|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$56.00 |
$56.00 |
$56.00 |
$294.92
|
|
Hydroxyurea 500 mg
|
$1.80 |
$1.80 |
$1.80 |
$13.02
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$39.00 |
$39.00 |
$39.00 |
$72.65
|
|
Hysterosalpingography s&i
|
$784.00 |
$784.00 |
$784.00 |
$663.50
|
|
I-123 sod iodide diag per 100 uci
|
$130.40 |
$130.40 |
$130.40 |
$144.24
|
|
Iadna legionella pneumophila amplified probe tq
|
$145.60 |
$145.60 |
$145.60 |
$109.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$202.40 |
$202.40 |
$202.40 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$761.60 |
$761.60 |
$761.60 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$554.40 |
$554.40 |
$554.40 |
$272.30
|
|
Immobilizer shldr dlx str 24-36in med
|
$250.40 |
$250.40 |
$250.40 |
$114.60
|
|
Immune complex assay
|
$101.60 |
$101.60 |
$101.60 |
$100.80
|
|
Immunoassay tumor antigen quantitative ca 125
|
$85.00 |
$85.00 |
$85.00 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$85.00 |
$85.00 |
$85.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$49.60 |
$49.60 |
$49.60 |
$48.38
|
|
Immunofixation electrophoresis serum
|
$92.80 |
$92.80 |
$92.80 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$198.40 |
$198.40 |
$198.40 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$55.20 |
$55.20 |
$55.20 |
$231.40
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$4,440.80 |
$4,440.80 |
$4,440.80 |
$2,056.93
|
|
Infect ag drug suscept pheno predict
|
$650.40 |
$650.40 |
$650.40 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$642.40 |
$642.40 |
$642.40 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,285.60 |
$1,285.60 |
$1,285.60 |
$603.75
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$172.00 |
$172.00 |
$172.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$68.80 |
$68.80 |
$68.80 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$60.00 |
$60.00 |
$60.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$60.00 |
$60.00 |
$60.00 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$51.20 |
$51.20 |
$51.20 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$144.80 |
$144.80 |
$144.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$60.00 |
$60.00 |
$60.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$60.00 |
$60.00 |
$60.00 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$60.00 |
$60.00 |
$60.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$211.20 |
$211.20 |
$211.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$211.20 |
$211.20 |
$211.20 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$186.40 |
$186.40 |
$186.40 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$2,080.80 |
$2,080.80 |
$2,080.80 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$145.60 |
$145.60 |
$145.60 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$140.00 |
$140.00 |
$140.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$208.00 |
$208.00 |
$208.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$100.00 |
$100.00 |
$100.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$100.00 |
$100.00 |
$100.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$132.00 |
$132.00 |
$132.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$198.40 |
$198.40 |
$198.40 |
$108.75
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$307.20 |
$307.20 |
$307.20 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,132.00 |
$1,132.00 |
$1,132.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,094.40 |
$1,094.40 |
$1,094.40 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$178.40 |
$178.40 |
$178.40 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$178.40 |
$178.40 |
$178.40 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$178.40 |
$178.40 |
$178.40 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$354.40 |
$354.40 |
$354.40 |
$374.00
|
|
Infliximab 100 mg intravenous solution
|
$1,666.60 |
$1,666.60 |
$1,666.60 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,706.80 |
$1,706.80 |
$1,706.80 |
$1,062.00
|
|
Initiation & management bipap/cpap initial day
|
$1,038.40 |
$1,038.40 |
$1,038.40 |
$576.00
|
|
Inj cefazolin sodium, hikma
|
$19.00 |
$19.00 |
$19.00 |
$28.08
|
|
Inj cntr knee arthro incl ct/mri
|
$660.80 |
$660.80 |
$660.80 |
$436.80
|
|
Inj. denosumab-bbdz, 1 mg
|
$4,741.40 |
$4,741.40 |
$4,741.40 |
$4,615.43
|
|
Injection arthrography hip without anesthesia (both sides)
|
$264.80 |
$264.80 |
$264.80 |
$495.84
|
|
Injection for arthrography wrist (both sides)
|
$268.80 |
$268.80 |
$268.80 |
$428.40
|
|
Injection for bladder x-ray
|
$196.80 |
$196.80 |
$196.80 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$222.40 |
$222.40 |
$222.40 |
$494.65
|
|
Injection,onabotulinumtoxina
|
$1,822.80 |
$1,822.80 |
$1,822.80 |
$2,277.65
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,635.20 |
$1,635.20 |
$1,635.20 |
$1,023.50
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$422.40 |
$422.40 |
$422.40 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$548.80 |
$548.80 |
$548.80 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$548.80 |
$548.80 |
$548.80 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$217.60 |
$217.60 |
$217.60 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$144.00 |
$144.00 |
$144.00 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$283.20 |
$283.20 |
$283.20 |
$135.60
|
|
Inj, lidocaine w epinephrine
|
$21.00 |
$21.00 |
$21.00 |
$47.52
|
|
Inj proc elbow arthro
|
$272.00 |
$272.00 |
$272.00 |
$419.60
|
|
Insert cath pleura with image
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$2,524.00 |
$2,524.00 |
$2,524.00 |
$2,073.18
|
|
Insert intrauterine device iud
|
$131.20 |
$131.20 |
$131.20 |
$347.10
|
|
Insertion catheter bladder non indwelling
|
$375.20 |
$375.20 |
$375.20 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$375.20 |
$375.20 |
$375.20 |
$232.25
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,036.00 |
$5,036.00 |
$5,036.00 |
$4,782.00
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$8,252.80 |
$8,252.80 |
$8,252.80 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,967.20 |
$3,967.20 |
$3,967.20 |
$2,505.60
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,982.40 |
$2,982.40 |
$2,982.40 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$4,058.40 |
$4,058.40 |
$4,058.40 |
$2,419.65
|
|
In situ hybridization per specimen each additional single probe stain
|
$304.80 |
$304.80 |
$304.80 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$565.60 |
$565.60 |
$565.60 |
$331.69
|
|
Ins pq tunnld ip cath w/img
|
$2,670.40 |
$2,670.40 |
$2,670.40 |
$5,377.00
|
|
Insulin total
|
$47.20 |
$47.20 |
$47.20 |
$66.64
|
|
Intrinsic factor antibody
|
$62.40 |
$62.40 |
$62.40 |
$63.15
|
|
Intro cath svc/ivc
|
$1,604.80 |
$1,604.80 |
$1,604.80 |
$1,323.27
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$4,220.80 |
$4,220.80 |
$4,220.80 |
$3,409.29
|
|
Intubation endotracheal emergency procedure
|
$877.60 |
$877.60 |
$877.60 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$8.00 |
$8.00 |
$8.00 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1.60 |
$1.60 |
$1.60 |
$288.11
|
|
Iron
|
$20.00 |
$20.00 |
$20.00 |
$72.29
|
|
Iron dextran 50 mg/ml injection solution
|
$99.80 |
$99.80 |
$99.80 |
$81.70
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$312.80 |
$312.80 |
$312.80 |
$187.06
|
|
Irrigation implantable venous access device for drug delivery systems
|
$100.00 |
$100.00 |
$100.00 |
$144.62
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$283.20 |
$283.20 |
$283.20 |
$190.56
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$123.20 |
$123.20 |
$123.20 |
$159.00
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$154.40 |
$154.40 |
$154.40 |
$153.60
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$552.00 |
$552.00 |
$552.00 |
$437.45
|
|
Ivp w/wo kub w/wo tomography
|
$844.00 |
$844.00 |
$844.00 |
$692.18
|
|
Jak2 targeted sequence analysis
|
$770.40 |
$770.40 |
$770.40 |
$393.43
|
|
Ketone body(s) beta-hydroxybutyrate quantitative
|
$40.80 |
$40.80 |
$40.80 |
$58.50
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$21.20 |
$21.20 |
$21.20 |
$23.77
|
