,859.18 |
$1,859.18 |
$1,859.18 |
$2,624.08
|
|
Inj cefazolin sodium, hikma
|
$36.88 |
$36.88 |
$36.88 |
$27.38
|
|
Inj cefazolin (wg crit care)
|
$37.45 |
$37.45 |
$37.45 |
$18.43
|
|
Inj, clindamycin (baxter)
|
$74.08 |
$74.08 |
$74.08 |
$48.30
|
|
Inj cyclophosphamd auromedic
|
$667.19 |
$667.19 |
$667.19 |
$249.68
|
|
Injection arthrography hip without anesthesia (both sides)
|
$652.00 |
$652.00 |
$652.00 |
$503.50
|
|
Injection, daratumumab 10 mg
|
$2,767.54 |
$2,767.54 |
$2,767.54 |
$5,324.34
|
|
Injection epidural blood patch or clot
|
$1,593.60 |
$1,593.60 |
$1,593.60 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$552.80 |
$552.80 |
$552.80 |
$436.00
|
|
Injection for bladder x-ray
|
$460.00 |
$460.00 |
$460.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$641.60 |
$641.60 |
$641.60 |
$497.76
|
|
Injection, fulvestrant
|
$514.21 |
$514.21 |
$514.21 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$5,630.57 |
$5,630.57 |
$5,630.57 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$1,683.43 |
$1,683.43 |
$1,683.43 |
$2,277.65
|
|
Injection, pentamidine iseth
|
$105.46 |
$105.46 |
$105.46 |
$383.03
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,078.40 |
$1,078.40 |
$1,078.40 |
$685.44
|
|
Injection, renflexis
|
$1,076.56 |
$1,076.56 |
$1,076.56 |
$1,341.52
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,198.40 |
$1,198.40 |
$1,198.40 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,155.20 |
$2,155.20 |
$2,155.20 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,111.20 |
$2,111.20 |
$2,111.20 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$851.20 |
$851.20 |
$851.20 |
$1,043.20
|