|
Incision of eardrum
|
$523.25 |
$523.25 |
$523.25 |
$470.73
|
|
Incision of tendon sheath
|
$1,543.15 |
$1,543.15 |
$1,543.15 |
$2,263.68
|
|
Incision of tongue fold
|
$1,251.95 |
$1,251.95 |
$1,251.95 |
$1,865.58
|
|
Incision of urethra
|
$1,983.80 |
$1,983.80 |
$1,983.80 |
$3,549.60
|
|
Incisn of toe tndn
|
$1,531.25 |
$1,531.25 |
$1,531.25 |
$2,298.99
|
|
Incisn windpipe
|
$2,169.30 |
$2,169.30 |
$2,169.30 |
$3,837.72
|
|
Incobotulinumtoxin a
|
$3,778.88 |
$3,778.88 |
$3,778.88 |
$1,339.57
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,448.59 |
$1,448.59 |
$1,448.59 |
$876.13
|
|
Induced abortion d&c
|
$2,907.10 |
$2,907.10 |
$2,907.10 |
$3,649.80
|
|
Infect ag ia optc obs influenza
|
$92.40 |
$92.40 |
$92.40 |
$66.72
|
|
Infect ag na hpv high-risk types
|
$52.50 |
$52.50 |
$52.50 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$140.00 |
$140.00 |
$140.00 |
$227.96
|
|
Infect ag na resp virus 12-25 targets
|
$730.45 |
$730.45 |
$730.45 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$57.05 |
$57.05 |
$57.05 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$317.80 |
$317.80 |
$317.80 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$189.00 |
$189.00 |
$189.00 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$133.00 |
$133.00 |
$133.00 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$171.85 |
$171.85 |
$171.85 |
$132.60
|
|
Infectious agent nucleic acid amplified probe
|
$90.30 |
$90.30 |
$90.30 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$43.05 |
$43.05 |
$43.05 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$171.85 |
$171.85 |
$171.85 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$730.45 |
$730.45 |
$730.45 |
$855.45
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$126.70 |
$126.70 |
$126.70 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$51.10 |
$51.10 |
$51.10 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$43.05 |
$43.05 |
$43.05 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$115.50 |
$115.50 |
$115.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$667.80 |
$667.80 |
$667.80 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$667.80 |
$667.80 |
$667.80 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$87.85 |
$87.85 |
$87.85 |
$98.15
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$556.50 |
$556.50 |
$556.50 |
$727.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$210.00 |
$210.00 |
$210.00 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$4,195.34 |
$4,195.34 |
$4,195.34 |
$2,102.08
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$496.30 |
$496.30 |
$496.30 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$1,285.55 |
$1,285.55 |
$1,285.55 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$8,989.54 |
$8,989.54 |
$8,989.54 |
$7,176.71
|
|
Inj, bupivacaine liposome
|
$69.14 |
$69.14 |
$69.14 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$33.39 |
$33.39 |
$33.39 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$34.56 |
$34.56 |
$34.56 |
$34.59
|
|
Inj ceftolozane tazobactam
|
$649.05 |
$649.05 |
$649.05 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$537.25 |
$537.25 |
$537.25 |
$464.28
|
|
Inj cyclophosphamd auromedic
|
$862.66 |
$862.66 |
$862.66 |
$231.57
|
|
Inj cyclophosphamd (ingenus)
|
$1,246.13 |
$1,246.13 |
$1,246.13 |
$493.23
|
|
Inj disk cerv-thor ea lev
|
$304.15 |
$304.15 |
$304.15 |
$869.80
|
|
Inj dx for sinogram
|
$386.40 |
$386.40 |
$386.40 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$896.35 |
$896.35 |
$896.35 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$240.80 |
$240.80 |
$240.80 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$275.45 |
$275.45 |
$275.45 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$10,586.32 |
$10,586.32 |
$10,586.32 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$1,111.60 |
$1,111.60 |
$1,111.60 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,095.50 |
$1,095.50 |
$1,095.50 |
$1,473.12
|
|
Injection eye drug
|
$340.90 |
$340.90 |
$340.90 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$254.80 |
$254.80 |
$254.80 |
$441.12
|
|
Injection for bladder x-ray
|
$291.90 |
$291.90 |
$291.90 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$240.80 |
$240.80 |
$240.80 |
$504.00
|
|
Injection for spleen x-ray
|
$558.60 |
$558.60 |
$558.60 |
$686.40
|
|
Injection for ureter x-ray
|
$558.60 |
$558.60 |
$558.60 |
$444.95
|
|
Injection for ureter x-ray
|
$558.60 |
$558.60 |
$558.60 |
$515.21
|
|
Injection, fulvestrant
|
$351.81 |
$351.81 |
$351.81 |
$1,817.65
|
|
Injection into brain canal
|
$543.90 |
$543.90 |
$543.90 |
$933.60
|
|
Injection into hemorrhoid(s)
|
$735.70 |
$735.70 |
$735.70 |
$1,278.72
|
|
Injection of sinus tract
|
$1,375.15 |
$1,375.15 |
$1,375.15 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,532.32 |
$2,532.32 |
$2,532.32 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$410.20 |
$410.20 |
$410.20 |
$717.20
|
|
Injection, renflexis
|
$1,725.90 |
$1,725.90 |
$1,725.90 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$779.10 |
$779.10 |
$779.10 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,449.35 |
$1,449.35 |
$1,449.35 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,144.15 |
$1,144.15 |
$1,144.15 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,419.20 |
$2,419.20 |
$2,419.20 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,837.70 |
$4,837.70 |
$4,837.70 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,113.30 |
$2,113.30 |
$2,113.30 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,113.30 |
$2,113.30 |
$2,113.30 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$838.60 |
$838.60 |
$838.60 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$522.55 |
$522.55 |
$522.55 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$536.20 |
$536.20 |
$536.20 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$166.60 |
$166.60 |
$166.60 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$166.60 |
$166.60 |
$166.60 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$183.40 |
$183.40 |
$183.40 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$166.60 |
$166.60 |
$166.60 |
$141.60
|
|
Injection treatment of eye
|
$1,365.70 |
$1,365.70 |
$1,365.70 |
$2,698.92
|
|
Inject sacroiliac joint
|
$1,967.00 |
$1,967.00 |
$1,967.00 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$779.10 |
$779.10 |
$779.10 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$912.10 |
$912.10 |
$912.10 |
$1,450.84
|
|
Inj. fe derisomaltose 10 mg
|
$8,101.86 |
$8,101.86 |
$8,101.86 |
$854.61
|
|
Inj for ext venography
|
$273.35 |
$273.35 |
$273.35 |
$737.55
|
|
Inj for mammo ductogram
|
$405.30 |
$405.30 |
$405.30 |
$433.50
|
|
Inj hrt cath w/s&i sel right vent
|
$1,056.30 |
$1,056.30 |
$1,056.30 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$523.25 |
$523.25 |
$523.25 |
$241.74
|
|
Inj levocarnitine per 1 gm
|
$39.55 |
$39.55 |
$39.55 |
$136.62
|
|
Inj, levothyroxine, freskabi
|
$302.07 |
$302.07 |
$302.07 |
$303.45
|
|
Inj mepivacaine hcl/10 ml
|
$32.94 |
$32.94 |
$32.94 |
$31.28
|
|
Inj. mycophenolate mofetil
|
$248.38 |
$248.38 |
$248.38 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,162.00 |
$1,162.00 |
$1,162.00 |
$1,522.56
|
|
Inj, nithiodote, 3mg / 125mg
|
$85.17 |
$85.17 |
$85.17 |
$228.00
|
|
Inj ogivri 10 mg
|
$4,798.78 |
$4,798.78 |
$4,798.78 |
$4,096.71
|
|
Inj pantoprazole(hikma) 40mg
|
$33.52 |
$33.52 |
$33.52 |
$33.52
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$8,363.84 |
$8,363.84 |
$8,363.84 |
$6,244.73
|
|
Inj proc lumbr disk ea lvl
|
$304.15 |
$304.15 |
$304.15 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$413.35 |
$413.35 |
$413.35 |
$922.80
|
|
Inj proc sialogram
|
$210.35 |
$210.35 |
$210.35 |
$380.80
|
|
Inj progesterone per 50 mg
|
$33.63 |
$33.63 |
$33.63 |
$19.53
|