|
Graft puraplyam antimicrob 1.6-q4196-cost per sq cm
|
$343.64 |
$343.64 |
$343.64 |
$486.45
|
|
Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm
|
$635.07 |
$635.07 |
$635.07 |
$1,123.34
|
|
Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm
|
$357.21 |
$357.21 |
$357.21 |
$5,533.20
|
|
G-tube reposition
|
$479.82 |
$479.82 |
$479.82 |
$727.35
|
|
Gu dilat ureter/urethra s&i
|
$416.43 |
$416.43 |
$416.43 |
$1,585.00
|
|
Guided cath fluid drainage 10030
|
$1,465.77 |
$1,465.77 |
$1,465.77 |
$1,451.40
|
|
Guid loc target vol rad tx
|
$800.55 |
$800.55 |
$800.55 |
$620.91
|
|
Haloperidol decanoate 50 mg/ml intramuscular solution
|
$60.35 |
$60.35 |
$60.35 |
$120.02
|
|
Haloperidol lactate 5 mg/ml injection solution
|
$12.87 |
$12.87 |
$12.87 |
$11.25
|
|
Hand X-ray
|
$86.67 |
$86.67 |
$86.67 |
$317.78
|
|
Haptoglobin quantitative
|
$64.40 |
$64.40 |
$64.40 |
$75.00
|
|
Hbot, full body chamber, 30m
|
$1,092.66 |
$1,092.66 |
$1,092.66 |
$524.17
|
|
Hc fl sm bowel enteroclss tube w kub double contrast
|
$527.13 |
$527.13 |
$527.13 |
$527.13
|
|
Hcg qualitative
|
$62.90 |
$62.90 |
$62.90 |
$72.50
|
|
Hcg quantitative
|
$104.48 |
$104.48 |
$104.48 |
$105.00
|
|
Hc i-131 sodium iodide cap dx per mci
|
$49.95 |
$49.95 |
$49.95 |
$184.20
|
|
Hc nm myocard infarct avid plnr tomo spect w/wo quant
|
$458.24 |
$458.24 |
$458.24 |
$1,061.26
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,908.60 |
$1,908.60 |
$1,908.60 |
$2,668.85
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,908.60 |
$1,908.60 |
$1,908.60 |
$2,960.63
|
|
Hdr rdncl ntrstl/icav brchtx
|
$1,817.79 |
$1,817.79 |
$1,817.79 |
$3,111.55
|
|
Head CT scan (with and without contrast)
|
$802.19 |
$802.19 |
$802.19 |
$1,732.80
|
|
Head CT scan (with contrast)
|
$746.03 |
$746.03 |
$746.03 |
$1,496.25
|
|
Head CT scan (without contrast)
|
$581.79 |
$581.79 |
$581.79 |
$1,252.80
|
|
Hematocrit
|
$37.20 |
$37.20 |
$37.20 |
$32.50
|
|
Hemin 350 mg intravenous powder for solution
|
$43.82 |
$43.82 |
$43.82 |
$37,212.55
|
|
Hemoglobin
|
$37.20 |
$37.20 |
$37.20 |
$28.60
|
|
Hemoglobin methemoglobin quantitative
|
$72.72 |
$72.72 |
$72.72 |
$43.01
|
|
Hemoglobin plasma
|
$79.34 |
$79.34 |
$79.34 |
$43.80
|
|
Hemorrhoidectomy intrnl lig rbbr band ligations
|
$672.71 |
$672.71 |
$672.71 |
$1,073.68
|
|
Heparin assay
|
$140.10 |
$140.10 |
$140.10 |
$107.50
|
|
Heparin bolus from bag
|
$62.54 |
$62.54 |
$62.54 |
$50.95
|
|
Heparin neutralization
|
$22.32 |
$22.32 |
$22.32 |
$56.55
|
|
Heparin, porcine (pf) 10 unit/ml flush (wrapper)
|
$1.01 |
$1.01 |
$1.01 |
$7.15
|
|
Hepatitis a antibody igm
|
$79.34 |
$79.34 |
$79.34 |
$80.60
|
|
Hepatitis b core antibody igm
|
$54.14 |
$54.14 |
$54.14 |
$85.80
|
|
Hepatitis b core antibody total
|
$79.34 |
$79.34 |
$79.34 |
$84.75
|
|
Hepatitis b immune globulin greater than 1,560 units/5 ml im solution
|
$1,617.78 |
$1,617.78 |
$1,617.78 |
$468.80
|
|
Hepatitis b surface antibody
|
$63.26 |
$63.26 |
$63.26 |
$81.12
|
|
Hepatitis c antibody
|
$54.26 |
$54.26 |
$54.26 |
$106.50
|
|
Hepatobiliary system imaging
|
$647.03 |
$647.03 |
$647.03 |
$1,438.58
|
|
Herpes simplex type 1 antibody igg
|
$34.74 |
$34.74 |
$34.74 |
$79.92
|
|
Herpes simplex type 2 antibody igg
|
$50.96 |
$50.96 |
$50.96 |
$96.20
|
|
Herpes simplex virus isolation
|
$28.53 |
$28.53 |
$28.53 |
$110.50
|
|
Heterophile antibodies screening
|
$59.15 |
$59.15 |
$59.15 |
$59.40
|
|
Hip X-ray
|
$191.21 |
$191.21 |
$191.21 |
$262.64
|
|
Histamine
|
$114.84 |
$114.84 |
$114.84 |
$132.60
|
|
Hla i low res one antigen equiv ea
|
$62.61 |
$62.61 |
$62.61 |
$164.00
|
|
Hla i typing high res 1 allele grp ea
|
$143.09 |
$143.09 |
$143.09 |
$340.00
|
|
Hla typing a b or c
|
$292.40 |
$292.40 |
$292.40 |
$379.20
|
|
Hla x-math non-cytotoxic
|
$98.00 |
$98.00 |
$98.00 |
$265.00
|
|
Hocm 250-299mg/ml iodine,1ml
|
$0.65 |
$0.65 |
$0.65 |
$49.12
|
|
Hocm 350-399mg/ml iodine,1ml
|
$2.24 |
$2.24 |
$2.24 |
$9.00
|
|
Homocysteine
|
$94.23 |
$94.23 |
$94.23 |
$100.00
|
|
Homogenization tissue
|
$57.96 |
$57.96 |
$57.96 |
$39.20
|
|
Hpv types 16 & 18 only
|
$114.33 |
$114.33 |
$114.33 |
$114.33
|
|
H pylori (c-13) breath
|
$212.25 |
$212.25 |
$212.25 |
$236.00
|
|
Human prothrombin complex concentrate (pcc)-lans 500 unit (400-640 unit) IV solution
|
$6.77 |
$6.77 |
$6.77 |
$3.39
|
|
Hyaluronidase, human recombinant 150 unit/ml injection solution
|
$0.80 |
$0.80 |
$0.80 |
$180.48
|
|
Hydralazine 20 mg/ml injection solution
|
$30.77 |
$30.77 |
$30.77 |
$46.01
|
|
Hydration IV infusion each additional hour
|
$43.41 |
$43.41 |
$43.41 |
$125.45
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$148.43 |
$148.43 |
$148.43 |
$388.70
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$1.37 |
$1.37 |
$1.37 |
$47.18
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$158.70 |
$158.70 |
$158.70 |
$86.45
|
|
Hysterosalpingography s&i
|
$287.55 |
$287.55 |
$287.55 |
$555.39
|
|
I-123 iobenguane diag
|
$7,733.04 |
$7,733.04 |
$7,733.04 |
$5,730.40
|
|
I-123 sod iodide diag per 100 uci
|
$279.74 |
$279.74 |
$279.74 |
$157.09
|
|
I131 iodide cap, rx
|
$49.95 |
$49.95 |
$49.95 |
$117.00
|
|
Idarubicin hcl injection
|
$115.85 |
$115.85 |
$115.85 |
$249.51
|
|
Idh2 common variants
|
$502.88 |
$502.88 |
$502.88 |
$463.45
|
|
Ifosfamide 1 gram intravenous solution
|
$78.96 |
$78.96 |
$78.96 |
$185.67
|
|
Ihc/icc per specimen each additional single antibody stain
|
$79.29 |
$79.29 |
$79.29 |
$187.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$174.12 |
$174.12 |
$174.12 |
$274.86
|
|
Iliac/fem angio cath insert
|
$1,410.45 |
$1,410.45 |
$1,410.45 |
$2,070.72
|
|
Iliac revasc add-on 37222
|
$6,684.72 |
$6,684.72 |
$6,684.72 |
$8,583.60
|
|
Immune complex assay
|
$86.81 |
$86.81 |
$86.81 |
$89.25
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$182.16 |
$182.16 |
$182.16 |
$2,621.62
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$200.72 |
$200.72 |
$200.72 |
$3,132.49
|
|
Immunoassay tumor antigen quantitative ca 125
|
$69.66 |
$69.66 |
$69.66 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$83.06 |
$83.06 |
$83.06 |
$117.00
|
|
Immunodiff gel qual ea antigen/ab
|
$14.96 |
$14.96 |
$14.96 |
$58.25
|
|
Immunofixation electrophoresis serum
|
$18.81 |
$18.81 |
$18.81 |
$133.38
|
|
Immunofluorescence per specimen initial single antibody stain
|
$243.92 |
$243.92 |
$243.92 |
$288.00
|
|
Immunoglobulin assay
|
$94.38 |
$94.38 |
$94.38 |
$74.15
|
|
In-111 autol wbc diag per dose
|
$3,926.84 |
$3,926.84 |
$3,926.84 |
$3,785.34
|
|
In-111 pentetate dtpa / 0.5 mci
|
$3,827.64 |
$3,827.64 |
$3,827.64 |
$2,156.25
|
|
In-111 pentetreotide
|
$7,278.98 |
$7,278.98 |
$7,278.98 |
$6,862.70
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,462.71 |
$1,462.71 |
$1,462.71 |
$2,056.93
|
|
Infect ag drug suscept pheno predict
|
$443.01 |
$443.01 |
$443.01 |
$382.20
|
|
Infect ag genotype na cytomegalovirus
|
$1,483.20 |
$1,483.20 |
$1,483.20 |
$577.60
|
|
Infect ag genotype na hiv-1 other region
|
$63.78 |
$63.78 |
$63.78 |
$390.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$603.83 |
$603.83 |
$603.83 |
$619.11
|
|
Infect ag if hep delta agent
|
$349.55 |
$349.55 |
$349.55 |
$125.97
|
|
Infect ag na hep b amp
|
$252.87 |
$252.87 |
$252.87 |
$108.44
|
|
Infect ag na hpv high-risk types
|
$116.97 |
$116.97 |
$116.97 |
$147.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$222.98 |
$222.98 |
$222.98 |
$248.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$141.99 |
$141.99 |
$141.99 |
$127.50
|
|
Infect ag na resp virus 12-25 targets
|
$441.47 |
$441.47 |
$441.47 |
$878.20
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,675.79 |
$1,675.79 |
$1,675.79 |
$843.26
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$28.64 |
$28.64 |
$28.64 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$91.10 |
$91.10 |
$91.10 |
$76.00
|