|
Immune globulin, gamma (igg) 10 gram-gly-gluc-iga 0 to 50 mcg/ml IV solution
|
$1,635.38 |
$1,635.38 |
$1,635.38 |
$2,900.11
|
|
Immunoassay tumor antigen quantitative ca 125
|
$7.64 |
$7.64 |
$7.64 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$7.64 |
$7.64 |
$7.64 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$4.46 |
$4.46 |
$4.46 |
$48.57
|
|
Immunodiffusion nes
|
$3.18 |
$3.18 |
$3.18 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$15.29 |
$15.29 |
$15.29 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$58.66 |
$58.66 |
$58.66 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$15.61 |
$15.61 |
$15.61 |
$234.27
|
|
Immunoglobulin assay
|
$118.48 |
$118.48 |
$118.48 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$58,492.95 |
$58,492.95 |
$58,492.95 |
$8,332.51
|
|
Implant ureth bulk agent
|
$1,868.35 |
$1,868.35 |
$1,868.35 |
$2,168.00
|
|
Infect ag drug suscept pheno predict
|
$133.36 |
$133.36 |
$133.36 |
$325.00
|
|
Infect ag eia influenza a or b ea
|
$23.99 |
$23.99 |
$23.99 |
$71.20
|
|
Infect ag genotype na cytomegalovirus
|
$306.34 |
$306.34 |
$306.34 |
$665.40
|
|
Infect ag genotype na dna hepatitis b
|
$90.95 |
$90.95 |
$90.95 |
$409.27
|
|
Infect ag genotype na hiv-1 other region
|
$63.61 |
$63.61 |
$63.61 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$75.89 |
$75.89 |
$75.89 |
$603.83
|
|
Infect ag if pneumocystis carinii
|
$14.51 |
$14.51 |
$14.51 |
$66.06
|
|
Infect ag na hep b amp
|
$47.43 |
$47.43 |
$47.43 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$20.09 |
$20.09 |
$20.09 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$71.98 |
$71.98 |
$71.98 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$19.53 |
$19.53 |
$19.53 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$71.42 |
$71.42 |
$71.42 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$13.39 |
$13.39 |
$13.39 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$20.09 |
$20.09 |
$20.09 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$15.62 |
$15.62 |
$15.62 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$5.02 |
$5.02 |
$5.02 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$19.53 |
$19.53 |
$19.53 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$48.55 |
$48.55 |
$48.55 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$59.71 |
$59.71 |
$59.71 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$22.88 |
$22.88 |
$22.88 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$21.76 |
$21.76 |
$21.76 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$261.14 |
$261.14 |
$261.14 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$5.58 |
$5.58 |
$5.58 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$62.50 |
$62.50 |
$62.50 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$195.30 |
$195.30 |
$195.30 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$20.09 |
$20.09 |
$20.09 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$25.11 |
$25.11 |
$25.11 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$36.27 |
$36.27 |
$36.27 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$10.60 |
$10.60 |
$10.60 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$85.93 |
$85.93 |
$85.93 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$53.57 |
$53.57 |
$53.57 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$59.15 |
$59.15 |
$59.15 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$34.04 |
$34.04 |
$34.04 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$371.63 |
$371.63 |
$371.63 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$440.26 |
$440.26 |
$440.26 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$125.55 |
$125.55 |
$125.55 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$42.97 |
$42.97 |
$42.97 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$54.13 |
$54.13 |
$54.13 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$33.48 |
$33.48 |
$33.48 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$238.82 |
$238.82 |
$238.82 |
$304.20
|
|
Inj cntr knee arthro incl ct/mri
|
$210.89 |
$210.89 |
$210.89 |
$436.80
|
|
Inj crotalidae im f(ab')2 eq
|
$425.29 |
$425.29 |
$425.29 |
$2,613.60
|
|
Injection arthrography hip without anesthesia (both sides)
|
$236.47 |
$236.47 |
$236.47 |
$503.50
|
|
Injection epidural blood patch or clot
|
$651.93 |
$651.93 |
$651.93 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$256.82 |
$256.82 |
$256.82 |
$436.00
|
|
Injection for bladder x-ray
|
$277.70 |
$277.70 |
$277.70 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$266.22 |
$266.22 |
$266.22 |
$497.76
|
|
Injection for ureter x-ray
|
$456.75 |
$456.75 |
$456.75 |
$415.80
|
|
Injection radioactive tracer sentinel node (both sides)
|
$375.32 |
$375.32 |
$375.32 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$853.65 |
$853.65 |
$853.65 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$162.88 |
$162.88 |
$162.88 |
$1,043.72
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$870.41 |
$870.41 |
$870.41 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,068.87 |
$2,068.87 |
$2,068.87 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$901.82 |
$901.82 |
$901.82 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,909.73 |
$1,909.73 |
$1,909.73 |
$2,006.79
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$61.82 |
$61.82 |
$61.82 |
$145.60
|
|
Inject sacroiliac joint
|
$1,083.67 |
$1,083.67 |
$1,083.67 |
$1,029.04
|
|
Inj, epinephrine (belcher)
|
$2.04 |
$2.04 |
$2.04 |
$6.55
|
|
Inj proc ankle arthr
|
$196.79 |
$196.79 |
$196.79 |
$405.31
|
|
Inj proc elbow arthro
|
$247.43 |
$247.43 |
$247.43 |
$432.00
|
|
Inj proc myelogram lumbar
|
$373.23 |
$373.23 |
$373.23 |
$838.30
|
|
Inj retacrit esrd on dialysi
|
$4.04 |
$4.04 |
$4.04 |
$349.45
|
|
Inj retro urethrocysto
|
$189.49 |
$189.49 |
$189.49 |
$447.74
|
|
Ins cerv dilator (sep proc)
|
$577.43 |
$577.43 |
$577.43 |
$490.73
|
|
Insert cath pleura with image
|
$1,432.37 |
$1,432.37 |
$1,432.37 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$110.28 |
$110.28 |
$110.28 |
$208.01
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$216.61 |
$216.61 |
$216.61 |
$2,585.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$691.13 |
$691.13 |
$691.13 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$829.98 |
$829.98 |
$829.98 |
$2,453.83
|
|
Insitu hybridization auto
|
$105.50 |
$105.50 |
$105.50 |
$377.37
|
|
Insitu hybridization manual
|
$321.56 |
$321.56 |
$321.56 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$168.80 |
$168.80 |
$168.80 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$154.03 |
$154.03 |
$154.03 |
$338.40
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$896.80 |
$896.80 |
$896.80 |
$1,690.00
|
|
Ins pq tunnld ip cath w/img
|
$3,279.73 |
$3,279.73 |
$3,279.73 |
$5,486.00
|
|
Instillation anticarcinogenic agent bladder
|
$694.51 |
$694.51 |
$694.51 |
$638.40
|
|
Insulin total
|
$4.38 |
$4.38 |
$4.38 |
$66.64
|
|
Intrinsic factor antibody
|
$5.73 |
$5.73 |
$5.73 |
$65.00
|
|
Intubation endotracheal emergency procedure
|
$364.53 |
$364.53 |
$364.53 |
$601.28
|
|
Iron
|
$98.28 |
$98.28 |
$98.28 |
$75.00
|
|
Iron binding capacity
|
$16.90 |
$16.90 |
$16.90 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$202.86 |
$202.86 |
$202.86 |
$146.11
|
|
IV Fluids (each additional hour)
|
$55.53 |
$55.53 |
$55.53 |
$133.90
|
|
IV Fluids (first hour)
|
$343.87 |
$343.87 |
$343.87 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$127.11 |
$127.11 |
$127.11 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$146.51 |
$146.51 |
$146.51 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$68.24 |
$68.24 |
$68.24 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$414.78 |
$414.78 |
$414.78 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$83.08 |
$83.08 |
$83.08 |
$167.50
|