|
Hydration IV infusion each additional hour
|
$101.45 |
$101.45 |
$101.45 |
$134.53
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$239.45 |
$239.45 |
$239.45 |
$394.40
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$19.69 |
$19.69 |
$19.69 |
$76.13
|
|
Hymenotomy
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,107.36
|
|
Hyoid myotomy & suspension
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,110.00
|
|
#hypersens-actinomyces ab
|
$11.20 |
$11.20 |
$11.20 |
$19.60
|
|
Hysterosalpingography s&i
|
$148.32 |
$148.32 |
$148.32 |
$629.46
|
|
Hysteroscopy ablation
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,841.60
|
|
Hysteroscopy biopsy
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,753.18
|
|
Hysteroscopy dx sep proc
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,762.53
|
|
Hysteroscopy lysis
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,339.00
|
|
Hysteroscopy remove fb
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,451.18
|
|
Hysteroscopy remove myoma
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,350.00
|
|
Hysteroscopy resect septum
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,881.00
|
|
Hysterotomy abdominal 59100
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,375.25
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$39.91 |
$39.91 |
$39.91 |
$331.10
|
|
Iaadi respiratory synctial virus
|
$14.76 |
$14.76 |
$14.76 |
$42.48
|
|
Iadna legionella pneumophila amplified probe tq
|
$38.60 |
$38.60 |
$38.60 |
$125.25
|
|
Ia infect ag ab qual/semiquant sgl step
|
$19.90 |
$19.90 |
$19.90 |
$48.57
|
|
Ia nfct ab sarscov2 covid19
|
$49.81 |
$49.81 |
$49.81 |
$49.81
|
|
Ibmfs seq alys pnl 30 genes
|
$2,693.42 |
$2,693.42 |
$2,693.42 |
$2,693.42
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,837.72
|
|
I&d/bursa/foot 28001
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,814.47
|
|
I&d frarm&/wrst deep absc/hematoma
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,821.05
|
|
Idh1 common variants
|
$212.58 |
$212.58 |
$212.58 |
$415.35
|
|
Idh2 common variants
|
$325.37 |
$325.37 |
$325.37 |
$451.91
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,245.23
|
|
I&d lacrimal gland
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,163.82
|
|
I&d lacrimal sac
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,747.43
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,386.84
|
|
I & d vag hematoma non-ob 57023
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,386.84
|
|
I&d vag hemtma obst/postpart
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,370.52
|
|
Ifnl3 gene
|
$80.71 |
$80.71 |
$80.71 |
$90.53
|
|
Igh@/bcl2 translocation alys
|
$228.04 |
$228.04 |
$228.04 |
$228.04
|
|
Igh gene rearrang dir probe
|
$75.41 |
$75.41 |
$75.41 |
$82.26
|
|
Igh gene rearrange amp meth
|
$217.79 |
$217.79 |
$217.79 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$323.97 |
$323.97 |
$323.97 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$190.00 |
$190.00 |
$190.00 |
$373.16
|
|
Ihc/icc per specimen each additional single antibody stain
|
$70.96 |
$70.96 |
$70.96 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$122.92 |
$122.92 |
$122.92 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$112.27 |
$112.27 |
$112.27 |
$266.76
|
|
Ikbkap gene
|
$43.24 |
$43.24 |
$43.24 |
$156.20
|
|
Iliac/fem angio cath insert
|
$1,170.90 |
$1,170.90 |
$1,170.90 |
$1,651.09
|
|
Immobilizer shldr cntor adlt
|
$24.87 |
$24.87 |
$24.87 |
$154.00
|
|
Immobilizer shldr dlx str 24-36in med
|
$10.77 |
$10.77 |
$10.77 |
$97.20
|
|
Immobilizer shldr sling med
|
$20.00 |
$20.00 |
$20.00 |
$34.03
|
|
Immt breast prosthesis 19340
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,883.20
|
|
Immune complex assay
|
$26.81 |
$26.81 |
$26.81 |
$88.80
|
|
Immunoassay tumor antigen quantitative ca 125
|
$22.89 |
$22.89 |
$22.89 |
$123.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$22.89 |
$22.89 |
$22.89 |
$116.40
|
|
Immunoassay tumor qual
|
$28.13 |
$28.13 |
$28.13 |
$39.35
|
|
Immunodiff gel qual ea antigen/ab
|
$13.18 |
$13.18 |
$13.18 |
$53.95
|
|
Immunodiffusion nes
|
$15.46 |
$15.46 |
$15.46 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$24.57 |
$24.57 |
$24.57 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$30.64 |
$30.64 |
$30.64 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$57.85 |
$57.85 |
$57.85 |
$250.00
|
|
Immunoglobulin assay
|
$13.71 |
$13.71 |
$13.71 |
$74.00
|
|
Impedence cardiogram
|
$31.63 |
$31.63 |
$31.63 |
$121.55
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$2,477.12 |
$2,477.12 |
$2,477.12 |
$1,670.40
|
|
Implant cochlear device
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$33,466.40
|
|
Implant cochlear osia osi300
|
$2,189.74 |
$2,189.74 |
$2,189.74 |
$16,195.55
|
|
Implant eye drug system
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,839.00
|
|
Implant hormone pellet(s) 11980
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$315.75
|
|
Implant neuroelectrodes
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$19,287.34
|
|
Implant neuroelectrodes
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$12,807.00
|
|
Implant neuroelectrodes
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$7,345.58
|
|
Implant neuroelectrodes
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$7,266.73
|
|
Implant neurostim arrays
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$32,045.00
|
|
Implant power module patient cable cable 14 volt
|
$2,839.56 |
$2,839.56 |
$2,839.56 |
$4,275.95
|
|
Implant spinal canal cath
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,060.97
|
|
Implant spine infusion pump
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$15,743.44
|
|
Implant spine infusion pump
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$18,613.91
|
|
Implant ureth bulk agent
|
$592.59 |
$592.59 |
$592.59 |
$2,046.87
|
|
Impl ear abutment ba300 9mm
|
$864.26 |
$864.26 |
$864.26 |
$2,446.55
|
|
Impl neurostim electr perc
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$7,636.00
|
|
Implnt spinl canal catheter 62350
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,095.20
|
|
Impl oi implt sk tc esp<100
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$15,226.08
|
|
Impl oi implt sk tc esp>=100
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$14,241.77
|
|
Impl oi implt skull perq esp
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$9,396.80
|
|
Impltj ntrstrml crnl rng seg
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,881.00
|
|
Impres&prep auricular prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,339.00
|
|
Impres&prep def obt prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,369.60
|
|
Impres&prep facial prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,837.72
|
|
Impres&prep intrm obt prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,837.72
|
|
Impres&prep mndbl res prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,465.11
|
|
Impres&prep nasal prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$6,468.80
|
|
Impres&prep oral surg splint
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,716.80
|
|
Impres&prep paltl lft prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,592.74
|
|
Impres&prep sp aid prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,271.20
|
|
Inc dp bone crtx f/arm&/wrst
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$5,741.00
|
|
Inc dp opn b1 crtx hum/elbw
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,594.44
|
|
Incise diaphragm nerve
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,310.83
|
|
Incise/drain eyelid lining
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$1,215.48
|
|
Incise flexor carpi radialis
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$3,839.54
|
|
Incise hand/finger tendon
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,310.83
|
|
Incise hip/thigh nerve
|
$5,110.00 |
$5,110.00 |
$5,110.00 |
$2,685.07
|
