|
Implant ureth bulk agent
|
$2,105.74 |
$2,105.74 |
$2,105.74 |
$1,930.57
|
|
In-111 oxyquinolin per 0.5 mci
|
$403.32 |
$403.32 |
$403.32 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$520.89 |
$520.89 |
$520.89 |
$2,135.29
|
|
Incobotulinumtoxin a
|
$1,733.37 |
$1,733.37 |
$1,733.37 |
$1,339.57
|
|
Indigotindisulfonate 8 mg/ml soln 5 ml ampule
|
$1,397.76 |
$1,397.76 |
$1,397.76 |
$1,099.05
|
|
Infect ag eia influenza a or b ea
|
$157.98 |
$157.98 |
$157.98 |
$69.03
|
|
Infect ag if influenza a
|
$3.11 |
$3.11 |
$3.11 |
$40.61
|
|
Infect ag if influenza b
|
$3.11 |
$3.11 |
$3.11 |
$34.67
|
|
Infect ag if nos ea
|
$3.11 |
$3.11 |
$3.11 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$5.46 |
$5.46 |
$5.46 |
$62.29
|
|
Infect ag if varicella zoster
|
$13.20 |
$13.20 |
$13.20 |
$66.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$356.72 |
$356.72 |
$356.72 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$30.94 |
$30.94 |
$30.94 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$545.64 |
$545.64 |
$545.64 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$32.31 |
$32.31 |
$32.31 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$32.28 |
$32.28 |
$32.28 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$269.00 |
$269.00 |
$269.00 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$5.46 |
$5.46 |
$5.46 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$4.37 |
$4.37 |
$4.37 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$6.19 |
$6.19 |
$6.19 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$218.40 |
$218.40 |
$218.40 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$11.18 |
$11.18 |
$11.18 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$55.33 |
$55.33 |
$55.33 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$43.32 |
$43.32 |
$43.32 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$4.60 |
$4.60 |
$4.60 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$6.00 |
$6.00 |
$6.00 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$160.89 |
$160.89 |
$160.89 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$46.60 |
$46.60 |
$46.60 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$333.06 |
$333.06 |
$333.06 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$104.11 |
$104.11 |
$104.11 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$108.48 |
$108.48 |
$108.48 |
$178.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$398.26 |
$398.26 |
$398.26 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$46.60 |
$46.60 |
$46.60 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$47.69 |
$47.69 |
$47.69 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$129.95 |
$129.95 |
$129.95 |
$248.15
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$45.50 |
$45.50 |
$45.50 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$176.54 |
$176.54 |
$176.54 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$68.87 |
$68.87 |
$68.87 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$74.26 |
$74.26 |
$74.26 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$18.20 |
$18.20 |
$18.20 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$14.08 |
$14.08 |
$14.08 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$21.84 |
$21.84 |
$21.84 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$185.64 |
$185.64 |
$185.64 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$2,791.24
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$1,654.83
|
|
Influenza dna amp prob addl
|
$30.22 |
$30.22 |
$30.22 |
$69.60
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$199.48 |
$199.48 |
$199.48 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$3,983.26 |
$3,983.26 |
$3,983.26 |
$645.79
|
|
Inj anifrolumab-fnia 1mg
|
$3,151.52 |
$3,151.52 |
$3,151.52 |
$9,878.82
|
|
Inj., benralizumab, 1 mg
|
$3,304.40 |
$3,304.40 |
$3,304.40 |
$16,865.48
|
|
Inj, bupivacaine liposome
|
$1,167.72 |
$1,167.72 |
$1,167.72 |
$816.31
|
|
Inj calcitriol per 0.1 mcg
|
$34.95 |
$34.95 |
$34.95 |
$33.36
|
|
Inj, cefepime hcl (b braun)
|
$85.18 |
$85.18 |
$85.18 |
$81.41
|
|
Inj ceftolozane tazobactam
|
$290.11 |
$290.11 |
$290.11 |
$447.36
|
|
Inj crotalidae im f(ab')2 eq
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$2,836.95
|
|
Injection, cangrelor
|
$3,498.77 |
$3,498.77 |
$3,498.77 |
$2,546.20
|
|
Injection, daratumumab 10 mg
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$1,534.26 |
$1,534.26 |
$1,534.26 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$531.81 |
$531.81 |
$531.81 |
$1,473.12
|
|
Injection, fulvestrant
|
$349.44 |
$349.44 |
$349.44 |
$2,756.47
|
|
Injection glatiramer acetate
|
$647.92 |
$647.92 |
$647.92 |
$405.93
|
|
Injection, inclisiran, 1 mg
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$10,366.61
|
|
Injection, isavuconazonium
|
$833.56 |
$833.56 |
$833.56 |
$646.20
|
|
Injection,onabotulinumtoxina
|
$1,890.62 |
$1,890.62 |
$1,890.62 |
$2,154.07
|
|
Injection, renflexis
|
$2,632.82 |
$2,632.82 |
$2,632.82 |
$1,457.42
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$175.45 |
$175.45 |
$175.45 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$175.45 |
$175.45 |
$175.45 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$175.45 |
$175.45 |
$175.45 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$199.84 |
$199.84 |
$199.84 |
$141.60
|
|
Inj fluphenazine hcl 1.25 mg
|
$33.86 |
$33.86 |
$33.86 |
$37.93
|
|
Inj ivig privigen 500 mg
|
$3,878.79 |
$3,878.79 |
$3,878.79 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$37.86 |
$37.86 |
$37.86 |
$28.41
|
|
Inj, nithiodote, 3mg / 125mg
|
$663.94 |
$663.94 |
$663.94 |
$389.50
|
|
Inj ogivri 10 mg
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$3,968.67
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$2,572.03 |
$2,572.03 |
$2,572.03 |
$6,403.59
|
|
Inj, releuko 1 mcg
|
$889.26 |
$889.26 |
$889.26 |
$557.11
|
|
Inj retacrit esrd on dialysi
|
$1,541.91 |
$1,541.91 |
$1,541.91 |
$307.40
|
|
Inj sulf hexa lipid microsph
|
$496.86 |
$496.86 |
$496.86 |
$315.78
|
|
Inj, tyenne, 1 mg
|
$2,366.00 |
$2,366.00 |
$2,366.00 |
$860.68
|
|
Ins cerv dilator (sep proc)
|
$266.09 |
$266.09 |
$266.09 |
$544.00
|
|
Insertion intra aortic balloon assist device percutaneous
|
$3,706.25 |
$3,706.25 |
$3,706.25 |
$2,549.95
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$21,269.25 |
$21,269.25 |
$21,269.25 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$19,567.55 |
$19,567.55 |
$19,567.55 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$9,493.85 |
$9,493.85 |
$9,493.85 |
$9,855.00
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$34,267.69 |
$34,267.69 |
$34,267.69 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$10,154.51 |
$10,154.51 |
$10,154.51 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$10,154.51 |
$10,154.51 |
$10,154.51 |
$7,673.12
|
|
Insert pm/icd lead dual
|
$10,154.51 |
$10,154.51 |
$10,154.51 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$47,894.40 |
$47,894.40 |
$47,894.40 |
$33,948.20
|
|
Insert swan-ganz cath
|
$1,342.07 |
$1,342.07 |
$1,342.07 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$8,639.54 |
$8,639.54 |
$8,639.54 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$27,440.87 |
$27,440.87 |
$27,440.87 |
$31,286.77
|
|
Insitu hybridization auto
|
$249.63 |
$249.63 |
$249.63 |
$398.16
|
|
Insitu hybridization manual
|
$249.63 |
$249.63 |
$249.63 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$81.41 |
$81.41 |
$81.41 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$118.92 |
$118.92 |
$118.92 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$11,287.64 |
$11,287.64 |
$11,287.64 |
$12,384.25
|
|
Ins pm gen w/exist mlt leads
|
$17,025.01 |
$17,025.01 |
$17,025.01 |
$15,600.75
|
|
Ins/rpl ldless pm right vent w img & eval
|
$17,319.12 |
$17,319.12 |
$17,319.12 |
$24,135.54
|
|
Ins/rpl pm gen exist dual lead
|
$17,015.55 |
$17,015.55 |
$17,015.55 |
$11,593.70
|