|
I-123 sod iodide diag per 100 uci
|
$91.52 |
$91.52 |
$91.52 |
$139.20
|
|
I131 iodide cap, rx
|
$200.80 |
$200.80 |
$200.80 |
$78.75
|
|
Iaadi respiratory synctial virus
|
$1.41 |
$1.41 |
$1.41 |
$49.40
|
|
Iadna legionella pneumophila amplified probe tq
|
$5.25 |
$5.25 |
$5.25 |
$109.80
|
|
Icd reliance df4 ib 64cm
|
$415.20 |
$415.20 |
$415.20 |
$9,259.80
|
|
Idh1 common variants
|
$24.74 |
$24.74 |
$24.74 |
$406.90
|
|
Idh2 common variants
|
$47.98 |
$47.98 |
$47.98 |
$486.00
|
|
Igh gene rearrange amp meth
|
$33.60 |
$33.60 |
$33.60 |
$456.54
|
|
Igh@ var region somatic mutation analy
|
$64.80 |
$64.80 |
$64.80 |
$660.80
|
|
Igk rearrangeabn clonal pop
|
$30.40 |
$30.40 |
$30.40 |
$396.00
|
|
Ihc/icc per specimen each additional single antibody stain
|
$81.12 |
$81.12 |
$81.12 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$132.80 |
$132.80 |
$132.80 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$56.96 |
$56.96 |
$56.96 |
$274.86
|
|
Ikbkap gene
|
$5.03 |
$5.03 |
$5.03 |
$176.15
|
|
Iliac/fem angio cath insert
|
$1,316.80 |
$1,316.80 |
$1,316.80 |
$1,827.35
|
|
Immobilizer lwr extrem nylon 20in reinforc 21-35in
|
$71.68 |
$71.68 |
$71.68 |
$336.17
|
|
Immobilizer shldr dlx str 24-36in med
|
$46.40 |
$46.40 |
$46.40 |
$102.00
|
|
Immune complex assay
|
$3.47 |
$3.47 |
$3.47 |
$109.20
|
|
Immunoassay tumor antigen quantitative ca 125
|
$58.72 |
$58.72 |
$58.72 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$58.72 |
$58.72 |
$58.72 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$33.76 |
$33.76 |
$33.76 |
$48.50
|
|
Immunodiffusion nes
|
$36.32 |
$36.32 |
$36.32 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$63.20 |
$63.20 |
$63.20 |
$138.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$15.97 |
$15.97 |
$15.97 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$86.40 |
$86.40 |
$86.40 |
$232.05
|
|
Immunoglobulin assay
|
$14.22 |
$14.22 |
$14.22 |
$74.15
|
|
Immunology procedure
|
$10.68 |
$10.68 |
$10.68 |
$118.25
|
|
Implant cartilage 10mm synthetic
|
$4,650.08 |
$4,650.08 |
$4,650.08 |
$10,050.00
|
|
Implant ureth bulk agent
|
$1,288.00 |
$1,288.00 |
$1,288.00 |
$2,139.62
|
|
In-111 autol wbc diag per dose
|
$552.80 |
$552.80 |
$552.80 |
$3,567.60
|
|
In-111 ibritumomab tiux dx
|
$967.52 |
$967.52 |
$967.52 |
$5,260.84
|
|
In-111 oxyquinolin per 0.5 mci
|
$783.04 |
$783.04 |
$783.04 |
$2,568.98
|
|
In-111 pentetate dtpa / 0.5 mci
|
$467.84 |
$467.84 |
$467.84 |
$2,550.60
|
|
In-111 pentetreotide
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$4,944.55
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$400.48 |
$400.48 |
$400.48 |
$2,080.80
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$111.52 |
$111.52 |
$111.52 |
$131.20
|
|
Infect ag drug suscept pheno predict
|
$38.70 |
$38.70 |
$38.70 |
$320.00
|
|
Infect ag eia influenza a or b ea
|
$35.20 |
$35.20 |
$35.20 |
$69.03
|
|
Infect ag genotype na cytomegalovirus
|
$41.19 |
$41.19 |
$41.19 |
$636.35
|
|
Infect ag genotype na dna hepatitis b
|
$56.48 |
$56.48 |
$56.48 |
$427.43
|
|
Infect ag genotype na hiv-1 other region
|
$24.94 |
$24.94 |
$24.94 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$69.52 |
$69.52 |
$69.52 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$48.64 |
$48.64 |
$48.64 |
$72.93
|
|
Infect ag if hep delta agent
|
$20.00 |
$20.00 |
$20.00 |
$125.97
|
|
Infect ag if influenza a
|
$2.57 |
$2.57 |
$2.57 |
$40.61
|
|
Infect ag if influenza b
|
$1.96 |
$1.96 |
$1.96 |
$37.95
|
|
Infect ag if legionella pneumophila
|
$1.62 |
$1.62 |
$1.62 |
$73.46
|
|
Infect ag if nos ea
|
$1.62 |
$1.62 |
$1.62 |
$74.10
|
|
Infect ag if pneumocystis carinii
|
$59.20 |
$59.20 |
$59.20 |
$67.46
|
|
Infect ag if varicella zoster
|
$1.62 |
$1.62 |
$1.62 |
$72.00
|
|
Infect ag na hpv high-risk types
|
$111.52 |
$111.52 |
$111.52 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$120.00 |
$120.00 |
$120.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$13.60 |
$13.60 |
$13.60 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$331.68 |
$331.68 |
$331.68 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$94.00 |
$94.00 |
$94.00 |
$855.60
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$6.88 |
$6.88 |
$6.88 |
$77.00
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$20.00 |
$20.00 |
$20.00 |
$51.31
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$45.44 |
$45.44 |
$45.44 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$35.52 |
$35.52 |
$35.52 |
$69.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$52.64 |
$52.64 |
$52.64 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$34.08 |
$34.08 |
$34.08 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$2.31 |
$2.31 |
$2.31 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$40.80 |
$40.80 |
$40.80 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$50.24 |
$50.24 |
$50.24 |
$57.60
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$79.84 |
$79.84 |
$79.84 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$32.00 |
$32.00 |
$32.00 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$37.12 |
$37.12 |
$37.12 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$1.41 |
$1.41 |
$1.41 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$114.40 |
$114.40 |
$114.40 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$124.32 |
$124.32 |
$124.32 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$117.44 |
$117.44 |
$117.44 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$250.56 |
$250.56 |
$250.56 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$26.72 |
$26.72 |
$26.72 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$102.56 |
$102.56 |
$102.56 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$114.40 |
$114.40 |
$114.40 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$124.32 |
$124.32 |
$124.32 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$64.16 |
$64.16 |
$64.16 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$79.20 |
$79.20 |
$79.20 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$109.60 |
$109.60 |
$109.60 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$4.94 |
$4.94 |
$4.94 |
$105.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$124.32 |
$124.32 |
$124.32 |
$250.50
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$114.40 |
$114.40 |
$114.40 |
$184.80
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$440.16 |
$440.16 |
$440.16 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$18.25 |
$18.25 |
$18.25 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$133.76 |
$133.76 |
$133.76 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$86.24 |
$86.24 |
$86.24 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$6.09 |
$6.09 |
$6.09 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$97.44 |
$97.44 |
$97.44 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$14.96 |
$14.96 |
$14.96 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$81.44 |
$81.44 |
$81.44 |
$303.59
|
|
Initiation & management bipap/cpap initial day
|
$287.20 |
$287.20 |
$287.20 |
$576.00
|
|
Inj, bupivacaine liposome
|
$424.84 |
$424.84 |
$424.84 |
$699.38
|
|
Inj, cefiderocol, 10 mg
|
$248.11 |
$248.11 |
$248.11 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$185.80 |
$185.80 |
$185.80 |
$408.00
|
|
Inj cntr knee arthro incl ct/mri
|
$211.68 |
$211.68 |
$211.68 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$269.60 |
$269.60 |
$269.60 |
$945.00
|
|
Inj dx for sinogram
|
$40.00 |
$40.00 |
$40.00 |
$413.82
|
|
Injection arthrography hip without anesthesia (both sides)
|
$245.12 |
$245.12 |
$245.12 |
$500.50
|
|
Injection during cath supravalvular aortography
|
$477.12 |
$477.12 |
$477.12 |
$904.17
|
|
Injection epidural blood patch or clot
|
$380.48 |
$380.48 |
$380.48 |
$1,156.80
|