|
Hydration IV infusion each additional hour
|
$79.50 |
$79.50 |
$79.50 |
$131.20
|
|
Hydration IV infusion initial 31minutes - 1 hour
|
$237.60 |
$237.60 |
$237.60 |
$383.00
|
|
Hydrocortisone in ns IV syringe 1 mg/ml (neo/ped) - cnr
|
$158.86 |
$158.86 |
$158.86 |
$154.78
|
|
Hydromorphone 0.2 mg/ml in 0.9% nacl IV pca opioid naive - 4 hr dose limit (wrapper)
|
$176.55 |
$176.55 |
$176.55 |
$131.47
|
|
Hydromorphone 20-0.9 mg/100ml-% soln 100 ml cartridge
|
$9.00 |
$9.00 |
$9.00 |
$294.92
|
|
Hydroxyzine hcl 50 mg/ml intramuscular solution
|
$111.25 |
$111.25 |
$111.25 |
$72.65
|
|
#hypersens-actinomyces ab
|
$18.90 |
$18.90 |
$18.90 |
$31.74
|
|
Hysteroscopy biopsy
|
$7,140.51 |
$7,140.51 |
$7,140.51 |
$5,110.50
|
|
I-123 iobenguane diag
|
$10,636.20 |
$10,636.20 |
$10,636.20 |
$5,256.50
|
|
I-123 ioflupane diag
|
$6,220.80 |
$6,220.80 |
$6,220.80 |
$3,887.10
|
|
I-123 sod iodide diag per 100 uci
|
$405.60 |
$405.60 |
$405.60 |
$139.20
|
|
Icd cobalt xt dr MRI is1 df1
|
$48,592.66 |
$48,592.66 |
$48,592.66 |
$34,234.20
|
|
Icd crtd cobalt hf MRI is1 df1
|
$47,153.25 |
$47,153.25 |
$47,153.25 |
$37,789.50
|
|
Icd crtp serena MRI
|
$38,053.50 |
$38,053.50 |
$38,053.50 |
$14,346.00
|
|
Icd reliance df4 ib 64cm
|
$44,962.69 |
$44,962.69 |
$44,962.69 |
$9,259.80
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$1,976.70 |
$1,976.70 |
$1,976.70 |
$3,771.20
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$1,794.30 |
$1,794.30 |
$1,794.30 |
$3,322.80
|
|
Ifosfamide 1 gram intravenous solution
|
$138.88 |
$138.88 |
$138.88 |
$243.78
|
|
Ihc/icc per specimen each additional single antibody stain
|
$110.40 |
$110.40 |
$110.40 |
$191.52
|
|
Ihc/icc per specimen initial single antibody stain
|
$124.50 |
$124.50 |
$124.50 |
$274.86
|
|
Immob elbow child sm
|
$1,015.98 |
$1,015.98 |
$1,015.98 |
$74.20
|
|
Immobilizer shldr cntor adlt
|
$413.62 |
$413.62 |
$413.62 |
$171.43
|
|
Immobilizer shldr dlx str 24-36in med
|
$477.95 |
$477.95 |
$477.95 |
$102.00
|
|
Immobilizer shldr sling med
|
$490.71 |
$490.71 |
$490.71 |
$99.45
|
|
Immunoassay tumor antigen quantitative ca 125
|
$206.10 |
$206.10 |
$206.10 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$54.00 |
$54.00 |
$54.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$21.60 |
$21.60 |
$21.60 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$58.20 |
$58.20 |
$58.20 |
$138.60
|
|
Immunology procedure
|
$53.10 |
$53.10 |
$53.10 |
$118.25
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$4,222.28 |
$4,222.28 |
$4,222.28 |
$3,840.76
|
|
Implant cartilage 10mm synthetic
|
$3,072.80 |
$3,072.80 |
$3,072.80 |
$10,050.00
|
|
Implant cochlear osia osi300
|
$20,681.25 |
$20,681.25 |
$20,681.25 |
$17,423.06
|
|
Implant ureth bulk agent
|
$3,391.72 |
$3,391.72 |
$3,391.72 |
$2,139.62
|
|
Impl ear abutment ba300 9mm
|
$6,127.23 |
$6,127.23 |
$6,127.23 |
$3,974.88
|
|
In-111 oxyquinolin per 0.5 mci
|
$3,684.00 |
$3,684.00 |
$3,684.00 |
$2,568.98
|
|
In-111 pentetate dtpa / 0.5 mci
|
$8,190.90 |
$8,190.90 |
$8,190.90 |
$2,550.60
|
|
In-111 pentetreotide
|
$3,015.00 |
$3,015.00 |
$3,015.00 |
$4,944.55
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,041.90 |
$1,041.90 |
$1,041.90 |
$2,080.80
|
|
Incision of breast lesion
|
$1,041.90 |
$1,041.90 |
$1,041.90 |
$2,577.85
|
|
Incision of burn scab initi
|
$259.20 |
$259.20 |
$259.20 |
$494.40
|
|
Incision of metatarsal
|
$20,753.40 |
$20,753.40 |
$20,753.40 |
$3,591.33
|
|
Incision tendon sheath
|
$5,426.57 |
$5,426.57 |
$5,426.57 |
$3,073.20
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$110.70 |
$110.70 |
$110.70 |
$131.20
|
|
Infect ag drug suscept pheno predict
|
$237.90 |
$237.90 |
$237.90 |
$320.00
|
|
Infect ag genotype na cytomegalovirus
|
$405.30 |
$405.30 |
$405.30 |
$636.35
|
|
Infect ag genotype na dna hepatitis b
|
$405.30 |
$405.30 |
$405.30 |
$427.43
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$821.10 |
$821.10 |
$821.10 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$37.50 |
$37.50 |
$37.50 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$73.80 |
$73.80 |
$73.80 |
$73.46
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$50.10 |
$50.10 |
$50.10 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$40.50 |
$40.50 |
$40.50 |
$69.44
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$59.10 |
$59.10 |
$59.10 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$53.70 |
$53.70 |
$53.70 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$114.00 |
$114.00 |
$114.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$65.10 |
$65.10 |
$65.10 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$183.30 |
$183.30 |
$183.30 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$184.50 |
$184.50 |
$184.50 |
$97.50
|
|
Infectious agent nucleic acid amplified probe
|
$132.30 |
$132.30 |
$132.30 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$97.80 |
$97.80 |
$97.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$94.20 |
$94.20 |
$94.20 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$687.90 |
$687.90 |
$687.90 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$97.80 |
$97.80 |
$97.80 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$67.50 |
$67.50 |
$67.50 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$103.50 |
$103.50 |
$103.50 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$65.10 |
$65.10 |
$65.10 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$136.80 |
$136.80 |
$136.80 |
$217.70
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$57.90 |
$57.90 |
$57.90 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$429.00 |
$429.00 |
$429.00 |
$105.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$115.20 |
$115.20 |
$115.20 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$131.10 |
$131.10 |
$131.10 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$201.90 |
$201.90 |
$201.90 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$529.20 |
$529.20 |
$529.20 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$539.70 |
$539.70 |
$539.70 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$146.40 |
$146.40 |
$146.40 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$363.60 |
$363.60 |
$363.60 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$366.60 |
$366.60 |
$366.60 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$247.50 |
$247.50 |
$247.50 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$5,850.78 |
$5,850.78 |
$5,850.78 |
$2,080.86
|
|
Initiation & management bipap/cpap initial day
|
$231.60 |
$231.60 |
$231.60 |
$576.00
|
|
Inj., benralizumab, 1 mg
|
$29,293.72 |
$29,293.72 |
$29,293.72 |
$11,604.71
|
|
Inj, clindamycin (baxter)
|
$45.87 |
$45.87 |
$45.87 |
$48.39
|
|
Inj cntr knee arthro incl ct/mri
|
$405.00 |
$405.00 |
$405.00 |
$436.80
|
|
Inj, cyclophosphamd, sandoz
|
$455.11 |
$455.11 |
$455.11 |
$735.20
|
|
Inj daptomycin (xellia)
|
$300.60 |
$300.60 |
$300.60 |
$56.04
|
|
Injection arthrography hip without anesthesia (both sides)
|
$405.00 |
$405.00 |
$405.00 |
$500.50
|
|
Injection, doxercalciferol
|
$9.00 |
$9.00 |
$9.00 |
$23.12
|
|
Injection epidural blood patch or clot
|
$672.00 |
$672.00 |
$672.00 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$145.20 |
$145.20 |
$145.20 |
$441.12
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$405.00 |
$405.00 |
$405.00 |
$494.65
|
|
Injection, inclisiran, 1 mg
|
$17,974.53 |
$17,974.53 |
$17,974.53 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$3,261.51 |
$3,261.51 |
$3,261.51 |
$2,241.61
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$537.30 |
$537.30 |
$537.30 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$672.00 |
$672.00 |
$672.00 |
$1,045.65
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$748.80 |
$748.80 |
$748.80 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$888.00 |
$888.00 |
$888.00 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,251.00 |
$1,251.00 |
$1,251.00 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$888.00 |
$888.00 |
$888.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$672.00 |
$672.00 |
$672.00 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$672.00 |
$672.00 |
$672.00 |
$1,704.78
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$189.00 |
$189.00 |
$189.00 |
$517.24
|
