|
Hla i & ii typing lr
|
$1,061.60 |
$1,061.60 |
$1,272.00 |
|
|
Hla ii typing 1 loc hr
|
$80.00 |
$80.00 |
$180.00 |
|
|
Hla ii typing ag equiv lr
|
$240.00 |
$294.40 |
$600.00 |
|
|
Hla i low res one antigen equiv ea
|
$140.00 |
$152.00 |
$172.00 |
|
|
Hla i typing complete lr
|
$568.00 |
$720.00 |
$788.00 |
|
|
Hla i typing low res one locus ea
|
$137.20 |
$137.20 |
$172.00 |
|
|
Hla typing a b or c
|
$184.80 |
$184.80 |
$300.00 |
|
|
Hla x-match noncytotoxc addl
|
$288.00 |
$288.00 |
$360.00 |
|
|
Hla x-math non-cytotoxic
|
$288.00 |
$288.00 |
$360.00 |
|
|
Hlth bhv assmt/reassessment
|
$208.80 |
$208.80 |
$208.80 |
|
|
Hlth bhv ivntj grp 1st 30
|
$196.80 |
$196.80 |
$196.80 |
|
|
Hlth bhv ivntj indiv 1st 30
|
$258.40 |
$258.40 |
$258.40 |
|
|
Ho abduction static plastic
|
$343.34 |
$343.34 |
$399.21 |
|
|
Hocm 250-299mg/ml iodine,1ml
|
$52.80 |
$52.80 |
$52.80 |
|
|
Hocm 350-399mg/ml iodine,1ml
|
$144.00 |
$144.00 |
$144.00 |
|
|
Ho flex pavlik harns pre cst
|
$317.92 |
$317.92 |
$317.92 |
|
|
Home sleep test/type 2 porta
|
$358.40 |
$474.40 |
$474.40 |
|
|
Home sleep test/type 3 porta
|
$297.60 |
$297.60 |
$321.60 |
|
|
Home sleep test/type 4 porta
|
$448.00 |
$448.00 |
$448.00 |
|
|
Homocysteine
|
$96.00 |
$96.00 |
$96.00 |
|
|
Homogenization tissue
|
$39.20 |
$39.20 |
$39.20 |
|
|
Hopd mntl hlt, 15-29 min
|
$488.00 |
$488.00 |
$488.00 |
|
|
Hopd mntl hlt, 30-60 min
|
$640.80 |
$640.80 |
$640.80 |
|
|
Hopd mntl hlt, grp
|
$605.60 |
$605.60 |
$605.60 |
|
|
Ho post-op hip abduction
|
$758.30 |
$758.30 |
$909.96 |
|
|
H pylori (c-13) breath
|
$308.00 |
$308.00 |
$308.00 |
|
|
Hyaluronidase 150 unit/ml injection solution
|
$109.38 |
$109.38 |
$109.38 |
|
|
Hyaluronidase 200 units/ml inj
|
$115.87 |
$115.87 |
$115.87 |
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$94.43 |
$98.63 |
$167.04 |
|
|
Hydralazine 20 mg/ml injection solution
|
$26.76 |
$28.44 |
$35.32 |
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$38.36 |
$63.55 |
$75.41 |
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$13.66 |
$171.88 |
$394.99 |
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$28.56 |
$4,900.00 |
$42,810.40 |
|
|
Hydroxocobalamin im 10mcg
|
$58.29 |
$61.18 |
$78.93 |
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$25.88 |
$27.20 |
$36.08 |
|
|
Hymenotomy
|
$4,050.40 |
$4,050.40 |
$4,050.40 |
|
|
Hypothermia ill neonate
|
$581.60 |
$581.60 |
$581.60 |
|
|
Hyqvia 100mg immuneglobulin
|
$830.16 |
$830.16 |
$830.16 |
|
|
Hysterosalpingography s&i
|
$528.80 |
$528.80 |
$824.00 |
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$295.52 |
$295.52 |
$295.52 |
|
|
I-123 iobenguane diag
|
$5,632.80 |
$5,632.80 |
$5,632.80 |
|
|
I-123 ioflupane diag
|
$4,611.20 |
$4,611.20 |
$5,440.80 |
|
|
I-123 sod iodide diag per 100 uci
|
$224.80 |
$224.80 |
$420.00 |
|
|
I131 iodide cap, rx
|
$66.40 |
$66.40 |
$140.00 |
|
|
I131 iodide sol, rx
|
$110.40 |
$110.40 |
$140.00 |
|
|
I131 max 100uci
|
$205.60 |
$205.60 |
$205.60 |
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$157.54 |
$588.30 |
$841.49 |
|
|
Ibuprofen injection
|
$1,210.73 |
$1,210.73 |
$1,502.20 |
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$130.24 |
$130.24 |
$962.29 |
|
|
Icd cobalt xt dr MRI is1 df1
|
$50,927.36 |
$50,927.36 |
$55,557.12 |
|
|
Icd crtd cobalt hf MRI is1 df1
|
$63,469.12 |
$63,469.12 |
$69,239.04 |
|
|
Icd crtp serena MRI
|
$27,799.20 |
$27,799.20 |
$30,326.40 |
|
|
Icd reliance df4 ib 64cm
|
$12,735.36 |
$12,735.36 |
$13,893.12 |
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$3,709.60 |
$3,709.60 |
$3,771.20 |
|
|
Idarubicin hcl injection
|
$559.28 |
$559.28 |
$702.38 |
|
|
Idecabtagene vicleucel car
|
$1,532,850.40 |
$1,532,850.40 |
$1,532,850.40 |
|
|
Idet 1 or more levels
|
$4,649.60 |
$4,649.60 |
$4,649.60 |
|
|
Idet single level
|
$4,649.60 |
$4,649.60 |
$4,649.60 |
|
|
I&d frarm&/wrst deep absc/hematoma
|
$3,772.00 |
$3,772.00 |
$4,834.40 |
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$2,793.60 |
$2,793.60 |
$2,793.60 |
|
|
I&d vag hemtma obst/postpart
|
$444.80 |
$444.80 |
$444.80 |
|
|
Ifosfamide 1 gram intravenous solution
|
$238.29 |
$238.29 |
$288.43 |
|
|
Ihc/icc per specimen each additional single antibody stain
|
$159.20 |
$165.60 |
$213.60 |
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$338.40 |
$338.40 |
$508.00 |
|
|
Ihc/icc per specimen initial single antibody stain
|
$180.80 |
$238.40 |
$241.60 |
|
|
Iliac/fem angio cath insert
|
$2,461.60 |
$2,461.60 |
$2,737.60 |
|
|
Imatinib 100 mg tab
|
$6.36 |
$6.36 |
$23.43 |
|
|
Imetelstat 188 mg intravenous solution
|
$11,124.56 |
$11,124.56 |
$29,107.24 |
|
|
Img rta detc/mntr ds phy/qhp
|
$129.60 |
$129.60 |
$129.60 |
|
|
Immob elbow child sm
|
$50.46 |
$50.46 |
$153.17 |
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$181.85 |
$181.85 |
$181.85 |
|
|
Immobilizer shldr cntor adlt
|
$260.54 |
$260.54 |
$268.36 |
|
|
Immobilizer shldr dlx str 24-36in med
|
$118.43 |
$118.43 |
$171.78 |
|
|
Immobilizer shldr sling med
|
$166.51 |
$166.51 |
$345.00 |
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$2,525.52 |
$3,076.91 |
$3,343.04 |
|
|
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 |
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$3,372.71 |
$3,372.71 |
$3,372.71 |
|
|
Immunoassay tumor antigen quantitative ca 125
|
$101.60 |
$101.60 |
$101.60 |
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$101.60 |
$101.60 |
$101.60 |
|
|
Immunodiff gel qual ea antigen/ab
|
$90.40 |
$90.40 |
$90.40 |
|
|
Immunofixation electrophoresis serum
|
$141.60 |
$141.60 |
$141.60 |
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$215.20 |
$215.20 |
$215.20 |
|
|
Immunofluorescence per specimen initial single antibody stain
|
$280.80 |
$288.00 |
$288.00 |
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$1,728.00 |
$1,728.00 |
$1,728.00 |
|
|
Implant cartilage 10mm synthetic
|
$5,086.40 |
$5,086.40 |
$6,011.20 |
|
|
Implant cochlear osia osi300
|
$10,560.00 |
$10,560.00 |
$27,836.16 |
|
|
Implant neuroelectrodes
|
$8,986.40 |
$8,986.40 |
$8,986.40 |
|
|
Implant neuroelectrodes
|
$8,961.60 |
$8,961.60 |
$8,961.60 |
|
|
Implant spine infusion pump
|
$10,436.00 |
$10,436.00 |
$10,436.00 |
|
|
Implant ureth bulk agent
|
$1,569.60 |
$1,569.60 |
$2,024.00 |
|
|
Impl neurostim electr perc
|
$9,797.60 |
$9,797.60 |
$11,121.60 |
|
|
Implnt spinl canal catheter 62350
|
$8,412.00 |
$8,412.00 |
$8,412.00 |
|
|
In-111 autol wbc diag per dose
|
$4,928.00 |
$4,928.00 |
$5,571.20 |
|
|
In-111 pentetate dtpa / 0.5 mci
|
$4,383.20 |
$4,383.20 |
$5,174.40 |
|
|
In-111 pentetreotide
|
$7,015.20 |
$7,015.20 |
$8,008.00 |
|
|
Incise tear duct opening 68440
|
$457.60 |
$457.60 |
$457.60 |
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,047.20 |
$2,047.20 |
$2,570.40 |
|
|
Incision of achilles tendon
|
$2,340.80 |
$2,340.80 |
$2,340.80 |
|
|
Incision of breast lesion
|
$3,029.60 |
$3,029.60 |
$3,029.60 |
|
|
Incision of burn scab initi
|
$600.00 |
$600.00 |
$811.20 |
|
