|
Infect ag if influenza b
|
$82.36 |
$82.36 |
$82.36 |
$34.67
|
|
Infect ag if legionella pneumophila
|
$115.71 |
$115.71 |
$115.71 |
$75.79
|
|
Infect ag if nos ea
|
$107.96 |
$107.96 |
$107.96 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$75.60 |
$75.60 |
$75.60 |
$62.29
|
|
Infect ag if varicella zoster
|
$90.15 |
$90.15 |
$90.15 |
$66.00
|
|
Infect ag na herpes simplex quant
|
$286.04 |
$286.04 |
$286.04 |
$145.20
|
|
Infect ag na hpv high-risk types
|
$234.84 |
$234.84 |
$234.84 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$639.98 |
$639.98 |
$639.98 |
$227.96
|
|
Infect ag na orthopoxvirus amp prb each
|
$159.00 |
$159.00 |
$159.00 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$2,783.61 |
$2,783.61 |
$2,783.61 |
$859.44
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$3,263.32 |
$3,263.32 |
$3,263.32 |
$714.67
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$173.63 |
$173.63 |
$173.63 |
$77.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$88.63 |
$88.63 |
$88.63 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$98.60 |
$98.60 |
$98.60 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$100.00 |
$100.00 |
$100.00 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$88.63 |
$88.63 |
$88.63 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$105.87 |
$105.87 |
$105.87 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$76.33 |
$76.33 |
$76.33 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$36.16 |
$36.16 |
$36.16 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$84.28 |
$84.28 |
$84.28 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$88.63 |
$88.63 |
$88.63 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$88.63 |
$88.63 |
$88.63 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$80.14 |
$80.14 |
$80.14 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$957.18 |
$957.18 |
$957.18 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$259.73 |
$259.73 |
$259.73 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$275.74 |
$275.74 |
$275.74 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,458.73 |
$1,458.73 |
$1,458.73 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$259.73 |
$259.73 |
$259.73 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$122.82 |
$122.82 |
$122.82 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$278.25 |
$278.25 |
$278.25 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$259.73 |
$259.73 |
$259.73 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$379.14 |
$379.14 |
$379.14 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$952.73 |
$952.73 |
$952.73 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$499.21 |
$499.21 |
$499.21 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$122.82 |
$122.82 |
$122.82 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$259.73 |
$259.73 |
$259.73 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$268.70 |
$268.70 |
$268.70 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,458.73 |
$1,458.73 |
$1,458.73 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$449.02 |
$449.02 |
$449.02 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$1,756.31 |
$1,756.31 |
$1,756.31 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$316.36 |
$316.36 |
$316.36 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$316.36 |
$316.36 |
$316.36 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$316.36 |
$316.36 |
$316.36 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$629.03 |
$629.03 |
$629.03 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$952.73 |
$952.73 |
$952.73 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$351.71 |
$351.71 |
$351.71 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$2,460.73 |
$2,460.73 |
$2,460.73 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$97,345.10 |
$97,345.10 |
$97,345.10 |
$16,865.48
|
|
Inj, bupivacaine liposome
|
$6,208.94 |
$6,208.94 |
$6,208.94 |
$816.31
|
|
Inj cefazolin sodium, hikma
|
$397.05 |
$397.05 |
$397.05 |
$56.70
|
|
Inj cefazolin (wg crit care)
|
$404.51 |
$404.51 |
$404.51 |
$32.05
|
|
Inj, cefiderocol, 10 mg
|
$1,126.97 |
$1,126.97 |
$1,126.97 |
$718.84
|
|
Inj cntr knee arthro incl ct/mri
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$464.28
|
|
Inj daptomycin (xellia)
|
$401.07 |
$401.07 |
$401.07 |
$0.04
|
|
Inj. denosumab-bbdz, 1 mg
|
$53,983.30 |
$53,983.30 |
$53,983.30 |
$6,636.36
|
|
Inj disk cerv-thor ea lev
|
$1,786.05 |
$1,786.05 |
$1,786.05 |
$869.80
|
|
Inj, durolane 1 mg
|
$9,692.68 |
$9,692.68 |
$9,692.68 |
$3,382.31
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$507.10
|
|
Injection during cath supravalvular aortography
|
$3,276.56 |
$3,276.56 |
$3,276.56 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$4,100.75 |
$4,100.75 |
$4,100.75 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$441.12
|
|
Injection for bladder x-ray
|
$1,668.45 |
$1,668.45 |
$1,668.45 |
$585.00
|
|
Injection for hip x-ray
|
$2,295.01 |
$2,295.01 |
$2,295.01 |
$567.45
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,295.01 |
$2,295.01 |
$2,295.01 |
$504.00
|
|
Injection for ureter x-ray
|
$2,880.15 |
$2,880.15 |
$2,880.15 |
$444.95
|
|
Injection for ureter x-ray
|
$2,553.70 |
$2,553.70 |
$2,553.70 |
$515.21
|
|
Injection, fulvestrant
|
$2,083.33 |
$2,083.33 |
$2,083.33 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$67,495.35 |
$67,495.35 |
$67,495.35 |
$10,366.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,008.00 |
$1,008.00 |
$1,008.00 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$2,824.79 |
$2,824.79 |
$2,824.79 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,092.66 |
$2,092.66 |
$2,092.66 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,092.66 |
$2,092.66 |
$2,092.66 |
$1,017.28
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$5,552.76 |
$5,552.76 |
$5,552.76 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$5,631.33 |
$5,631.33 |
$5,631.33 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,230.98 |
$1,230.98 |
$1,230.98 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,230.98 |
$1,230.98 |
$1,230.98 |
$552.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$794.02 |
$794.02 |
$794.02 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$611.35 |
$611.35 |
$611.35 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$803.95 |
$803.95 |
$803.95 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$708.28 |
$708.28 |
$708.28 |
$141.60
|
|
Inject sacroiliac joint
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$308,686.51 |
$308,686.51 |
$308,686.51 |
$66,229.74
|
|
Inj for ext venography
|
$1,529.68 |
$1,529.68 |
$1,529.68 |
$737.55
|
|
Inj for mammo ductogram
|
$1,799.70 |
$1,799.70 |
$1,799.70 |
$433.50
|
|
Inj, fulvestrant (fresenius)
|
$3,581.62 |
$3,581.62 |
$3,581.62 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$376.01 |
$376.01 |
$376.01 |
$96.70
|
|
Inj., guselkumab, 1 mg
|
$260,827.18 |
$260,827.18 |
$260,827.18 |
$74.86
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,914.05 |
$2,914.05 |
$2,914.05 |
$1,482.00
|
|
Inj hrt cath w/s&i sel hrt ang
|
$4,233.54 |
$4,233.54 |
$4,233.54 |
$1,837.17
|
|
Inj hrt cath w/s&i sel hrt art
|
$1,484.99 |
$1,484.99 |
$1,484.99 |
$1,192.50
|
|
Inj hrt cath w/s&i sel left vent
|
$3,661.87 |
$3,661.87 |
$3,661.87 |
$1,214.40
|
|
Inj hrt cath w/s&i sel right vent
|
$3,815.49 |
$3,815.49 |
$3,815.49 |
$947.65
|
|
Inj ivig privigen 500 mg
|
$4,584.40 |
$4,584.40 |
$4,584.40 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$356.12 |
$356.12 |
$356.12 |
$28.41
|
|
Inj multihance
|
$112.06 |
$112.06 |
$112.06 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$7,664.92 |
$7,664.92 |
$7,664.92 |
$1,522.56
|
|
Inj pantoprazole(hikma) 40mg
|
$369.42 |
$369.42 |
$369.42 |
$36.04
|
|
Inj proc ankle arthr
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$405.31
|
|
Inj proc elbow arthro
|
$2,165.10 |
$2,165.10 |
$2,165.10 |
$453.60
|
|
Inj proc for lymphang
|
$954.45 |
$954.45 |
$954.45 |
$1,372.00
|