|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$70.00 |
$70.00 |
$645.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$1,794.34 |
$1,794.34 |
$1,794.34 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$350.13 |
$350.13 |
$350.13 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$441.45 |
$441.45 |
$441.45 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$230.31 |
$230.31 |
$230.31 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,572.97 |
$1,572.97 |
$1,572.97 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$1,613.93 |
$1,613.93 |
$1,613.93 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$3,308.51 |
$3,308.51 |
$3,308.51 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$76.50 |
$76.50 |
$538.94 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$70.00 |
$70.00 |
$538.94 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$538.94 |
$538.94 |
$865.00 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,070.59 |
$1,070.59 |
$1,070.59 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$1,794.34 |
$1,794.34 |
$1,794.34 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$640.00 |
$640.00 |
$2,281.34 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$645.79 |
$645.79 |
$859.00 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$53,085.14 |
$53,085.14 |
$53,085.14 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$11,902.81 |
$11,902.81 |
$11,902.81 |
$9,702.65
|
|
Inj calcitriol per 0.1 mcg
|
$269.00 |
$269.00 |
$269.00 |
$33.36
|
|
Inj cefazolin sodium, hikma
|
$140.46 |
$140.46 |
$140.46 |
$56.70
|
|
Inj, durolane 1 mg
|
$5,616.96 |
$5,616.96 |
$5,616.96 |
$3,382.31
|
|
Inj dx for sinogram
|
$857.47 |
$857.47 |
$857.47 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$2,822.35 |
$2,822.35 |
$2,822.35 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$10,759.50 |
$10,759.50 |
$10,759.50 |
$7,107.73
|
|
Injection, doxercalciferol
|
$373.00 |
$373.00 |
$373.00 |
$30.35
|
|
Injection during cath supravalvular aortography
|
$1,077.00 |
$1,077.00 |
$3,544.40 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,471.18 |
$1,471.18 |
$1,471.18 |
$1,473.12
|
|
Injection for bladder x-ray
|
$1,709.65 |
$1,709.65 |
$1,709.65 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$2,505.56 |
$2,505.56 |
$2,505.56 |
$504.00
|
|
Injection, fulvestrant
|
$7,077.79 |
$7,077.79 |
$7,077.79 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$37,549.89 |
$37,549.89 |
$37,549.89 |
$10,366.61
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,814.28 |
$2,814.28 |
$2,814.28 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,814.28 |
$2,814.28 |
$2,814.28 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$11,692.01 |
$11,692.01 |
$11,692.01 |
$2,251.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$6,785.76 |
$6,785.76 |
$6,785.76 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$6,785.76 |
$6,785.76 |
$6,785.76 |
$1,758.12
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,704.16 |
$1,704.16 |
$1,704.16 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,704.16 |
$1,704.16 |
$1,704.16 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$321.77 |
$321.77 |
$321.77 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$360.26 |
$360.26 |
$360.26 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$426.04 |
$426.04 |
$426.04 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$305.24 |
$305.24 |
$305.24 |
$141.60
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$171,628.11 |
$171,628.11 |
$171,628.11 |
$66,229.74
|
|
Inj epidural sgl lumb-sacral without img
|
$6,785.76 |
$6,785.76 |
$6,785.76 |
$1,450.84
|
|
Inj for ext venography
|
$405.03 |
$405.03 |
$405.03 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$1,446.20 |
$1,446.20 |
$1,446.20 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$97.62 |
$97.62 |
$97.62 |
$96.70
|
|
Inj hydroxocobalamin IV 25mg
|
$9,884.73 |
$9,884.73 |
$9,884.73 |
$3,180.35
|
|
Inj ivig privigen 500 mg
|
$59,011.49 |
$59,011.49 |
$59,011.49 |
$7,298.71
|
|
Inj, levothyroxine, freskabi
|
$331.00 |
$331.00 |
$331.00 |
$302.07
|
|
Inj mepivacaine hcl/10 ml
|
$18.92 |
$18.92 |
$18.92 |
$28.41
|
|
Inj, moxifloxacin 100 mg
|
$649.00 |
$649.00 |
$649.00 |
$190.81
|
|
Inj multihance
|
$410.96 |
$410.96 |
$410.96 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,302.04 |
$2,302.04 |
$2,302.04 |
$1,522.56
|
|
Inj pantoprazole(hikma) 40mg
|
$188.00 |
$188.00 |
$188.00 |
$36.04
|
|
Inj proc myelogram lumbar
|
$1,432.63 |
$1,432.63 |
$1,432.63 |
$922.80
|
|
Inj retro urethrocysto
|
$1,545.64 |
$1,545.64 |
$1,545.64 |
$551.29
|
|
Inj secukinumab intrav 1mg
|
$23,490.28 |
$23,490.28 |
$23,490.28 |
$9,077.39
|
|
Inj, spesolimab-sbzo, 1 mg
|
$567,475.17 |
$567,475.17 |
$567,475.17 |
$253,022.14
|
|
Inj testosterone cypionate
|
$225.68 |
$225.68 |
$225.68 |
$77.15
|
|
Inj, tislelizumab-jsgr
|
$38,006.30 |
$38,006.30 |
$38,006.30 |
$45,250.97
|
|
Inj, vancomycin hcl (mylan)
|
$70.39 |
$70.39 |
$70.39 |
$63.82
|
|
Inj, vegzelma, 10 mg
|
$10,927.67 |
$10,927.67 |
$10,927.67 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$1,179.61 |
$1,179.61 |
$1,179.61 |
$588.90
|
|
Ins cath ren art 1st bi
|
$7,143.28 |
$7,143.28 |
$7,143.28 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$7,143.28 |
$7,143.28 |
$7,143.28 |
$4,667.63
|
|
Ins cerv dilator (sep proc)
|
$4,348.83 |
$4,348.83 |
$4,348.83 |
$544.00
|
|
Insert cath pleura with image
|
$5,460.61 |
$5,460.61 |
$5,460.61 |
$2,239.02
|
|
Insert hepatic shunt (tips)
|
$19,242.54 |
$19,242.54 |
$19,242.54 |
$9,754.48
|
|
Insertion catheter bladder non indwelling
|
$1,570.16 |
$1,570.16 |
$1,570.16 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$635.02 |
$635.02 |
$635.02 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$40,212.36 |
$40,212.36 |
$40,212.36 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$7,554.70 |
$7,554.70 |
$7,554.70 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$13,888.81 |
$13,888.81 |
$13,888.81 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$7,906.29 |
$7,906.29 |
$7,906.29 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$35,924.66 |
$35,924.66 |
$35,924.66 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$53,066.23 |
$53,066.23 |
$53,066.23 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$31,871.15 |
$31,871.15 |
$31,871.15 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,867.73 |
$3,867.73 |
$3,867.73 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$16,272.61 |
$16,272.61 |
$16,272.61 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$39,623.44 |
$39,623.44 |
$39,623.44 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$19,073.11 |
$19,073.11 |
$19,073.11 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$30,789.26 |
$30,789.26 |
$30,789.26 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$24,722.62 |
$24,722.62 |
$24,722.62 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$13,721.07 |
$13,721.07 |
$13,721.07 |
$5,470.54
|
|
Insert pessary/other device
|
$2,620.80 |
$2,620.80 |
$2,620.80 |
$278.90
|
|
Insert pm/icd lead dual
|
$30,789.26 |
$30,789.26 |
$30,789.26 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$109,092.73 |
$109,092.73 |
$109,092.73 |
$33,948.20
|
|
Insert swan-ganz cath
|
$14,155.30 |
$14,155.30 |
$14,155.30 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$18,424.79 |
$18,424.79 |
$18,424.79 |
$5,062.80
|
|
Insitu hybridization auto
|
$470.00 |
$470.00 |
$470.00 |
$398.16
|
|
In situ hybridization per specimen each additional single probe stain
|
$259.01 |
$259.01 |
$259.01 |
$251.55
|
|
In situ hybridization per specimen initial single probe stain
|
$115.00 |
$115.00 |
$1,817.94 |
$338.40
|
|
Ins lv lead exist pm/icd
|
$36,084.79 |
$36,084.79 |
$36,084.79 |
$12,384.25
|
|
Ins pq tunnld ip cath w/img
|
$40,212.36 |
$40,212.36 |
$40,212.36 |
$5,593.60
|
|
Ins/rpl ldless pm right vent w img & eval
|
$58,789.99 |
$58,789.99 |
$58,789.99 |
$24,135.54
|
|
Ins/rpl pm w/tv ld atrl
|
$51,406.62 |
$51,406.62 |
$51,406.62 |
$12,384.25
|
|
Inst fibrinolysis agent ini day
|
$6,892.17 |
$6,892.17 |
$6,892.17 |
$1,095.00
|
|
Instillation anticarcinogenic agent bladder
|
$1,990.05 |
$1,990.05 |
$1,990.05 |
$721.50
|
|
Instill, bupivac and meloxic
|
$1,516.51 |
$1,516.51 |
$1,516.51 |
$1,127.61
|
|
Ins tun cv cath wo subq prt/pm
|
$12,448.81 |
$12,448.81 |
$12,448.81 |
$4,748.00
|
