|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$42.24 |
$42.24 |
$42.24 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$92.23 |
$92.23 |
$92.23 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$49.92 |
$49.92 |
$49.92 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$69.12 |
$69.12 |
$69.12 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$332.64 |
$332.64 |
$332.64 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$423.36 |
$423.36 |
$423.36 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$42.24 |
$42.24 |
$42.24 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$78.48 |
$78.48 |
$78.48 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$97.92 |
$97.92 |
$97.92 |
$282.10
|
|
Infectious agent nucleic acid quantification bk virus
|
$179.52 |
$179.52 |
$179.52 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$156.00 |
$156.00 |
$156.00 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$202.56 |
$202.56 |
$202.56 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$141.60 |
$141.60 |
$141.60 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$213.12 |
$213.12 |
$213.12 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$319.68 |
$319.68 |
$319.68 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$1,505.28 |
$1,505.28 |
$1,505.28 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$0.00 |
$0.00 |
$0.00 |
$6,796.39
|
|
Inj calcitriol per 0.1 mcg
|
$44.76 |
$44.76 |
$44.76 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$44.76 |
$44.76 |
$44.76 |
$34.59
|
|
Inj cefazolin (wg crit care)
|
$44.76 |
$44.76 |
$44.76 |
$25.00
|
|
Inj, cefiderocol, 10 mg
|
$717.33 |
$717.33 |
$717.33 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$445.07 |
$445.07 |
$445.07 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$915.84 |
$915.84 |
$915.84 |
$464.28
|
|
Inj cyclophosphamd auromedic
|
$220.91 |
$220.91 |
$220.91 |
$231.57
|
|
Inj cyclophosphamd (ingenus)
|
$424.57 |
$424.57 |
$424.57 |
$493.23
|
|
Inj, daptomycin (hospira)
|
$132.80 |
$132.80 |
$132.80 |
$152.35
|
|
Inj. denosumab-bbdz, 1 mg
|
$6,636.36 |
$6,636.36 |
$6,636.36 |
$4,416.07
|
|
Inj dx for sinogram
|
$847.20 |
$847.20 |
$847.20 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,345.44 |
$1,345.44 |
$1,345.44 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$921.60 |
$921.60 |
$921.60 |
$507.10
|
|
Injection, cangrelor
|
$2,638.56 |
$2,638.56 |
$2,638.56 |
$1,943.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$630.24 |
$630.24 |
$630.24 |
$536.00
|
|
Injection during cath supravalvular aortography
|
$282.24 |
$282.24 |
$282.24 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$2,198.88 |
$2,198.88 |
$2,198.88 |
$1,473.12
|
|
Injection eye drug
|
$214.08 |
$214.08 |
$214.08 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$749.76 |
$749.76 |
$749.76 |
$441.12
|
|
Injection for bladder x-ray
|
$1,063.20 |
$1,063.20 |
$1,063.20 |
$585.00
|
|
Injection for hip x-ray
|
$805.44 |
$805.44 |
$805.44 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$647.04 |
$647.04 |
$647.04 |
$504.00
|
|
Injection for spleen x-ray
|
$332.16 |
$332.16 |
$332.16 |
$686.40
|
|
Injection for ureter x-ray
|
$355.68 |
$355.68 |
$355.68 |
$444.95
|
|
Injection for ureter x-ray
|
$355.68 |
$355.68 |
$355.68 |
$515.21
|
|
Injection into brain canal
|
$394.08 |
$394.08 |
$394.08 |
$970.61
|
|
Injection into brain canal
|
$672.48 |
$672.48 |
$672.48 |
$933.60
|
|
Injection into hemorrhoid(s)
|
$1,637.28 |
$1,637.28 |
$1,637.28 |
$1,278.72
|
|
Injection, isavuconazonium
|
$1,122.64 |
$1,122.64 |
$1,122.64 |
$863.93
|
|
Injection jugular
|
$1,565.28 |
$1,565.28 |
$1,565.28 |
$1,048.20
|
|
Injection of sinus tract
|
$2,130.72 |
$2,130.72 |
$2,130.72 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$1,860.48 |
$1,860.48 |
$1,860.48 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$625.44 |
$625.44 |
$625.44 |
$717.20
|
|
Injection, renflexis
|
$1,479.34 |
$1,479.34 |
$1,479.34 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,340.16 |
$1,340.16 |
$1,340.16 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,802.40 |
$1,802.40 |
$1,802.40 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,947.20 |
$2,947.20 |
$2,947.20 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,428.48 |
$1,428.48 |
$1,428.48 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$724.80 |
$724.80 |
$724.80 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$724.80 |
$724.80 |
$724.80 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$724.80 |
$724.80 |
$724.80 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$108.96 |
$108.96 |
$108.96 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$135.84 |
$135.84 |
$135.84 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$208.32 |
$208.32 |
$208.32 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$73.44 |
$73.44 |
$73.44 |
$141.60
|
|
Injection treatment of eye
|
$1,836.96 |
$1,836.96 |
$1,836.96 |
$2,698.92
|
|
Inject sacroiliac joint
|
$369.60 |
$369.60 |
$369.60 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$1,345.44 |
$1,345.44 |
$1,345.44 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$1,169.28 |
$1,169.28 |
$1,169.28 |
$1,450.84
|
|
Inj fluphenazine hcl 1.25 mg
|
$44.76 |
$44.76 |
$44.76 |
$44.95
|
|
Inj for ext venography
|
$552.96 |
$552.96 |
$552.96 |
$737.55
|
|
Inj for mammo ductogram
|
$334.08 |
$334.08 |
$334.08 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$282.24 |
$282.24 |
$282.24 |
$1,482.00
|
|
Inj hrt cath w/s&i sel left vent
|
$282.24 |
$282.24 |
$282.24 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$282.24 |
$282.24 |
$282.24 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$489.60 |
$489.60 |
$489.60 |
$241.74
|
|
Inj, kovaltry, 1 i.u
|
$3,380.83 |
$3,380.83 |
$3,380.83 |
$5.12
|
|
Inj levocarnitine per 1 gm
|
$145.37 |
$145.37 |
$145.37 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$44.76 |
$44.76 |
$44.76 |
$31.28
|
|
Inj. mycophenolate mofetil
|
$225.06 |
$225.06 |
$225.06 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,100.64 |
$1,100.64 |
$1,100.64 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$760.89 |
$760.89 |
$760.89 |
$4,096.71
|
|
Inj peritoneal venous shunt
|
$408.48 |
$408.48 |
$408.48 |
$386.88
|
|
Inj., perseris, 0.5 mg
|
$2,736.93 |
$2,736.93 |
$2,736.93 |
$5,372.48
|
|
Inj proc elbow arthro
|
$760.32 |
$760.32 |
$760.32 |
$453.60
|
|
Inj proc for lymphang
|
$441.60 |
$441.60 |
$441.60 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$1,296.96 |
$1,296.96 |
$1,296.96 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$3,167.52 |
$3,167.52 |
$3,167.52 |
$922.80
|
|
Inj progesterone per 50 mg
|
$44.76 |
$44.76 |
$44.76 |
$19.53
|
|
Inj, releuko 1 mcg
|
$503.56 |
$503.56 |
$503.56 |
$519.53
|
|
Inj retro urethrocysto
|
$636.00 |
$636.00 |
$636.00 |
$551.29
|
|
Inj scleros sol sgl vein
|
$474.72 |
$474.72 |
$474.72 |
$534.40
|
|
Inj testosterone cypionate
|
$60.00 |
$60.00 |
$60.00 |
$82.58
|
|
Inj w/fluor eval cv device
|
$205.44 |
$205.44 |
$205.44 |
$588.90
|
|
Ins cath ren art 1st bi
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$3,204.00 |
$3,204.00 |
$3,204.00 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$8,242.08 |
$8,242.08 |
$8,242.08 |
$5,528.94
|