|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$580.41 |
$580.41 |
$580.41 |
$131.47
|
|
Hymenotomy
|
$3,212.76 |
$3,212.76 |
$3,212.76 |
$4,446.00
|
|
Ia infect ag ab qual/semiquant sgl step
|
$52.89 |
$52.89 |
$52.89 |
$50.60
|
|
Ia nfct ab sarscov2 covid19
|
$76.26 |
$76.26 |
$76.26 |
$55.35
|
|
Ibmfs seq alys pnl 30 genes
|
$3,257.86 |
$3,257.86 |
$3,257.86 |
$2,828.00
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$848.58 |
$848.58 |
$848.58 |
$980.94
|
|
Icatibant injection
|
$4,585.46 |
$4,585.46 |
$4,585.46 |
$8,695.05
|
|
Igh@/bcl2 translocation alys
|
$125.05 |
$125.05 |
$125.05 |
$277.80
|
|
Igh gene rearrang dir probe
|
$95.12 |
$95.12 |
$95.12 |
$82.26
|
|
Igh gene rearrange amp meth
|
$264.04 |
$264.04 |
$264.04 |
$456.54
|
|
Igk rearrangeabn clonal pop
|
$264.04 |
$264.04 |
$264.04 |
$396.00
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$225.09 |
$225.09 |
$225.09 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$56.99 |
$56.99 |
$56.99 |
$274.86
|
|
Immune complex assay
|
$154.16 |
$154.16 |
$154.16 |
$109.20
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$1,003.43 |
$1,003.43 |
$1,003.43 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$115.21 |
$115.21 |
$115.21 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$36.90 |
$36.90 |
$36.90 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$117.26 |
$117.26 |
$117.26 |
$138.60
|
|
Immunofluorescence per specimen initial single antibody stain
|
$57.40 |
$57.40 |
$57.40 |
$232.05
|
|
Immunoglobulin assay
|
$104.14 |
$104.14 |
$104.14 |
$74.15
|
|
Impl neurostim electr perc
|
$3,725.26 |
$3,725.26 |
$3,725.26 |
$7,546.20
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,334.05 |
$2,334.05 |
$2,334.05 |
$2,568.98
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$469.45 |
$469.45 |
$469.45 |
$2,080.80
|
|
Incision of breast lesion
|
$1,835.57 |
$1,835.57 |
$1,835.57 |
$2,577.85
|
|
Incision of burn scab initi
|
$433.78 |
$433.78 |
$433.78 |
$494.40
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$50.43 |
$50.43 |
$50.43 |
$131.20
|
|
Infect ag genotype na cytomegalovirus
|
$342.35 |
$342.35 |
$342.35 |
$636.35
|
|
Infect ag genotype na hiv-1 other region
|
$128.33 |
$128.33 |
$128.33 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$594.91 |
$594.91 |
$594.91 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$86.92 |
$86.92 |
$86.92 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$14.76 |
$14.76 |
$14.76 |
$73.46
|
|
Infect ag na herpes simplex quant
|
$56.99 |
$56.99 |
$56.99 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$54.94 |
$54.94 |
$54.94 |
$139.20
|
|
Infect ag na orthopoxvirus amp prb each
|
$48.38 |
$48.38 |
$48.38 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$599.42 |
$599.42 |
$599.42 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$650.26 |
$650.26 |
$650.26 |
$855.60
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$34.44 |
$34.44 |
$34.44 |
$77.00
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$60.68 |
$60.68 |
$60.68 |
$51.31
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$53.30 |
$53.30 |
$53.30 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$14.76 |
$14.76 |
$14.76 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$129.56 |
$129.56 |
$129.56 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$25.01 |
$25.01 |
$25.01 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$51.25 |
$51.25 |
$51.25 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$59.45 |
$59.45 |
$59.45 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$53.71 |
$53.71 |
$53.71 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$28.70 |
$28.70 |
$28.70 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$139.81 |
$139.81 |
$139.81 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$139.81 |
$139.81 |
$139.81 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$56.99 |
$56.99 |
$56.99 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$721.19 |
$721.19 |
$721.19 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$176.30 |
$176.30 |
$176.30 |
$181.35
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$139.81 |
$139.81 |
$139.81 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$76.26 |
$76.26 |
$76.26 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$205.41 |
$205.41 |
$205.41 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$205.41 |
$205.41 |
$205.41 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$38.54 |
$38.54 |
$38.54 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$38.13 |
$38.13 |
$38.13 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$54.94 |
$54.94 |
$54.94 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$533.82 |
$533.82 |
$533.82 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$176.30 |
$176.30 |
$176.30 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$364.08 |
$364.08 |
$364.08 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$168.10 |
$168.10 |
$168.10 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$82.41 |
$82.41 |
$82.41 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$82.00 |
$82.00 |
$82.00 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$68.88 |
$68.88 |
$68.88 |
$374.50
|
|
Infliximab 100 mg intravenous solution
|
$540.22 |
$540.22 |
$540.22 |
$2,080.86
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$264.45 |
$264.45 |
$264.45 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$151.29 |
$151.29 |
$151.29 |
$576.00
|
|
Inj, acetaminophen (b braun)
|
$17.37 |
$17.37 |
$17.37 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$17.22 |
$17.22 |
$17.22 |
$38.87
|
|
Inj, acetaminophen (hikma)
|
$12.92 |
$12.92 |
$12.92 |
$68.30
|
|
Inj allopurinol sodium 1 mg
|
$2,702.45 |
$2,702.45 |
$2,702.45 |
$6,968.99
|
|
Inj, bortezomib freseniuskab
|
$1,459.52 |
$1,459.52 |
$1,459.52 |
$2,464.14
|
|
Inj, bortezomib, hospira
|
$56.78 |
$56.78 |
$56.78 |
$175.35
|
|
Inj cefazolin sodium, baxter
|
$35.67 |
$35.67 |
$35.67 |
$27.38
|
|
Inj cefazolin sodium, hikma
|
$14.94 |
$14.94 |
$14.94 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$11.07 |
$11.07 |
$11.07 |
$18.30
|
|
Inj. cefepime hcl (baxter)
|
$163.59 |
$163.59 |
$163.59 |
$86.84
|
|
Inj, cefepime hcl (b braun)
|
$84.91 |
$84.91 |
$84.91 |
$69.85
|
|
Inj, clindamycin (baxter)
|
$18.76 |
$18.76 |
$18.76 |
$48.39
|
|
Inj cyclophos dr.reddy's 5mg
|
$4,305.00 |
$4,305.00 |
$4,305.00 |
$4,725.00
|
|
Inj cyclophosphamd auromedic
|
$286.73 |
$286.73 |
$286.73 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$1,666.98 |
$1,666.98 |
$1,666.98 |
$742.72
|
|
Inj, daptomycin (hospira)
|
$100.98 |
$100.98 |
$100.98 |
$110.83
|
|
Inj daptomycin (xellia)
|
$36.99 |
$36.99 |
$36.99 |
$56.04
|
|
Inj, decitabine (sun pharma)
|
$113.79 |
$113.79 |
$113.79 |
$295.94
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$376.38 |
$376.38 |
$376.38 |
$1,214.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$206.23 |
$206.23 |
$206.23 |
$504.90
|
|
Injection, edaravone, 1 mg
|
$409.59 |
$409.59 |
$409.59 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$982.77 |
$982.77 |
$982.77 |
$1,156.80
|
|
Injection eye drug
|
$202.95 |
$202.95 |
$202.95 |
$644.50
|
|
Injection, fulvestrant
|
$1,967.66 |
$1,967.66 |
$1,967.66 |
$1,719.16
|
|
Injection glatiramer acetate
|
$184.90 |
$184.90 |
$184.90 |
$830.51
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$592.86 |
$592.86 |
$592.86 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$432.96 |
$432.96 |
$432.96 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$820.82 |
$820.82 |
$820.82 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$609.26 |
$609.26 |
$609.26 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$633.45 |
$633.45 |
$633.45 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$376.38 |
$376.38 |
$376.38 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$376.38 |
$376.38 |
$376.38 |
$1,704.78
|