|
Hydrocolld drg >16<=48 w/bdr
|
$61.78 |
$72.07 |
$72.07 |
|
|
Hydrocolld drg <=16 without bdr
|
$4.37 |
$5.10 |
$5.10 |
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$39.23 |
$106.10 |
$345.89 |
|
|
Hydrogel dsg<=16 sq in
|
$4.32 |
$5.04 |
$5.04 |
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$24.82 |
$92.04 |
$641.45 |
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$37.12 |
$147.84 |
$837.12 |
|
|
Hydromorphone injection
|
$55.88 |
$55.88 |
$55.88 |
|
|
Hydroxocobalamin im 10mcg
|
$66.53 |
$66.53 |
$66.53 |
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$34.77 |
$61.98 |
$67.88 |
|
|
Hydroxyzine pamoate 25 mg capsule
|
$2.56 |
$2.64 |
$4.43 |
|
|
#hypersens-actinomyces ab
|
$21.11 |
$21.11 |
$27.22 |
|
|
Hysterosalpingography s&i
|
$208.99 |
$209.38 |
$1,033.60 |
|
|
Hysteroscopy ablation
|
$7,251.20 |
$7,251.20 |
$7,251.20 |
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$267.33 |
$405.38 |
$1,381.84 |
|
|
I-123 iobenguane diag
|
$4,432.03 |
$5,170.70 |
$5,170.70 |
|
|
I-123 ioflupane diag
|
$4,101.33 |
$5,030.26 |
$5,030.26 |
|
|
I-123 sod iodide diag per 100 uci
|
$43.20 |
$50.40 |
$224.80 |
|
|
I-131 iobenguane sulf diag mibg
|
$1,502.40 |
$1,752.80 |
$1,752.80 |
|
|
I131 iodide cap, rx
|
$21.46 |
$25.03 |
$140.00 |
|
|
Iaadi respiratory synctial virus
|
$49.60 |
$71.20 |
$71.20 |
|
|
Iadna legionella pneumophila amplified probe tq
|
$67.25 |
$78.46 |
$78.46 |
|
|
Ia infect ag ab qual/semiquant sgl step
|
$164.00 |
$164.00 |
$164.00 |
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$102.71 |
$768.24 |
$1,038.74 |
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$193.60 |
$273.20 |
$1,003.72 |
|
|
Icatibant injection
|
$3,899.77 |
$4,928.38 |
$4,928.38 |
|
|
Icd cobalt xt dr MRI is1 df1
|
$32,765.57 |
$38,226.50 |
$53,242.24 |
|
|
Icd crtd cobalt hf MRI is1 df1
|
$43,313.95 |
$50,532.94 |
$65,757.92 |
|
|
Icd crtp serena MRI
|
$19,016.26 |
$22,185.63 |
$29,062.80 |
|
|
Icd reliance df4 ib 64cm
|
$13,121.62 |
$14,590.24 |
$15,308.55 |
|
|
Idarubicin hcl injection
|
$782.24 |
$912.61 |
$912.61 |
|
|
Idet 1 or more levels
|
$1,256.50 |
$1,256.50 |
$1,256.50 |
|
|
Idet single level
|
$2,714.98 |
$2,714.98 |
$2,714.98 |
|
|
Idh1 common variants
|
$471.20 |
$553.34 |
$918.91 |
|
|
Idh2 common variants
|
$553.34 |
$679.11 |
$918.91 |
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$767.20 |
$767.20 |
$767.20 |
|
|
Ifosfamide 1 gram intravenous solution
|
$257.39 |
$324.53 |
$358.92 |
|
|
Igh gene rearrange amp meth
|
$227.18 |
$238.84 |
$464.00 |
|
|
Igh@ var region somatic mutation analy
|
$718.40 |
$718.40 |
$718.40 |
|
|
Igk rearrangeabn clonal pop
|
$404.80 |
$404.80 |
$404.80 |
|
|
Ihc/icc per specimen each additional single antibody stain
|
$159.20 |
$246.68 |
$390.58 |
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$106.46 |
$331.86 |
$558.40 |
|
|
Ihc/icc per specimen initial single antibody stain
|
$172.80 |
$265.60 |
$390.58 |
|
|
Ikbkap gene
|
$173.49 |
$173.49 |
$224.95 |
|
|
Iliac/fem angio cath insert
|
$2,992.00 |
$6,723.70 |
$6,723.70 |
|
|
Imetelstat 188 mg intravenous solution
|
$13,860.77 |
$16,170.90 |
$16,265.91 |
|
|
Img rta detc/mntr ds phy/qhp
|
$180.94 |
$180.94 |
$205.25 |
|
|
Immob elbow child sm
|
$154.84 |
$181.30 |
$211.51 |
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$126.96 |
$148.12 |
$148.12 |
|
|
Immobilizer shldr cntor adlt
|
$37.60 |
$1,089.36 |
$1,270.92 |
|
|
Immobilizer shldr dlx str 24-36in med
|
$59.20 |
$164.16 |
$191.52 |
|
|
Immobilizer shldr sling med
|
$160.94 |
$188.22 |
$208.32 |
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$2,156.91 |
$3,446.49 |
$4,020.90 |
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,485.81 |
$2,900.11 |
$2,900.11 |
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$5,289.54 |
$5,289.54 |
$5,289.54 |
|
|
Immunoassay tumor antigen quantitative ca 125
|
$32.59 |
$33.60 |
$101.60 |
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$53.86 |
$62.83 |
$101.60 |
|
|
Immunodiff gel qual ea antigen/ab
|
$24.86 |
$26.59 |
$90.40 |
|
|
Immunofixation electrophoresis serum
|
$119.20 |
$144.80 |
$264.80 |
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$67.14 |
$77.71 |
$215.20 |
|
|
Immunofluorescence per specimen initial single antibody stain
|
$77.71 |
$160.27 |
$288.00 |
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$4,503.74 |
$5,254.37 |
$5,254.37 |
|
|
Implant cartilage 10mm synthetic
|
$3,261.79 |
$3,805.42 |
$5,317.60 |
|
|
Implant cochlear osia osi300
|
$13,627.04 |
$19,311.26 |
$20,318.42 |
|
|
Implant neuroelectrodes
|
$9,864.72 |
$9,864.72 |
$9,864.72 |
|
|
Implant neuroelectrodes
|
$11,301.36 |
$11,301.36 |
$11,301.36 |
|
|
Implant neuroelectrodes
|
$2,175.02 |
$2,175.02 |
$2,175.02 |
|
|
Implant power module patient cable cable 14 volt
|
$2,116.80 |
$2,469.60 |
$2,469.60 |
|
|
Implant pulse generator remede el
|
$39,458.35 |
$46,034.74 |
$46,034.74 |
|
|
Implant tcat pulm vlv perq
|
$26,933.18 |
$26,933.18 |
$26,933.18 |
|
|
Implant ureth bulk agent
|
$1,310.40 |
$1,310.40 |
$2,438.00 |
|
|
Impl neurostim electr perc
|
$8,555.20 |
$9,283.87 |
$9,283.87 |
|
|
Implnt spinl canal catheter 62350
|
$439.60 |
$439.60 |
$968.69 |
|
|
Imuglucerase injection
|
$2,851.70 |
$2,851.70 |
$2,851.70 |
|
|
In-111 autol wbc diag per dose
|
$1,217.18 |
$1,420.05 |
$1,420.05 |
|
|
In-111 capromab pendet
|
$4,219.73 |
$4,923.02 |
$4,923.02 |
|
|
In-111 ibritumomab tiux dx
|
$4,069.73 |
$4,748.02 |
$4,748.02 |
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,212.99 |
$2,581.82 |
$2,581.82 |
|
|
In-111 pentetate dtpa / 0.5 mci
|
$804.43 |
$938.50 |
$938.50 |
|
|
In-111 pentetreotide
|
$4,252.66 |
$4,961.43 |
$4,961.43 |
|
|
In-111 satumomab pend
|
$1,514.64 |
$1,767.08 |
$1,767.08 |
|
|
Incise inner eye adhesions
|
$812.73 |
$812.73 |
$812.73 |
|
|
Incise tear duct opening 68440
|
$1,439.20 |
$1,439.20 |
$1,439.20 |
|
|
Incise tendon(s) & muscle(s)
|
$8,528.80 |
$8,528.80 |
$8,528.80 |
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$688.56 |
$1,894.40 |
$3,747.20 |
|
|
Incision of achilles tendon
|
$4,276.00 |
$4,276.00 |
$4,276.00 |
|
|
Incision of breast lesion
|
$236.26 |
$236.26 |
$4,999.20 |
|
|
Incision of burn scab initi
|
$590.40 |
$590.40 |
$1,541.60 |
|
|
Incision of foot tendon 28234
|
$3,852.80 |
$3,852.80 |
$3,852.80 |
|
|
Incision of hip tendons
|
$5,143.20 |
$5,143.20 |
$5,143.20 |
|
|
Incision of spinal nerve 64772
|
$3,431.20 |
$3,431.20 |
$3,431.20 |
|
|
Incision of tendon & muscle
|
$5,784.00 |
$5,784.00 |
$5,784.00 |
|
|
Incision of tendon sheath
|
$2,345.60 |
$2,345.60 |
$4,356.00 |
|
|
Incision of toe tendons 28011
|
$1,819.25 |
$1,819.25 |
$2,620.00 |
|
|
Incision of tongue fold
|
$205.86 |
$205.86 |
$542.11 |
|
|
Incision tendon sheath
|
$1,963.20 |
$1,963.20 |
$2,747.20 |
|
|
Incisn of toe tndn
|
$422.18 |
$1,529.14 |
$2,482.40 |
|
|
Incobotulinumtoxin a
|
$929.14 |
$929.14 |
$929.14 |
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$324.92 |
$324.92 |
$577.56 |
|
|
Induced ab 1+vag supp d&c
|
$1,799.33 |
$2,178.68 |
$2,178.68 |
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$115.20 |
$202.61 |
$236.38 |
|
