|
Icd crtd cobalt hf MRI is1 df1
|
$29,475.00 |
$29,475.00 |
$32,269.05 |
$41,418.00
|
|
Icd crtp serena MRI
|
$10,506.00 |
$10,506.00 |
$11,556.60 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$5,992.50 |
$5,992.50 |
$6,591.75 |
$9,267.72
|
|
Idarubicin hcl injection
|
$187.80 |
$187.80 |
$206.58 |
$447.02
|
|
Ifosfamide 1 gram intravenous solution
|
$109.95 |
$109.95 |
$120.95 |
$246.95
|
|
Igh gene rearrange amp meth
|
$272.25 |
$272.25 |
$272.25 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$408.54 |
$408.54 |
$408.54 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$80.85 |
$80.85 |
$154.35 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$137.94 |
$137.94 |
$263.34 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$80.85 |
$80.85 |
$154.35 |
$272.30
|
|
Iliac/fem angio cath insert
|
$543.00 |
$543.00 |
$597.30 |
$1,856.01
|
|
Imetelstat 188 mg intravenous solution
|
$10,642.76 |
$10,642.76 |
$11,707.03 |
$20,373.55
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$137.99 |
$137.99 |
$137.99 |
$259.20
|
|
Immobilizer shldr cntor adlt
|
$139.27 |
$139.27 |
$153.19 |
$175.60
|
|
Immobilizer shldr dlx str 24-36in med
|
$52.76 |
$52.76 |
$61.15 |
$114.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$9,127.22 |
$9,127.22 |
$10,039.94 |
$6,106.32
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$2,292.83 |
$2,292.83 |
$2,522.12 |
$2,900.11
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$3,335.81 |
$3,335.81 |
$3,669.39 |
$3,846.15
|
|
Immunoassay tumor antigen quantitative ca 125
|
$70.29 |
$70.29 |
$134.19 |
$131.95
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$70.29 |
$70.29 |
$134.19 |
$116.40
|
|
Immunofixation electrophoresis serum
|
$119.46 |
$119.46 |
$228.06 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$66.00 |
$66.00 |
$126.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$116.82 |
$116.82 |
$223.02 |
$231.40
|
|
Implant cartilage 10mm synthetic
|
$1,612.50 |
$1,612.50 |
$1,773.75 |
$8,184.00
|
|
Implant cochlear osia osi300
|
$7,920.00 |
$7,920.00 |
$7,920.00 |
$16,200.89
|
|
Implant tcat pulm vlv perq
|
$13,035.00 |
$13,035.00 |
$13,035.00 |
$9,812.40
|
|
Implant ureth bulk agent
|
$930.60 |
$930.60 |
$1,897.50 |
$2,168.00
|
|
In-111 autol wbc diag per dose
|
$1,434.20 |
$1,434.20 |
$1,577.62 |
$3,523.65
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,670.72 |
$1,670.72 |
$1,837.79 |
$2,598.17
|
|
In-111 pentetreotide
|
$3,307.62 |
$3,307.62 |
$3,638.38 |
$5,201.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$451.20 |
$451.20 |
$496.32 |
$2,056.93
|
|
Incisn of toe tndn
|
$741.51 |
$741.51 |
$741.51 |
$2,627.96
|
|
Incobotulinumtoxin a
|
$1,044.89 |
$1,044.89 |
$1,149.38 |
$1,339.57
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$696.96 |
$696.96 |
$766.66 |
$766.66
|
|
Infect ag drug suscept pheno predict
|
$32.67 |
$32.67 |
$32.67 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$94.38 |
$94.38 |
$94.38 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$152.79 |
$152.79 |
$152.79 |
$603.75
|
|
Infect ag if ea plyvlnt antsrm
|
$19.14 |
$19.14 |
$36.54 |
$62.80
|
|
Infect ag if influenza a
|
$37.95 |
$37.95 |
$72.45 |
$41.30
|
|
Infect ag if influenza b
|
$37.95 |
$37.95 |
$72.45 |
$40.08
|
|
Infect ag if legionella pneumophila
|
$63.63 |
$63.63 |
$63.63 |
$72.58
|
|
Infect ag na orthopoxvirus amp prb each
|
$0.01 |
$0.01 |
$0.01 |
$99.36
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$463.98 |
$463.98 |
$463.98 |
$943.80
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$24.75 |
$24.75 |
$24.75 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$35.97 |
$35.97 |
$68.67 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$36.96 |
$36.96 |
$70.56 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$36.96 |
$36.96 |
$70.56 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$29.04 |
$29.04 |
$55.44 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$29.04 |
$29.04 |
$70.56 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$78.87 |
$78.87 |
$150.57 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$112.20 |
$112.20 |
$214.20 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$32.01 |
$32.01 |
$32.01 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$37.29 |
$37.29 |
$71.19 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$110.55 |
$110.55 |
$211.05 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$116.82 |
$116.82 |
$223.02 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$114.18 |
$114.18 |
$217.98 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$594.00 |
$594.00 |
$1,134.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$49.17 |
$49.17 |
$93.87 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$110.55 |
$110.55 |
$211.05 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$77.88 |
$77.88 |
$148.68 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$116.82 |
$116.82 |
$223.02 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$118.47 |
$118.47 |
$226.17 |
$103.20
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$32.67 |
$32.67 |
$62.37 |
$92.50
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$162.03 |
$162.03 |
$309.33 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$177.21 |
$177.21 |
$338.31 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$165.00 |
$165.00 |
$165.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$191.40 |
$191.40 |
$365.40 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$229.68 |
$229.68 |
$438.48 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$69.63 |
$69.63 |
$132.93 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$49.50 |
$49.50 |
$94.50 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$67.98 |
$67.98 |
$129.78 |
$374.00
|
|
Infliximab 100 mg intravenous solution
|
$1,193.98 |
$1,193.98 |
$1,313.37 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$511.20 |
$511.20 |
$562.32 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$967.48 |
$967.48 |
$1,064.23 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$110.88 |
$110.88 |
$110.88 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$259.80 |
$259.80 |
$285.78 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$2,969.50 |
$2,969.50 |
$3,266.45 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$1,246.07 |
$1,246.07 |
$1,370.68 |
$12,098.05
|
|
Inj, adstiladrin, per tx dos
|
$60,188.69 |
$60,188.69 |
$66,207.56 |
$63,354.77
|
|
Inj allopurinol sodium 1 mg
|
$4,076.37 |
$4,076.37 |
$4,484.00 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$2,938.79 |
$2,938.79 |
$3,232.67 |
$1,280.74
|
|
Inj, artesunate, 1mg
|
$5,091.55 |
$5,091.55 |
$5,600.71 |
$14,460.21
|
|
Inj beta interferon sq 1 mcg
|
$329.65 |
$329.65 |
$362.61 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$3,885.12 |
$3,885.12 |
$4,273.63 |
$7,612.43
|
|
Inj calcitriol per 0.1 mcg
|
$16.43 |
$16.43 |
$18.07 |
$23.28
|
|
Inj, cefiderocol, 10 mg
|
$238.06 |
$238.06 |
$261.86 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$178.27 |
$178.27 |
$196.09 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$229.80 |
$229.80 |
$252.78 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$21,063.08 |
$21,063.08 |
$23,169.38 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$1,198.25 |
$1,198.25 |
$1,318.08 |
$742.72
|
|
Inj. denosumab-bbdz, 1 mg
|
$3,280.12 |
$3,280.12 |
$3,608.13 |
$4,615.43
|
|
Inj disk cerv-thor ea lev
|
$130.80 |
$130.80 |
$143.88 |
$875.28
|
|
Inj, durolane 1 mg
|
$401.40 |
$401.40 |
$441.54 |
$1,950.93
|
|
Inj dx for sinogram
|
$50.40 |
$50.40 |
$55.44 |
$422.59
|
|
Inject for sacroiliac joint
|
$66.90 |
$66.90 |
$73.59 |
$1,025.77
|
|
Injection arthrography hip without anesthesia (both sides)
|
$240.30 |
$240.30 |
$264.33 |
$495.84
|
|
Injection, belinostat, 10mg
|
$2,203.92 |
$2,203.92 |
$2,424.31 |
$4,446.10
|
|
Injection, caplacizumab-yhdp
|
$8,763.69 |
$8,763.69 |
$9,640.06 |
$16,375.33
|
|
Injection, daratumumab 10 mg
|
$3,007.19 |
$3,007.19 |
$3,307.90 |
$5,239.24
|
|
Injection, doxercalciferol
|
$14.63 |
$14.63 |
$16.09 |
$23.86
|