|
Infect ag na influenza r/amp 1st 2 types
|
$123.84 |
$123.84 |
$123.84 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$66.22 |
$66.22 |
$66.22 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$25.80 |
$25.80 |
$25.80 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$18.06 |
$18.06 |
$18.06 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$28.38 |
$28.38 |
$28.38 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$32.25 |
$32.25 |
$32.25 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$99.33 |
$99.33 |
$99.33 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$36.55 |
$36.55 |
$36.55 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$37.41 |
$37.41 |
$37.41 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$67.51 |
$67.51 |
$67.51 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$15.48 |
$15.48 |
$15.48 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$27.52 |
$27.52 |
$27.52 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$181.03 |
$181.03 |
$181.03 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$49.45 |
$49.45 |
$49.45 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$48.16 |
$48.16 |
$48.16 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$537.93 |
$537.93 |
$537.93 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$45.58 |
$45.58 |
$45.58 |
$181.35
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$54.18 |
$54.18 |
$54.18 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$45.58 |
$45.58 |
$45.58 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$66.22 |
$66.22 |
$66.22 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$41.28 |
$41.28 |
$41.28 |
$206.00
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$45.58 |
$45.58 |
$45.58 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$47.73 |
$47.73 |
$47.73 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$537.93 |
$537.93 |
$537.93 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$165.55 |
$165.55 |
$165.55 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$339.27 |
$339.27 |
$339.27 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$118.25 |
$118.25 |
$118.25 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$55.47 |
$55.47 |
$55.47 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$63.21 |
$63.21 |
$63.21 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$110.08 |
$110.08 |
$110.08 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$184.04 |
$184.04 |
$184.04 |
$304.20
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$204.62 |
$204.62 |
$204.62 |
$296.00
|
|
Inj cntr knee arthro incl ct/mri
|
$104.80 |
$104.80 |
$104.80 |
$436.80
|
|
Inj dx for sinogram
|
$103.94 |
$103.94 |
$103.94 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$159.75 |
$159.75 |
$159.75 |
$503.50
|
|
Injection epidural blood patch or clot
|
$490.17 |
$490.17 |
$490.17 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$206.61 |
$206.61 |
$206.61 |
$436.00
|
|
Injection for bladder x-ray
|
$155.06 |
$155.06 |
$155.06 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$247.51 |
$247.51 |
$247.51 |
$497.76
|
|
Injection for ureter x-ray
|
$284.57 |
$284.57 |
$284.57 |
$415.80
|
|
Injection jaw joint x-ray
|
$71.14 |
$71.14 |
$71.14 |
$307.80
|
|
Injection radioactive tracer sentinel node (both sides)
|
$387.23 |
$387.23 |
$387.23 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$635.17 |
$635.17 |
$635.17 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,626.47 |
$1,626.47 |
$1,626.47 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$912.07 |
$912.07 |
$912.07 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,626.47 |
$1,626.47 |
$1,626.47 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,144.66 |
$1,144.66 |
$1,144.66 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,001.35 |
$2,001.35 |
$2,001.35 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,046.26 |
$1,046.26 |
$1,046.26 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$723.77 |
$723.77 |
$723.77 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$305.02 |
$305.02 |
$305.02 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$261.99 |
$261.99 |
$261.99 |
$548.80
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$83.48 |
$83.48 |
$83.48 |
$145.60
|
|
Inject sacroiliac joint
|
$880.12 |
$880.12 |
$880.12 |
$1,029.04
|
|
Inj for ext venography
|
$296.07 |
$296.07 |
$296.07 |
$628.80
|
|
Inj for mammo ductogram
|
$138.88 |
$138.88 |
$138.88 |
$397.80
|
|
Inj naloxone hydrochloride
|
$0.36 |
$0.36 |
$0.36 |
$83.16
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$600.66 |
$600.66 |
$600.66 |
$1,413.35
|
|
Inj proc ankle arthr
|
$122.26 |
$122.26 |
$122.26 |
$405.31
|
|
Inj proc elbow arthro
|
$154.21 |
$154.21 |
$154.21 |
$432.00
|
|
Inj proc myelogram lumbar
|
$273.92 |
$273.92 |
$273.92 |
$838.30
|
|
Inj proc sialogram
|
$117.58 |
$117.58 |
$117.58 |
$373.00
|
|
Inj retacrit esrd on dialysi
|
$2.97 |
$2.97 |
$2.97 |
$349.45
|
|
Inj retro urethrocysto
|
$128.65 |
$128.65 |
$128.65 |
$447.74
|
|
Inj w/fluor eval cv device
|
$364.66 |
$364.66 |
$364.66 |
$504.40
|
|
Ins cerv dilator (sep proc)
|
$238.64 |
$238.64 |
$238.64 |
$490.73
|
|
Insert cath pleura with image
|
$1,664.81 |
$1,664.81 |
$1,664.81 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$119.61 |
$119.61 |
$119.61 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$2,016.26 |
$2,016.26 |
$2,016.26 |
$4,897.20
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$4,795.06 |
$4,795.06 |
$4,795.06 |
$7,210.78
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$879.56 |
$879.56 |
$879.56 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,213.01 |
$1,213.01 |
$1,213.01 |
$2,453.83
|
|
Insitu hybridization (fish)
|
$169.59 |
$169.59 |
$169.59 |
$481.00
|
|
Insitu hybridization manual
|
$353.97 |
$353.97 |
$353.97 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$105.50 |
$105.50 |
$105.50 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$169.59 |
$169.59 |
$169.59 |
$338.40
|
|
Ins mark abd/pel for right perq
|
$873.73 |
$873.73 |
$873.73 |
$2,477.24
|
|
Ins picc wo subq prt/pmp w image guidnc <5yr
|
$853.81 |
$853.81 |
$853.81 |
$1,690.00
|
|
Ins pq tunnld ip cath w/img
|
$2,550.46 |
$2,550.46 |
$2,550.46 |
$5,486.00
|
|
Instillation anticarcinogenic agent bladder
|
$364.52 |
$364.52 |
$364.52 |
$638.40
|
|
Insulin total
|
$18.81 |
$18.81 |
$18.81 |
$66.64
|
|
Intrinsic factor antibody
|
$24.01 |
$24.01 |
$24.01 |
$65.00
|
|
Intro long gi tube
|
$585.32 |
$585.32 |
$585.32 |
$974.17
|
|
Intro long gi tube w/mult fluo
|
$207.90 |
$207.90 |
$207.90 |
$469.00
|
|
Iodine i-123 sod iodide mil
|
$330.15 |
$330.15 |
$330.15 |
$386.37
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$0.12 |
$0.12 |
$0.12 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1.31 |
$1.31 |
$1.31 |
$279.10
|
|
Iron
|
$68.64 |
$68.64 |
$68.64 |
$75.00
|
|
Iron binding capacity
|
$8.91 |
$8.91 |
$8.91 |
$63.91
|
|
Irrigation implantable venous access device for drug delivery systems
|
$110.74 |
$110.74 |
$110.74 |
$146.11
|
|
IV Fluids (each additional hour)
|
$58.03 |
$58.03 |
$58.03 |
$133.90
|
|
IV Fluids (first hour)
|
$215.82 |
$215.82 |
$215.82 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$128.78 |
$128.78 |
$128.78 |
$162.68
|
|
IV inj ra drug dx study
|
$209.75 |
$209.75 |
$209.75 |
$567.00
|
|
IV Medicine Infusion (additional drug)
|
$67.70 |
$67.70 |
$67.70 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$62.10 |
$62.10 |
$62.10 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$229.05 |
$229.05 |
$229.05 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$113.00 |
$113.00 |
$113.00 |
$167.50
|
|
IV Push Injection (first drug)
|
$162.88 |
$162.88 |
$162.88 |
$252.76
|
|
Ivp w/nephrotomography
|
$626.85 |
$626.85 |
$626.85 |
$748.15
|