|
I-123 sod iodide diag per 100 uci
|
$92.50 |
$154.20 |
$840.00 |
|
|
I-131 iobenguane sulf diag mibg
|
$2,932.50 |
$2,932.50 |
$2,932.50 |
|
|
I131 iodide cap, rx
|
$38.00 |
$600.00 |
$5,852.00 |
|
|
I131 iodide sol, rx
|
$88.00 |
$88.00 |
$3,260.00 |
|
|
I131 max 100uci
|
$5.00 |
$65.50 |
$8,800.00 |
|
|
Iadna legionella pneumophila amplified probe tq
|
$32.50 |
$32.50 |
$52.00 |
|
|
Ia infect ag ab qual/semiquant sgl step
|
$53.50 |
$78.00 |
$81.50 |
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$97.79 |
$97.79 |
$1,672.20 |
|
|
Ibutilide fumarate 0.1 mg/ml intravenous solution
|
$191.16 |
$191.16 |
$191.16 |
|
|
Icd cobalt xt dr MRI is1 df1
|
$8,528.50 |
$13,650.50 |
$51,889.60 |
|
|
Icd crtd cobalt hf MRI is1 df1
|
$14,475.04 |
$16,785.00 |
$34,274.52 |
|
|
Icd crtp serena MRI
|
$5,711.00 |
$8,606.00 |
$10,012.50 |
|
|
Icd reliance df4 ib 64cm
|
$1,441.19 |
$3,646.00 |
$6,313.50 |
|
|
Icg angiography i&r uni/bi
|
$470.00 |
$470.00 |
$470.00 |
|
|
Icut allergy test drug/bug
|
$1.00 |
$2.40 |
$808.00 |
|
|
Icut allergy titrate-airborn
|
$4.50 |
$8.00 |
$1,720.00 |
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$2,200.00 |
$2,200.00 |
$2,200.00 |
|
|
Idarubicin hcl injection
|
$165.78 |
$165.78 |
$165.78 |
|
|
I&d/bursa/foot 28001
|
$100.00 |
$100.50 |
$880.00 |
|
|
Idecabtagene vicleucel car
|
$498,407.95 |
$498,407.95 |
$498,407.95 |
|
|
Idet single level
|
$11,429.00 |
$11,429.00 |
$11,429.00 |
|
|
I&d frarm&/wrst deep absc/hematoma
|
$689.50 |
$734.50 |
$7,690.08 |
|
|
Idh1 common variants
|
$331.25 |
$331.25 |
$331.25 |
|
|
Idh2 common variants
|
$332.50 |
$332.50 |
$332.50 |
|
|
I&d intramural/intramuscular/submuc abscess transanal anes
|
$461.50 |
$501.00 |
$3,812.50 |
|
|
I&d lacrimal gland
|
$124.00 |
$132.00 |
$198.40 |
|
|
I&d lacrimal sac
|
$155.50 |
$155.50 |
$3,996.50 |
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$229.00 |
$232.00 |
$371.20 |
|
|
I & d vag hematoma non-ob 57023
|
$326.50 |
$326.50 |
$522.40 |
|
|
Ifosfamide 1 gram intravenous solution
|
$41.50 |
$62.00 |
$162.96 |
|
|
Igh gene rearrang dir probe
|
$578.00 |
$578.00 |
$578.00 |
|
|
Igh gene rearrange amp meth
|
$199.50 |
$516.00 |
$1,818.50 |
|
|
Igh@ var region somatic mutation analy
|
$465.00 |
$550.00 |
$1,724.00 |
|
|
Igk rearrangeabn clonal pop
|
$199.50 |
$619.00 |
$1,140.00 |
|
|
Ihc/icc per specimen each additional single antibody stain
|
$89.00 |
$351.00 |
$1,998.00 |
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$40.00 |
$183.50 |
$4,560.00 |
|
|
Ihc/icc per specimen initial single antibody stain
|
$87.50 |
$204.00 |
$1,338.00 |
|
|
Iiv3 vacc no prsv 0.25 ml im
|
$15.00 |
$16.50 |
$16.50 |
|
|
Ikbkap gene
|
$25.50 |
$25.50 |
$168.00 |
|
|
Ileostomy/jejunostomy non-tube 44310
|
$1,108.50 |
$1,131.50 |
$1,810.40 |
|
|
Iliac/fem angio cath insert
|
$546.00 |
$1,793.00 |
$6,609.00 |
|
|
Iliac revasc add-on 37222
|
$197.50 |
$749.00 |
$6,469.33 |
|
|
Imbrication/diaphragm/transthor/transabd 39545
|
$956.00 |
$1,017.00 |
$6,412.62 |
|
|
Img rta detcj/mntr ds staff
|
$29.50 |
$29.50 |
$47.20 |
|
|
Img rta detc/mntr ds phy/qhp
|
$19.50 |
$19.50 |
$31.20 |
|
|
Img rta detc/mntr ds poc aly
|
$29.50 |
$56.50 |
$91.20 |
|
|
Immntx 4 sting insects
|
$68.00 |
$74.00 |
$860.00 |
|
|
Immntx 5 sting insects
|
$117.50 |
$127.50 |
$160.50 |
|
|
Immob elbow child sm
|
$42.50 |
$42.50 |
$42.50 |
|
|
Immobilizer shldr cntor adlt
|
$63.97 |
$67.00 |
$115.50 |
|
|
Immobilizer shldr dlx str 24-36in med
|
$37.50 |
$92.00 |
$163.50 |
|
|
Immt breast prosthesis 19340
|
$40,570.00 |
$40,570.00 |
$40,570.00 |
|
|
Immune complex assay
|
$157.00 |
$157.00 |
$1,078.00 |
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$84.50 |
$126.50 |
$15,268.20 |
|
|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$116.00 |
$173.50 |
$10,789.73 |
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$9,790.88 |
$9,790.88 |
$9,790.88 |
|
|
Immune globulin ig human im use 90281
|
$143.00 |
$214.00 |
$228.80 |
|
|
Immunoassay tumor antigen quantitative ca 125
|
$28.80 |
$117.50 |
$699.60 |
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$31.00 |
$120.50 |
$192.60 |
|
|
Immunodiff gel qual ea antigen/ab
|
$9.00 |
$14.00 |
$77.50 |
|
|
Immunodiffusion nes
|
$52.00 |
$52.00 |
$172.50 |
|
|
Immunofixation electrophoresis serum
|
$150.00 |
$150.00 |
$349.20 |
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$88.00 |
$151.00 |
$1,452.50 |
|
|
Immunofluorescence per specimen initial single antibody stain
|
$230.00 |
$230.00 |
$999.50 |
|
|
Immunoglobulin assay
|
$18.00 |
$60.00 |
$265.50 |
|
|
Immunology procedure
|
$72.00 |
$72.00 |
$720.50 |
|
|
Impedence cardiogram
|
$585.50 |
$585.50 |
$585.50 |
|
|
Impl absrb msh/prsth dly cls
|
$422.00 |
$422.00 |
$675.20 |
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$1,183.50 |
$1,337.50 |
$2,135.00 |
|
|
Implant biventricular device 33976
|
$16,952.00 |
$16,952.00 |
$16,952.00 |
|
|
Implant cartilage 10mm synthetic
|
$554.00 |
$1,328.00 |
$8,709.38 |
|
|
Implant cochlear device
|
$3,061.80 |
$3,061.80 |
$27,962.00 |
|
|
Implant cochlear osia osi300
|
$2,898.00 |
$3,274.50 |
$6,703.20 |
|
|
Implant eye drug system
|
$8,892.00 |
$8,892.00 |
$8,892.00 |
|
|
Implant hormone pellet(s) 11980
|
$496.00 |
$513.50 |
$714.00 |
|
|
Implant nerve end
|
$2,349.50 |
$2,349.50 |
$2,349.50 |
|
|
Implant neuroelectrode
|
$7,056.67 |
$7,056.67 |
$7,056.67 |
|
|
Implant neuroelectrode
|
$24,703.00 |
$24,703.00 |
$24,703.00 |
|
|
Implant neuroelectrodes
|
$5,237.00 |
$17,995.00 |
$20,654.50 |
|
|
Implant neuroelectrodes
|
$532.80 |
$3,370.00 |
$9,976.00 |
|
|
Implant neuroelectrodes
|
$312.50 |
$2,919.50 |
$21,298.00 |
|
|
Implant neuroelectrodes
|
$7,255.34 |
$7,255.34 |
$7,255.34 |
|
|
Implant neuroelectrodes
|
$19,409.00 |
$19,409.00 |
$19,409.00 |
|
|
Implant neurostim arrays
|
$4,921.50 |
$4,921.50 |
$4,921.50 |
|
|
Implant pulse generator remede el
|
$21,885.00 |
$21,885.00 |
$21,885.00 |
|
|
Implant single ventricular device 33975
|
$13,820.00 |
$13,820.00 |
$13,820.00 |
|
|
Implant spine infusion pump
|
$6,879.00 |
$7,595.34 |
$15,552.50 |
|
|
Implant tcat pulm vlv perq
|
$7,524.50 |
$7,524.50 |
$7,524.50 |
|
|
Implant ureth bulk agent
|
$656.00 |
$1,718.75 |
$1,718.75 |
|
|
Impl ear abutment ba300 9mm
|
$2,078.78 |
$2,315.50 |
$2,688.50 |
|
|
Impl neurostim electr perc
|
$425.50 |
$3,538.50 |
$29,986.00 |
|
|
Implnt bio implnt for soft tiss reinforcement 15777
|
$2,696.83 |
$3,917.67 |
$10,220.00 |
|
|
Implnt spinl canal catheter 62350
|
$3,797.67 |
$4,963.00 |
$9,951.50 |
|
|
Impl oi implt sk tc esp<100
|
$12,913.00 |
$18,368.50 |
$24,178.50 |
|
|
Impl oi implt skull perq esp
|
$2,092.80 |
$7,598.50 |
$18,914.50 |
|
|
Impltj ntrstrml crnl rng seg
|
$3,786.00 |
$3,786.00 |
$4,521.50 |
|
|
Impres&prep auricular prosth
|
$4,743.00 |
$4,743.00 |
$4,743.00 |
|
|
Impres&prep oral surg splint
|
$298.00 |
$326.00 |
$404.00 |
|
|
In-111 autol wbc diag per dose
|
$1,160.00 |
$1,948.50 |
$3,648.00 |
|
|
In-111 capromab pendet
|
$3,112.00 |
$5,266.00 |
$5,266.00 |
|
