|
Head CT scan (with and without contrast)
|
$1,150.20 |
$1,150.20 |
$1,150.20 |
$1,818.96
|
|
Head CT scan (with contrast)
|
$927.00 |
$927.00 |
$927.00 |
$1,527.60
|
|
Head CT scan (without contrast)
|
$993.60 |
$993.60 |
$993.60 |
$1,268.90
|
|
Heart first pass add-on
|
$885.00 |
$885.00 |
$885.00 |
$485.27
|
|
Heart first pass multiple
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$1,422.05
|
|
Heart image spect
|
$940.20 |
$940.20 |
$940.20 |
$1,135.68
|
|
Heart infarct image
|
$418.80 |
$418.80 |
$418.80 |
$942.29
|
|
Heavy metal qual any number
|
$383.40 |
$383.40 |
$383.40 |
$72.50
|
|
Heel (Calcaneus) X-ray (both feet)
|
$201.00 |
$201.00 |
$201.00 |
$276.00
|
|
Helicobacter pylori antibody igm
|
$78.60 |
$78.60 |
$78.60 |
$92.00
|
|
Hematocrit
|
$31.20 |
$31.20 |
$31.20 |
$33.80
|
|
Hemoglobin
|
$31.20 |
$31.20 |
$31.20 |
$33.54
|
|
Hemoglobin methemoglobin quantitative
|
$90.60 |
$90.60 |
$90.60 |
$52.32
|
|
Hemoglobin plasma
|
$107.40 |
$107.40 |
$107.40 |
$41.40
|
|
Hemolysin acid
|
$163.80 |
$163.80 |
$163.80 |
$79.04
|
|
Hemophilus influenza antibdy
|
$202.80 |
$202.80 |
$202.80 |
$62.70
|
|
Heparin assay
|
$27.00 |
$27.00 |
$27.00 |
$139.15
|
|
Heparin bolus from bag
|
$19.20 |
$19.20 |
$19.20 |
$66.06
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$6.60 |
$6.60 |
$6.60 |
$12.00
|
|
Hepatitis a antibody igm
|
$163.20 |
$163.20 |
$163.20 |
$89.44
|
|
Hepatitis b core antibody igm
|
$174.60 |
$174.60 |
$174.60 |
$89.60
|
|
Hepatitis b core antibody total
|
$150.00 |
$150.00 |
$150.00 |
$77.50
|
|
Hepatitis b surface antibody
|
$58.20 |
$58.20 |
$58.20 |
$82.32
|
|
Hepatitis c antibody
|
$78.00 |
$78.00 |
$78.00 |
$108.25
|
|
Herpes simplex type 1 antibody igg
|
$165.00 |
$165.00 |
$165.00 |
$69.12
|
|
Herpes simplex type 2 antibody igg
|
$165.00 |
$165.00 |
$165.00 |
$87.36
|
|
Herpes simplex virus isolation
|
$121.20 |
$121.20 |
$121.20 |
$110.00
|
|
Heterophile antibodies screening
|
$108.00 |
$108.00 |
$108.00 |
$73.87
|
|
Hip and Pelvis X-ray (2 views, both hips)
|
$513.60 |
$513.60 |
$513.60 |
$374.40
|
|
Hip and Pelvis X-ray (single view, left side)
|
$106.20 |
$106.20 |
$106.20 |
$233.50
|
|
Hip arthr0 w/debridement
|
$4,613.40 |
$4,613.40 |
$4,613.40 |
$7,907.11
|
|
Hip arthroscopy dx
|
$5,169.00 |
$5,169.00 |
$5,169.00 |
$5,339.00
|
|
Hip X-ray
|
$256.20 |
$256.20 |
$256.20 |
$294.75
|
|
Histamine
|
$382.20 |
$382.20 |
$382.20 |
$115.00
|
|
Hiv-1 ag ia
|
$90.00 |
$90.00 |
$90.00 |
$107.90
|
|
Hla typing a b or c
|
$924.60 |
$924.60 |
$924.60 |
$364.00
|
|
Hla typing dr/dq
|
$1,444.80 |
$1,444.80 |
$1,444.80 |
$135.20
|
|
Hocm 350-399mg/ml iodine,1ml
|
$220.20 |
$220.20 |
$220.20 |
$79.78
|
|
Homocysteine
|
$91.20 |
$91.20 |
$91.20 |
$125.40
|
|
Homovanillic acid (hva)
|
$150.00 |
$150.00 |
$150.00 |
$59.95
|
|
Hopd covid-19 spec collect
|
$50.40 |
$50.40 |
$50.40 |
$30.41
|
|
H pylori (c-13) breath
|
$139.80 |
$139.80 |
$139.80 |
$212.25
|
|
Human epididymis protein 4 (he4)
|
$91.20 |
$91.20 |
$91.20 |
$157.32
|
|
Hydralazine 20 mg/ml injection solution
|
$37.80 |
$37.80 |
$37.80 |
$48.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$292.20 |
$292.20 |
$292.20 |
$140.54
|
|
Hydrogel drg > 48 sq in w/b
|
$2.40 |
$2.40 |
$2.40 |
$22.41
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$34.20 |
$34.20 |
$34.20 |
$112.66
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$94.80 |
$94.80 |
$94.80 |
$73.45
|
|
Hysterosalpingography s&i
|
$363.00 |
$363.00 |
$363.00 |
$669.12
|
|
I-123 sod iodide diag per 100 uci
|
$163.20 |
$163.20 |
$163.20 |
$147.46
|
|
Ihc/icc per specimen each additional single antibody stain
|
$139.20 |
$139.20 |
$139.20 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$356.40 |
$356.40 |
$356.40 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$449.40 |
$449.40 |
$449.40 |
$277.90
|
|
Immune complex assay
|
$227.40 |
$227.40 |
$227.40 |
$101.60
|
|
Immunoassay tumor antigen quantitative ca 125
|
$112.20 |
$112.20 |
$112.20 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$200.40 |
$200.40 |
$200.40 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$121.20 |
$121.20 |
$121.20 |
$142.50
|
|
Immunofluorescence per specimen initial single antibody stain
|
$241.20 |
$241.20 |
$241.20 |
$234.27
|
|
Immunoglobulin assay
|
$116.40 |
$116.40 |
$116.40 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$6,820.80 |
$6,820.80 |
$6,820.80 |
$8,332.51
|
|
Implant open hernia repair w/mesh 49568
|
$4,243.80 |
$4,243.80 |
$4,243.80 |
$632.40
|
|
Impl neurostim electr perc
|
$5,749.20 |
$5,749.20 |
$5,749.20 |
$7,672.50
|
|
Impreg gauze no h20/sal/yard
|
$5.40 |
$5.40 |
$5.40 |
$11.90
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,047.60 |
$1,047.60 |
$1,047.60 |
$2,086.70
|
|
Incision of breast lesion
|
$1,635.60 |
$1,635.60 |
$1,635.60 |
$2,577.85
|
|
Infect ag eia influenza a or b ea
|
$165.00 |
$165.00 |
$165.00 |
$71.20
|
|
Infect ag genotype na hiv-1 other region
|
$394.80 |
$394.80 |
$394.80 |
$361.65
|
|
Infect ag if hep delta agent
|
$187.20 |
$187.20 |
$187.20 |
$125.97
|
|
Infect ag na hpv high-risk types
|
$152.40 |
$152.40 |
$152.40 |
$139.20
|
|
Infect ag na orthopoxvirus amp prb each
|
$168.60 |
$168.60 |
$168.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$88.20 |
$88.20 |
$88.20 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$200.40 |
$200.40 |
$200.40 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$146.40 |
$146.40 |
$146.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$235.80 |
$235.80 |
$235.80 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$56.40 |
$56.40 |
$56.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$130.20 |
$130.20 |
$130.20 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$10.80 |
$10.80 |
$10.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$192.60 |
$192.60 |
$192.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$187.20 |
$187.20 |
$187.20 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$125.40 |
$125.40 |
$125.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$452.40 |
$452.40 |
$452.40 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$197.40 |
$197.40 |
$197.40 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$129.00 |
$129.00 |
$129.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$409.20 |
$409.20 |
$409.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$79.20 |
$79.20 |
$79.20 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$199.20 |
$199.20 |
$199.20 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$191.40 |
$191.40 |
$191.40 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.60 |
$87.60 |
$87.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$201.00 |
$201.00 |
$201.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$79.20 |
$79.20 |
$79.20 |
$96.00
|
|
Infectious agent nucleic acid quantification bk virus
|
$547.80 |
$547.80 |
$547.80 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$516.00 |
$516.00 |
$516.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$231.60 |
$231.60 |
$231.60 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$538.80 |
$538.80 |
$538.80 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$271.20 |
$271.20 |
$271.20 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$684.00 |
$684.00 |
$684.00 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$570.00 |
$570.00 |
$570.00 |
$1,062.00
|
|
Inj cefazolin sodium, hikma
|
$19.20 |
$19.20 |
$19.20 |
$27.38
|
|
Inj crotalidae im f(ab')2 eq
|
$1,900.80 |
$1,900.80 |
$1,900.80 |
$2,613.60
|
|
Inj dx for sinogram
|
$606.60 |
$606.60 |
$606.60 |
$436.00
|
