|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$603.20 |
$603.20 |
$603.20 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$295.20 |
$295.20 |
$295.20 |
$233.50
|
|
Hip X-ray
|
$412.80 |
$412.80 |
$412.80 |
$294.75
|
|
Histamine
|
$130.40 |
$130.40 |
$130.40 |
$115.00
|
|
Hla ii typing 1 loc hr
|
$299.20 |
$299.20 |
$299.20 |
$299.20
|
|
Hla i low res one antigen equiv ea
|
$228.00 |
$228.00 |
$228.00 |
$164.00
|
|
Home sleep test/type 3 porta
|
$680.80 |
$680.80 |
$680.80 |
$570.00
|
|
Homocysteine
|
$96.00 |
$96.00 |
$96.00 |
$125.40
|
|
H pylori (c-13) breath
|
$418.40 |
$418.40 |
$418.40 |
$212.25
|
|
Human epididymis protein 4 (he4)
|
$56.80 |
$56.80 |
$56.80 |
$157.32
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$98.44 |
$98.44 |
$98.44 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$62.65 |
$62.65 |
$62.65 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$73.56 |
$73.56 |
$73.56 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$60.84 |
$60.84 |
$60.84 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$65.86 |
$65.86 |
$65.86 |
$294.92
|
|
I-123 sod iodide diag per 100 uci
|
$224.80 |
$224.80 |
$224.80 |
$147.46
|
|
Iaadi respiratory synctial virus
|
$71.20 |
$71.20 |
$71.20 |
$54.58
|
|
Ia infect ag ab qual/semiquant sgl step
|
$164.00 |
$164.00 |
$164.00 |
$50.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$754.18 |
$754.18 |
$754.18 |
$684.45
|
|
Igh@ var region somatic mutation analy
|
$718.40 |
$718.40 |
$718.40 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$159.20 |
$159.20 |
$159.20 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$406.40 |
$406.40 |
$406.40 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$214.40 |
$214.40 |
$214.40 |
$277.90
|
|
Immobilizer shldr cntor adlt
|
$45.60 |
$45.60 |
$45.60 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$78.40 |
$78.40 |
$78.40 |
$118.43
|
|
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
|
$44.00 |
$44.00 |
$44.00 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$264.80 |
$264.80 |
$264.80 |
$142.50
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,910.40 |
$2,910.40 |
$2,910.40 |
$2,086.70
|
|
Incisn of toe tndn
|
$2,256.00 |
$2,256.00 |
$2,256.00 |
$2,667.00
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$139.20 |
$139.20 |
$139.20 |
$140.80
|
|
Infect ag ia optc obs influenza
|
$161.60 |
$161.60 |
$161.60 |
$72.93
|
|
Infect ag if influenza a
|
$94.40 |
$94.40 |
$94.40 |
$41.30
|
|
Infect ag if influenza b
|
$94.40 |
$94.40 |
$94.40 |
$37.95
|
|
Infect ag if nos ea
|
$82.40 |
$82.40 |
$82.40 |
$74.88
|
|
Infect ag na hpv high-risk types
|
$139.20 |
$139.20 |
$139.20 |
$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
|
$151.20 |
$151.20 |
$151.20 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$152.80 |
$152.80 |
$152.80 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$126.40 |
$126.40 |
$126.40 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$138.40 |
$138.40 |
$138.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$256.00 |
$256.00 |
$256.00 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$148.80 |
$148.80 |
$148.80 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$176.80 |
$176.80 |
$176.80 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$127.20 |
$127.20 |
$127.20 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$169.60 |
$169.60 |
$169.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$156.80 |
$156.80 |
$156.80 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$138.40 |
$138.40 |
$138.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$373.60 |
$373.60 |
$373.60 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$171.20 |
$171.20 |
$171.20 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$227.20 |
$227.20 |
$227.20 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$165.60 |
$165.60 |
$165.60 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$108.80 |
$108.80 |
$108.80 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$186.40 |
$186.40 |
$186.40 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$110.40 |
$110.40 |
$110.40 |
$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
|
$137.60 |
$137.60 |
$137.60 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$271.20 |
$271.20 |
$271.20 |
$217.60
|
|
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
|
$696.00 |
$696.00 |
$696.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$302.40 |
$302.40 |
$302.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$100.00 |
$100.00 |
$100.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$124.00 |
$124.00 |
$124.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$413.60 |
$413.60 |
$413.60 |
$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
|
$1,587.80 |
$1,587.80 |
$1,587.80 |
$2,047.13
|
|
Inj acetaminophen -fresenius
|
$132.78 |
$132.78 |
$132.78 |
$36.60
|
|
Inj., benralizumab, 1 mg
|
$7,893.17 |
$7,893.17 |
$7,893.17 |
$11,310.00
|
|
Inj, daptomycin (hospira)
|
$76.80 |
$76.80 |
$76.80 |
$128.08
|
|
Inj disk cerv-thor ea lev
|
$2,373.60 |
$2,373.60 |
$2,373.60 |
$875.28
|
|
Injection for bladder x-ray
|
$771.20 |
$771.20 |
$771.20 |
$459.20
|
|
Injection, fulvestrant
|
$508.12 |
$508.12 |
$508.12 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$5,483.36 |
$5,483.36 |
$5,483.36 |
$6,679.35
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,168.80 |
$1,168.80 |
$1,168.80 |
$1,043.72
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$667.20 |
$667.20 |
$667.20 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$608.80 |
$608.80 |
$608.80 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$183.20 |
$183.20 |
$183.20 |
$145.60
|
|
Inj. fe derisomaltose 10 mg
|
$3,179.68 |
$3,179.68 |
$3,179.68 |
$3,221.52
|
|
Inj hydroxocobalamin IV 25mg
|
$1,289.75 |
$1,289.75 |
$1,289.75 |
$2,452.32
|
|
Inj intralesional <= 7 lsn(s)
|
$272.00 |
$272.00 |
$272.00 |
$235.13
|
|
Inj ivig privigen 500 mg
|
$4,299.36 |
$4,299.36 |
$4,299.36 |
$6,967.29
|
|
Inj levocarnitine per 1 gm
|
$64.23 |
$64.23 |
$64.23 |
$136.62
|
|
Inj, lidocaine w epinephrine
|
$62.62 |
$62.62 |
$62.62 |
$45.60
|
|
Inj pantoprazole(hikma) 40mg
|
$62.10 |
$62.10 |
$62.10 |
$34.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,177.96 |
$3,177.96 |
$3,177.96 |
$6,614.40
|
|
Inj proc lumbr disk ea lvl
|
$2,721.60 |
$2,721.60 |
$2,721.60 |
$1,106.93
|
|
Inj testosterone cypionate
|
$64.80 |
$64.80 |
$64.80 |
$64.96
|
|
Insertion catheter bladder non indwelling
|
$183.20 |
$183.20 |
$183.20 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,937.60 |
$1,937.60 |
$1,937.60 |
$2,585.25
|
|
In situ hybridization per specimen initial single probe stain
|
$394.40 |
$394.40 |
$394.40 |
$338.40
|
|
Ins tun cv cath wo subq prt/pm
|
$6,042.40 |
$6,042.40 |
$6,042.40 |
$4,218.00
|
|
Insulin total
|
$132.80 |
$132.80 |
$132.80 |
$66.64
|
|
Intracranial complete study
|
$1,917.60 |
$1,917.60 |
$1,917.60 |
$881.50
|
|
Intrinsic factor antibody
|
$56.80 |
$56.80 |
$56.80 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$617.60 |
$617.60 |
$617.60 |
$601.28
|