|
Infect ag if pneumocystis carinii
|
$15.73 |
$15.73 |
$15.73 |
$66.06
|
|
Infect ag if varicella zoster
|
$12.42 |
$12.42 |
$12.42 |
$72.00
|
|
Infect ag na hep b amp
|
$27.94 |
$27.94 |
$27.94 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$26.70 |
$26.70 |
$26.70 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$21.94 |
$21.94 |
$21.94 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$59.62 |
$59.62 |
$59.62 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$61.89 |
$61.89 |
$61.89 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$258.96 |
$258.96 |
$258.96 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$12.42 |
$12.42 |
$12.42 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$13.66 |
$13.66 |
$13.66 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$15.32 |
$15.32 |
$15.32 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$47.82 |
$47.82 |
$47.82 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$17.59 |
$17.59 |
$17.59 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$18.01 |
$18.01 |
$18.01 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$32.50 |
$32.50 |
$32.50 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$7.45 |
$7.45 |
$7.45 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$13.25 |
$13.25 |
$13.25 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$87.15 |
$87.15 |
$87.15 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$23.80 |
$23.80 |
$23.80 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$23.18 |
$23.18 |
$23.18 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$258.96 |
$258.96 |
$258.96 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$21.94 |
$21.94 |
$21.94 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$21.94 |
$21.94 |
$21.94 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$26.08 |
$26.08 |
$26.08 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$21.94 |
$21.94 |
$21.94 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$31.88 |
$31.88 |
$31.88 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$19.87 |
$19.87 |
$19.87 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$21.94 |
$21.94 |
$21.94 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$22.98 |
$22.98 |
$22.98 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$258.96 |
$258.96 |
$258.96 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$56.92 |
$56.92 |
$56.92 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$26.70 |
$26.70 |
$26.70 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$30.43 |
$30.43 |
$30.43 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$52.99 |
$52.99 |
$52.99 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$88.60 |
$88.60 |
$88.60 |
$304.20
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$54.46 |
$54.46 |
$54.46 |
$296.00
|
|
Inj cntr knee arthro incl ct/mri
|
$128.80 |
$128.80 |
$128.80 |
$436.80
|
|
Inj dx for sinogram
|
$75.62 |
$75.62 |
$75.62 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$177.00 |
$177.00 |
$177.00 |
$503.50
|
|
Injection during cath supravalvular aortography
|
$211.36 |
$211.36 |
$211.36 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$393.89 |
$393.89 |
$393.89 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$198.61 |
$198.61 |
$198.61 |
$436.00
|
|
Injection for bladder x-ray
|
$141.27 |
$141.27 |
$141.27 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$192.79 |
$192.79 |
$192.79 |
$497.76
|
|
Injection for ureter x-ray
|
$64.82 |
$64.82 |
$64.82 |
$515.21
|
|
Injection radioactive tracer sentinel node (both sides)
|
$411.90 |
$411.90 |
$411.90 |
$685.44
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$758.70 |
$758.70 |
$758.70 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$604.97 |
$604.97 |
$604.97 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,231.27 |
$1,231.27 |
$1,231.27 |
$2,006.79
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$63.53 |
$63.53 |
$63.53 |
$145.60
|
|
Inject sacroiliac joint
|
$372.84 |
$372.84 |
$372.84 |
$1,029.04
|
|
Inj for ext venography
|
$201.66 |
$201.66 |
$201.66 |
$628.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$231.80 |
$231.80 |
$231.80 |
$1,492.00
|
|
Inj hrt cath w/s&i sel right vent
|
$193.17 |
$193.17 |
$193.17 |
$999.96
|
|
Inj ivig privigen 500 mg
|
$3.59 |
$3.59 |
$3.59 |
$6,967.29
|
|
Inj multihance
|
$0.36 |
$0.36 |
$0.36 |
$70.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$545.97 |
$545.97 |
$545.97 |
$1,413.35
|
|
Inj peritoneal venous shunt
|
$79.50 |
$79.50 |
$79.50 |
$406.80
|
|
Inj proc ankle arthr
|
$231.85 |
$231.85 |
$231.85 |
$405.31
|
|
Inj proc elbow arthro
|
$215.23 |
$215.23 |
$215.23 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$261.49 |
$261.49 |
$261.49 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$281.16 |
$281.16 |
$281.16 |
$838.30
|
|
Inj proc sialogram
|
$131.85 |
$131.85 |
$131.85 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$1.20 |
$1.20 |
$1.20 |
$349.45
|
|
Inj retro urethrocysto
|
$71.74 |
$71.74 |
$71.74 |
$447.74
|
|
Inj w/fluor eval cv device
|
$192.24 |
$192.24 |
$192.24 |
$504.40
|
|
Ins cath ren art 1st bi
|
$2,189.41 |
$2,189.41 |
$2,189.41 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$1,686.38 |
$1,686.38 |
$1,686.38 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$2,818.20 |
$2,818.20 |
$2,818.20 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$2,160.05 |
$2,160.05 |
$2,160.05 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$326.46 |
$326.46 |
$326.46 |
$490.73
|
|
Insert cath pleura with image
|
$855.93 |
$855.93 |
$855.93 |
$2,194.40
|
|
Insert hepatic shunt (tips)
|
$2,319.04 |
$2,319.04 |
$2,319.04 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$52.63 |
$52.63 |
$52.63 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,274.20 |
$1,274.20 |
$1,274.20 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,712.69 |
$1,712.69 |
$1,712.69 |
$2,447.63
|
|
Insertion intra-aortic circulation dev 33970
|
$222.99 |
$222.99 |
$222.99 |
$1,752.40
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$1,909.36 |
$1,909.36 |
$1,909.36 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,090.83 |
$1,090.83 |
$1,090.83 |
$2,585.25
|
|
Insertion of catheter vein
|
$472.01 |
$472.01 |
$472.01 |
$1,525.80
|
|
Insertion of catheter vein
|
$295.01 |
$295.01 |
$295.01 |
$870.59
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$5,818.38 |
$5,818.38 |
$5,818.38 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$4,014.84 |
$4,014.84 |
$4,014.84 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$4,314.00 |
$4,314.00 |
$4,314.00 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$758.70 |
$758.70 |
$758.70 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$790.84 |
$790.84 |
$790.84 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$6,091.51 |
$6,091.51 |
$6,091.51 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$1,984.43 |
$1,984.43 |
$1,984.43 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$2,209.91 |
$2,209.91 |
$2,209.91 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$3,089.94 |
$3,089.94 |
$3,089.94 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$1,580.84 |
$1,580.84 |
$1,580.84 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$2,547.85 |
$2,547.85 |
$2,547.85 |
$7,115.90
|
|
Insert swan-ganz cath
|
$1,227.38 |
$1,227.38 |
$1,227.38 |
$2,164.52
|
|
Insert tunneled cv 2cath 2sits without port/pmp 36565
|
$2,086.64 |
$2,086.64 |
$2,086.64 |
$4,997.60
|
|
Ins icd gen exist sgl lead
|
$4,321.20 |
$4,321.20 |
$4,321.20 |
$23,230.50
|
|
Insitu hybridization auto
|
$174.50 |
$174.50 |
$174.50 |
$377.37
|
|
Insitu hybridization (fish)
|
$229.00 |
$229.00 |
$229.00 |
$481.00
|
|
Insitu hybridization manual
|
$174.50 |
$174.50 |
$174.50 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$106.48 |
$106.48 |
$106.48 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$139.92 |
$139.92 |
$139.92 |
$338.40
|