|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$11.02 |
$11.02 |
$15.44 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$12.36 |
$12.36 |
$17.32 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$38.58 |
$38.58 |
$54.05 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$14.20 |
$14.20 |
$19.89 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$14.53 |
$14.53 |
$20.36 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$26.22 |
$26.22 |
$36.74 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$6.01 |
$6.01 |
$8.42 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$10.69 |
$10.69 |
$14.98 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$70.31 |
$70.31 |
$98.51 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$19.21 |
$19.21 |
$26.91 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$18.70 |
$18.70 |
$26.21 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$208.92 |
$208.92 |
$292.73 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$17.70 |
$17.70 |
$24.80 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$17.70 |
$17.70 |
$24.80 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$21.04 |
$21.04 |
$29.48 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$17.70 |
$17.70 |
$24.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$25.72 |
$25.72 |
$152.10 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$16.03 |
$16.03 |
$22.46 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$17.70 |
$17.70 |
$24.80 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$18.54 |
$18.54 |
$25.97 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$208.92 |
$208.92 |
$292.73 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$64.30 |
$64.30 |
$90.09 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$131.76 |
$131.76 |
$184.63 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$45.93 |
$45.93 |
$70.20 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$21.54 |
$21.54 |
$30.19 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$24.55 |
$24.55 |
$34.40 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$42.75 |
$42.75 |
$59.90 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$71.48 |
$71.48 |
$100.15 |
$304.20
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$64.98 |
$64.98 |
$64.98 |
$296.00
|
|
Inj cntr knee arthro incl ct/mri
|
$193.84 |
$193.84 |
$281.42 |
$436.80
|
|
Inj dx for sinogram
|
$78.77 |
$78.77 |
$114.36 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$558.66 |
$558.66 |
$811.05 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$243.57 |
$243.57 |
$353.62 |
$503.50
|
|
Injection during cath supravalvular aortography
|
$163.88 |
$163.88 |
$300.68 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$422.17 |
$422.17 |
$612.90 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$268.62 |
$268.62 |
$389.98 |
$436.00
|
|
Injection for bladder x-ray
|
$177.14 |
$177.14 |
$257.18 |
$459.20
|
|
Injection for hip x-ray
|
$294.76 |
$294.76 |
$427.92 |
$763.60
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$238.49 |
$238.49 |
$346.24 |
$497.76
|
|
Injection for ureter x-ray
|
$257.73 |
$257.73 |
$374.17 |
$415.80
|
|
Injection for ureter x-ray
|
$206.18 |
$206.18 |
$299.34 |
$515.21
|
|
Injection into brain canal
|
$757.22 |
$757.22 |
$757.22 |
$844.50
|
|
Injection jugular
|
$306.74 |
$306.74 |
$306.74 |
$790.00
|
|
Injection of sinus tract
|
$933.27 |
$933.27 |
$933.27 |
$1,640.99
|
|
Injection radioactive tracer sentinel node (both sides)
|
$773.19 |
$773.19 |
$773.19 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$696.96 |
$696.96 |
$1,011.84 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$545.23 |
$545.23 |
$545.23 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$734.71 |
$734.71 |
$1,066.65 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$687.16 |
$687.16 |
$997.61 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$734.71 |
$734.71 |
$1,066.65 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$541.96 |
$541.96 |
$786.81 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$910.04 |
$910.04 |
$1,321.19 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$865.03 |
$865.03 |
$1,255.84 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$878.97 |
$878.97 |
$948.00 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$239.58 |
$239.58 |
$239.58 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$159.72 |
$159.72 |
$231.88 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$181.50 |
$181.50 |
$654.35 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$53.29 |
$53.29 |
$71.82 |
$145.60
|
|
Injection treatment of nerve
|
$1,682.14 |
$1,682.14 |
$1,682.14 |
$4,446.30
|
|
Injection treatment of nerve
|
$759.40 |
$759.40 |
$759.40 |
$2,054.00
|
|
Inject sacroiliac joint
|
$1,057.06 |
$1,057.06 |
$1,534.62 |
$1,029.04
|
|
Inj., emapalumab-lzsg, 1 mg
|
$78.25 |
$78.25 |
$78.25 |
$3,181.80
|
|
Inj epidural sgl cerv-thor without img
|
$807.31 |
$807.31 |
$1,172.05 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$807.31 |
$807.31 |
$1,172.05 |
$1,450.84
|
|
Inj for ext venography
|
$410.55 |
$410.55 |
$596.04 |
$628.80
|
|
Inj for mammo ductogram
|
$518.57 |
$518.57 |
$518.57 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$184.34 |
$184.34 |
$338.23 |
$1,492.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$180.21 |
$180.21 |
$330.64 |
$1,818.15
|
|
Inj hrt cath w/s&i sel hrt art
|
$189.98 |
$189.98 |
$348.57 |
$1,045.80
|
|
Inj hrt cath w/s&i sel left vent
|
$139.27 |
$139.27 |
$255.52 |
$1,250.34
|
|
Inj hrt cath w/s&i sel right vent
|
$144.21 |
$144.21 |
$264.59 |
$999.96
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$489.69 |
$489.69 |
$489.69 |
$1,938.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$748.14 |
$748.14 |
$1,086.15 |
$1,413.35
|
|
Inj peritoneal venous shunt
|
$297.30 |
$297.30 |
$297.30 |
$406.80
|
|
Inj proc ankle arthr
|
$177.14 |
$177.14 |
$257.18 |
$405.31
|
|
Inj proc elbow arthro
|
$217.80 |
$217.80 |
$316.20 |
$432.00
|
|
Inj proc for lymphang
|
$1,143.45 |
$1,143.45 |
$1,660.05 |
$742.40
|
|
Inj proc lumbr disk ea lvl
|
$614.92 |
$614.92 |
$892.74 |
$1,106.93
|
|
Inj proc myelogram lumbar
|
$353.92 |
$353.92 |
$513.82 |
$838.30
|
|
Inj proc sialogram
|
$124.87 |
$124.87 |
$124.87 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$0.74 |
$0.74 |
$1.13 |
$349.45
|
|
Inj retro urethrocysto
|
$135.76 |
$135.76 |
$135.76 |
$447.74
|
|
Inj scleros sol mult veins
|
$626.18 |
$626.18 |
$909.08 |
$692.90
|
|
Inj scleros sol sgl vein
|
$323.07 |
$323.07 |
$469.03 |
$561.88
|
|
Inj thrc fascial pln blk bi w/wo image
|
$602.22 |
$602.22 |
$602.22 |
$1,049.50
|
|
Inj thrc fascial pln blk uni w/wo image
|
$401.48 |
$401.48 |
$401.48 |
$818.00
|
|
Inj w/fluor eval cv device
|
$224.70 |
$224.70 |
$326.21 |
$504.40
|
|
Ins cath ren art 1st bi
|
$2,917.07 |
$2,917.07 |
$4,234.97 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$2,161.30 |
$2,161.30 |
$3,137.76 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$4,472.89 |
$4,472.89 |
$6,493.69 |
$5,663.98
|
|
Ins cath ren art 2nd+ uni
|
$3,889.54 |
$3,889.54 |
$5,646.80 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$323.61 |
$323.61 |
$323.61 |
$490.73
|
|
Insert abdomen-venous drain
|
$2,286.90 |
$2,286.90 |
$3,320.10 |
$4,039.47
|
|
Insert cath pleura with image
|
$1,075.93 |
$1,075.93 |
$1,562.03 |
$2,194.40
|
|
Insert cath pleura without image
|
$969.94 |
$969.94 |
$1,408.14 |
$2,099.70
|
|
Insert hepatic shunt (tips)
|
$4,039.83 |
$4,039.83 |
$5,864.98 |
$7,571.20
|
|
Insertion catheter bladder non indwelling
|
$68.24 |
$68.24 |
$99.08 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$1,662.18 |
$1,662.18 |
$2,413.13 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$1,168.86 |
$1,168.86 |
$1,696.94 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$2,484.74 |
$2,484.74 |
$3,607.32 |
$7,210.78
|