|
Immunodiff gel qual ea antigen/ab
|
$15.77 |
$15.77 |
$15.77 |
$53.95
|
|
Immunofixation electrophoresis serum
|
$6.57 |
$6.57 |
$6.57 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$41.39 |
$41.39 |
$41.39 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$53.88 |
$53.88 |
$53.88 |
$250.00
|
|
Immunoglobulin assay
|
$207.62 |
$207.62 |
$207.62 |
$74.00
|
|
Implant cartilage 10mm synthetic
|
$78,244.76 |
$78,244.76 |
$78,244.76 |
$9,261.00
|
|
Implant cochlear osia osi300
|
$27,771.39 |
$27,771.39 |
$27,771.39 |
$15,318.47
|
|
Implant ureth bulk agent
|
$751.17 |
$751.17 |
$751.17 |
$1,930.57
|
|
In-111 capromab pendet
|
$3,240.33 |
$3,240.33 |
$3,240.33 |
$3,941.34
|
|
In-111 oxyquinolin per 0.5 mci
|
$900.53 |
$900.53 |
$900.53 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$1,712.15 |
$1,712.15 |
$1,712.15 |
$2,135.29
|
|
In-111 pentetreotide
|
$2,588.15 |
$2,588.15 |
$2,588.15 |
$6,617.05
|
|
In-111 satumomab pend
|
$2,588.15 |
$2,588.15 |
$2,588.15 |
$3,524.25
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,125.66 |
$1,125.66 |
$1,125.66 |
$2,261.20
|
|
Infect ag drug suscept pheno predict
|
$61.32 |
$61.32 |
$61.32 |
$325.00
|
|
Infect ag genotype na dna hepatitis b
|
$112.51 |
$112.51 |
$112.51 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$61.32 |
$61.32 |
$61.32 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$61.32 |
$61.32 |
$61.32 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$70.08 |
$70.08 |
$70.08 |
$66.72
|
|
Infect ag if hep delta agent
|
$54.75 |
$54.75 |
$54.75 |
$125.97
|
|
Infect ag if legionella pneumophila
|
$13.14 |
$13.14 |
$13.14 |
$75.79
|
|
Infect ag if varicella zoster
|
$26.41 |
$26.41 |
$26.41 |
$66.00
|
|
Infect ag na hpv high-risk types
|
$30.74 |
$30.74 |
$30.74 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$167.85 |
$167.85 |
$167.85 |
$227.96
|
|
Infect ag na resp virus 12-25 targets
|
$298.72 |
$298.72 |
$298.72 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$50.55 |
$50.55 |
$50.55 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$50.55 |
$50.55 |
$50.55 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$63.08 |
$63.08 |
$63.08 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$9.64 |
$9.64 |
$9.64 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$167.76 |
$167.76 |
$167.76 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$170.82 |
$170.82 |
$170.82 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$7.45 |
$7.45 |
$7.45 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$79.72 |
$79.72 |
$79.72 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$70.08 |
$70.08 |
$70.08 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$4.38 |
$4.38 |
$4.38 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$76.65 |
$76.65 |
$76.65 |
$132.60
|
|
Infectious agent nucleic acid amplified probe
|
$105.12 |
$105.12 |
$105.12 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$67.02 |
$67.02 |
$67.02 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$165.57 |
$165.57 |
$165.57 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$125.27 |
$125.27 |
$125.27 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$21.90 |
$21.90 |
$21.90 |
$178.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$32.42 |
$32.42 |
$32.42 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$74.03 |
$74.03 |
$74.03 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$106.44 |
$106.44 |
$106.44 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$199.73 |
$199.73 |
$199.73 |
$222.60
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.42 |
$92.42 |
$92.42 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$61.48 |
$61.48 |
$61.48 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$54.75 |
$54.75 |
$54.75 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$212.43 |
$212.43 |
$212.43 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$460.76 |
$460.76 |
$460.76 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$89.36 |
$89.36 |
$89.36 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$21.90 |
$21.90 |
$21.90 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$56.51 |
$56.51 |
$56.51 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$26.28 |
$26.28 |
$26.28 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$65.70 |
$65.70 |
$65.70 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$74.92 |
$74.92 |
$74.92 |
$1,654.83
|
|
Infuse radioactive materials
|
$200.61 |
$200.61 |
$200.61 |
$600.89
|
|
Initiation & management bipap/cpap initial day
|
$4,508.78 |
$4,508.78 |
$4,508.78 |
$645.79
|
|
Inj, adzynma, 10 iu
|
$90.33 |
$90.33 |
$90.33 |
$34.60
|
|
Inj allopurinol sodium 1 mg
|
$4,609.95 |
$4,609.95 |
$4,609.95 |
$5,948.29
|
|
Inj alymsys 10 mg
|
$2.24 |
$2.24 |
$2.24 |
$928.80
|
|
Inj anifrolumab-fnia 1mg
|
$27.34 |
$27.34 |
$27.34 |
$9,878.82
|
|
Inj calcitriol per 0.1 mcg
|
$29.35 |
$29.35 |
$29.35 |
$33.36
|
|
Inj, cefiderocol, 10 mg
|
$289.08 |
$289.08 |
$289.08 |
$718.84
|
|
Inj cntr knee arthro incl ct/mri
|
$179.58 |
$179.58 |
$179.58 |
$464.28
|
|
Inj cyclophosphamd (ingenus)
|
$198.07 |
$198.07 |
$198.07 |
$1,040.94
|
|
Inj, cyclophosphamd, sandoz
|
$1,588.19 |
$1,588.19 |
$1,588.19 |
$4.34
|
|
Inj disk cerv-thor ea lev
|
$673.65 |
$673.65 |
$673.65 |
$869.80
|
|
Inj dx for sinogram
|
$179.58 |
$179.58 |
$179.58 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$179.58 |
$179.58 |
$179.58 |
$507.10
|
|
Injection, belinostat, 10mg
|
$50.13 |
$50.13 |
$50.13 |
$5,341.40
|
|
Injection, cangrelor
|
$1,578.99 |
$1,578.99 |
$1,578.99 |
$2,546.20
|
|
Injection, daratumumab 10 mg
|
$1,734.48 |
$1,734.48 |
$1,734.48 |
$7,107.73
|
|
Injection, doxercalciferol
|
$29.35 |
$29.35 |
$29.35 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$73.59 |
$73.59 |
$73.59 |
$1,148.80
|
|
Injection, edaravone, 1 mg
|
$856.29 |
$856.29 |
$856.29 |
$2,345.85
|
|
Injection epidural blood patch or clot
|
$838.34 |
$838.34 |
$838.34 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$179.58 |
$179.58 |
$179.58 |
$441.12
|
|
Injection for bladder x-ray
|
$206.74 |
$206.74 |
$206.74 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$179.58 |
$179.58 |
$179.58 |
$504.00
|
|
Injection for spleen x-ray
|
$197.98 |
$197.98 |
$197.98 |
$686.40
|
|
Injection for ureter x-ray
|
$156.37 |
$156.37 |
$156.37 |
$515.21
|
|
Injection, fulvestrant
|
$144.83 |
$144.83 |
$144.83 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$19.10 |
$19.10 |
$19.10 |
$10,366.61
|
|
Injection, isavuconazonium
|
$376.25 |
$376.25 |
$376.25 |
$646.20
|
|
Injection of sinus tract
|
$764.31 |
$764.31 |
$764.31 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$406.47 |
$406.47 |
$406.47 |
$717.20
|
|
Injection, renflexis
|
$1,314.00 |
$1,314.00 |
$1,314.00 |
$1,457.42
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$334.20 |
$334.20 |
$334.20 |
$1,160.25
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,464.24 |
$1,464.24 |
$1,464.24 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$459.47 |
$459.47 |
$459.47 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,313.57 |
$1,313.57 |
$1,313.57 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$290.84 |
$290.84 |
$290.84 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$904.91 |
$904.91 |
$904.91 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$738.03 |
$738.03 |
$738.03 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$738.03 |
$738.03 |
$738.03 |
$1,758.12
|
|
Injection, siltuximab
|
$144.05 |
$144.05 |
$144.05 |
$18,164.96
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$448.52 |
$448.52 |
$448.52 |
$472.76
|