|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$72.63 |
$72.63 |
$72.63 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$277.32 |
$277.32 |
$277.32 |
$294.92
|
|
Hydroxocobalamin im 10mcg
|
$83.64 |
$83.64 |
$83.64 |
$4.86
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$87.60 |
$87.60 |
$87.60 |
$72.65
|
|
Hymovis injection 1 mg
|
$2,459.97 |
$2,459.97 |
$2,459.97 |
$28.00
|
|
Hyoscyamine sulfate inj
|
$308.52 |
$308.52 |
$308.52 |
$123.83
|
|
Hyperbaric oxygen therapy
|
$4,048.50 |
$4,048.50 |
$4,048.50 |
$1,081.04
|
|
Hysterosalpingography s&i
|
$1,139.25 |
$1,139.25 |
$1,139.25 |
$669.12
|
|
Hysteroscopy ablation
|
$5,865.75 |
$5,865.75 |
$5,865.75 |
$5,865.75
|
|
Hysteroscopy biopsy
|
$5,110.50 |
$5,110.50 |
$5,110.50 |
$5,419.00
|
|
Hysteroscopy dx sep proc
|
$3,568.50 |
$3,568.50 |
$3,568.50 |
$3,997.50
|
|
Hysteroscopy lysis
|
$5,766.75 |
$5,766.75 |
$5,766.75 |
$5,766.75
|
|
Hysteroscopy remove fb
|
$5,843.25 |
$5,843.25 |
$5,843.25 |
$4,719.18
|
|
Hysteroscopy remove myoma
|
$4,302.75 |
$4,302.75 |
$4,302.75 |
$5,463.96
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$650.11 |
$650.11 |
$650.11 |
$352.24
|
|
I-123 iobenguane diag
|
$17,222.25 |
$17,222.25 |
$17,222.25 |
$5,170.70
|
|
I-123 ioflupane diag
|
$9,058.88 |
$9,058.88 |
$9,058.88 |
$4,158.00
|
|
Iadna legionella pneumophila amplified probe tq
|
$329.25 |
$329.25 |
$329.25 |
$109.80
|
|
Ia infect ag ab qual/semiquant sgl step
|
$36.75 |
$36.75 |
$36.75 |
$50.60
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$839.85 |
$839.85 |
$839.85 |
$684.45
|
|
Ibuprofen injection
|
$86.20 |
$86.20 |
$86.20 |
$256.76
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$1,022.55 |
$1,022.55 |
$1,022.55 |
$980.94
|
|
Icatibant injection
|
$3,697.02 |
$3,697.02 |
$3,697.02 |
$8,695.05
|
|
Icd cobalt xt dr MRI is1 df1
|
$48,847.50 |
$48,847.50 |
$48,847.50 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$44,003.25 |
$44,003.25 |
$44,003.25 |
$39,070.50
|
|
Icd crtp serena MRI
|
$15,759.00 |
$15,759.00 |
$15,759.00 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$6,463.81 |
$6,463.81 |
$6,463.81 |
$9,264.83
|
|
Icut allergy test drug/bug
|
$118.50 |
$118.50 |
$118.50 |
$70.29
|
|
Idarubicin hcl injection
|
$249.51 |
$249.51 |
$249.51 |
$447.02
|
|
I&d frarm&/wrst deep absc/hematoma
|
$3,761.25 |
$3,761.25 |
$3,761.25 |
$3,839.54
|
|
I&d lacrimal sac
|
$2,729.25 |
$2,729.25 |
$2,729.25 |
$2,760.73
|
|
Idursulfase injection
|
$11,942.56 |
$11,942.56 |
$11,942.56 |
$5,646.08
|
|
Ifosfamide 1 gram intravenous solution
|
$294.81 |
$294.81 |
$294.81 |
$246.95
|
|
Igh gene rearrange amp meth
|
$464.25 |
$464.25 |
$464.25 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$607.50 |
$607.50 |
$607.50 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$309.75 |
$309.75 |
$309.75 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$318.75 |
$318.75 |
$318.75 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$310.50 |
$310.50 |
$310.50 |
$277.90
|
|
Iliac/fem angio cath insert
|
$2,980.50 |
$2,980.50 |
$2,980.50 |
$1,856.01
|
|
Img rta detc/mntr ds poc aly
|
$71.25 |
$71.25 |
$71.25 |
$71.25
|
|
Immobilizer shldr cntor adlt
|
$134.01 |
$134.01 |
$134.01 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$67.77 |
$67.77 |
$67.77 |
$118.43
|
|
Immobilizer shldr sling med
|
$29.14 |
$29.14 |
$29.14 |
$126.00
|
|
Immune complex assay
|
$89.25 |
$89.25 |
$89.25 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$2,613.77 |
$2,613.77 |
$2,613.77 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,778.42 |
$2,778.42 |
$2,778.42 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$3,486.01 |
$3,486.01 |
$3,486.01 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$104.25 |
$104.25 |
$104.25 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$130.50 |
$130.50 |
$130.50 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$108.00 |
$108.00 |
$108.00 |
$48.57
|
|
Immunodiffusion nes
|
$189.75 |
$189.75 |
$189.75 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$231.00 |
$231.00 |
$231.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$511.50 |
$511.50 |
$511.50 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$408.00 |
$408.00 |
$408.00 |
$234.27
|
|
Immunoglobulin assay
|
$258.00 |
$258.00 |
$258.00 |
$78.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$1,518.75 |
$1,518.75 |
$1,518.75 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$101,250.00 |
$101,250.00 |
$101,250.00 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$20,655.00 |
$20,655.00 |
$20,655.00 |
$16,195.55
|
|
Implant hormone pellet(s) 11980
|
$315.75 |
$315.75 |
$315.75 |
$315.75
|
|
Implant neuroelectrodes
|
$12,807.00 |
$12,807.00 |
$12,807.00 |
$13,628.55
|
|
Implant neuroelectrodes
|
$5,517.75 |
$5,517.75 |
$5,517.75 |
$8,836.80
|
|
Implant neuroelectrodes
|
$6,447.00 |
$6,447.00 |
$6,447.00 |
$7,728.86
|
|
Implant power module patient cable cable 14 volt
|
$2,812.50 |
$2,812.50 |
$2,812.50 |
$3,695.42
|
|
Implant pulse generator remede el
|
$57,375.00 |
$57,375.00 |
$57,375.00 |
$43,752.80
|
|
Implant ureth bulk agent
|
$2,587.50 |
$2,587.50 |
$2,587.50 |
$2,168.00
|
|
Impl neurostim electr perc
|
$5,517.75 |
$5,517.75 |
$5,517.75 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$7,722.75 |
$7,722.75 |
$7,722.75 |
$5,095.20
|
|
Imp neurosti pls gn any type
|
$534.75 |
$534.75 |
$534.75 |
$8,789.19
|
|
In-111 oxyquinolin per 0.5 mci
|
$2,808.00 |
$2,808.00 |
$2,808.00 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,156.25 |
$2,156.25 |
$2,156.25 |
$2,598.17
|
|
In-111 pentetreotide
|
$47,542.46 |
$47,542.46 |
$47,542.46 |
$5,294.90
|
|
Inactivated je vacc im
|
$2,069.33 |
$2,069.33 |
$2,069.33 |
$481.34
|
|
Incise/drain eyelid lining
|
$1,104.00 |
$1,104.00 |
$1,104.00 |
$1,271.00
|
|
Incise inner ear
|
$3,648.00 |
$3,648.00 |
$3,648.00 |
$2,186.08
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,867.00 |
$3,867.00 |
$3,867.00 |
$2,086.70
|
|
Incision of achilles tendon
|
$1,863.75 |
$1,863.75 |
$1,863.75 |
$3,318.90
|
|
Incision of breast lesion
|
$1,897.50 |
$1,897.50 |
$1,897.50 |
$2,577.85
|
|
Incision of eardrum
|
$1,272.00 |
$1,272.00 |
$1,272.00 |
$552.75
|
|
Incision of foot fascia
|
$3,752.25 |
$3,752.25 |
$3,752.25 |
$4,599.40
|
|
Incision of hip tendons
|
$3,752.25 |
$3,752.25 |
$3,752.25 |
$3,865.95
|
|
Incision of tendon & muscle
|
$8,293.50 |
$8,293.50 |
$8,293.50 |
$5,855.00
|
|
Incision of thigh tendon
|
$3,752.25 |
$3,752.25 |
$3,752.25 |
$4,491.50
|
|
Incision of tongue fold
|
$1,792.50 |
$1,792.50 |
$1,792.50 |
$1,792.50
|
|
Incision tendon sheath
|
$2,124.75 |
$2,124.75 |
$2,124.75 |
$3,073.20
|
|
Incisn of toe tndn
|
$2,825.25 |
$2,825.25 |
$2,825.25 |
$2,667.00
|
|
Incobotulinumtoxin a
|
$1,889.43 |
$1,889.43 |
$1,889.43 |
$1,339.57
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$586.73 |
$586.73 |
$586.73 |
$766.66
|
|
Induced abortion d&c
|
$3,624.75 |
$3,624.75 |
$3,624.75 |
$3,762.53
|
|
Induced abortion dilat&evac
|
$6,344.25 |
$6,344.25 |
$6,344.25 |
$4,451.18
|
|
Induction of vomiting
|
$409.50 |
$409.50 |
$409.50 |
$126.72
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$234.75 |
$234.75 |
$234.75 |
$140.80
|
|
Infect ag drug suscept pheno predict
|
$479.25 |
$479.25 |
$479.25 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$2,588.25 |
$2,588.25 |
$2,588.25 |
$665.40
|
|
Infect ag genotype na hiv-1 other region
|
$301.50 |
$301.50 |
$301.50 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$603.75 |
$603.75 |
$603.75 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$101.25 |
$101.25 |
$101.25 |
$72.93
|
|
Infect ag if hep delta agent
|
$189.75 |
$189.75 |
$189.75 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$85.50 |
$85.50 |
$85.50 |
$73.45
|
|
Infect ag na herpes simplex quant
|
$324.75 |
$324.75 |
$324.75 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$272.25 |
$272.25 |
$272.25 |
$139.20
|
