|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$109.93 |
$109.93 |
$109.93 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$147.04 |
$147.04 |
$147.04 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$79.80 |
$79.80 |
$79.80 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$17.86 |
$17.86 |
$17.86 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$140.34 |
$140.34 |
$140.34 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$150.11 |
$150.11 |
$150.11 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$131.97 |
$131.97 |
$131.97 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$42.97 |
$42.97 |
$42.97 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$216.51 |
$216.51 |
$216.51 |
$222.60
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$45.76 |
$45.76 |
$45.76 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$34.88 |
$34.88 |
$34.88 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$135.32 |
$135.32 |
$135.32 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$52.79 |
$52.79 |
$52.79 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$423.53 |
$423.53 |
$423.53 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$56.92 |
$56.92 |
$56.92 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$13.95 |
$13.95 |
$13.95 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$71.43 |
$71.43 |
$71.43 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$22.96 |
$22.96 |
$22.96 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$170.75 |
$170.75 |
$170.75 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$2,102.08
|
|
Initiation & management bipap/cpap initial day
|
$1,218.96 |
$1,218.96 |
$1,218.96 |
$645.79
|
|
Inj allopurinol sodium 1 mg
|
$3,070.12 |
$3,070.12 |
$3,070.12 |
$7,176.71
|
|
Inj alymsys 10 mg
|
$928.80 |
$928.80 |
$928.80 |
$676.74
|
|
Inj, artesunate, 1mg
|
$3,834.86 |
$3,834.86 |
$3,834.86 |
$18,824.75
|
|
Inj., benralizumab, 1 mg
|
$3,883.68 |
$3,883.68 |
$3,883.68 |
$13,682.10
|
|
Inj, bortezomib, dr. reddy's
|
$772.83 |
$772.83 |
$772.83 |
$48.55
|
|
Inj calcitriol per 0.1 mcg
|
$13.12 |
$13.12 |
$13.12 |
$31.69
|
|
Inj, cefiderocol, 10 mg
|
$237.15 |
$237.15 |
$237.15 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$107.42 |
$107.42 |
$107.42 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$131.13 |
$131.13 |
$131.13 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$2,735.85
|
|
Inj disk cerv-thor ea lev
|
$177.17 |
$177.17 |
$177.17 |
$869.80
|
|
Inj dx for sinogram
|
$139.78 |
$139.78 |
$139.78 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$686.62 |
$686.62 |
$686.62 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$144.53 |
$144.53 |
$144.53 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$180.24 |
$180.24 |
$180.24 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$647.01 |
$647.01 |
$647.01 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$131.13 |
$131.13 |
$131.13 |
$441.12
|
|
Injection for bladder x-ray
|
$272.31 |
$272.31 |
$272.31 |
$585.00
|
|
Injection for hip x-ray
|
$203.67 |
$203.67 |
$203.67 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$139.78 |
$139.78 |
$139.78 |
$504.00
|
|
Injection for spleen x-ray
|
$1,049.32 |
$1,049.32 |
$1,049.32 |
$686.40
|
|
Injection for ureter x-ray
|
$139.78 |
$139.78 |
$139.78 |
$444.95
|
|
Injection, fulvestrant
|
$129.46 |
$129.46 |
$129.46 |
$1,817.65
|
|
Injection glatiramer acetate
|
$239.67 |
$239.67 |
$239.67 |
$646.72
|
|
Injection, inclisiran, 1 mg
|
$2,502.63 |
$2,502.63 |
$2,502.63 |
$6,830.50
|
|
Injection,onabotulinumtoxina
|
$699.18 |
$699.18 |
$699.18 |
$2,154.07
|
|
Injection, renflexis
|
$973.71 |
$973.71 |
$973.71 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$540.99 |
$540.99 |
$540.99 |
$1,501.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$712.85 |
$712.85 |
$712.85 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$512.81 |
$512.81 |
$512.81 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$712.85 |
$712.85 |
$712.85 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$586.18 |
$586.18 |
$586.18 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$469.56 |
$469.56 |
$469.56 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$236.04 |
$236.04 |
$236.04 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$236.04 |
$236.04 |
$236.04 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$236.04 |
$236.04 |
$236.04 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$198.37 |
$198.37 |
$198.37 |
$141.60
|
|
Injection treatment of nerve
|
$1,799.00 |
$1,799.00 |
$1,799.00 |
$3,986.00
|
|
Inj fluphenazine hcl 1.25 mg
|
$12.56 |
$12.56 |
$12.56 |
$44.95
|
|
Inj for ext venography
|
$244.69 |
$244.69 |
$244.69 |
$737.55
|
|
Inj for mammo ductogram
|
$131.13 |
$131.13 |
$131.13 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$164.06 |
$164.06 |
$164.06 |
$1,482.00
|
|
Inj ivig privigen 500 mg
|
$807.71 |
$807.71 |
$807.71 |
$7,173.90
|
|
Inj melpha hydroch nos 50 mg
|
$1,930.13 |
$1,930.13 |
$1,930.13 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$13.95 |
$13.95 |
$13.95 |
$31.28
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,572.60 |
$3,572.60 |
$3,572.60 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$1,255.50 |
$1,255.50 |
$1,255.50 |
$4,096.71
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$3,022.97 |
$3,022.97 |
$3,022.97 |
$6,244.73
|
|
Inj proc lumbr disk ea lvl
|
$177.17 |
$177.17 |
$177.17 |
$1,224.30
|
|
Inj progesterone per 50 mg
|
$38.79 |
$38.79 |
$38.79 |
$19.53
|
|
Inj, releuko 1 mcg
|
$328.95 |
$328.95 |
$328.95 |
$519.53
|
|
Inj retacrit esrd on dialysi
|
$570.28 |
$570.28 |
$570.28 |
$343.53
|
|
Inj retro urethrocysto
|
$159.03 |
$159.03 |
$159.03 |
$551.29
|
|
Inj testosterone cypionate
|
$30.97 |
$30.97 |
$30.97 |
$82.58
|
|
Inj, vancomycin hcl (mylan)
|
$10.61 |
$10.61 |
$10.61 |
$89.83
|
|
Inj w/fluor eval cv device
|
$683.83 |
$683.83 |
$683.83 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,293.32 |
$3,293.32 |
$3,293.32 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$2,502.91 |
$2,502.91 |
$2,502.91 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$3,787.43 |
$3,787.43 |
$3,787.43 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,523.77 |
$3,523.77 |
$3,523.77 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$212.60 |
$212.60 |
$212.60 |
$544.00
|
|
Insert cath pleura with image
|
$927.68 |
$927.68 |
$927.68 |
$2,239.02
|
|
Insert cath pleura without image
|
$943.02 |
$943.02 |
$943.02 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$4,232.71 |
$4,232.71 |
$4,232.71 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$129.46 |
$129.46 |
$129.46 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$129.46 |
$129.46 |
$129.46 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,280.27 |
$2,280.27 |
$2,280.27 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,010.97 |
$3,010.97 |
$3,010.97 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,523.71 |
$4,523.71 |
$4,523.71 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,180.17 |
$1,180.17 |
$1,180.17 |
$2,618.40
|
|
Insertion of catheter vein
|
$149.83 |
$149.83 |
$149.83 |
$1,749.80
|
|
Insertion of catheter vein
|
$792.92 |
$792.92 |
$792.92 |
$858.05
|
|
Insertion of heart electrode 33211
|
$5,884.11 |
$5,884.11 |
$5,884.11 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$11,402.46 |
$11,402.46 |
$11,402.46 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,374.40 |
$9,374.40 |
$9,374.40 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$11,402.46 |
$11,402.46 |
$11,402.46 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,210.31 |
$1,210.31 |
$1,210.31 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,210.31 |
$1,210.31 |
$1,210.31 |
$2,527.91
|