|
I&d frarm&/wrst deep absc/hematoma
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$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
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,245.23
|
|
I&d lacrimal gland
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,163.82
|
|
I&d lacrimal sac
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,747.43
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
I & d vag hematoma non-ob 57023
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,386.84
|
|
I&d vag hemtma obst/postpart
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$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
|
$90.56 |
$90.56 |
$90.56 |
$191.75
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$169.00 |
$169.00 |
$169.00 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$121.94 |
$121.94 |
$121.94 |
$266.76
|
|
Ikbkap gene
|
$43.24 |
$43.24 |
$43.24 |
$156.20
|
|
Iliac revasc add-on 37222
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,513.10
|
|
Immobilizer shldr cntor adlt
|
$25.76 |
$25.76 |
$25.76 |
$154.00
|
|
Immobilizer shldr dlx str 24-36in med
|
$11.16 |
$11.16 |
$11.16 |
$90.86
|
|
Immobilizer shldr sling med
|
$20.72 |
$20.72 |
$20.72 |
$34.03
|
|
Immt breast prosthesis 19340
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$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
|
$141.43 |
$141.43 |
$141.43 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$156.40 |
$156.40 |
$156.40 |
$250.00
|
|
Immunoglobulin assay
|
$13.71 |
$13.71 |
$13.71 |
$74.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$2,566.07 |
$2,566.07 |
$2,566.07 |
$1,670.40
|
|
Implant cochlear device
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$33,466.40
|
|
Implant cochlear osia osi300
|
$2,268.38 |
$2,268.38 |
$2,268.38 |
$17,423.06
|
|
Implant eye drug system
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,839.00
|
|
Implant hormone pellet(s) 11980
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$315.75
|
|
Implant neuroelectrodes
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$19,287.34
|
|
Implant neuroelectrodes
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$12,807.00
|
|
Implant neuroelectrodes
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,345.58
|
|
Implant neuroelectrodes
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,266.73
|
|
Implant neurostim arrays
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$32,045.00
|
|
Implant power module patient cable cable 14 volt
|
$2,941.53 |
$2,941.53 |
$2,941.53 |
$4,275.95
|
|
Implant spinal canal cath
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,060.97
|
|
Implant spine infusion pump
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$15,743.44
|
|
Implant spine infusion pump
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$18,613.91
|
|
Implant ureth bulk agent
|
$613.87 |
$613.87 |
$613.87 |
$2,003.82
|
|
Impl ear abutment ba300 9mm
|
$895.29 |
$895.29 |
$895.29 |
$2,446.55
|
|
Impl neurostim electr perc
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,636.00
|
|
Implnt spinl canal catheter 62350
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,095.20
|
|
Impl oi implt sk tc esp<100
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$15,226.08
|
|
Impl oi implt sk tc esp>=100
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$14,241.77
|
|
Impl oi implt skull perq esp
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$9,396.80
|
|
Impltj ntrstrml crnl rng seg
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,881.00
|
|
Impres&prep auricular prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,339.00
|
|
Impres&prep def obt prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,369.60
|
|
Impres&prep facial prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,837.72
|
|
Impres&prep intrm obt prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,837.72
|
|
Impres&prep mndbl res prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,465.11
|
|
Impres&prep nasal prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,468.80
|
|
Impres&prep oral surg splint
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,751.20
|
|
Impres&prep orbital prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,000.36
|
|
Impres&prep paltl aug prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,716.80
|
|
Impres&prep paltl lft prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,592.74
|
|
Impres&prep sp aid prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,054.40
|
|
Impres&prep surg obt prosth
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,271.20
|
|
Inc dp bone crtx f/arm&/wrst
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,741.00
|
|
Inc dp opn b1 crtx hum/elbw
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,594.44
|
|
Incise diaphragm nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,310.83
|
|
Incise/drain eyelid lining
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,215.48
|
|
Incise flexor carpi radialis
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,839.54
|
|
Incise hand/finger tendon
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,007.15
|
|
Incise hip/thigh nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,310.83
|
|
Incise hip/thigh nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,685.07
|
|
Incise inner ear
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,133.48
|
|
Incise inner ear nerve
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,289.89
|
|
Incise inner eye adhesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,202.90
|
|
Incise inner eye adhesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,526.64
|
|
Incise inner eye adhesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,698.92
|
|
Incise inner eye adhesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,698.92
|
|
Incise inner eye adhesions
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$4,452.74
|
|
Incise inner eye strands
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,698.92
|
|
Incise nerve back of head
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,344.00
|
|
Incise perq finger tendon 26060
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$1,893.86
|
|
Incise skull/brain surgery
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$6,839.00
|
|
Incise skull for treatment
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,741.00
|
|
Incise sperm duct pouch
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,424.12
|
|
Incise tear duct opening 68440
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$507.20
|
|
Incise tendon(s) & muscle(s)
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$7,855.87
|
|
Incise thigh tendon & fascia
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,591.33
|
|
Incise wrist/forearm tendon
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,591.33
|
|
Incision anal septum infant
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,245.23
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$2,261.20
|
|
Incision of achilles tendon
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,306.48
|
|
Incision of achilles tendon
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,591.33
|
|
Incision of anal sphincter
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,061.53
|
|
Incision of ankle bone
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$5,886.74
|
|
Incision of breast lesion
|
$4,350.00 |
$4,350.00 |
$4,350.00 |
$3,029.60
|
