|
Immunofixation electrophoresis serum
|
$14.16 |
$14.16 |
$27.50 |
$133.38
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$42.93 |
$42.93 |
$83.37 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$72.92 |
$72.92 |
$141.61 |
$250.00
|
|
Immunoglobulin assay
|
$7.45 |
$7.45 |
$14.47 |
$74.00
|
|
Implant cartilage 10mm synthetic
|
$33,767.08 |
$33,767.08 |
$33,767.08 |
$11,811.60
|
|
Implant spine infusion pump
|
$12,636.71 |
$12,636.71 |
$12,636.71 |
$18,613.91
|
|
Implant ureth bulk agent
|
$1,123.67 |
$1,123.67 |
$1,123.67 |
$2,003.82
|
|
Implnt spinl canal catheter 62350
|
$2,911.19 |
$2,911.19 |
$2,911.19 |
$5,095.20
|
|
In-111 ibritumomab tiux dx
|
$1,624.35 |
$1,624.35 |
$1,624.35 |
$3,217.50
|
|
In-111 oxyquinolin per 0.5 mci
|
$1,008.42 |
$1,008.42 |
$1,008.42 |
$2,808.00
|
|
In-111 pentetate dtpa / 0.5 mci
|
$793.80 |
$793.80 |
$793.80 |
$2,135.29
|
|
In-111 pentetreotide
|
$1,938.05 |
$1,938.05 |
$1,938.05 |
$6,617.05
|
|
In-111 satumomab pend
|
$1,987.74 |
$1,987.74 |
$1,987.74 |
$3,524.25
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,528.22 |
$1,528.22 |
$1,528.22 |
$2,261.20
|
|
Incisn windpipe
|
$5,278.77 |
$5,278.77 |
$6,726.38 |
$3,837.72
|
|
Incobotulinumtoxin a
|
$1,137.49 |
$1,137.49 |
$1,137.49 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$95.17 |
$95.17 |
$184.84 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$55.57 |
$55.57 |
$125.05 |
$69.03
|
|
Infect ag genotype na dna hepatitis b
|
$75.52 |
$75.52 |
$146.67 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$41.16 |
$41.16 |
$79.94 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$82.41 |
$82.41 |
$160.04 |
$574.60
|
|
Infect ag ia optc obs influenza
|
$41.69 |
$41.69 |
$59.39 |
$66.72
|
|
Infect ag if hep delta agent
|
$36.75 |
$36.75 |
$71.38 |
$125.97
|
|
Infect ag if influenza a
|
$2.52 |
$2.52 |
$4.88 |
$40.61
|
|
Infect ag if influenza b
|
$2.52 |
$2.52 |
$4.88 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$8.82 |
$8.82 |
$17.13 |
$75.79
|
|
Infect ag if nos ea
|
$32.05 |
$32.05 |
$62.24 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$4.41 |
$4.41 |
$8.57 |
$62.29
|
|
Infect ag if varicella zoster
|
$17.73 |
$17.73 |
$34.42 |
$66.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$104.96 |
$104.96 |
$212.99 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$24.99 |
$24.99 |
$48.54 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$546.26 |
$546.26 |
$879.34 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$33.93 |
$33.93 |
$65.90 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$33.93 |
$33.93 |
$65.90 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$81.44 |
$81.44 |
$104.50 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$12.57 |
$12.57 |
$69.68 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$91.44 |
$91.44 |
$194.14 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$87.03 |
$87.03 |
$125.05 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$50.57 |
$50.57 |
$91.94 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$114.78 |
$114.78 |
$259.02 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$33.69 |
$33.69 |
$42.93 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$79.37 |
$79.37 |
$83.50 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$160.82 |
$160.82 |
$317.48 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$174.05 |
$174.05 |
$329.47 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$59.98 |
$59.98 |
$105.64 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$170.16 |
$170.16 |
$264.90 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$98.20 |
$98.20 |
$137.04 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$265.19 |
$265.19 |
$400.85 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$451.59 |
$451.59 |
$879.34 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$28.55 |
$28.55 |
$94.67 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$99.93 |
$99.93 |
$265.19 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$71.38 |
$71.38 |
$122.90 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$98.20 |
$98.20 |
$137.04 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$60.57 |
$60.57 |
$73.66 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$167.88 |
$167.88 |
$203.85 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$23.56 |
$23.56 |
$50.28 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$36.75 |
$36.75 |
$71.38 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$337.52 |
$337.52 |
$612.69 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$55.63 |
$55.63 |
$108.04 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$327.52 |
$327.52 |
$603.55 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$59.98 |
$59.98 |
$116.49 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$25.88 |
$25.88 |
$28.55 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$49.11 |
$49.11 |
$322.82 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$60.53 |
$60.53 |
$321.05 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$192.87 |
$192.87 |
$325.47 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$1,339.17 |
$1,339.17 |
$1,339.17 |
$2,102.08
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,085.16 |
$1,085.16 |
$1,085.16 |
$1,432.80
|
|
Infuse radioactive materials
|
$172.58 |
$172.58 |
$172.58 |
$600.89
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$83.50 |
$83.50 |
$121.06 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$1,912.77 |
$1,912.77 |
$2,088.72 |
$645.79
|
|
Inj, abilify maintena, 1 mg
|
$2,608.37 |
$2,608.37 |
$4,754.15 |
$6,796.39
|
|
Inj alymsys 10 mg
|
$3,296.04 |
$3,296.04 |
$3,296.04 |
$676.74
|
|
Inj anifrolumab-fnia 1mg
|
$5,514.86 |
$5,514.86 |
$5,514.86 |
$9,648.88
|
|
Inj., aristada initio, 1 mg
|
$4,797.55 |
$4,797.55 |
$4,797.55 |
$3,854.61
|
|
Inj., benralizumab, 1 mg
|
$5,530.73 |
$5,530.73 |
$5,530.73 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$4,357.08 |
$4,357.08 |
$4,357.08 |
$8,698.20
|
|
Inj, bupivacaine liposome
|
$361.33 |
$361.33 |
$361.33 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$19.11 |
$19.11 |
$19.11 |
$31.69
|
|
Inj, cefiderocol, 10 mg
|
$217.86 |
$217.86 |
$217.86 |
$596.08
|
|
Inj ceftolozane tazobactam
|
$113.49 |
$113.49 |
$113.49 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$708.84 |
$708.84 |
$708.84 |
$464.28
|
|
Inj crotalidae im f(ab')2 eq
|
$1,513.52 |
$1,513.52 |
$1,513.52 |
$2,735.85
|
|
Inj cyclophosphamd (ingenus)
|
$7.35 |
$7.35 |
$7.35 |
$493.23
|
|
Inj dx for sinogram
|
$574.77 |
$574.77 |
$574.77 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$516.56 |
$516.56 |
$516.56 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,045.47 |
$1,045.47 |
$1,045.47 |
$507.10
|
|
Injection, cangrelor
|
$905.52 |
$905.52 |
$905.52 |
$1,943.40
|
|
Injection, daratumumab 10 mg
|
$2,429.62 |
$2,429.62 |
$2,429.62 |
$5,324.34
|
|
Injection, doxercalciferol
|
$19.11 |
$19.11 |
$19.11 |
$31.83
|
|
Injection during cath supravalvular aortography
|
$705.60 |
$705.60 |
$705.60 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$856.43 |
$856.43 |
$856.43 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$1,128.38 |
$1,128.38 |
$1,128.38 |
$441.12
|
|
Injection for bladder x-ray
|
$538.32 |
$538.32 |
$538.32 |
$585.00
|
|
Injection for hip x-ray
|
$387.50 |
$387.50 |
$387.50 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,102.50 |
$1,102.50 |
$1,102.50 |
$504.00
|
|
Injection for spleen x-ray
|
$2,287.91 |
$2,287.91 |
$2,287.91 |
$686.40
|
|
Injection for ureter x-ray
|
$506.57 |
$506.57 |
$506.57 |
$444.95
|
|
Injection for ureter x-ray
|
$705.02 |
$705.02 |
$705.02 |
$515.21
|
|
Injection, fulvestrant
|
$2,000.97 |
$2,000.97 |
$2,000.97 |
$1,817.65
|
|
Injection glatiramer acetate
|
$5,531.32 |
$5,531.32 |
$5,531.32 |
$646.72
|