|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$9.84 |
$13.38 |
$61.51 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$10.00 |
$10.00 |
$51.87 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$10.82 |
$14.72 |
$16.10 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$12.14 |
$16.50 |
$28.66 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$37.88 |
$51.51 |
$56.36 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$13.94 |
$18.96 |
$31.37 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$14.27 |
$19.40 |
$46.93 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$25.75 |
$35.01 |
$129.68 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$5.90 |
$8.03 |
$58.79 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$10.50 |
$14.27 |
$46.44 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$69.04 |
$93.88 |
$137.83 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$18.86 |
$25.64 |
$71.14 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$18.37 |
$24.98 |
$96.58 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$205.16 |
$278.97 |
$305.24 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$17.38 |
$23.64 |
$43.97 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$17.38 |
$23.64 |
$25.86 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$20.66 |
$28.10 |
$144.50 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$17.38 |
$23.64 |
$71.39 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$25.26 |
$34.34 |
$52.12 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$15.74 |
$21.41 |
$23.42 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$17.38 |
$23.64 |
$83.74 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$18.20 |
$24.75 |
$51.87 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$40.27 |
$40.27 |
$40.27 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$205.16 |
$278.97 |
$564.89 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$192.52 |
$192.52 |
$192.52 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$45.10 |
$61.33 |
$229.47 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$21.16 |
$28.77 |
$214.40 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$24.11 |
$32.78 |
$130.42 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$41.98 |
$57.09 |
$90.90 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$70.19 |
$95.44 |
$152.65 |
$304.20
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$68.38 |
$68.38 |
$76.07 |
$296.00
|
|
Inj, bortezomib, hospira
|
$0.15 |
$0.15 |
$0.15 |
$175.35
|
|
Inj cefazolin sodium, baxter
|
$86.45 |
$86.45 |
$86.45 |
$27.38
|
|
Inj ceftolozane tazobactam
|
$248.98 |
$248.98 |
$248.98 |
$364.86
|
|
Inj, clindamycin (baxter)
|
$33.10 |
$33.10 |
$33.10 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$131.60 |
$159.03 |
$164.61 |
$436.80
|
|
Inj crotalidae im f(ab')2 eq
|
$3,325.61 |
$3,325.61 |
$3,325.61 |
$2,613.60
|
|
Inj disk cerv-thor ea lev
|
$318.25 |
$318.25 |
$318.25 |
$875.28
|
|
Inj dx for sinogram
|
$77.26 |
$93.37 |
$96.64 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$180.84 |
$218.54 |
$226.21 |
$503.50
|
|
Injection during cath supravalvular aortography
|
$302.80 |
$307.29 |
$377.84 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$402.43 |
$486.32 |
$503.39 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$202.91 |
$245.21 |
$253.82 |
$436.00
|
|
Injection for bladder x-ray
|
$144.33 |
$174.42 |
$180.54 |
$459.20
|
|
Injection for hip x-ray
|
$218.76 |
$264.37 |
$273.64 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$196.97 |
$238.03 |
$246.38 |
$497.76
|
|
Injection for spleen x-ray
|
$191.16 |
$191.16 |
$191.16 |
$686.40
|
|
Injection for tear sac x-ray
|
$90.27 |
$90.27 |
$90.27 |
$225.20
|
|
Injection for ureter x-ray
|
$90.56 |
$109.44 |
$113.28 |
$415.80
|
|
Injection for ureter x-ray
|
$66.22 |
$80.03 |
$82.84 |
$515.21
|
|
Injection into brain canal
|
$286.11 |
$345.76 |
$357.89 |
$844.50
|
|
Injection jaw joint x-ray
|
$51.51 |
$51.51 |
$62.24 |
$307.80
|
|
Injection jugular
|
$157.88 |
$157.88 |
$157.88 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$0.87 |
$0.87 |
$2,645.37 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$508.55 |
$508.55 |
$526.40 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$393.98 |
$393.98 |
$393.98 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$775.14 |
$936.74 |
$969.61 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$262.34 |
$317.03 |
$328.16 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$298.85 |
$361.15 |
$373.82 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$618.07 |
$746.93 |
$773.14 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,257.93 |
$1,520.19 |
$1,573.53 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$812.78 |
$982.22 |
$1,016.69 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$812.78 |
$982.22 |
$1,016.69 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$186.78 |
$225.72 |
$233.64 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$124.52 |
$150.48 |
$155.76 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$141.50 |
$171.00 |
$177.00 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$54.18 |
$69.03 |
$124.25 |
$145.60
|
|
Inject sacroiliac joint
|
$460.33 |
$460.33 |
$476.48 |
$1,029.04
|
|
Inj epidural sgl cerv-thor without img
|
$569.11 |
$687.76 |
$711.89 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$569.11 |
$687.76 |
$711.89 |
$1,450.84
|
|
Inj for ext venography
|
$206.02 |
$248.98 |
$257.71 |
$628.80
|
|
Inj for mammo ductogram
|
$452.41 |
$542.51 |
$655.61 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$332.09 |
$337.02 |
$414.39 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$444.00 |
$450.59 |
$554.03 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$468.24 |
$475.19 |
$584.28 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$257.35 |
$261.17 |
$321.12 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$276.74 |
$280.85 |
$345.32 |
$999.96
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$518.96 |
$518.96 |
$518.96 |
$1,938.00
|
|
Inj intralesional <= 7 lsn(s)
|
$34.07 |
$34.07 |
$34.07 |
$235.13
|
|
Inj, lidocaine w epinephrine
|
$13.34 |
$13.34 |
$13.34 |
$45.60
|
|
Inj naloxone hydrochloride
|
$299.37 |
$299.37 |
$299.37 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$557.79 |
$674.08 |
$697.73 |
$1,413.35
|
|
Inj peritoneal venous shunt
|
$101.60 |
$101.60 |
$101.60 |
$406.80
|
|
Inj proc ankle arthr
|
$236.87 |
$286.25 |
$296.30 |
$405.31
|
|
Inj proc elbow arthro
|
$219.89 |
$265.73 |
$275.06 |
$432.00
|
|
Inj proc for lymphang
|
$351.52 |
$351.52 |
$351.52 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$334.18 |
$334.18 |
$334.18 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$287.24 |
$347.13 |
$359.31 |
$838.30
|
|
Inj proc sialogram
|
$134.71 |
$162.79 |
$168.50 |
$373.00
|
|
Inj prohance multipack
|
$29.64 |
$29.64 |
$29.64 |
$10.40
|
|
Inj retacrit esrd on dialysi
|
$0.69 |
$0.92 |
$278.13 |
$349.45
|
|
Inj retro urethrocysto
|
$73.30 |
$88.58 |
$91.69 |
$447.74
|
|
Inj scleros sol mult veins
|
$144.33 |
$174.42 |
$180.54 |
$692.90
|
|
Inj scleros sol sgl vein
|
$72.16 |
$87.21 |
$90.27 |
$561.88
|
|
Inj, vancomycin hcl (mylan)
|
$61.01 |
$61.01 |
$61.01 |
$72.33
|
|
Inj vasopressin (am reg) 1 u
|
$0.21 |
$0.21 |
$0.21 |
$41.79
|
|
Inj w/fluor eval cv device
|
$196.40 |
$237.35 |
$245.68 |
$504.40
|
|
Ins cath ren art 1st bi
|
$2,236.83 |
$2,703.17 |
$2,798.02 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$1,722.90 |
$2,082.10 |
$2,155.15 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$2,879.24 |
$3,479.51 |
$3,601.60 |
$5,663.98
|