|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$207.76 |
$207.76 |
$207.76 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$37.49 |
$37.49 |
$37.49 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$112.05 |
$112.05 |
$112.05 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$356.91 |
$356.91 |
$356.91 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$271.58 |
$271.58 |
$271.58 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$281.96 |
$281.96 |
$281.96 |
$174.06
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$322.03 |
$322.03 |
$322.03 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$172.15 |
$172.15 |
$172.15 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$885.21 |
$885.21 |
$885.21 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$237.44 |
$237.44 |
$237.44 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$168.44 |
$168.44 |
$168.44 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$168.44 |
$168.44 |
$168.44 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$296.06 |
$296.06 |
$296.06 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$104.15 |
$104.15 |
$104.15 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,439.48 |
$1,439.48 |
$1,439.48 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$354.68 |
$354.68 |
$354.68 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$148.40 |
$148.40 |
$148.40 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$127.15 |
$127.15 |
$127.15 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$252.58 |
$252.58 |
$252.58 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$2,766.92 |
$2,766.92 |
$2,766.92 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,453.80 |
$2,453.80 |
$2,453.80 |
$1,432.80
|
|
Influenza virus vaccine, live trivalent intranasal
|
$28.20 |
$28.20 |
$28.20 |
$40.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$258.22 |
$258.22 |
$258.22 |
$359.64
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$525.34 |
$525.34 |
$525.34 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$206.28 |
$206.28 |
$206.28 |
$231.42
|
|
Initial nursing facility care/day 45 minutes
|
$281.22 |
$281.22 |
$281.22 |
$322.20
|
|
Initial nursing facility care/day low severity 99304
|
$127.63 |
$127.63 |
$127.63 |
$162.40
|
|
Initiation & management bipap/cpap initial day
|
$459.30 |
$459.30 |
$459.30 |
$645.79
|
|
Inj aval alfa-nqpt 4mg
|
$8,276.27 |
$8,276.27 |
$8,276.27 |
$4,741.91
|
|
Inj., benralizumab, 1 mg
|
$15,366.08 |
$15,366.08 |
$15,366.08 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$14,072.03 |
$14,072.03 |
$14,072.03 |
$8,698.20
|
|
Inj, bupivacaine liposome
|
$2,519.84 |
$2,519.84 |
$2,519.84 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$65.30 |
$65.30 |
$65.30 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$54.91 |
$54.91 |
$54.91 |
$34.59
|
|
Inj ceftolozane tazobactam
|
$882.24 |
$882.24 |
$882.24 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$2,164.42 |
$2,164.42 |
$2,164.42 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$5,259.30 |
$5,259.30 |
$5,259.30 |
$2,735.85
|
|
Inj disk cerv-thor ea lev
|
$945.31 |
$945.31 |
$945.31 |
$869.80
|
|
Inj dx for sinogram
|
$200.34 |
$200.34 |
$200.34 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$352.45 |
$352.45 |
$352.45 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$872.60 |
$872.60 |
$872.60 |
$507.10
|
|
Injection, cangrelor
|
$592.86 |
$592.86 |
$592.86 |
$1,943.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$115.76 |
$115.76 |
$115.76 |
$536.00
|
|
Injection during cath supravalvular aortography
|
$877.05 |
$877.05 |
$877.05 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,502.55 |
$1,502.55 |
$1,502.55 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$983.90 |
$983.90 |
$983.90 |
$441.12
|
|
Injection for bladder x-ray
|
$1,100.39 |
$1,100.39 |
$1,100.39 |
$585.00
|
|
Injection for hip x-ray
|
$2,217.10 |
$2,217.10 |
$2,217.10 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,857.97 |
$1,857.97 |
$1,857.97 |
$504.00
|
|
Injection for ureter x-ray
|
$2,187.42 |
$2,187.42 |
$2,187.42 |
$515.21
|
|
Injection, fulvestrant
|
$611.41 |
$611.41 |
$611.41 |
$1,817.65
|
|
Injection into hemorrhoid(s)
|
$1,432.81 |
$1,432.81 |
$1,432.81 |
$1,278.72
|
|
Injection,onabotulinumtoxina
|
$2,776.57 |
$2,776.57 |
$2,776.57 |
$2,154.07
|
|
Injection px peyronie ds
|
$179.57 |
$179.57 |
$179.57 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,251.02 |
$1,251.02 |
$1,251.02 |
$717.20
|
|
Injection, renflexis
|
$2,305.40 |
$2,305.40 |
$2,305.40 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$130.60 |
$130.60 |
$130.60 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,270.31 |
$1,270.31 |
$1,270.31 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,501.07 |
$1,501.07 |
$1,501.07 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,106.33 |
$1,106.33 |
$1,106.33 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,676.92 |
$1,676.92 |
$1,676.92 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$745.71 |
$745.71 |
$745.71 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,694.73 |
$1,694.73 |
$1,694.73 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,903.23 |
$1,903.23 |
$1,903.23 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,212.65 |
$2,212.65 |
$2,212.65 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$729.39 |
$729.39 |
$729.39 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$792.46 |
$792.46 |
$792.46 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$89.04 |
$89.04 |
$89.04 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$301.26 |
$301.26 |
$301.26 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$301.26 |
$301.26 |
$301.26 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$301.26 |
$301.26 |
$301.26 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$217.41 |
$217.41 |
$217.41 |
$141.60
|
|
Injection treatment of nerve
|
$313.87 |
$313.87 |
$313.87 |
$2,037.10
|
|
Inject sacroiliac joint
|
$544.63 |
$544.63 |
$544.63 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$155.08 |
$155.08 |
$155.08 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$211.47 |
$211.47 |
$211.47 |
$1,450.84
|
|
Inj fluphenazine hcl 1.25 mg
|
$312.39 |
$312.39 |
$312.39 |
$44.95
|
|
Inj for ext venography
|
$4,102.52 |
$4,102.52 |
$4,102.52 |
$737.55
|
|
Inj for mammo ductogram
|
$348.74 |
$348.74 |
$348.74 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$254.51 |
$254.51 |
$254.51 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$727.91 |
$727.91 |
$727.91 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$6,681.71 |
$6,681.71 |
$6,681.71 |
$2,452.32
|
|
Inj intralesional <= 7 lsn(s)
|
$88.30 |
$88.30 |
$88.30 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$23,928.76 |
$23,928.76 |
$23,928.76 |
$7,173.90
|
|
Inj mepivacaine hcl/10 ml
|
$45.27 |
$45.27 |
$45.27 |
$31.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,073.68 |
$1,073.68 |
$1,073.68 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$7,558.02 |
$7,558.02 |
$7,558.02 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$5,064.15 |
$5,064.15 |
$5,064.15 |
$2,164.64
|
|
Inj proc ankle arthr
|
$1,601.98 |
$1,601.98 |
$1,601.98 |
$405.31
|
|
Inj proc elbow arthro
|
$1,729.61 |
$1,729.61 |
$1,729.61 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$1,040.29 |
$1,040.29 |
$1,040.29 |
$1,224.30
|
|
Inj retacrit esrd on dialysi
|
$2,381.82 |
$2,381.82 |
$2,381.82 |
$343.53
|
|
Inj retro urethrocysto
|
$2,242.33 |
$2,242.33 |
$2,242.33 |
$551.29
|
|
Inj scleros sol mult veins
|
$1,238.40 |
$1,238.40 |
$1,238.40 |
$687.96
|
|
Inj scleros sol sgl vein
|
$619.57 |
$619.57 |
$619.57 |
$534.40
|
|
Inj, tyenne, 1 mg
|
$4,013.48 |
$4,013.48 |
$4,013.48 |
$3,525.12
|
|
Inj w/fluor eval cv device
|
$430.36 |
$430.36 |
$430.36 |
$588.90
|
|
Ins cath ren art 1st bi
|
$7,531.30 |
$7,531.30 |
$7,531.30 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$5,004.79 |
$5,004.79 |
$5,004.79 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$11,382.28 |
$11,382.28 |
$11,382.28 |
$5,408.65
|