|
Infect ag if nos ea
|
$4.00 |
$4.00 |
$4.00 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$5.84 |
$5.84 |
$5.84 |
$62.29
|
|
Infect ag if varicella zoster
|
$3.93 |
$3.93 |
$3.93 |
$66.00
|
|
Infect ag na hpv high-risk types
|
$165.33 |
$165.33 |
$165.33 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$308.87 |
$308.87 |
$308.87 |
$227.96
|
|
Infect ag na influenza revr/amp ea type
|
$185.17 |
$185.17 |
$185.17 |
$124.80
|
|
Infect ag na orthopoxvirus amp prb each
|
$33.07 |
$33.07 |
$33.07 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$453.58 |
$453.58 |
$453.58 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$269.06 |
$269.06 |
$269.06 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$44.90 |
$44.90 |
$44.90 |
$77.00
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$44.35 |
$44.35 |
$44.35 |
$47.50
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$64.58 |
$64.58 |
$64.58 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$3.93 |
$3.93 |
$3.93 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$5.84 |
$5.84 |
$5.84 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$43.57 |
$43.57 |
$43.57 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$105.42 |
$105.42 |
$105.42 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$48.63 |
$48.63 |
$48.63 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$32.29 |
$32.29 |
$32.29 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$70.02 |
$70.02 |
$70.02 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$56.80 |
$56.80 |
$56.80 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$81.69 |
$81.69 |
$81.69 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$3.44 |
$3.44 |
$3.44 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$158.72 |
$158.72 |
$158.72 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$102.70 |
$102.70 |
$102.70 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$157.16 |
$157.16 |
$157.16 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$298.37 |
$298.37 |
$298.37 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$23.91 |
$23.91 |
$23.91 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$167.27 |
$167.27 |
$167.27 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$147.05 |
$147.05 |
$147.05 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$102.70 |
$102.70 |
$102.70 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$61.47 |
$61.47 |
$61.47 |
$103.20
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$104.26 |
$104.26 |
$104.26 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$48.63 |
$48.63 |
$48.63 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$472.25 |
$472.25 |
$472.25 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$15.51 |
$15.51 |
$15.51 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$14.92 |
$14.92 |
$14.92 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$15.15 |
$15.15 |
$15.15 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$23.34 |
$23.34 |
$23.34 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$284.36 |
$284.36 |
$284.36 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,180.74 |
$2,180.74 |
$2,180.74 |
$2,102.08
|
|
Initiation & management bipap/cpap initial day
|
$1,716.66 |
$1,716.66 |
$1,716.66 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$7,443.91 |
$7,443.91 |
$7,443.91 |
$7,176.71
|
|
Inj., benralizumab, 1 mg
|
$9,006.52 |
$9,006.52 |
$9,006.52 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$7,095.36 |
$7,095.36 |
$7,095.36 |
$8,698.20
|
|
Inj, bupivacaine liposome
|
$588.17 |
$588.17 |
$588.17 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$19.45 |
$19.45 |
$19.45 |
$31.69
|
|
Inj, cefiderocol, 10 mg
|
$354.38 |
$354.38 |
$354.38 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$184.39 |
$184.39 |
$184.39 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$127.60 |
$127.60 |
$127.60 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$2,464.71 |
$2,464.71 |
$2,464.71 |
$2,735.85
|
|
Inj dx for sinogram
|
$304.20 |
$304.20 |
$304.20 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$963.17 |
$963.17 |
$963.17 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$152.49 |
$152.49 |
$152.49 |
$507.10
|
|
Injection during cath supravalvular aortography
|
$1,252.97 |
$1,252.97 |
$1,252.97 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,447.86 |
$1,447.86 |
$1,447.86 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$133.43 |
$133.43 |
$133.43 |
$441.12
|
|
Injection for bladder x-ray
|
$205.01 |
$205.01 |
$205.01 |
$585.00
|
|
Injection for hip x-ray
|
$229.13 |
$229.13 |
$229.13 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$289.81 |
$289.81 |
$289.81 |
$504.00
|
|
Injection for ureter x-ray
|
$112.43 |
$112.43 |
$112.43 |
$444.95
|
|
Injection for ureter x-ray
|
$152.49 |
$152.49 |
$152.49 |
$515.21
|
|
Injection glatiramer acetate
|
$9,007.30 |
$9,007.30 |
$9,007.30 |
$646.72
|
|
Injection,onabotulinumtoxina
|
$1,081.42 |
$1,081.42 |
$1,081.42 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$287.48 |
$287.48 |
$287.48 |
$717.20
|
|
Injection, renflexis
|
$1,407.02 |
$1,407.02 |
$1,407.02 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,254.92 |
$1,254.92 |
$1,254.92 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$410.40 |
$410.40 |
$410.40 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,871.09 |
$1,871.09 |
$1,871.09 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$919.21 |
$919.21 |
$919.21 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,436.58 |
$1,436.58 |
$1,436.58 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,436.58 |
$1,436.58 |
$1,436.58 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,154.68 |
$2,154.68 |
$2,154.68 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,499.21 |
$1,499.21 |
$1,499.21 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,499.21 |
$1,499.21 |
$1,499.21 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$390.95 |
$390.95 |
$390.95 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$311.20 |
$311.20 |
$311.20 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$282.81 |
$282.81 |
$282.81 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$283.20 |
$283.20 |
$283.20 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$199.17 |
$199.17 |
$199.17 |
$141.60
|
|
Inj for ext venography
|
$774.50 |
$774.50 |
$774.50 |
$737.55
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,252.97 |
$1,252.97 |
$1,252.97 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$5,212.22 |
$5,212.22 |
$5,212.22 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$5,726.08 |
$5,726.08 |
$5,726.08 |
$947.65
|
|
Inj ivig privigen 500 mg
|
$4,145.19 |
$4,145.19 |
$4,145.19 |
$7,173.90
|
|
Inj multihance
|
$196.45 |
$196.45 |
$196.45 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$201.90 |
$201.90 |
$201.90 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$924.27 |
$924.27 |
$924.27 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$2,631.59 |
$2,631.59 |
$2,631.59 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$2,631.59 |
$2,631.59 |
$2,631.59 |
$2,164.64
|
|
Inj proc myelogram lumbar
|
$1,395.74 |
$1,395.74 |
$1,395.74 |
$922.80
|
|
Inj prohance multipack
|
$19.45 |
$19.45 |
$19.45 |
$51.48
|
|
Inj, releuko 1 mcg
|
$475.36 |
$475.36 |
$475.36 |
$519.53
|
|
Inj retacrit esrd on dialysi
|
$206.17 |
$206.17 |
$206.17 |
$343.53
|
|
Inj retro urethrocysto
|
$112.43 |
$112.43 |
$112.43 |
$551.29
|
|
Inj scleros sol mult veins
|
$369.17 |
$369.17 |
$369.17 |
$687.96
|
|
Inj scleros sol sgl vein
|
$369.17 |
$369.17 |
$369.17 |
$534.40
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$438.80 |
$438.80 |
$438.80 |
$436.64
|
|
Inj testosterone cypionate
|
$44.74 |
$44.74 |
$44.74 |
$82.58
|
|
Inj, vancomycin hcl (mylan)
|
$778.00 |
$778.00 |
$778.00 |
$89.83
|
|
Inj w/fluor eval cv device
|
$1,453.31 |
$1,453.31 |
$1,453.31 |
$588.90
|