|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$25.60 |
$25.60 |
$25.60 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$36.00 |
$36.00 |
$36.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$76.00 |
$76.00 |
$76.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$39.40 |
$39.40 |
$39.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$49.80 |
$49.80 |
$49.80 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$81.40 |
$81.40 |
$81.40 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$85.80 |
$85.80 |
$85.80 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$178.80 |
$178.80 |
$178.80 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$966.60 |
$966.60 |
$966.60 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$98.00 |
$98.00 |
$98.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$91.00 |
$91.00 |
$91.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$95.80 |
$95.80 |
$95.80 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$85.80 |
$85.80 |
$85.80 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$137.60 |
$137.60 |
$137.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$221.40 |
$221.40 |
$221.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$78.60 |
$78.60 |
$78.60 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$57.80 |
$57.80 |
$57.80 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$85.80 |
$85.80 |
$85.80 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$95.80 |
$95.80 |
$95.80 |
$185.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$376.80 |
$376.80 |
$376.80 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,155.00 |
$1,155.00 |
$1,155.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$293.00 |
$293.00 |
$293.00 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$42.08 |
$42.08 |
$42.08 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$23.90 |
$23.90 |
$23.90 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$7.62 |
$7.62 |
$7.62 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$47.20 |
$47.20 |
$47.20 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$18.70 |
$18.70 |
$18.70 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$28.53 |
$28.53 |
$28.53 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,065.05 |
$1,065.05 |
$1,065.05 |
$2,080.86
|
|
Infliximab-axxq 100 mg intravenous solution
|
$456.00 |
$456.00 |
$456.00 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$863.01 |
$863.01 |
$863.01 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$54.00 |
$54.00 |
$54.00 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$45.20 |
$45.20 |
$45.20 |
$111.51
|
|
Influenza virus vaccine, live trivalent intranasal
|
$14.40 |
$14.40 |
$14.40 |
$36.50
|
|
Ingest challenge ea addl 60 min
|
$43.40 |
$43.40 |
$43.40 |
$289.64
|
|
Ingest challenge ini 120 min
|
$147.80 |
$147.80 |
$147.80 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$152.60 |
$152.60 |
$152.60 |
$293.25
|
|
Initial foot exam pt lops
|
$32.40 |
$32.40 |
$32.40 |
$155.50
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$163.80 |
$163.80 |
$163.80 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$65.60 |
$65.60 |
$65.60 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$89.40 |
$89.40 |
$89.40 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$39.40 |
$39.40 |
$39.40 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$238.20 |
$238.20 |
$238.20 |
$576.00
|
|
Init nb em per day non-fac
|
$29.60 |
$29.60 |
$29.60 |
$109.15
|
|
Init pm e/m new pat 65+ yrs
|
$69.40 |
$69.40 |
$69.40 |
$185.90
|
|
Inj, abilify maintena, 1 mg
|
$1,631.60 |
$1,631.60 |
$1,631.60 |
$5,355.30
|
|
Inj bimatoprost itc imp1mcg
|
$117.00 |
$117.00 |
$117.00 |
$3,287.96
|
|
Inj, bupivacaine liposome
|
$521.48 |
$521.48 |
$521.48 |
$699.38
|
|
Inj cntr knee arthro incl ct/mri
|
$164.40 |
$164.40 |
$164.40 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$4.70 |
$4.70 |
$4.70 |
$742.72
|
|
Inj dupuytren cord w/enzyme
|
$139.20 |
$139.20 |
$139.20 |
$416.00
|
|
Inj, durolane 1 mg
|
$226.00 |
$226.00 |
$226.00 |
$1,950.93
|
|
Inj dx for sinogram
|
$73.40 |
$73.40 |
$73.40 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$56.60 |
$56.60 |
$56.60 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$274.00 |
$274.00 |
$274.00 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$58.20 |
$58.20 |
$58.20 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$17.20 |
$17.20 |
$17.20 |
$952.66
|
|
Injection epidural blood patch or clot
|
$589.00 |
$589.00 |
$589.00 |
$1,156.80
|
|
Injection eye drug
|
$93.40 |
$93.40 |
$93.40 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$202.80 |
$202.80 |
$202.80 |
$428.40
|
|
Injection for bladder x-ray
|
$131.60 |
$131.60 |
$131.60 |
$459.20
|
|
Injection for hip x-ray
|
$1,397.20 |
$1,397.20 |
$1,397.20 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$243.40 |
$243.40 |
$243.40 |
$494.65
|
|
Injection for ureter x-ray
|
$53.20 |
$53.20 |
$53.20 |
$427.70
|
|
Injection for ureter x-ray
|
$145.00 |
$145.00 |
$145.00 |
$515.21
|
|
Injection, fulvestrant
|
$64.20 |
$64.20 |
$64.20 |
$1,817.65
|
|
Injection into brain canal
|
$230.40 |
$230.40 |
$230.40 |
$836.40
|
|
Injection into hemorrhoid(s)
|
$132.00 |
$132.00 |
$132.00 |
$1,432.81
|
|
Injection into vocal cord
|
$90.20 |
$90.20 |
$90.20 |
$499.50
|
|
Injection jaw joint x-ray
|
$97.20 |
$97.20 |
$97.20 |
$307.80
|
|
Injection of sinus tract
|
$63.60 |
$63.60 |
$63.60 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$2.60 |
$2.60 |
$2.60 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$21.60 |
$21.60 |
$21.60 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$589.00 |
$589.00 |
$589.00 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$568.60 |
$568.60 |
$568.60 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$291.40 |
$291.40 |
$291.40 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$72.60 |
$72.60 |
$72.60 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$109.40 |
$109.40 |
$109.40 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$52.00 |
$52.00 |
$52.00 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$94.40 |
$94.40 |
$94.40 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$73.80 |
$73.80 |
$73.80 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,124.80 |
$1,124.80 |
$1,124.80 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$251.00 |
$251.00 |
$251.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$94.60 |
$94.60 |
$94.60 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$88.40 |
$88.40 |
$88.40 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$86.80 |
$86.80 |
$86.80 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$74.80 |
$74.80 |
$74.80 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$173.60 |
$173.60 |
$173.60 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$68.40 |
$68.40 |
$68.40 |
$135.60
|
|
Injection treatment of eye
|
$1,054.80 |
$1,054.80 |
$1,054.80 |
$2,665.60
|
|
Injection treatment of nerve
|
$625.80 |
$625.80 |
$625.80 |
$3,219.20
|
|
Injection treatment of nerve
|
$526.20 |
$526.20 |
$526.20 |
$4,350.00
|
|
Injection treatment of nerve
|
$323.60 |
$323.60 |
$323.60 |
$2,025.45
|
|
Injection treatment of nose
|
$78.40 |
$78.40 |
$78.40 |
$859.59
|
|
Inject sacroiliac joint
|
$148.80 |
$148.80 |
$148.80 |
$1,028.95
|
|
Inject/treat eye socket
|
$89.40 |
$89.40 |
$89.40 |
$670.02
|
|
Inj epidural sgl cerv-thor without img
|
$67.00 |
$67.00 |
$67.00 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$53.20 |
$53.20 |
$53.20 |
$1,415.50
|
|
Inj for ext venography
|
$63.20 |
$63.20 |
$63.20 |
$649.95
|
|
Inj for mammo ductogram
|
$129.40 |
$129.40 |
$129.40 |
$399.60
|