|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$12,096.00 |
$12,096.00 |
$12,096.00 |
$5,836.20
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$44.82 |
$44.82 |
$44.82 |
$142.40
|
|
Hydration IV infusion each additional hour
|
$258.60 |
$258.60 |
$258.60 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$438.00 |
$438.00 |
$438.00 |
$383.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$114.12 |
$114.12 |
$114.12 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$56.88 |
$56.88 |
$56.88 |
$131.47
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$163.56 |
$163.56 |
$163.56 |
$294.92
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$79.92 |
$79.92 |
$79.92 |
$72.65
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$110.40 |
$110.40 |
$110.40 |
$76.13
|
|
Hyoscyamine sulfate inj
|
$255.96 |
$255.96 |
$255.96 |
$123.83
|
|
Hysterosalpingography s&i
|
$1,255.20 |
$1,255.20 |
$1,255.20 |
$651.85
|
|
Hysteroscopy ablation
|
$18,288.45 |
$18,288.45 |
$18,288.45 |
$5,841.60
|
|
Hysteroscopy biopsy
|
$9,081.96 |
$9,081.96 |
$9,081.96 |
$5,110.50
|
|
Hysteroscopy dx sep proc
|
$11,776.62 |
$11,776.62 |
$11,776.62 |
$3,997.50
|
|
Hysteroscopy remove fb
|
$8,468.22 |
$8,468.22 |
$8,468.22 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$28,385.30 |
$28,385.30 |
$28,385.30 |
$4,881.00
|
|
I-123 iobenguane diag
|
$8,810.40 |
$8,810.40 |
$8,810.40 |
$5,256.50
|
|
I-123 sod iodide diag per 100 uci
|
$102.60 |
$102.60 |
$102.60 |
$139.20
|
|
Iadna legionella pneumophila amplified probe tq
|
$105.60 |
$105.60 |
$105.60 |
$109.80
|
|
Ia infect ag ab qual/semiquant sgl step
|
$204.00 |
$204.00 |
$204.00 |
$50.60
|
|
Icd cobalt xt dr MRI is1 df1
|
$77,073.34 |
$77,073.34 |
$77,073.34 |
$34,234.20
|
|
Icd crtd cobalt hf MRI is1 df1
|
$74,790.27 |
$74,790.27 |
$74,790.27 |
$37,789.50
|
|
Icd crtp serena MRI
|
$60,357.06 |
$60,357.06 |
$60,357.06 |
$14,346.00
|
|
Icd reliance df4 ib 64cm
|
$71,315.80 |
$71,315.80 |
$71,315.80 |
$9,259.80
|
|
Idh1 common variants
|
$323.40 |
$323.40 |
$323.40 |
$406.90
|
|
Idh2 common variants
|
$486.00 |
$486.00 |
$486.00 |
$486.00
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$4,537.80 |
$4,537.80 |
$4,537.80 |
$3,322.80
|
|
Ifosfamide 1 gram intravenous solution
|
$144.84 |
$144.84 |
$144.84 |
$243.78
|
|
Igh gene rearrange amp meth
|
$404.40 |
$404.40 |
$404.40 |
$456.54
|
|
Igh@ var region somatic mutation analy
|
$642.00 |
$642.00 |
$642.00 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$304.80 |
$304.80 |
$304.80 |
$396.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$118.80 |
$118.80 |
$118.80 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$682.20 |
$682.20 |
$682.20 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$291.00 |
$291.00 |
$291.00 |
$274.86
|
|
Ikbkap gene
|
$228.00 |
$228.00 |
$228.00 |
$176.15
|
|
Immob elbow child sm
|
$1,611.46 |
$1,611.46 |
$1,611.46 |
$74.20
|
|
Immobilizer shldr cntor adlt
|
$656.06 |
$656.06 |
$656.06 |
$171.43
|
|
Immobilizer shldr dlx str 24-36in med
|
$758.08 |
$758.08 |
$758.08 |
$102.00
|
|
Immobilizer shldr sling med
|
$778.32 |
$778.32 |
$778.32 |
$99.45
|
|
Immune complex assay
|
$261.00 |
$261.00 |
$261.00 |
$109.20
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$22,377.60 |
$22,377.60 |
$22,377.60 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$379.20 |
$379.20 |
$379.20 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$401.40 |
$401.40 |
$401.40 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$113.40 |
$113.40 |
$113.40 |
$48.50
|
|
Immunodiffusion nes
|
$169.20 |
$169.20 |
$169.20 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$42.60 |
$42.60 |
$42.60 |
$138.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$67.80 |
$67.80 |
$67.80 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$514.80 |
$514.80 |
$514.80 |
$232.05
|
|
Immunoglobulin assay
|
$306.00 |
$306.00 |
$306.00 |
$74.15
|
|
Immunology procedure
|
$168.00 |
$168.00 |
$168.00 |
$118.25
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$6,697.01 |
$6,697.01 |
$6,697.01 |
$3,840.76
|
|
Implant cartilage 10mm synthetic
|
$4,873.81 |
$4,873.81 |
$4,873.81 |
$10,050.00
|
|
Implant cochlear osia osi300
|
$32,802.75 |
$32,802.75 |
$32,802.75 |
$17,423.06
|
|
Implant neuroelectrodes
|
$135,678.33 |
$135,678.33 |
$135,678.33 |
$18,334.40
|
|
Implant ureth bulk agent
|
$5,379.65 |
$5,379.65 |
$5,379.65 |
$2,139.62
|
|
Impl ear abutment ba300 9mm
|
$9,718.46 |
$9,718.46 |
$9,718.46 |
$3,974.88
|
|
Impl neurostim electr perc
|
$31,611.32 |
$31,611.32 |
$31,611.32 |
$7,546.20
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$59,437.54 |
$59,437.54 |
$59,437.54 |
$1,072.00
|
|
In-111 pentetreotide
|
$2,430.60 |
$2,430.60 |
$2,430.60 |
$4,944.55
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$10,697.40 |
$10,697.40 |
$10,697.40 |
$2,080.80
|
|
Incision of breast lesion
|
$1,600.80 |
$1,600.80 |
$1,600.80 |
$2,577.85
|
|
Incision of burn scab initi
|
$629.40 |
$629.40 |
$629.40 |
$494.40
|
|
Incision of foot tendon 28234
|
$2,724.00 |
$2,724.00 |
$2,724.00 |
$2,116.27
|
|
Incision of tendon sheath
|
$9,936.54 |
$9,936.54 |
$9,936.54 |
$2,176.80
|
|
Incision of toe tendons 28011
|
$2,799.60 |
$2,799.60 |
$2,799.60 |
$2,068.30
|
|
Incision of tongue fold
|
$2,579.40 |
$2,579.40 |
$2,579.40 |
$1,792.50
|
|
Incision tendon sheath
|
$17,879.84 |
$17,879.84 |
$17,879.84 |
$3,073.20
|
|
Incisn of toe tndn
|
$2,667.00 |
$2,667.00 |
$2,667.00 |
$2,493.15
|
|
Incisn windpipe
|
$2,175.00 |
$2,175.00 |
$2,175.00 |
$3,819.23
|
|
Infect ag drug suscept pheno predict
|
$340.20 |
$340.20 |
$340.20 |
$320.00
|
|
Infect ag eia chlamydia trachomatis
|
$100.80 |
$100.80 |
$100.80 |
$74.88
|
|
Infect ag genotype na dna hepatitis b
|
$241.80 |
$241.80 |
$241.80 |
$427.43
|
|
Infect ag genotype na hiv-1 other region
|
$609.00 |
$609.00 |
$609.00 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$703.80 |
$703.80 |
$703.80 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$81.00 |
$81.00 |
$81.00 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$80.40 |
$80.40 |
$80.40 |
$65.10
|
|
Infect ag if hep delta agent
|
$158.40 |
$158.40 |
$158.40 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$75.00 |
$75.00 |
$75.00 |
$73.46
|
|
Infect ag if nos ea
|
$28.80 |
$28.80 |
$28.80 |
$74.10
|
|
Infect ag if varicella zoster
|
$135.00 |
$135.00 |
$135.00 |
$72.00
|
|
Infect ag na hpv high-risk types
|
$76.80 |
$76.80 |
$76.80 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$192.00 |
$192.00 |
$192.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$96.00 |
$96.00 |
$96.00 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$979.80 |
$979.80 |
$979.80 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$832.20 |
$832.20 |
$832.20 |
$855.60
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$135.60 |
$135.60 |
$135.60 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$214.20 |
$214.20 |
$214.20 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$239.40 |
$239.40 |
$239.40 |
$69.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$124.20 |
$124.20 |
$124.20 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$64.20 |
$64.20 |
$64.20 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$90.60 |
$90.60 |
$90.60 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$174.00 |
$174.00 |
$174.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$25.80 |
$25.80 |
$25.80 |
$57.60
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$63.00 |
$63.00 |
$63.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$127.80 |
$127.80 |
$127.80 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$97.80 |
$97.80 |
$97.80 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$24.00 |
$24.00 |
$24.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$357.60 |
$357.60 |
$357.60 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$235.80 |
$235.80 |
$235.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$159.00 |
$159.00 |
$159.00 |
$167.05
|
