|
Hip and Pelvis X-ray (single view, left side)
|
$144.80 |
$144.80 |
$144.80 |
$233.50
|
|
Hip X-ray
|
$193.60 |
$193.60 |
$193.60 |
$294.75
|
|
Histochemical stains add-on
|
$175.20 |
$175.20 |
$175.20 |
$152.75
|
|
Hizentra injection
|
$2,072.85 |
$2,072.85 |
$2,072.85 |
$3,912.58
|
|
Hla class i high defin qual
|
$449.60 |
$449.60 |
$449.60 |
$631.15
|
|
Hla class ii high defin qual
|
$414.40 |
$414.40 |
$414.40 |
$569.25
|
|
Hla i & ii typing lr
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$1,407.51
|
|
Hla ii typing 1 loc hr
|
$180.00 |
$180.00 |
$180.00 |
$299.20
|
|
Hla ii typing ag equiv lr
|
$600.00 |
$600.00 |
$600.00 |
$475.00
|
|
Hla i low res one antigen equiv ea
|
$172.00 |
$172.00 |
$172.00 |
$164.00
|
|
Hla i typing complete lr
|
$720.00 |
$720.00 |
$720.00 |
$720.00
|
|
Hla i typing low res one locus ea
|
$172.00 |
$172.00 |
$172.00 |
$340.00
|
|
Hla typing a b or c
|
$300.00 |
$300.00 |
$300.00 |
$364.00
|
|
Hla x-match noncytotoxc addl
|
$360.00 |
$360.00 |
$360.00 |
$163.80
|
|
Hla x-math non-cytotoxic
|
$360.00 |
$360.00 |
$360.00 |
$364.80
|
|
Ho abduction static plastic
|
$343.34 |
$343.34 |
$343.34 |
$390.66
|
|
Hocm 350-399mg/ml iodine,1ml
|
$144.00 |
$144.00 |
$144.00 |
$79.78
|
|
Home sleep test/type 3 porta
|
$321.60 |
$321.60 |
$321.60 |
$570.00
|
|
Ho post-op hip abduction
|
$758.30 |
$758.30 |
$758.30 |
$1,753.00
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$94.43 |
$94.43 |
$94.43 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$35.32 |
$35.32 |
$35.32 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$63.55 |
$63.55 |
$63.55 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$171.88 |
$171.88 |
$171.88 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$4,900.00 |
$4,900.00 |
$4,900.00 |
$294.92
|
|
Hydroxocobalamin im 10mcg
|
$58.29 |
$58.29 |
$58.29 |
$4.86
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$25.88 |
$25.88 |
$25.88 |
$72.65
|
|
Hypothermia ill neonate
|
$581.60 |
$581.60 |
$581.60 |
$567.20
|
|
Hyqvia 100mg immuneglobulin
|
$830.16 |
$830.16 |
$830.16 |
$13,494.15
|
|
Hysterosalpingography s&i
|
$528.80 |
$528.80 |
$528.80 |
$669.12
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$295.52 |
$295.52 |
$295.52 |
$352.24
|
|
I-123 ioflupane diag
|
$4,611.20 |
$4,611.20 |
$4,611.20 |
$4,158.00
|
|
I-123 sod iodide diag per 100 uci
|
$420.00 |
$420.00 |
$420.00 |
$147.46
|
|
I131 iodide cap, rx
|
$66.40 |
$66.40 |
$66.40 |
$71.70
|
|
I131 iodide sol, rx
|
$110.40 |
$110.40 |
$110.40 |
$34.87
|
|
I131 max 100uci
|
$205.60 |
$205.60 |
$205.60 |
$53.39
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$841.49 |
$841.49 |
$841.49 |
$684.45
|
|
Ibuprofen injection
|
$1,210.73 |
$1,210.73 |
$1,210.73 |
$256.76
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$130.24 |
$130.24 |
$130.24 |
$980.94
|
|
Icd cobalt xt dr MRI is1 df1
|
$50,927.36 |
$50,927.36 |
$50,927.36 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$63,469.12 |
$63,469.12 |
$63,469.12 |
$39,070.50
|
|
Icd crtp serena MRI
|
$27,799.20 |
$27,799.20 |
$27,799.20 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$12,735.36 |
$12,735.36 |
$12,735.36 |
$9,264.83
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$3,709.60 |
$3,709.60 |
$3,709.60 |
$3,592.74
|
|
Idarubicin hcl injection
|
$559.28 |
$559.28 |
$559.28 |
$447.02
|
|
Idet 1 or more levels
|
$4,649.60 |
$4,649.60 |
$4,649.60 |
$4,649.60
|
|
Idet single level
|
$4,649.60 |
$4,649.60 |
$4,649.60 |
$3,347.50
|
|
I&d frarm&/wrst deep absc/hematoma
|
$3,772.00 |
$3,772.00 |
$3,772.00 |
$3,839.54
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$2,793.60 |
$2,793.60 |
$2,793.60 |
$3,371.02
|
|
Ifosfamide 1 gram intravenous solution
|
$238.29 |
$238.29 |
$238.29 |
$246.95
|
|
Ihc/icc per specimen each additional single antibody stain
|
$165.60 |
$165.60 |
$165.60 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$508.00 |
$508.00 |
$508.00 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$241.60 |
$241.60 |
$241.60 |
$277.90
|
|
Iliac/fem angio cath insert
|
$2,461.60 |
$2,461.60 |
$2,461.60 |
$1,856.01
|
|
Imatinib 100 mg tab
|
$6.36 |
$6.36 |
$6.36 |
$248.00
|
|
Imetelstat 188 mg intravenous solution
|
$11,124.56 |
$11,124.56 |
$11,124.56 |
$20,373.55
|
|
Img rta detc/mntr ds phy/qhp
|
$129.60 |
$129.60 |
$129.60 |
$51.36
|
|
Immob elbow child sm
|
$153.17 |
$153.17 |
$153.17 |
$85.39
|
|
Immobilizer shldr cntor adlt
|
$268.36 |
$268.36 |
$268.36 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$118.43 |
$118.43 |
$118.43 |
$118.43
|
|
Immobilizer shldr sling med
|
$345.00 |
$345.00 |
$345.00 |
$126.00
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$3,076.91 |
$3,076.91 |
$3,076.91 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,168.96 |
$2,168.96 |
$2,168.96 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$3,372.71 |
$3,372.71 |
$3,372.71 |
$3,846.15
|
|
Immunofluorescence per specimen initial single antibody stain
|
$280.80 |
$280.80 |
$280.80 |
$234.27
|
|
Implant cartilage 10mm synthetic
|
$5,086.40 |
$5,086.40 |
$5,086.40 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$10,560.00 |
$10,560.00 |
$10,560.00 |
$16,195.55
|
|
Implant ureth bulk agent
|
$2,024.00 |
$2,024.00 |
$2,024.00 |
$2,168.00
|
|
Impl neurostim electr perc
|
$11,121.60 |
$11,121.60 |
$11,121.60 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$8,412.00 |
$8,412.00 |
$8,412.00 |
$5,095.20
|
|
In-111 autol wbc diag per dose
|
$5,571.20 |
$5,571.20 |
$5,571.20 |
$3,493.75
|
|
In-111 pentetate dtpa / 0.5 mci
|
$4,383.20 |
$4,383.20 |
$4,383.20 |
$2,598.17
|
|
In-111 pentetreotide
|
$7,015.20 |
$7,015.20 |
$7,015.20 |
$5,294.90
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,570.40 |
$2,570.40 |
$2,570.40 |
$2,086.70
|
|
Incision of burn scab initi
|
$600.00 |
$600.00 |
$600.00 |
$494.40
|
|
Incision of tendon sheath
|
$3,239.20 |
$3,239.20 |
$3,239.20 |
$2,263.68
|
|
Incision of tongue fold
|
$1,945.60 |
$1,945.60 |
$1,945.60 |
$1,792.50
|
|
Incision of urethra
|
$3,384.00 |
$3,384.00 |
$3,384.00 |
$3,198.58
|
|
Incision tendon sheath
|
$2,868.80 |
$2,868.80 |
$2,868.80 |
$3,073.20
|
|
Incobotulinumtoxin a
|
$866.00 |
$866.00 |
$866.00 |
$1,339.57
|
|
Infliximab 100 mg intravenous solution
|
$1,892.43 |
$1,892.43 |
$1,892.43 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$839.53 |
$839.53 |
$839.53 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,114.15 |
$1,114.15 |
$1,114.15 |
$1,537.84
|
|
Inf thrc fascial pln blk bi w/wo image
|
$1,648.00 |
$1,648.00 |
$1,648.00 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$1,153.60 |
$1,153.60 |
$1,153.60 |
$770.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$479.20 |
$479.20 |
$479.20 |
$296.00
|
|
Inj, acetaminophen (b braun)
|
$68.56 |
$68.56 |
$68.56 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$68.48 |
$68.48 |
$68.48 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$89.68 |
$89.68 |
$89.68 |
$56.70
|
|
Inj, adstiladrin, per tx dos
|
$16,000.00 |
$16,000.00 |
$16,000.00 |
$63,354.77
|
|
Inj, alfentanil hcl, 500mcg
|
$25.95 |
$25.95 |
$25.95 |
$35.94
|
|
Inj allopurinol sodium 1 mg
|
$4,499.41 |
$4,499.41 |
$4,499.41 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$2,964.29 |
$2,964.29 |
$2,964.29 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$6,304.63 |
$6,304.63 |
$6,304.63 |
$10,052.58
|
|
Inj, artesunate, 1mg
|
$5,957.07 |
$5,957.07 |
$5,957.07 |
$14,460.21
|
|
Inj, aspara, rylaze, 0.1 mg
|
$5,806.34 |
$5,806.34 |
$5,806.34 |
$10,458.00
|
|
Inj., benralizumab, 1 mg
|
$5,752.12 |
$5,752.12 |
$5,752.12 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$10,759.89 |
$10,759.89 |
$10,759.89 |
$7,612.43
|
|
Inj, biorphen, 20 micrograms
|
$26.89 |
$26.89 |
$26.89 |
$17.33
|
|
Inj, bortezomib, hospira
|
$195.60 |
$195.60 |
$195.60 |
$175.35
|
|
Inj calcitriol per 0.1 mcg
|
$26.81 |
$26.81 |
$26.81 |
$22.69
|
