|
Hepatitis b core antibody total
|
$183.75 |
$183.75 |
$183.75 |
$77.50
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$3,369.00 |
$3,369.00 |
$3,369.00 |
$1,154.13
|
|
Hepatitis b surface antibody
|
$188.45 |
$188.45 |
$188.45 |
$82.32
|
|
Hepatitis c antibody
|
$167.10 |
$167.10 |
$167.10 |
$108.25
|
|
Hepb vacc 3 dose immunsup im
|
$88.40 |
$88.40 |
$88.40 |
$319.52
|
|
Herpes simplex type 1 antibody igg
|
$168.65 |
$168.65 |
$168.65 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$215.45 |
$215.45 |
$215.45 |
$87.36
|
|
Heterophile antibodies screening
|
$134.00 |
$134.00 |
$134.00 |
$73.87
|
|
Hexa gene
|
$414.75 |
$414.75 |
$414.75 |
$150.82
|
|
Hfo nontorsion jnts pre cst
|
$248.15 |
$248.15 |
$248.15 |
$110.88
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$497.05 |
$497.05 |
$497.05 |
$374.40
|
|
Hip and Pelvis X-ray (3 to 4 views, both hips)
|
$497.05 |
$497.05 |
$497.05 |
$424.80
|
|
Hip and Pelvis X-ray (single view, left side)
|
$301.20 |
$301.20 |
$301.20 |
$233.50
|
|
Hip X-ray
|
$304.90 |
$304.90 |
$304.90 |
$294.75
|
|
Histamine
|
$372.75 |
$372.75 |
$372.75 |
$115.00
|
|
HIV prep, ftc/taf 200/25mg
|
$350.71 |
$350.71 |
$350.71 |
$88.39
|
|
HIV prep, ftc/tdf 200/300mg
|
$349.15 |
$349.15 |
$349.15 |
$31.80
|
|
HIV prep, inj, cabotegravir
|
$7,822.13 |
$7,822.13 |
$7,822.13 |
$7,320.13
|
|
Hizentra injection
|
$6,107.68 |
$6,107.68 |
$6,107.68 |
$3,912.58
|
|
Hla class i high defin qual
|
$841.80 |
$841.80 |
$841.80 |
$631.15
|
|
Hla class ii high defin qual
|
$847.10 |
$847.10 |
$847.10 |
$569.25
|
|
Hla i typing high res 1 allele grp ea
|
$1,154.35 |
$1,154.35 |
$1,154.35 |
$304.20
|
|
Hla typing a b or c
|
$1,369.40 |
$1,369.40 |
$1,369.40 |
$364.00
|
|
Hlth bhv assmt/reassessment
|
$179.90 |
$179.90 |
$179.90 |
$181.00
|
|
Hlth bhv ivntj fam 1st 30
|
$131.30 |
$131.30 |
$131.30 |
$147.16
|
|
Hlth bhv ivntj fam without pt ea
|
$56.85 |
$56.85 |
$56.85 |
$87.00
|
|
Hlth bhv ivntj fam wo pt 1st
|
$156.90 |
$156.90 |
$156.90 |
$183.68
|
|
Hlth bhv ivntj grp 1st 30
|
$56.50 |
$56.50 |
$56.50 |
$78.50
|
|
Hlth bhv ivntj indiv 1st 30
|
$122.85 |
$122.85 |
$122.85 |
$200.00
|
|
Hocm 250-299mg/ml iodine,1ml
|
$49.76 |
$49.76 |
$49.76 |
$37.80
|
|
Hocm 350-399mg/ml iodine,1ml
|
$365.12 |
$365.12 |
$365.12 |
$79.78
|
|
Home/res vst est high mdm 60
|
$444.35 |
$444.35 |
$444.35 |
$338.40
|
|
Home/res vst est mod mdm 40
|
$320.45 |
$320.45 |
$320.45 |
$233.60
|
|
Home/res vst est sf mdm 20
|
$166.25 |
$166.25 |
$166.25 |
$93.24
|
|
Home/res vst new high mdm 75
|
$549.00 |
$549.00 |
$549.00 |
$398.40
|
|
Home/res vst new low mdm 30
|
$208.05 |
$208.05 |
$208.05 |
$145.60
|
|
Home/res vst new mod mdm 60
|
$455.40 |
$455.40 |
$455.40 |
$327.20
|
|
Home/res vst new sf mdm 15
|
$138.75 |
$138.75 |
$138.75 |
$98.40
|
|
Home sleep test/type 3 porta
|
$825.15 |
$825.15 |
$825.15 |
$570.00
|
|
Home visit est patient 99348
|
$310.85 |
$310.85 |
$310.85 |
$140.00
|
|
Homocysteine
|
$594.25 |
$594.25 |
$594.25 |
$125.40
|
|
Homovanillic acid (hva)
|
$380.75 |
$380.75 |
$380.75 |
$59.95
|
|
Human epididymis protein 4 (he4)
|
$217.80 |
$217.80 |
$217.80 |
$157.32
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6,918.37 |
$6,918.37 |
$6,918.37 |
$5,568.57
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$343.80 |
$343.80 |
$343.80 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$145.77 |
$145.77 |
$145.77 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$229.04 |
$229.04 |
$229.04 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1,246.98 |
$1,246.98 |
$1,246.98 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$197.49 |
$197.49 |
$197.49 |
$294.92
|
|
Hydroxocobalamin im 10mcg
|
$254.39 |
$254.39 |
$254.39 |
$4.86
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$328.39 |
$328.39 |
$328.39 |
$72.65
|
|
Hyperbaric oxygen therapy
|
$272.30 |
$272.30 |
$272.30 |
$1,081.04
|
|
Hysterosalpingography s&i
|
$1,744.05 |
$1,744.05 |
$1,744.05 |
$669.12
|
|
Hysteroscopy biopsy
|
$775.95 |
$775.95 |
$775.95 |
$5,419.00
|
|
Hysteroscopy dx sep proc
|
$549.80 |
$549.80 |
$549.80 |
$3,997.50
|
|
Hysteroscopy remove fb
|
$882.00 |
$882.00 |
$882.00 |
$4,719.18
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$435.15 |
$435.15 |
$435.15 |
$352.24
|
|
I-123 iobenguane diag
|
$5,671.85 |
$5,671.85 |
$5,671.85 |
$5,170.70
|
|
I-123 ioflupane diag
|
$7,429.25 |
$7,429.25 |
$7,429.25 |
$4,158.00
|
|
I-123 sod iodide diag per 100 uci
|
$508.40 |
$508.40 |
$508.40 |
$147.46
|
|
I131 iodide cap, rx
|
$43.85 |
$43.85 |
$43.85 |
$71.70
|
|
I131 max 100uci
|
$7.40 |
$7.40 |
$7.40 |
$53.39
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$4,243.77 |
$4,243.77 |
$4,243.77 |
$980.94
|
|
Icd cobalt xt dr MRI is1 df1
|
$14,838.00 |
$14,838.00 |
$14,838.00 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$19,540.00 |
$19,540.00 |
$19,540.00 |
$39,070.50
|
|
Icd crtp serena MRI
|
$7,411.00 |
$7,411.00 |
$7,411.00 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$4,000.00 |
$4,000.00 |
$4,000.00 |
$9,264.83
|
|
I&d/bursa/foot 28001
|
$3,548.85 |
$3,548.85 |
$3,548.85 |
$1,917.33
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$2,095.90 |
$2,095.90 |
$2,095.90 |
$3,371.02
|
|
Idursulfase injection
|
$7,000.88 |
$7,000.88 |
$7,000.88 |
$5,646.08
|
|
I & d vag hematoma non-ob 57023
|
$2,563.65 |
$2,563.65 |
$2,563.65 |
$3,444.42
|
|
Ifosfamide 1 gram intravenous solution
|
$1,094.70 |
$1,094.70 |
$1,094.70 |
$246.95
|
|
Igh@ var region somatic mutation analy
|
$1,382.45 |
$1,382.45 |
$1,382.45 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$539.35 |
$539.35 |
$539.35 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$1,046.65 |
$1,046.65 |
$1,046.65 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$534.75 |
$534.75 |
$534.75 |
$277.90
|
|
Iiv3 vacc no prsv 0.25 ml im
|
$29.70 |
$29.70 |
$29.70 |
$29.70
|
|
Ikbkap gene
|
$316.85 |
$316.85 |
$316.85 |
$173.49
|
|
Iliac/fem angio cath insert
|
$1,805.75 |
$1,805.75 |
$1,805.75 |
$1,856.01
|
|
Iliac revasc add-on 37222
|
$11,899.40 |
$11,899.40 |
$11,899.40 |
$6,082.65
|
|
Immob elbow child sm
|
$172.80 |
$172.80 |
$172.80 |
$85.39
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$18,797.65 |
$18,797.65 |
$18,797.65 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$6,016.09 |
$6,016.09 |
$6,016.09 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$20,912.00 |
$20,912.00 |
$20,912.00 |
$3,846.15
|
|
Immune globulin ig human im use 90281
|
$85.30 |
$85.30 |
$85.30 |
$92.00
|
|
Immunoassay tumor antigen quantitative ca 125
|
$261.65 |
$261.65 |
$261.65 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$261.65 |
$261.65 |
$261.65 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$161.45 |
$161.45 |
$161.45 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$559.25 |
$559.25 |
$559.25 |
$142.50
|
|
Immunofluorescence per specimen initial single antibody stain
|
$241.95 |
$241.95 |
$241.95 |
$234.27
|
|
Immunoglobulin assay
|
$712.25 |
$712.25 |
$712.25 |
$78.00
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$1,045.00 |
$1,045.00 |
$1,045.00 |
$2,946.00
|
|
Implant cartilage 10mm synthetic
|
$4,935.00 |
$4,935.00 |
$4,935.00 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$21,480.00 |
$21,480.00 |
$21,480.00 |
$16,195.55
|
|
Implant tcat pulm vlv perq
|
$31,438.75 |
$31,438.75 |
$31,438.75 |
$12,623.60
|
|
Implant ureth bulk agent
|
$3,177.46 |
$3,177.46 |
$3,177.46 |
$2,168.00
|
|
Impl eye bio-eye 16mm
|
$546.00 |
$546.00 |
$546.00 |
$3,917.20
|
|
Impl neurostim electr perc
|
$8,279.45 |
$8,279.45 |
$8,279.45 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$9,612.50 |
$9,612.50 |
$9,612.50 |
$5,095.20
|
|
Imuglucerase injection
|
$5,456.35 |
$5,456.35 |
$5,456.35 |
$3,399.59
|
