|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$34.89 |
$34.89 |
$34.89 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$199.14 |
$199.14 |
$199.14 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$6.67 |
$6.67 |
$6.67 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$66.25 |
$66.25 |
$66.25 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$12.04 |
$12.04 |
$12.04 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$96.83 |
$96.83 |
$96.83 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$46.65 |
$46.65 |
$46.65 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$111.33 |
$111.33 |
$111.33 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$188.56 |
$188.56 |
$188.56 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$156.30 |
$156.30 |
$156.30 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$103.88 |
$103.88 |
$103.88 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$188.56 |
$188.56 |
$188.56 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,113.68 |
$1,113.68 |
$1,113.68 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$25.09 |
$25.09 |
$25.09 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$71.74 |
$71.74 |
$71.74 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$112.12 |
$112.12 |
$112.12 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$103.88 |
$103.88 |
$103.88 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$90.16 |
$90.16 |
$90.16 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$251.67 |
$251.67 |
$251.67 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$90.16 |
$90.16 |
$90.16 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$49.00 |
$49.00 |
$49.00 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$771.85 |
$771.85 |
$771.85 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$239.12 |
$239.12 |
$239.12 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$486.08 |
$486.08 |
$486.08 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$190.91 |
$190.91 |
$190.91 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$19.60 |
$19.60 |
$19.60 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$15.17 |
$15.17 |
$15.17 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$23.52 |
$23.52 |
$23.52 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$330.85 |
$330.85 |
$330.85 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$4,274.76 |
$4,274.76 |
$4,274.76 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$4,451.56 |
$4,451.56 |
$4,451.56 |
$1,432.80
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$161.51 |
$161.51 |
$161.51 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$3,217.93 |
$3,217.93 |
$3,217.93 |
$645.79
|
|
Inj, bupivacaine liposome
|
$1,481.76 |
$1,481.76 |
$1,481.76 |
$638.07
|
|
Inj cefazolin sodium, hikma
|
$38.03 |
$38.03 |
$38.03 |
$34.59
|
|
Inj, cefepime hcl (b braun)
|
$114.47 |
$114.47 |
$114.47 |
$81.41
|
|
Inj, cefiderocol, 10 mg
|
$862.40 |
$862.40 |
$862.40 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$390.44 |
$390.44 |
$390.44 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$390.04 |
$390.04 |
$390.04 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$6,209.28 |
$6,209.28 |
$6,209.28 |
$2,735.85
|
|
Inj disk cerv-thor ea lev
|
$450.02 |
$450.02 |
$450.02 |
$869.80
|
|
Inj dx for sinogram
|
$383.38 |
$383.38 |
$383.38 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$690.32 |
$690.32 |
$690.32 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$492.36 |
$492.36 |
$492.36 |
$507.10
|
|
Injection, cangrelor
|
$4,709.88 |
$4,709.88 |
$4,709.88 |
$1,943.40
|
|
Injection, daratumumab 10 mg
|
$1,764.00 |
$1,764.00 |
$1,764.00 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$184.64 |
$184.64 |
$184.64 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,457.85 |
$1,457.85 |
$1,457.85 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$205.41 |
$205.41 |
$205.41 |
$441.12
|
|
Injection for bladder x-ray
|
$622.11 |
$622.11 |
$622.11 |
$585.00
|
|
Injection for hip x-ray
|
$492.36 |
$492.36 |
$492.36 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$568.40 |
$568.40 |
$568.40 |
$504.00
|
|
Injection for spleen x-ray
|
$471.19 |
$471.19 |
$471.19 |
$686.40
|
|
Injection for ureter x-ray
|
$883.57 |
$883.57 |
$883.57 |
$515.21
|
|
Injection, fulvestrant
|
$470.40 |
$470.40 |
$470.40 |
$1,817.65
|
|
Injection into spinal artery
|
$1,083.49 |
$1,083.49 |
$1,083.49 |
$1,468.18
|
|
Injection of sinus tract
|
$2,240.68 |
$2,240.68 |
$2,240.68 |
$1,651.20
|
|
Injection,onabotulinumtoxina
|
$2,544.87 |
$2,544.87 |
$2,544.87 |
$2,154.07
|
|
Injection, peramivir
|
$1,489.60 |
$1,489.60 |
$1,489.60 |
$857.98
|
|
Injection radioactive tracer sentinel node (both sides)
|
$503.72 |
$503.72 |
$503.72 |
$717.20
|
|
Injection, renflexis
|
$3,544.08 |
$3,544.08 |
$3,544.08 |
$1,356.10
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$1,052.13 |
$1,052.13 |
$1,052.13 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$649.16 |
$649.16 |
$649.16 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,333.98 |
$1,333.98 |
$1,333.98 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$385.34 |
$385.34 |
$385.34 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,401.01 |
$1,401.01 |
$1,401.01 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$368.48 |
$368.48 |
$368.48 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$948.25 |
$948.25 |
$948.25 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,675.41 |
$1,675.41 |
$1,675.41 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,461.38 |
$1,461.38 |
$1,461.38 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$370.05 |
$370.05 |
$370.05 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$427.68 |
$427.68 |
$427.68 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$427.68 |
$427.68 |
$427.68 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$85.85 |
$85.85 |
$85.85 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$221.09 |
$221.09 |
$221.09 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$452.37 |
$452.37 |
$452.37 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$140.34 |
$140.34 |
$140.34 |
$141.60
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$14,700.00 |
$14,700.00 |
$14,700.00 |
$32,176.93
|
|
Inj epidural sgl lumb-sacral without img
|
$1,169.34 |
$1,169.34 |
$1,169.34 |
$1,450.84
|
|
Inj for ext venography
|
$138.38 |
$138.38 |
$138.38 |
$737.55
|
|
Inj for mammo ductogram
|
$491.57 |
$491.57 |
$491.57 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$101.53 |
$101.53 |
$101.53 |
$1,482.00
|
|
Inj hrt cath w/s&i sel right vent
|
$232.07 |
$232.07 |
$232.07 |
$947.65
|
|
Inj hydroxocobalamin IV 25mg
|
$4,694.60 |
$4,694.60 |
$4,694.60 |
$2,452.32
|
|
Inj mepivacaine hcl/10 ml
|
$43.52 |
$43.52 |
$43.52 |
$31.28
|
|
Inj, moxifloxacin 100 mg
|
$216.39 |
$216.39 |
$216.39 |
$153.27
|
|
Inj multihance
|
$520.58 |
$520.58 |
$520.58 |
$119.25
|
|
Inj. mycophenolate mofetil
|
$508.04 |
$508.04 |
$508.04 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,067.42 |
$1,067.42 |
$1,067.42 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$6,231.24 |
$6,231.24 |
$6,231.24 |
$4,096.71
|
|
Inj pemetrexed (accord) 10mg
|
$3,477.04 |
$3,477.04 |
$3,477.04 |
$11.34
|
|
Inj proc ankle arthr
|
$459.43 |
$459.43 |
$459.43 |
$405.31
|
|
Inj proc elbow arthro
|
$308.90 |
$308.90 |
$308.90 |
$453.60
|
|
Inj proc for lymphang
|
$299.88 |
$299.88 |
$299.88 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$382.99 |
$382.99 |
$382.99 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$330.46 |
$330.46 |
$330.46 |
$922.80
|
|
Inj prohance multipack
|
$7.84 |
$7.84 |
$7.84 |
$51.48
|
|
Inj retacrit esrd on dialysi
|
$519.01 |
$519.01 |
$519.01 |
$343.53
|
|
Inj retro urethrocysto
|
$256.37 |
$256.37 |
$256.37 |
$551.29
|
|
Inj, tyenne, 1 mg
|
$4,606.40 |
$4,606.40 |
$4,606.40 |
$3,525.12
|