|
In-111 ibritumomab tiux dx
|
$1,530.76 |
$1,530.76 |
$1,547.45 |
$3,217.50
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,524.52 |
$1,524.52 |
$1,541.14 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,537.44 |
$2,537.44 |
$2,565.10 |
$2,135.29
|
|
In-111 pentetreotide
|
$2,994.72 |
$2,994.72 |
$3,027.36 |
$6,617.05
|
|
In-111 satumomab pend
|
$2,994.72 |
$2,994.72 |
$3,027.36 |
$3,524.25
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$2,003.40 |
$2,003.40 |
$2,005.29 |
$2,261.20
|
|
Incision of foot tendon 28234
|
$2,287.15 |
$2,287.15 |
$2,287.15 |
$2,116.27
|
|
Incision of toe tendons 28011
|
$2,287.15 |
$2,287.15 |
$2,287.15 |
$2,068.30
|
|
Incisn of toe tndn
|
$2,287.15 |
$2,287.15 |
$2,287.15 |
$2,298.99
|
|
Incisn windpipe
|
$3,245.02 |
$3,245.02 |
$3,280.39 |
$3,837.72
|
|
Incobotulinumtoxin a
|
$869.43 |
$869.43 |
$869.43 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$118.80 |
$118.80 |
$120.10 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$71.20 |
$71.20 |
$71.98 |
$69.03
|
|
Infect ag genotype na dna hepatitis b
|
$94.27 |
$94.27 |
$95.30 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$51.38 |
$51.38 |
$51.94 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$102.87 |
$102.87 |
$103.99 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$27.16 |
$27.16 |
$27.46 |
$66.72
|
|
Infect ag if hep delta agent
|
$45.88 |
$45.88 |
$46.38 |
$125.97
|
|
Infect ag if influenza a
|
$3.14 |
$3.14 |
$3.17 |
$40.61
|
|
Infect ag if influenza b
|
$3.14 |
$3.14 |
$3.17 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$11.01 |
$11.01 |
$11.13 |
$75.79
|
|
Infect ag if nos ea
|
$40.01 |
$40.01 |
$40.44 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$5.51 |
$5.51 |
$5.57 |
$62.29
|
|
Infect ag if varicella zoster
|
$22.13 |
$22.13 |
$22.37 |
$66.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$139.10 |
$139.10 |
$140.61 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$31.20 |
$31.20 |
$31.54 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$681.52 |
$681.52 |
$765.01 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$42.36 |
$42.36 |
$42.82 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$42.36 |
$42.36 |
$42.82 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$107.17 |
$107.17 |
$108.34 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$8.08 |
$8.08 |
$8.17 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$23.86 |
$23.86 |
$24.12 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$78.54 |
$78.54 |
$79.40 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$40.74 |
$40.74 |
$41.19 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$80.38 |
$80.38 |
$81.25 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$16.52 |
$16.52 |
$18.55 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$26.06 |
$26.06 |
$26.35 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$43.68 |
$43.68 |
$44.15 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$41.87 |
$41.87 |
$42.33 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$66.43 |
$66.43 |
$67.16 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$109.37 |
$109.37 |
$110.56 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$117.81 |
$117.81 |
$119.10 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$49.18 |
$49.18 |
$49.72 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$531.79 |
$531.79 |
$764.64 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$31.93 |
$31.93 |
$32.28 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$64.23 |
$64.23 |
$64.93 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$45.88 |
$45.88 |
$46.38 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$117.81 |
$117.81 |
$119.10 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$36.70 |
$36.70 |
$37.10 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$131.02 |
$131.02 |
$212.59 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$15.14 |
$15.14 |
$15.31 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$45.88 |
$45.88 |
$46.38 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$476.74 |
$476.74 |
$481.93 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$69.44 |
$69.44 |
$70.20 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$248.46 |
$248.46 |
$251.17 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$74.87 |
$74.87 |
$75.69 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$18.35 |
$18.35 |
$18.55 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$69.73 |
$69.73 |
$70.49 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$122.95 |
$122.95 |
$124.29 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$185.34 |
$185.34 |
$187.36 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,047.13 |
$2,047.13 |
$2,069.44 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,658.84 |
$1,658.84 |
$1,658.84 |
$1,432.80
|
|
Infuse radioactive materials
|
$221.67 |
$221.67 |
$224.09 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$87.72 |
$87.72 |
$88.67 |
$359.64
|
|
Initial foot exam pt lops
|
$78.91 |
$78.91 |
$78.91 |
$142.64
|
|
Initiation & management bipap/cpap initial day
|
$4,293.54 |
$4,293.54 |
$4,340.33 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$726.79 |
$726.79 |
$6,988.05 |
$7,176.71
|
|
Inj alymsys 10 mg
|
$5,038.55 |
$5,038.55 |
$5,038.55 |
$676.74
|
|
Inj anifrolumab-fnia 1mg
|
$8,430.36 |
$8,430.36 |
$8,430.36 |
$9,648.88
|
|
Inj., benralizumab, 1 mg
|
$8,454.58 |
$8,454.58 |
$8,546.73 |
$13,682.10
|
|
Inj, bupivacaine liposome
|
$558.36 |
$558.36 |
$558.36 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$17.62 |
$17.62 |
$17.81 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$16.15 |
$16.15 |
$16.15 |
$34.59
|
|
Inj, cefepime hcl (b braun)
|
$42.94 |
$42.94 |
$43.41 |
$81.41
|
|
Inj, cefiderocol, 10 mg
|
$332.87 |
$332.87 |
$336.50 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$173.23 |
$173.23 |
$175.12 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$325.90 |
$325.90 |
$329.45 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$2,313.94 |
$2,313.94 |
$2,339.16 |
$2,735.85
|
|
Inj dx for sinogram
|
$63.13 |
$63.13 |
$63.82 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$673.08 |
$673.08 |
$680.42 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$254.70 |
$254.70 |
$257.48 |
$507.10
|
|
Injection, cangrelor
|
$1,383.96 |
$1,383.96 |
$1,383.96 |
$1,943.40
|
|
Injection, daratumumab 10 mg
|
$3,714.04 |
$3,714.04 |
$3,754.52 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$1,594.99 |
$1,594.99 |
$1,594.99 |
$1,148.80
|
|
Injection, edaravone, 1 mg
|
$971.09 |
$971.09 |
$971.09 |
$18.84
|
|
Injection epidural blood patch or clot
|
$1,115.32 |
$1,115.32 |
$1,127.47 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$193.05 |
$193.05 |
$195.15 |
$441.12
|
|
Injection for bladder x-ray
|
$77.07 |
$77.07 |
$77.91 |
$585.00
|
|
Injection for hip x-ray
|
$193.05 |
$193.05 |
$195.15 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$248.83 |
$248.83 |
$251.54 |
$504.00
|
|
Injection for spleen x-ray
|
$2,024.38 |
$2,024.38 |
$2,046.44 |
$686.40
|
|
Injection for ureter x-ray
|
$664.27 |
$664.27 |
$671.51 |
$444.95
|
|
Injection for ureter x-ray
|
$925.21 |
$925.21 |
$935.30 |
$515.21
|
|
Injection, fulvestrant
|
$3,058.95 |
$3,058.95 |
$3,092.29 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$5,696.58 |
$5,696.58 |
$5,696.58 |
$6,830.50
|
|
Injection into brain canal
|
$1,021.73 |
$1,021.73 |
$1,032.87 |
$933.60
|
|
Injection into spinal artery
|
$850.71 |
$850.71 |
$850.71 |
$1,468.18
|
|
Injection, isavuconazonium
|
$553.07 |
$553.07 |
$559.10 |
$863.93
|
|
Injection jugular
|
$174.70 |
$174.70 |
$174.70 |
$1,048.20
|
|
Injection, necitumumab, 1 mg
|
$7,440.56 |
$7,440.56 |
$7,440.56 |
$5.73
|