|
Incision & drainage hematoma/seroma/fluid collection
|
$716.10 |
$716.10 |
$716.10 |
$2,086.70
|
|
Infect ag drug suscept pheno predict
|
$99.18 |
$99.18 |
$99.18 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$195.57 |
$195.57 |
$195.57 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$195.57 |
$195.57 |
$195.57 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$97.91 |
$97.91 |
$97.91 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$195.57 |
$195.57 |
$195.57 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$12.65 |
$12.65 |
$12.65 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$21.00 |
$21.00 |
$21.00 |
$68.40
|
|
Infect ag if influenza a
|
$15.18 |
$15.18 |
$15.18 |
$41.30
|
|
Infect ag if influenza b
|
$15.18 |
$15.18 |
$15.18 |
$37.95
|
|
Infect ag if legionella pneumophila
|
$11.89 |
$11.89 |
$11.89 |
$73.45
|
|
Infect ag if pneumocystis carinii
|
$19.23 |
$19.23 |
$19.23 |
$66.06
|
|
Infect ag if varicella zoster
|
$15.18 |
$15.18 |
$15.18 |
$72.00
|
|
Infect ag na hep b amp
|
$34.16 |
$34.16 |
$34.16 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$32.64 |
$32.64 |
$32.64 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$26.82 |
$26.82 |
$26.82 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$72.86 |
$72.86 |
$72.86 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$75.65 |
$75.65 |
$75.65 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$316.50 |
$316.50 |
$316.50 |
$854.70
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$15.18 |
$15.18 |
$15.18 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$16.70 |
$16.70 |
$16.70 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$18.72 |
$18.72 |
$18.72 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$58.44 |
$58.44 |
$58.44 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$21.50 |
$21.50 |
$21.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$22.01 |
$22.01 |
$22.01 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$39.72 |
$39.72 |
$39.72 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$9.11 |
$9.11 |
$9.11 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$16.19 |
$16.19 |
$16.19 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$106.51 |
$106.51 |
$106.51 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$29.09 |
$29.09 |
$29.09 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$28.34 |
$28.34 |
$28.34 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$316.50 |
$316.50 |
$316.50 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$26.82 |
$26.82 |
$26.82 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$26.82 |
$26.82 |
$26.82 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$31.88 |
$31.88 |
$31.88 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$26.82 |
$26.82 |
$26.82 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$38.96 |
$38.96 |
$38.96 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$24.29 |
$24.29 |
$24.29 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$26.82 |
$26.82 |
$26.82 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$28.08 |
$28.08 |
$28.08 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$316.50 |
$316.50 |
$316.50 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$97.40 |
$97.40 |
$97.40 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$199.62 |
$199.62 |
$199.62 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$69.58 |
$69.58 |
$69.58 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$32.64 |
$32.64 |
$32.64 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$37.19 |
$37.19 |
$37.19 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$64.77 |
$64.77 |
$64.77 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$108.28 |
$108.28 |
$108.28 |
$304.20
|
|
Inj, bezlotoxumab, 10 mg
|
$30.55 |
$30.55 |
$30.55 |
$7,612.43
|
|
Inj cntr knee arthro incl ct/mri
|
$143.22 |
$143.22 |
$143.22 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$276.89 |
$276.89 |
$276.89 |
$875.28
|
|
Inj dx for sinogram
|
$84.08 |
$84.08 |
$84.08 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$196.81 |
$196.81 |
$196.81 |
$503.50
|
|
Injection during cath supravalvular aortography
|
$314.79 |
$314.79 |
$314.79 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$437.98 |
$437.98 |
$437.98 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$220.84 |
$220.84 |
$220.84 |
$436.00
|
|
Injection for bladder x-ray
|
$157.08 |
$157.08 |
$157.08 |
$459.20
|
|
Injection for hip x-ray
|
$238.08 |
$238.08 |
$238.08 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$214.37 |
$214.37 |
$214.37 |
$497.76
|
|
Injection for spleen x-ray
|
$166.32 |
$166.32 |
$166.32 |
$686.40
|
|
Injection for tear sac x-ray
|
$78.54 |
$78.54 |
$78.54 |
$225.20
|
|
Injection for ureter x-ray
|
$98.56 |
$98.56 |
$98.56 |
$415.80
|
|
Injection for ureter x-ray
|
$72.07 |
$72.07 |
$72.07 |
$515.21
|
|
Injection, glucarpidase
|
$8.78 |
$8.78 |
$8.78 |
$74,113.20
|
|
Injection into brain canal
|
$311.39 |
$311.39 |
$311.39 |
$844.50
|
|
Injection jaw joint x-ray
|
$56.06 |
$56.06 |
$56.06 |
$307.80
|
|
Injection jugular
|
$137.37 |
$137.37 |
$137.37 |
$790.00
|
|
Injection radioactive tracer sentinel node (both sides)
|
$458.00 |
$458.00 |
$458.00 |
$685.44
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$843.61 |
$843.61 |
$843.61 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$285.52 |
$285.52 |
$285.52 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$325.25 |
$325.25 |
$325.25 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$672.67 |
$672.67 |
$672.67 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,369.06 |
$1,369.06 |
$1,369.06 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$884.58 |
$884.58 |
$884.58 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$884.58 |
$884.58 |
$884.58 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$203.28 |
$203.28 |
$203.28 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$135.52 |
$135.52 |
$135.52 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$154.00 |
$154.00 |
$154.00 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$74.53 |
$74.53 |
$74.53 |
$145.60
|
|
Inject sacroiliac joint
|
$414.57 |
$414.57 |
$414.57 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$619.39 |
$619.39 |
$619.39 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$619.39 |
$619.39 |
$619.39 |
$1,450.84
|
|
Inj for ext venography
|
$224.22 |
$224.22 |
$224.22 |
$628.80
|
|
Inj for mammo ductogram
|
$590.44 |
$590.44 |
$590.44 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$345.24 |
$345.24 |
$345.24 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$461.58 |
$461.58 |
$461.58 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$486.78 |
$486.78 |
$486.78 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$267.54 |
$267.54 |
$267.54 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$287.70 |
$287.70 |
$287.70 |
$999.96
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$451.53 |
$451.53 |
$451.53 |
$1,938.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$607.07 |
$607.07 |
$607.07 |
$1,413.35
|
|
Inj peritoneal venous shunt
|
$88.40 |
$88.40 |
$88.40 |
$406.80
|
|
Inj proc ankle arthr
|
$257.80 |
$257.80 |
$257.80 |
$405.31
|
|
Inj proc elbow arthro
|
$239.32 |
$239.32 |
$239.32 |
$432.00
|
|
Inj proc for lymphang
|
$305.84 |
$305.84 |
$305.84 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$290.75 |
$290.75 |
$290.75 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$312.62 |
$312.62 |
$312.62 |
$838.30
|
|
Inj proc sialogram
|
$146.61 |
$146.61 |
$146.61 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$0.46 |
$0.46 |
$0.46 |
$349.45
|
|
Inj retro urethrocysto
|
$79.77 |
$79.77 |
$79.77 |
$447.74
|