|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$111.30 |
$111.30 |
$111.30 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$119.00 |
$119.00 |
$119.00 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$119.00 |
$119.00 |
$119.00 |
$97.50
|
|
Infectious agent nucleic acid amplified probe
|
$94.50 |
$94.50 |
$94.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$43.05 |
$43.05 |
$43.05 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$487.90 |
$487.90 |
$487.90 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,124.20 |
$1,124.20 |
$1,124.20 |
$855.45
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$43.05 |
$43.05 |
$43.05 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$177.45 |
$177.45 |
$177.45 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$667.80 |
$667.80 |
$667.80 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$560.00 |
$560.00 |
$560.00 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$244.65 |
$244.65 |
$244.65 |
$98.15
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$682.85 |
$682.85 |
$682.85 |
$727.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$577.15 |
$577.15 |
$577.15 |
$298.35
|
|
Infliximab 100 mg intravenous solution
|
$4,195.34 |
$4,195.34 |
$4,195.34 |
$2,102.08
|
|
Initiation & management bipap/cpap initial day
|
$1,127.00 |
$1,127.00 |
$1,127.00 |
$645.79
|
|
Inj, bupivacaine liposome
|
$74.23 |
$74.23 |
$74.23 |
$638.07
|
|
Inj calcitriol per 0.1 mcg
|
$33.39 |
$33.39 |
$33.39 |
$31.69
|
|
Inj cefazolin sodium, hikma
|
$33.05 |
$33.05 |
$33.05 |
$34.59
|
|
Inj, cefepime hcl (b braun)
|
$84.18 |
$84.18 |
$84.18 |
$81.41
|
|
Inj ceftolozane tazobactam
|
$649.05 |
$649.05 |
$649.05 |
$431.36
|
|
Inj cntr knee arthro incl ct/mri
|
$115.85 |
$115.85 |
$115.85 |
$464.28
|
|
Inj disk cerv-thor ea lev
|
$428.40 |
$428.40 |
$428.40 |
$869.80
|
|
Inj dx for sinogram
|
$131.95 |
$131.95 |
$131.95 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$638.40 |
$638.40 |
$638.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$146.30 |
$146.30 |
$146.30 |
$507.10
|
|
Injection, belinostat, 10mg
|
$7,142.89 |
$7,142.89 |
$7,142.89 |
$4,985.88
|
|
Injection, cangrelor
|
$3,591.36 |
$3,591.36 |
$3,591.36 |
$1,943.40
|
|
Injection carpal tunnel therapeutic (both sides)
|
$182.70 |
$182.70 |
$182.70 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$10,586.32 |
$10,586.32 |
$10,586.32 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$857.50 |
$857.50 |
$857.50 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,058.40 |
$1,058.40 |
$1,058.40 |
$1,473.12
|
|
Injection eye drug
|
$266.70 |
$266.70 |
$266.70 |
$648.90
|
|
Injection for arthrography wrist (both sides)
|
$129.50 |
$129.50 |
$129.50 |
$441.12
|
|
Injection for bladder x-ray
|
$129.50 |
$129.50 |
$129.50 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$87.50 |
$87.50 |
$87.50 |
$504.00
|
|
Injection for ureter x-ray
|
$480.55 |
$480.55 |
$480.55 |
$515.21
|
|
Injection, fulvestrant
|
$3,240.61 |
$3,240.61 |
$3,240.61 |
$1,817.65
|
|
Injection into hemorrhoid(s)
|
$680.05 |
$680.05 |
$680.05 |
$1,278.72
|
|
Injection,onabotulinumtoxina
|
$2,532.32 |
$2,532.32 |
$2,532.32 |
$2,154.07
|
|
Injection radioactive tracer sentinel node (both sides)
|
$472.50 |
$472.50 |
$472.50 |
$717.20
|
|
Injection, renflexis
|
$1,388.27 |
$1,388.27 |
$1,388.27 |
$1,356.10
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$904.75 |
$904.75 |
$904.75 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$609.70 |
$609.70 |
$609.70 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,902.60 |
$1,902.60 |
$1,902.60 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$967.05 |
$967.05 |
$967.05 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,981.70 |
$1,981.70 |
$1,981.70 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$472.15 |
$472.15 |
$472.15 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$861.35 |
$861.35 |
$861.35 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,264.90 |
$1,264.90 |
$1,264.90 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,311.45 |
$1,311.45 |
$1,311.45 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$574.70 |
$574.70 |
$574.70 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$386.40 |
$386.40 |
$386.40 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$394.45 |
$394.45 |
$394.45 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$77.00 |
$77.00 |
$77.00 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$63.70 |
$63.70 |
$63.70 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$376.60 |
$376.60 |
$376.60 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$71.75 |
$71.75 |
$71.75 |
$141.60
|
|
Injection treatment of eye
|
$1,185.80 |
$1,185.80 |
$1,185.80 |
$2,698.92
|
|
Inject sacroiliac joint
|
$891.10 |
$891.10 |
$891.10 |
$1,090.00
|
|
Inj epidural sgl cerv-thor without img
|
$569.80 |
$569.80 |
$569.80 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$904.75 |
$904.75 |
$904.75 |
$1,450.84
|
|
Inj for ext venography
|
$153.30 |
$153.30 |
$153.30 |
$737.55
|
|
Inj for mammo ductogram
|
$236.25 |
$236.25 |
$236.25 |
$433.50
|
|
Inj heparin, pfizer, 1000u
|
$32.70 |
$32.70 |
$32.70 |
$26.85
|
|
Inj hrt cath w/s&i sel right vent
|
$612.50 |
$612.50 |
$612.50 |
$947.65
|
|
Inj, immphentiv, 20 mcg
|
$32.83 |
$32.83 |
$32.83 |
$38.40
|
|
Inj intralesional <= 7 lsn(s)
|
$122.85 |
$122.85 |
$122.85 |
$241.74
|
|
Inj, levothyroxine, freskabi
|
$256.37 |
$256.37 |
$256.37 |
$303.45
|
|
Inj mepivacaine hcl/10 ml
|
$33.18 |
$33.18 |
$33.18 |
$31.28
|
|
Inj. mycophenolate mofetil
|
$262.57 |
$262.57 |
$262.57 |
$291.54
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,204.00 |
$1,204.00 |
$1,204.00 |
$1,522.56
|
|
Inj ogivri 10 mg
|
$4,764.75 |
$4,764.75 |
$4,764.75 |
$4,096.71
|
|
Inj peritoneal venous shunt
|
$764.40 |
$764.40 |
$764.40 |
$386.88
|
|
Inj proc ankle arthr
|
$133.35 |
$133.35 |
$133.35 |
$405.31
|
|
Inj proc elbow arthro
|
$129.50 |
$129.50 |
$129.50 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$428.40 |
$428.40 |
$428.40 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$265.30 |
$265.30 |
$265.30 |
$922.80
|
|
Inj proc sialogram
|
$73.85 |
$73.85 |
$73.85 |
$380.80
|
|
Inj progesterone per 50 mg
|
$33.63 |
$33.63 |
$33.63 |
$19.53
|
|
Inj, releuko 1 mcg
|
$587.49 |
$587.49 |
$587.49 |
$519.53
|
|
Inj retro urethrocysto
|
$129.50 |
$129.50 |
$129.50 |
$551.29
|
|
Inj scleros sol sgl vein
|
$332.15 |
$332.15 |
$332.15 |
$534.40
|
|
Inj teclistamab cqyv 0.5 mg
|
$6,416.78 |
$6,416.78 |
$6,416.78 |
$17,517.56
|
|
Inj testosterone cypionate
|
$55.38 |
$55.38 |
$55.38 |
$82.58
|
|
Inj w/fluor eval cv device
|
$327.25 |
$327.25 |
$327.25 |
$588.90
|
|
Ins cath ren art 1st bi
|
$2,930.90 |
$2,930.90 |
$2,930.90 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$3,587.50 |
$3,587.50 |
$3,587.50 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$2,930.90 |
$2,930.90 |
$2,930.90 |
$5,408.65
|
|
Ins cath ren art 2nd+ uni
|
$3,994.90 |
$3,994.90 |
$3,994.90 |
$5,528.94
|
|
Ins cerv dilator (sep proc)
|
$241.85 |
$241.85 |
$241.85 |
$544.00
|
|
Insert and remove bone pin
|
$2,426.55 |
$2,426.55 |
$2,426.55 |
$4,335.60
|
|
Insert cath pleura with image
|
$2,375.45 |
$2,375.45 |
$2,375.45 |
$2,239.02
|
|
Insert cath pleura without image
|
$2,317.70 |
$2,317.70 |
$2,317.70 |
$2,212.00
|
|
Insert hepatic shunt (tips)
|
$24,509.10 |
$24,509.10 |
$24,509.10 |
$9,754.48
|
|
Insert intrauterine device iud
|
$157.85 |
$157.85 |
$157.85 |
$378.83
|
|
Insertion catheter bladder non indwelling
|
$171.15 |
$171.15 |
$171.15 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$156.80 |
$156.80 |
$156.80 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$4,863.60 |
$4,863.60 |
$4,863.60 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$882.00 |
$882.00 |
$882.00 |
$2,549.95
|