|
Hysterotomy abdominal 59100
|
$3,761.40 |
$3,761.40 |
$3,761.40 |
$5,110.00
|
|
Hzv zoster vacc recombinant adjuvanted im inj
|
$150.00 |
$150.00 |
$150.00 |
$352.24
|
|
I-123 sod iodide diag per 100 uci
|
$646.80 |
$646.80 |
$646.80 |
$147.46
|
|
I131 iodide cap, rx
|
$706.80 |
$706.80 |
$706.80 |
$71.70
|
|
Iadna legionella pneumophila amplified probe tq
|
$591.00 |
$591.00 |
$591.00 |
$109.80
|
|
Ia infect ag ab qual/semiquant sgl step
|
$149.40 |
$149.40 |
$149.40 |
$50.60
|
|
Icd crtd cobalt hf MRI is1 df1
|
$40,346.40 |
$40,346.40 |
$40,346.40 |
$39,070.50
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$2,812.80 |
$2,812.80 |
$2,812.80 |
$3,592.74
|
|
Ifosfamide 1 gram intravenous solution
|
$752.00 |
$752.00 |
$752.00 |
$246.95
|
|
Igh gene rearrange amp meth
|
$933.00 |
$933.00 |
$933.00 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$1,416.60 |
$1,416.60 |
$1,416.60 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$933.00 |
$933.00 |
$933.00 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$272.40 |
$272.40 |
$272.40 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$272.40 |
$272.40 |
$272.40 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$272.40 |
$272.40 |
$272.40 |
$277.90
|
|
Iliac revasc add-on 37222
|
$10,123.20 |
$10,123.20 |
$10,123.20 |
$6,082.65
|
|
Imetelstat 188 mg intravenous solution
|
$99.00 |
$99.00 |
$99.00 |
$20,373.55
|
|
Immobilizer shldr cntor adlt
|
$198.00 |
$198.00 |
$198.00 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$94.80 |
$94.80 |
$94.80 |
$118.43
|
|
Immune complex assay
|
$289.20 |
$289.20 |
$289.20 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$476.00 |
$476.00 |
$476.00 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$191.40 |
$191.40 |
$191.40 |
$2,900.11
|
|
Immunoassay tumor antigen quantitative ca 125
|
$141.00 |
$141.00 |
$141.00 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$141.00 |
$141.00 |
$141.00 |
$116.40
|
|
Immunoassay tumor qual
|
$233.40 |
$233.40 |
$233.40 |
$66.50
|
|
Immunodiff gel qual ea antigen/ab
|
$72.00 |
$72.00 |
$72.00 |
$48.57
|
|
Immunodiffusion nes
|
$129.60 |
$129.60 |
$129.60 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$114.00 |
$114.00 |
$114.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$108.00 |
$108.00 |
$108.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$108.00 |
$108.00 |
$108.00 |
$234.27
|
|
Immunoglobulin assay
|
$144.00 |
$144.00 |
$144.00 |
$78.00
|
|
Immunology procedure
|
$43.80 |
$43.80 |
$43.80 |
$150.70
|
|
Implant cartilage 10mm synthetic
|
$7,867.80 |
$7,867.80 |
$7,867.80 |
$8,332.51
|
|
Implant ureth bulk agent
|
$1,360.20 |
$1,360.20 |
$1,360.20 |
$2,168.00
|
|
Impl neurostim electr perc
|
$4,795.80 |
$4,795.80 |
$4,795.80 |
$7,672.50
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$2,086.70
|
|
Infect ag drug suscept pheno predict
|
$764.40 |
$764.40 |
$764.40 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$1,790.40 |
$1,790.40 |
$1,790.40 |
$665.40
|
|
Infect ag genotype na hiv-1 other region
|
$1,768.80 |
$1,768.80 |
$1,768.80 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$2,065.80 |
$2,065.80 |
$2,065.80 |
$603.83
|
|
Infect ag if hep delta agent
|
$252.60 |
$252.60 |
$252.60 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$303.00 |
$303.00 |
$303.00 |
$73.45
|
|
Infect ag if pneumocystis carinii
|
$100.20 |
$100.20 |
$100.20 |
$66.06
|
|
Infect ag na herpes simplex quant
|
$385.80 |
$385.80 |
$385.80 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$284.40 |
$284.40 |
$284.40 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$516.60 |
$516.60 |
$516.60 |
$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
|
$108.00 |
$108.00 |
$108.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$100.20 |
$100.20 |
$100.20 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$76.20 |
$76.20 |
$76.20 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$88.20 |
$88.20 |
$88.20 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$76.20 |
$76.20 |
$76.20 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$93.60 |
$93.60 |
$93.60 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$268.80 |
$268.80 |
$268.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$74.40 |
$74.40 |
$74.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$108.00 |
$108.00 |
$108.00 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$99.00 |
$99.00 |
$99.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$189.00 |
$189.00 |
$189.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$203.40 |
$203.40 |
$203.40 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$547.80 |
$547.80 |
$547.80 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$2,298.60 |
$2,298.60 |
$2,298.60 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$306.00 |
$306.00 |
$306.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$576.00 |
$576.00 |
$576.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$306.60 |
$306.60 |
$306.60 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$198.60 |
$198.60 |
$198.60 |
$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 streptococcus group a
|
$568.20 |
$568.20 |
$568.20 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$231.00 |
$231.00 |
$231.00 |
$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
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$385.80 |
$385.80 |
$385.80 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$385.80 |
$385.80 |
$385.80 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$346.80 |
$346.80 |
$346.80 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$754.20 |
$754.20 |
$754.20 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$951.60 |
$951.60 |
$951.60 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$380.80 |
$380.80 |
$380.80 |
$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 dna amp prob addl
|
$342.00 |
$342.00 |
$342.00 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$40.00 |
$40.00 |
$40.00 |
$111.51
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$377.40 |
$377.40 |
$377.40 |
$296.00
|
|
Inj, abilify maintena, 1 mg
|
$34.00 |
$34.00 |
$34.00 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$168.80 |
$168.80 |
$168.80 |
$12,098.05
|
|
Inj andexxa, 10 mg
|
$751.80 |
$751.80 |
$751.80 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$46.00 |
$46.00 |
$46.00 |
$10,052.58
|
|
Inj atezolizumb 5mg hya-tqjs
|
$54.60 |
$54.60 |
$54.60 |
$18,716.52
|
|
Inj, bezlotoxumab, 10 mg
|
$11,010.60 |
$11,010.60 |
$11,010.60 |
$7,612.43
|
|
Inj., brexanolone, 1 mg
|
$171.00 |
$171.00 |
$171.00 |
$13,019.44
|
|
Inj, brixadi, 7 days or less
|
$814.80 |
$814.80 |
$814.80 |
$748.85
|
|
Inj, bupivacaine liposome
|
$2.40 |
$2.40 |
$2.40 |
$699.38
|
|
Inj, cefepime hcl (b braun)
|
$43.40 |
$43.40 |
$43.40 |
$69.85
|
|
Inj ceftolozane tazobactam
|
$19.00 |
$19.00 |
$19.00 |
$364.86
|
|
Inj cntr knee arthro incl ct/mri
|
$162.00 |
$162.00 |
$162.00 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$2.40 |
$2.40 |
$2.40 |
$742.72
|
|
Inj, donanemab-azbt, 2 mg
|
$7.20 |
$7.20 |
$7.20 |
$1,233.44
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,505.40 |
$1,505.40 |
$1,505.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$450.00 |
$450.00 |
$450.00 |
$503.50
|
|
Injection, caplacizumab-yhdp
|
$19,956.00 |
$19,956.00 |
$19,956.00 |
$16,319.16
|
