|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$528.24 |
$528.24 |
$528.24 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$562.15 |
$562.15 |
$562.15 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$147.43 |
$147.43 |
$147.43 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$639.36 |
$639.36 |
$639.36 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$639.36 |
$639.36 |
$639.36 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$297.82 |
$297.82 |
$297.82 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$509.17 |
$509.17 |
$509.17 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$959.89 |
$959.89 |
$959.89 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$222.14 |
$222.14 |
$222.14 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$222.14 |
$222.14 |
$222.14 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$694.54 |
$694.54 |
$694.54 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$694.54 |
$694.54 |
$694.54 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$278.78 |
$278.78 |
$278.78 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,379.76 |
$1,379.76 |
$1,379.76 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$297.01 |
$297.01 |
$297.01 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$2,774.43 |
$2,774.43 |
$2,774.43 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$3,885.19 |
$3,885.19 |
$3,885.19 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$20,495.24 |
$20,495.24 |
$20,495.24 |
$13,682.10
|
|
Inj, bezlotoxumab, 10 mg
|
$4,606.88 |
$4,606.88 |
$4,606.88 |
$8,698.20
|
|
Inj cefazolin sodium, hikma
|
$221.96 |
$221.96 |
$221.96 |
$34.59
|
|
Inj cntr knee arthro incl ct/mri
|
$2,911.23 |
$2,911.23 |
$2,911.23 |
$464.28
|
|
Inj disk cerv-thor ea lev
|
$2,102.43 |
$2,102.43 |
$2,102.43 |
$869.80
|
|
Inj dupuytren cord w/enzyme
|
$792.45 |
$792.45 |
$792.45 |
$416.00
|
|
Inj, durolane 1 mg
|
$2,181.77 |
$2,181.77 |
$2,181.77 |
$2,181.77
|
|
Inj dx for sinogram
|
$1,281.62 |
$1,281.62 |
$1,281.62 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$4,236.87 |
$4,236.87 |
$4,236.87 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,473.45 |
$2,473.45 |
$2,473.45 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,655.85 |
$1,655.85 |
$1,655.85 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$35,666.83 |
$35,666.83 |
$35,666.83 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$1,450.35 |
$1,450.35 |
$1,450.35 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,853.05 |
$1,853.05 |
$1,853.05 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$2,945.99 |
$2,945.99 |
$2,945.99 |
$441.12
|
|
Injection for bladder x-ray
|
$2,087.40 |
$2,087.40 |
$2,087.40 |
$585.00
|
|
Injection for hip x-ray
|
$3,350.36 |
$3,350.36 |
$3,350.36 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,693.08 |
$2,693.08 |
$2,693.08 |
$504.00
|
|
Injection for ureter x-ray
|
$2,581.59 |
$2,581.59 |
$2,581.59 |
$444.95
|
|
Injection for ureter x-ray
|
$957.35 |
$957.35 |
$957.35 |
$515.21
|
|
Injection, fulvestrant
|
$29,849.42 |
$29,849.42 |
$29,849.42 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$14,501.66 |
$14,501.66 |
$14,501.66 |
$6,830.50
|
|
Injection into brain canal
|
$792.45 |
$792.45 |
$792.45 |
$933.60
|
|
Injection jugular
|
$6,755.78 |
$6,755.78 |
$6,755.78 |
$1,048.20
|
|
Injection of sinus tract
|
$8,878.85 |
$8,878.85 |
$8,878.85 |
$1,651.20
|
|
Injection px peyronie ds
|
$626.26 |
$626.26 |
$626.26 |
$343.55
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,384.73 |
$1,384.73 |
$1,384.73 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,219.79 |
$2,219.79 |
$2,219.79 |
$1,501.60
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,066.83 |
$2,066.83 |
$2,066.83 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,928.19 |
$2,928.19 |
$2,928.19 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,914.65 |
$2,914.65 |
$2,914.65 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,970.83 |
$3,970.83 |
$3,970.83 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,963.52 |
$4,963.52 |
$4,963.52 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,701.29 |
$3,701.29 |
$3,701.29 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$3,175.40 |
$3,175.40 |
$3,175.40 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,920.91 |
$2,920.91 |
$2,920.91 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,017.89 |
$3,017.89 |
$3,017.89 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,230.35 |
$1,230.35 |
$1,230.35 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,870.48 |
$1,870.48 |
$1,870.48 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$2,244.56 |
$2,244.56 |
$2,244.56 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$910.11 |
$910.11 |
$910.11 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$893.15 |
$893.15 |
$893.15 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$914.40 |
$914.40 |
$914.40 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$625.15 |
$625.15 |
$625.15 |
$141.60
|
|
Injection treatment of nerve
|
$5,989.98 |
$5,989.98 |
$5,989.98 |
$3,016.15
|
|
Injection treatment of nerve
|
$7,187.99 |
$7,187.99 |
$7,187.99 |
$3,986.00
|
|
Injection treatment of nerve
|
$1,343.98 |
$1,343.98 |
$1,343.98 |
$2,037.10
|
|
Inject sacroiliac joint
|
$2,296.10 |
$2,296.10 |
$2,296.10 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$66,229.74 |
$66,229.74 |
$66,229.74 |
$32,176.93
|
|
Inj epidural sgl cerv-thor without img
|
$2,434.09 |
$2,434.09 |
$2,434.09 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$2,132.48 |
$2,132.48 |
$2,132.48 |
$1,450.84
|
|
Inj for ext venography
|
$1,367.03 |
$1,367.03 |
$1,367.03 |
$737.55
|
|
Inj for mammo ductogram
|
$1,065.79 |
$1,065.79 |
$1,065.79 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$5,212.73 |
$5,212.73 |
$5,212.73 |
$1,242.20
|
|
Inj glycopyrrolate fres kabi
|
$135.15 |
$135.15 |
$135.15 |
$47.05
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$3,665.81 |
$3,665.81 |
$3,665.81 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$4,251.38 |
$4,251.38 |
$4,251.38 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,414.28 |
$1,414.28 |
$1,414.28 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$3,665.81 |
$3,665.81 |
$3,665.81 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$1,462.25 |
$1,462.25 |
$1,462.25 |
$947.65
|
|
Inj/inf neurolyt sbst spinal canal lesion 62282
|
$3,746.46 |
$3,746.46 |
$3,746.46 |
$1,901.25
|
|
Inj intralesional <= 7 lsn(s)
|
$526.32 |
$526.32 |
$526.32 |
$241.74
|
|
Inj intralesional > 7 lsns
|
$944.00 |
$944.00 |
$944.00 |
$234.00
|
|
Inj ivig privigen 500 mg
|
$12,796.97 |
$12,796.97 |
$12,796.97 |
$7,173.90
|
|
Inj mepivacaine hcl/10 ml
|
$35.34 |
$35.34 |
$35.34 |
$31.28
|
|
Inj multihance
|
$412.67 |
$412.67 |
$412.67 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$3,875.34 |
$3,875.34 |
$3,875.34 |
$1,522.56
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$5,077.35 |
$5,077.35 |
$5,077.35 |
$2,371.50
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$5,077.35 |
$5,077.35 |
$5,077.35 |
$2,164.64
|
|
Inj peritoneal venous shunt
|
$1,592.67 |
$1,592.67 |
$1,592.67 |
$386.88
|
|
Inj proc ankle arthr
|
$2,606.87 |
$2,606.87 |
$2,606.87 |
$405.31
|
|
Inj proc elbow arthro
|
$767.94 |
$767.94 |
$767.94 |
$453.60
|
|
Inj proc for lymphang
|
$1,727.21 |
$1,727.21 |
$1,727.21 |
$1,372.00
|
|
Inj proc lumbr disk ea lvl
|
$2,358.29 |
$2,358.29 |
$2,358.29 |
$1,224.30
|
|
Inj proc myelogram lumbar
|
$1,959.04 |
$1,959.04 |
$1,959.04 |
$922.80
|
|
Inj retro urethrocysto
|
$1,402.98 |
$1,402.98 |
$1,402.98 |
$551.29
|
|
Inj scleros sol mult veins
|
$5,077.35 |
$5,077.35 |
$5,077.35 |
$687.96
|
|
Inj scleros sol sgl vein
|
$3,385.63 |
$3,385.63 |
$3,385.63 |
$534.40
|
|
Inj secukinumab intrav 1mg
|
$9,077.39 |
$9,077.39 |
$9,077.39 |
$5,994.20
|
|
Inj, spesolimab-sbzo, 1 mg
|
$218,949.63 |
$218,949.63 |
$218,949.63 |
$178,150.09
|
|
Inj testosterone cypionate
|
$385.63 |
$385.63 |
$385.63 |
$82.58
|
|
Inj, tislelizumab-jsgr
|
$45,903.37 |
$45,903.37 |
$45,903.37 |
$103.20
|
|
Inj, vancomycin hcl (mylan)
|
$100.92 |
$100.92 |
$100.92 |
$89.83
|
