|
In-111 pentetreotide
|
$1,703.60 |
$1,703.60 |
$3,480.83 |
$5,294.90
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$899.78 |
$1,204.35 |
$1,514.63 |
$2,086.70
|
|
Incision of windpipe
|
$8,938.04 |
$8,938.04 |
$8,938.04 |
$6,465.11
|
|
Incision of windpipe
|
$8,938.04 |
$8,938.04 |
$8,938.04 |
$5,855.00
|
|
Incisn of toe tndn
|
$2,839.68 |
$2,839.68 |
$2,839.68 |
$2,667.00
|
|
Incisn windpipe
|
$4,762.40 |
$4,762.40 |
$4,762.40 |
$3,819.23
|
|
Incobotulinumtoxin a
|
$909.55 |
$909.55 |
$909.55 |
$1,339.57
|
|
Infec agen detec ampli probe
|
$43.55 |
$43.55 |
$43.55 |
$32.40
|
|
Infect ag drug suscept pheno predict
|
$86.63 |
$106.23 |
$500.04 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$170.83 |
$209.48 |
$921.39 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$170.83 |
$209.48 |
$571.09 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$59.09 |
$85.53 |
$104.88 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$170.83 |
$209.48 |
$1,000.08 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$11.05 |
$13.55 |
$44.70 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$13.26 |
$16.26 |
$16.49 |
$68.40
|
|
Infect ag if hep delta agent
|
$30.00 |
$30.00 |
$70.29 |
$125.97
|
|
Infect ag if influenza a
|
$12.99 |
$13.26 |
$16.26 |
$41.30
|
|
Infect ag if influenza b
|
$12.99 |
$13.26 |
$16.26 |
$37.95
|
|
Infect ag if legionella pneumophila
|
$10.39 |
$12.74 |
$28.27 |
$73.45
|
|
Infect ag if pneumocystis carinii
|
$16.80 |
$20.60 |
$107.35 |
$66.06
|
|
Infect ag if varicella zoster
|
$13.26 |
$16.26 |
$53.59 |
$72.00
|
|
Infect ag na hep b amp
|
$29.84 |
$29.84 |
$36.58 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$28.51 |
$34.96 |
$231.11 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$23.43 |
$28.73 |
$626.48 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$63.65 |
$78.05 |
$156.62 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$53.48 |
$66.08 |
$81.03 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$276.47 |
$339.02 |
$724.66 |
$854.70
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$105.71 |
$105.71 |
$1,082.59 |
$954.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$63.80 |
$63.80 |
$105.71 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$13.26 |
$16.26 |
$60.36 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$37.44 |
$37.44 |
$48.09 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$21.01 |
$21.01 |
$21.01 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$14.59 |
$14.59 |
$17.89 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$16.35 |
$20.05 |
$44.32 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$48.78 |
$51.05 |
$74.88 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$18.78 |
$21.78 |
$29.09 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$19.23 |
$23.58 |
$59.98 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$34.70 |
$42.55 |
$194.06 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$7.96 |
$9.76 |
$54.51 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$14.14 |
$17.34 |
$43.06 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$114.09 |
$127.79 |
$315.92 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$25.41 |
$31.17 |
$103.14 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$24.75 |
$30.35 |
$91.30 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$261.98 |
$276.47 |
$699.06 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$23.43 |
$28.73 |
$235.32 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$23.43 |
$28.73 |
$82.52 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$27.85 |
$34.15 |
$302.93 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$23.43 |
$28.73 |
$102.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$34.03 |
$41.73 |
$173.05 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$21.22 |
$21.22 |
$26.02 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$250.60 |
$250.60 |
$250.60 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$23.43 |
$28.73 |
$77.64 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$24.53 |
$30.08 |
$61.12 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$37.33 |
$37.33 |
$209.34 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$276.47 |
$339.02 |
$763.24 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$85.08 |
$85.08 |
$85.08 |
$289.91
|
|
Infectious agent nucleic acid quantification bk virus
|
$60.77 |
$74.53 |
$441.21 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$28.51 |
$34.96 |
$198.78 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$32.49 |
$39.84 |
$226.91 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$56.58 |
$69.38 |
$201.32 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$94.59 |
$115.99 |
$210.10 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$1,873.71 |
$1,873.71 |
$1,873.71 |
$2,047.13
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,873.71 |
$1,873.71 |
$1,873.71 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$57.42 |
$57.42 |
$58.02 |
$296.00
|
|
Inj alymsys 10 mg
|
$5,270.84 |
$5,270.84 |
$5,270.84 |
$1,280.74
|
|
Inj aval alfa-nqpt 4mg
|
$3,144.63 |
$3,144.63 |
$3,144.63 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$8,844.45 |
$8,844.45 |
$8,844.45 |
$11,310.00
|
|
Inj, bortezomib, hospira
|
$3.76 |
$3.76 |
$3.76 |
$175.35
|
|
Inj cefazolin sodium, baxter
|
$80.15 |
$80.15 |
$80.15 |
$27.38
|
|
Inj ceftolozane tazobactam
|
$181.07 |
$181.07 |
$230.84 |
$364.86
|
|
Inj. cetirizine hcl 0.5mg
|
$568.42 |
$568.42 |
$568.42 |
$159.98
|
|
Inj, clevidipine butyrate
|
$106.58 |
$106.58 |
$106.58 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$30.69 |
$30.69 |
$30.69 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$166.47 |
$179.96 |
$476.36 |
$436.80
|
|
Inj crotalidae im f(ab')2 eq
|
$3,083.26 |
$3,083.26 |
$3,083.26 |
$2,613.60
|
|
Inj cyclophosphamd (ingenus)
|
$6.12 |
$6.12 |
$6.12 |
$742.72
|
|
Inj disk cerv-thor ea lev
|
$321.84 |
$321.84 |
$347.91 |
$875.28
|
|
Inj dx for sinogram
|
$97.73 |
$105.65 |
$243.34 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$550.96 |
$595.59 |
$1,047.07 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$111.17 |
$228.76 |
$247.29 |
$503.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$291.63 |
$291.63 |
$291.63 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$3,885.33 |
$3,885.33 |
$3,885.33 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$283.31 |
$397.24 |
$786.54 |
$1,027.26
|
|
Injection, edaravone, 1 mg
|
$888.92 |
$888.92 |
$888.92 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$550.31 |
$736.60 |
$1,110.10 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$111.17 |
$256.69 |
$277.48 |
$436.00
|
|
Injection for bladder x-ray
|
$182.58 |
$197.37 |
$624.57 |
$459.20
|
|
Injection for hip x-ray
|
$169.61 |
$276.73 |
$299.15 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$119.95 |
$249.17 |
$269.35 |
$497.76
|
|
Injection for spleen x-ray
|
$193.32 |
$208.98 |
$371.69 |
$686.40
|
|
Injection for tear sac x-ray
|
$98.68 |
$98.68 |
$98.68 |
$225.20
|
|
Injection for ureter x-ray
|
$114.56 |
$114.56 |
$123.84 |
$415.80
|
|
Injection for ureter x-ray
|
$83.77 |
$83.77 |
$90.56 |
$515.21
|
|
Injection, fulvestrant
|
$1,777.83 |
$1,777.83 |
$1,777.83 |
$1,719.16
|
|
Injection glatiramer acetate
|
$259.76 |
$259.76 |
$259.76 |
$830.51
|
|
Injection into brain canal
|
$361.94 |
$391.26 |
$763.24 |
$844.50
|
|
Injection, isavuconazonium
|
$578.35 |
$578.35 |
$578.35 |
$787.67
|
|
Injection jaw joint x-ray
|
$70.43 |
$70.43 |
$70.43 |
$307.80
|
|
Injection jugular
|
$105.05 |
$105.05 |
$525.19 |
$790.00
|
|
Injection, necitumumab, 1 mg
|
$7,783.64 |
$7,783.64 |
$7,783.64 |
$8,572.91
|