|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$145.50 |
$145.50 |
$145.50 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$127.56 |
$127.56 |
$127.56 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$127.56 |
$127.56 |
$127.56 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$106.70 |
$106.70 |
$106.70 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$15.04 |
$15.04 |
$15.04 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$87.30 |
$87.30 |
$87.30 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$7.99 |
$7.99 |
$7.99 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$126.10 |
$126.10 |
$126.10 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$64.99 |
$64.99 |
$64.99 |
$141.48
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$138.71 |
$138.71 |
$138.71 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$24.25 |
$24.25 |
$24.25 |
$178.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$56.26 |
$56.26 |
$56.26 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$74.69 |
$74.69 |
$74.69 |
$103.20
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$60.63 |
$60.63 |
$60.63 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$235.23 |
$235.23 |
$235.23 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$91.77 |
$91.77 |
$91.77 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$401.58 |
$401.58 |
$401.58 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$57.96 |
$57.96 |
$57.96 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$24.25 |
$24.25 |
$24.25 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$65.48 |
$65.48 |
$65.48 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$29.10 |
$29.10 |
$29.10 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$72.75 |
$72.75 |
$72.75 |
$298.35
|
|
Initiation & management bipap/cpap initial day
|
$1,470.52 |
$1,470.52 |
$1,470.52 |
$645.79
|
|
Inj calcitriol per 0.1 mcg
|
$32.01 |
$32.01 |
$32.01 |
$33.36
|
|
Inj, cefiderocol, 10 mg
|
$584.91 |
$584.91 |
$584.91 |
$718.84
|
|
Inj ceftolozane tazobactam
|
$264.81 |
$264.81 |
$264.81 |
$447.36
|
|
Inj cntr knee arthro incl ct/mri
|
$211.46 |
$211.46 |
$211.46 |
$464.28
|
|
Inj disk cerv-thor ea lev
|
$149.87 |
$149.87 |
$149.87 |
$869.80
|
|
Inj dx for sinogram
|
$88.76 |
$88.76 |
$88.76 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$983.58 |
$983.58 |
$983.58 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$299.25 |
$299.25 |
$299.25 |
$507.10
|
|
Injection, cangrelor
|
$3,193.24 |
$3,193.24 |
$3,193.24 |
$2,546.20
|
|
Injection, doxercalciferol
|
$12.61 |
$12.61 |
$12.61 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$1,108.23 |
$1,108.23 |
$1,108.23 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$746.90 |
$746.90 |
$746.90 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$299.25 |
$299.25 |
$299.25 |
$441.12
|
|
Injection for bladder x-ray
|
$83.42 |
$83.42 |
$83.42 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$299.25 |
$299.25 |
$299.25 |
$504.00
|
|
Injection for spleen x-ray
|
$423.41 |
$423.41 |
$423.41 |
$686.40
|
|
Injection for ureter x-ray
|
$336.11 |
$336.11 |
$336.11 |
$515.21
|
|
Injection into brain canal
|
$1,199.41 |
$1,199.41 |
$1,199.41 |
$933.60
|
|
Injection,onabotulinumtoxina
|
$1,725.63 |
$1,725.63 |
$1,725.63 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$250.26 |
$250.26 |
$250.26 |
$717.20
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,235.30 |
$1,235.30 |
$1,235.30 |
$1,758.12
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$241.53 |
$241.53 |
$241.53 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$163.93 |
$163.93 |
$163.93 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$317.68 |
$317.68 |
$317.68 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$257.05 |
$257.05 |
$257.05 |
$141.60
|
|
Inj for ext venography
|
$313.80 |
$313.80 |
$313.80 |
$737.55
|
|
Inj for mammo ductogram
|
$120.28 |
$120.28 |
$120.28 |
$433.50
|
|
Inj hrt cath w/s&i sel right vent
|
$1,041.30 |
$1,041.30 |
$1,041.30 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$2,657.80 |
$2,657.80 |
$2,657.80 |
$3,180.35
|
|
Inj intralesional <= 7 lsn(s)
|
$363.75 |
$363.75 |
$363.75 |
$241.74
|
|
Inj., meropenem, vaborbactam
|
$568.42 |
$568.42 |
$568.42 |
$618.43
|
|
Inj, moxifloxacin 100 mg
|
$146.96 |
$146.96 |
$146.96 |
$190.81
|
|
Inj. mycophenolate mofetil
|
$344.84 |
$344.84 |
$344.84 |
$344.84
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,076.70 |
$1,076.70 |
$1,076.70 |
$1,522.56
|
|
Inj peritoneal venous shunt
|
$297.31 |
$297.31 |
$297.31 |
$386.88
|
|
Inj proc lumbr disk ea lvl
|
$639.72 |
$639.72 |
$639.72 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$95.06 |
$95.06 |
$95.06 |
$922.80
|
|
Inj proc sialogram
|
$83.42 |
$83.42 |
$83.42 |
$380.80
|
|
Inj retacrit esrd on dialysi
|
$352.11 |
$352.11 |
$352.11 |
$307.40
|
|
Inj retro urethrocysto
|
$83.42 |
$83.42 |
$83.42 |
$551.29
|
|
Inj testosterone cypionate
|
$370.54 |
$370.54 |
$370.54 |
$77.15
|
|
Inj, tyenne, 1 mg
|
$2,657.80 |
$2,657.80 |
$2,657.80 |
$860.68
|
|
Inj, vancomycin hcl (mylan)
|
$77.12 |
$77.12 |
$77.12 |
$63.82
|
|
Inj w/fluor eval cv device
|
$378.30 |
$378.30 |
$378.30 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,468.72 |
$3,468.72 |
$3,468.72 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,421.12 |
$2,421.12 |
$2,421.12 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$5,075.04 |
$5,075.04 |
$5,075.04 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,745.66 |
$3,745.66 |
$3,745.66 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$181.88 |
$181.88 |
$181.88 |
$544.00
|
|
Insert cath pleura with image
|
$1,036.45 |
$1,036.45 |
$1,036.45 |
$2,239.02
|
|
Insert cath pleura without image
|
$3,285.39 |
$3,285.39 |
$3,285.39 |
$2,212.00
|
|
Insert epicard eltrd endo 33203
|
$1,140.72 |
$1,140.72 |
$1,140.72 |
$1,967.20
|
|
Insert epicardial lead open 33202
|
$2,234.88 |
$2,234.88 |
$2,234.88 |
$1,879.20
|
|
Insert hepatic shunt (tips)
|
$14,228.93 |
$14,228.93 |
$14,228.93 |
$9,754.48
|
|
Insert intrauterine device iud
|
$114.95 |
$114.95 |
$114.95 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$178.97 |
$178.97 |
$178.97 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$202.73 |
$202.73 |
$202.73 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$5,787.51 |
$5,787.51 |
$5,787.51 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$2,051.55 |
$2,051.55 |
$2,051.55 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,707.07 |
$6,707.07 |
$6,707.07 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,839.12 |
$1,839.12 |
$1,839.12 |
$2,618.40
|
|
Insertion of catheter vein
|
$1,164.00 |
$1,164.00 |
$1,164.00 |
$1,749.80
|
|
Insertion of catheter vein
|
$114.46 |
$114.46 |
$114.46 |
$858.05
|
|
Insertion of heart electrode 33211
|
$7,264.82 |
$7,264.82 |
$7,264.82 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$12,367.99 |
$12,367.99 |
$12,367.99 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$11,378.59 |
$11,378.59 |
$11,378.59 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$9,330.43 |
$9,330.43 |
$9,330.43 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,111.21 |
$2,111.21 |
$2,111.21 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,010.81 |
$2,010.81 |
$2,010.81 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$36,326.02 |
$36,326.02 |
$36,326.02 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,122.23 |
$7,122.23 |
$7,122.23 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,653.16 |
$5,653.16 |
$5,653.16 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$8,724.67 |
$8,724.67 |
$8,724.67 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$5,633.28 |
$5,633.28 |
$5,633.28 |
$5,470.54
|
|
Insert pessary/other device
|
$273.54 |
$273.54 |
$273.54 |
$278.90
|
|
Insert picvad cath
|
$6,977.70 |
$6,977.70 |
$6,977.70 |
$4,490.00
|
|
Insert pm/icd lead dual
|
$5,653.16 |
$5,653.16 |
$5,653.16 |
$7,562.63
|