|
Hla i typing high res 1 allele grp ea
|
$837.60 |
$837.60 |
$837.60 |
$304.20
|
|
Hla i typing low res one locus ea
|
$1,671.60 |
$1,671.60 |
$1,671.60 |
$340.00
|
|
Hla typing a b or c
|
$562.20 |
$562.20 |
$562.20 |
$364.00
|
|
Hla x-match noncytotoxc addl
|
$307.80 |
$307.80 |
$307.80 |
$163.80
|
|
Hla x-math non-cytotoxic
|
$925.20 |
$925.20 |
$925.20 |
$364.80
|
|
Hocm 350-399mg/ml iodine,1ml
|
$0.80 |
$0.80 |
$0.80 |
$79.78
|
|
Home sleep test/type 3 porta
|
$1,350.60 |
$1,350.60 |
$1,350.60 |
$570.00
|
|
Homocysteine
|
$345.00 |
$345.00 |
$345.00 |
$125.40
|
|
Homogenization tissue
|
$63.60 |
$63.60 |
$63.60 |
$41.30
|
|
Hpv types 16 & 18 only
|
$657.60 |
$657.60 |
$657.60 |
$112.00
|
|
Hrdtry brst ca-rlatd do 5+
|
$1,920.00 |
$1,920.00 |
$1,920.00 |
$1,702.08
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$316.80 |
$316.80 |
$316.80 |
$142.40
|
|
Hydralazine 20 mg/ml injection solution
|
$66.00 |
$66.00 |
$66.00 |
$48.00
|
|
Hydrocolld drg <=16 without bdr
|
$3.60 |
$3.60 |
$3.60 |
$7.76
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$55.00 |
$55.00 |
$55.00 |
$140.54
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$2.40 |
$2.40 |
$2.40 |
$112.66
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$1,181.40 |
$1,181.40 |
$1,181.40 |
$294.92
|
|
I-123 iobenguane diag
|
$4,006.80 |
$4,006.80 |
$4,006.80 |
$5,170.70
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$954.60 |
$954.60 |
$954.60 |
$684.45
|
|
Icatibant injection
|
$25,465.20 |
$25,465.20 |
$25,465.20 |
$8,695.05
|
|
Icd cobalt xt dr MRI is1 df1
|
$139,505.40 |
$139,505.40 |
$139,505.40 |
$34,093.09
|
|
Icd crtd cobalt hf MRI is1 df1
|
$132,543.60 |
$132,543.60 |
$132,543.60 |
$39,070.50
|
|
Icd crtp serena MRI
|
$47,350.20 |
$47,350.20 |
$47,350.20 |
$14,360.25
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$2,812.80 |
$2,812.80 |
$2,812.80 |
$3,592.74
|
|
Idarubicin hcl injection
|
$2,408.00 |
$2,408.00 |
$2,408.00 |
$447.02
|
|
Igh gene rearrange amp meth
|
$606.00 |
$606.00 |
$606.00 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$1,397.40 |
$1,397.40 |
$1,397.40 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$975.00 |
$975.00 |
$975.00 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$166.20 |
$166.20 |
$166.20 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$303.00 |
$303.00 |
$303.00 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$303.00 |
$303.00 |
$303.00 |
$277.90
|
|
Iliac revasc add-on 37222
|
$8,494.80 |
$8,494.80 |
$8,494.80 |
$6,082.65
|
|
Imatinib 100 mg tab
|
$904.80 |
$904.80 |
$904.80 |
$248.00
|
|
Immobilizer shldr cntor adlt
|
$366.60 |
$366.60 |
$366.60 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$421.80 |
$421.80 |
$421.80 |
$118.43
|
|
Immune complex assay
|
$306.00 |
$306.00 |
$306.00 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$640.80 |
$640.80 |
$640.80 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$6,584.40 |
$6,584.40 |
$6,584.40 |
$2,900.11
|
|
Immunoassay tumor antigen quantitative ca 125
|
$427.20 |
$427.20 |
$427.20 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$427.20 |
$427.20 |
$427.20 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$180.60 |
$180.60 |
$180.60 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$336.00 |
$336.00 |
$336.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$75.60 |
$75.60 |
$75.60 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$153.00 |
$153.00 |
$153.00 |
$234.27
|
|
Implant cartilage 10mm synthetic
|
$11,233.20 |
$11,233.20 |
$11,233.20 |
$8,332.51
|
|
Implant ureth bulk agent
|
$1,096.20 |
$1,096.20 |
$1,096.20 |
$2,168.00
|
|
Impl neurostim electr perc
|
$3,768.60 |
$3,768.60 |
$3,768.60 |
$7,672.50
|
|
In-111 oxyquinolin per 0.5 mci
|
$3,093.00 |
$3,093.00 |
$3,093.00 |
$2,753.23
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$856.80 |
$856.80 |
$856.80 |
$2,086.70
|
|
Incision of breast lesion
|
$3,824.40 |
$3,824.40 |
$3,824.40 |
$2,577.85
|
|
Incision of burn scab initi
|
$4,147.80 |
$4,147.80 |
$4,147.80 |
$494.40
|
|
Infect ag drug suscept pheno predict
|
$1,287.00 |
$1,287.00 |
$1,287.00 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$113.40 |
$113.40 |
$113.40 |
$71.20
|
|
Infect ag genotype na cytomegalovirus
|
$1,147.20 |
$1,147.20 |
$1,147.20 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$1,338.60 |
$1,338.60 |
$1,338.60 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$1,132.80 |
$1,132.80 |
$1,132.80 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$5,280.00 |
$5,280.00 |
$5,280.00 |
$603.83
|
|
Infect ag if hep delta agent
|
$306.60 |
$306.60 |
$306.60 |
$125.97
|
|
Infect ag na herpes simplex quant
|
$879.00 |
$879.00 |
$879.00 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$697.20 |
$697.20 |
$697.20 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$963.60 |
$963.60 |
$963.60 |
$219.70
|
|
Infect ag na resp virus 12-25 targets
|
$2,801.40 |
$2,801.40 |
$2,801.40 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$126.00 |
$126.00 |
$126.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$126.60 |
$126.60 |
$126.60 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$227.40 |
$227.40 |
$227.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$198.60 |
$198.60 |
$198.60 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$203.40 |
$203.40 |
$203.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$370.80 |
$370.80 |
$370.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$225.60 |
$225.60 |
$225.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$152.40 |
$152.40 |
$152.40 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$129.60 |
$129.60 |
$129.60 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$697.20 |
$697.20 |
$697.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$697.20 |
$697.20 |
$697.20 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$350.40 |
$350.40 |
$350.40 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,408.80 |
$1,408.80 |
$1,408.80 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$697.20 |
$697.20 |
$697.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$406.20 |
$406.20 |
$406.20 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$363.60 |
$363.60 |
$363.60 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$697.20 |
$697.20 |
$697.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$75.00 |
$75.00 |
$75.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$210.00 |
$210.00 |
$210.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$139.20 |
$139.20 |
$139.20 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$147.00 |
$147.00 |
$147.00 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$454.20 |
$454.20 |
$454.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$793.20 |
$793.20 |
$793.20 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$879.00 |
$879.00 |
$879.00 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$879.00 |
$879.00 |
$879.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$879.00 |
$879.00 |
$879.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,743.00 |
$1,743.00 |
$1,743.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$667.20 |
$667.20 |
$667.20 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$645.60 |
$645.60 |
$645.60 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,062.00 |
$1,062.00 |
$1,062.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$203.20 |
$203.20 |
$203.20 |
$1,537.84
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$40.00 |
$40.00 |
$40.00 |
$111.51
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$896.40 |
$896.40 |
$896.40 |
$296.00
|
|
Inj andexxa, 10 mg
|
$14,184.00 |
$14,184.00 |
$14,184.00 |
$4,370.80
|
|
Inj, aponvie, 1 mg
|
$3.00 |
$3.00 |
$3.00 |
$3.36
|
|
Inj., benralizumab, 1 mg
|
$13,770.60 |
$13,770.60 |
$13,770.60 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$11,671.20 |
$11,671.20 |
$11,671.20 |
$7,612.43
|
|
Inj., brexanolone, 1 mg
|
$178.80 |
$178.80 |
$178.80 |
$13,019.44
|
