|
Hydrocolld drg <=16 in w/bdr
|
$5.70 |
$5.70 |
$5.70 |
$5.57
|
|
Hydrocolld drg <=16 without bdr
|
$5.18 |
$5.18 |
$5.18 |
$7.76
|
|
Hydrogel drg <= 16 in w/bdr
|
$6.73 |
$6.73 |
$6.73 |
$30.14
|
|
Hydrogel drsg gel filler
|
$18.12 |
$18.12 |
$18.12 |
$32.50
|
|
Hydrxycorticsterds 17- (17-ohcs)
|
$80.50 |
$80.50 |
$80.50 |
$75.24
|
|
#hypersens-actinomyces ab
|
$46.50 |
$46.50 |
$46.50 |
$29.70
|
|
Hysterosalpingography s&i
|
$219.50 |
$219.50 |
$219.50 |
$663.50
|
|
I-123 iobenguane diag
|
$2,022.50 |
$2,022.50 |
$2,022.50 |
$5,170.70
|
|
I-123 ioflupane diag
|
$2,137.00 |
$2,137.00 |
$2,137.00 |
$3,937.60
|
|
I-123 sod iodide diag per 100 uci
|
$78.50 |
$78.50 |
$78.50 |
$139.20
|
|
I131 iodide cap, rx
|
$41.50 |
$41.50 |
$41.50 |
$71.70
|
|
I131 iodide sol, rx
|
$18.50 |
$18.50 |
$18.50 |
$32.40
|
|
Iadna legionella pneumophila amplified probe tq
|
$167.00 |
$167.00 |
$167.00 |
$109.00
|
|
Ia infect ag ab qual/semiquant sgl step
|
$90.50 |
$90.50 |
$90.50 |
$50.60
|
|
Ia nfct ab sarscov2 covid19
|
$23.00 |
$23.00 |
$23.00 |
$58.03
|
|
Icd cobalt xt dr MRI is1 df1
|
$20,608.40 |
$20,608.40 |
$20,608.40 |
$35,347.68
|
|
Icd crtd cobalt hf MRI is1 df1
|
$20,608.40 |
$20,608.40 |
$20,608.40 |
$39,398.40
|
|
Icd crtp serena MRI
|
$9,880.63 |
$9,880.63 |
$9,880.63 |
$14,360.25
|
|
Icd reliance df4 ib 64cm
|
$5,681.12 |
$5,681.12 |
$5,681.12 |
$9,363.28
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$2,721.00 |
$2,721.00 |
$2,721.00 |
$3,771.20
|
|
I&d frarm&/wrst deep absc/hematoma
|
$4,786.50 |
$4,786.50 |
$4,786.50 |
$3,839.54
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$1,936.50 |
$1,936.50 |
$1,936.50 |
$3,245.23
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$1,393.00 |
$1,393.00 |
$1,393.00 |
$3,355.20
|
|
I & d vag hematoma non-ob 57023
|
$1,444.50 |
$1,444.50 |
$1,444.50 |
$3,435.60
|
|
Ifnl3 gene
|
$138.50 |
$138.50 |
$138.50 |
$143.40
|
|
Igh gene rearrange amp meth
|
$260.50 |
$260.50 |
$260.50 |
$464.00
|
|
Igh@ var region somatic mutation analy
|
$1,138.50 |
$1,138.50 |
$1,138.50 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$417.00 |
$417.00 |
$417.00 |
$399.36
|
|
Ihc/icc per specimen each additional single antibody stain
|
$158.00 |
$158.00 |
$158.00 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$264.50 |
$264.50 |
$264.50 |
$322.55
|
|
Ihc/icc per specimen initial single antibody stain
|
$139.00 |
$139.00 |
$139.00 |
$272.30
|
|
Iliac/fem angio cath insert
|
$58.00 |
$58.00 |
$58.00 |
$1,856.01
|
|
Iliac revasc add-on 37222
|
$1,829.00 |
$1,829.00 |
$1,829.00 |
$6,082.65
|
|
Img rta detcj/mntr ds staff
|
$61.50 |
$61.50 |
$61.50 |
$70.29
|
|
Immob elbow child sm
|
$82.50 |
$82.50 |
$82.50 |
$82.50
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$33.64 |
$33.64 |
$33.64 |
$307.80
|
|
Immobilizer shldr cntor adlt
|
$123.97 |
$123.97 |
$123.97 |
$175.47
|
|
Immobilizer shldr dlx str 24-36in med
|
$59.52 |
$59.52 |
$59.52 |
$110.00
|
|
Immune complex assay
|
$108.00 |
$108.00 |
$108.00 |
$109.20
|
|
Immunoassay tumor antigen quantitative ca 125
|
$88.00 |
$88.00 |
$88.00 |
$131.57
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$88.00 |
$88.00 |
$88.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$51.00 |
$51.00 |
$51.00 |
$48.57
|
|
Immunodiffusion nes
|
$61.50 |
$61.50 |
$61.50 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$34.00 |
$34.00 |
$34.00 |
$141.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$137.00 |
$137.00 |
$137.00 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$165.00 |
$165.00 |
$165.00 |
$232.96
|
|
Immunoglobulin assay
|
$42.50 |
$42.50 |
$42.50 |
$74.15
|
|
Implant neuroelectrodes
|
$10,666.00 |
$10,666.00 |
$10,666.00 |
$7,270.51
|
|
Impl neurostim electr perc
|
$3,988.00 |
$3,988.00 |
$3,988.00 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$3,373.50 |
$3,373.50 |
$3,373.50 |
$5,110.00
|
|
Implt neurostim elctr each
|
$350.35 |
$350.35 |
$350.35 |
$4,449.13
|
|
Impreg gauze no h20/sal/yard
|
$11.90 |
$11.90 |
$11.90 |
$11.90
|
|
In-111 autol wbc diag per dose
|
$1,928.00 |
$1,928.00 |
$1,928.00 |
$3,523.65
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,340.00 |
$1,340.00 |
$1,340.00 |
$2,565.10
|
|
In-111 pentetreotide
|
$3,584.00 |
$3,584.00 |
$3,584.00 |
$4,961.43
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,757.00 |
$1,757.00 |
$1,757.00 |
$2,080.80
|
|
Incision of breast lesion
|
$1,757.00 |
$1,757.00 |
$1,757.00 |
$2,577.85
|
|
Incision of burn scab initi
|
$339.50 |
$339.50 |
$339.50 |
$494.40
|
|
Incision of foot tendon 28234
|
$756.50 |
$756.50 |
$756.50 |
$2,116.27
|
|
Incision of hip tendon
|
$2,723.50 |
$2,723.50 |
$2,723.50 |
$2,861.60
|
|
Incision of tendon & muscle
|
$3,805.00 |
$3,805.00 |
$3,805.00 |
$5,376.00
|
|
Incision of thigh tendon
|
$2,860.00 |
$2,860.00 |
$2,860.00 |
$4,350.00
|
|
Incision of tongue fold
|
$710.50 |
$710.50 |
$710.50 |
$1,792.50
|
|
Incision tendon sheath
|
$1,010.50 |
$1,010.50 |
$1,010.50 |
$3,073.20
|
|
Incisn of toe tndn
|
$2,369.50 |
$2,369.50 |
$2,369.50 |
$2,539.80
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$1,565.50 |
$1,565.50 |
$1,565.50 |
$1,881.75
|
|
Infec agen detec ampli probe
|
$12.50 |
$12.50 |
$12.50 |
$26.00
|
|
Infect ag drug suscept pheno predict
|
$662.00 |
$662.00 |
$662.00 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$530.00 |
$530.00 |
$530.00 |
$340.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,154.50 |
$1,154.50 |
$1,154.50 |
$603.75
|
|
Infect ag ia direct hiv-1 antgn
|
$96.50 |
$96.50 |
$96.50 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$62.00 |
$62.00 |
$62.00 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$31.50 |
$31.50 |
$31.50 |
$68.40
|
|
Infect ag if legionella pneumophila
|
$61.00 |
$61.00 |
$61.00 |
$72.58
|
|
Infect ag na hep b amp
|
$120.50 |
$120.50 |
$120.50 |
$108.44
|
|
Infect ag na herpes simplex quant
|
$167.00 |
$167.00 |
$167.00 |
$168.50
|
|
Infect ag na hpv high-risk types
|
$49.50 |
$49.50 |
$49.50 |
$139.32
|
|
Infect ag na influenza r/amp 1st 2 types
|
$247.00 |
$247.00 |
$247.00 |
$217.88
|
|
Infect ag na orthopoxvirus amp prb each
|
$38.50 |
$38.50 |
$38.50 |
$100.46
|
|
Infect ag na resp virus 12-25 targets
|
$258.00 |
$258.00 |
$258.00 |
$845.40
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$2,471.50 |
$2,471.50 |
$2,471.50 |
$886.26
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$135.00 |
$135.00 |
$135.00 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$10.50 |
$10.50 |
$10.50 |
$82.50
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$61.50 |
$61.50 |
$61.50 |
$72.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$29.50 |
$29.50 |
$29.50 |
$76.45
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$61.50 |
$61.50 |
$61.50 |
$75.40
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$186.50 |
$186.50 |
$186.50 |
$96.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$52.00 |
$52.00 |
$52.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$61.50 |
$61.50 |
$61.50 |
$130.90
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$58.50 |
$58.50 |
$58.50 |
$99.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$58.50 |
$58.50 |
$58.50 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$167.00 |
$167.00 |
$167.00 |
$275.00
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$167.00 |
$167.00 |
$167.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$35.00 |
$35.00 |
$35.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$463.50 |
$463.50 |
$463.50 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$167.00 |
$167.00 |
$167.00 |
$184.50
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$145.00 |
$145.00 |
$145.00 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$138.50 |
$138.50 |
$138.50 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$167.00 |
$167.00 |
$167.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$54.00 |
$54.00 |
$54.00 |
$103.20
|