|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$642.08 |
$642.08 |
$642.08 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$740.69 |
$740.69 |
$740.69 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$1,318.81 |
$1,318.81 |
$1,318.81 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$1,655.01 |
$1,655.01 |
$1,655.01 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$790.25 |
$790.25 |
$790.25 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$553.64 |
$553.64 |
$553.64 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$1,290.59 |
$1,290.59 |
$1,290.59 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$642.08 |
$642.08 |
$642.08 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$642.08 |
$642.08 |
$642.08 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$642.08 |
$642.08 |
$642.08 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$148.17 |
$148.17 |
$148.17 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$22,337.62 |
$22,337.62 |
$22,337.62 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$1,473.06 |
$1,473.06 |
$1,473.06 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$56.55 |
$56.55 |
$56.55 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$530.27 |
$530.27 |
$530.27 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$707.02 |
$707.02 |
$707.02 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$1,880.67 |
$1,880.67 |
$1,880.67 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$2,276.27 |
$2,276.27 |
$2,276.27 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$6,875.80 |
$6,875.80 |
$6,875.80 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$2,296.04 |
$2,296.04 |
$2,296.04 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$2,296.04 |
$2,296.04 |
$2,296.04 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$1,862.97 |
$1,862.97 |
$1,862.97 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,284.15 |
$1,284.15 |
$1,284.15 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$7,644.36 |
$7,644.36 |
$7,644.36 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$2,143.83 |
$2,143.83 |
$2,143.83 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$2,143.83 |
$2,143.83 |
$2,143.83 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$80,706.49 |
$80,706.49 |
$80,706.49 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$18,089.86 |
$18,089.86 |
$18,089.86 |
$9,702.65
|
|
Inj cefazolin sodium, hikma
|
$205.21 |
$205.21 |
$205.21 |
$56.70
|
|
Inj, durolane 1 mg
|
$8,532.40 |
$8,532.40 |
$8,532.40 |
$3,382.31
|
|
Inj dx for sinogram
|
$1,070.21 |
$1,070.21 |
$1,070.21 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$4,371.06 |
$4,371.06 |
$4,371.06 |
$507.10
|
|
Injection, daratumumab 10 mg
|
$11,035.45 |
$11,035.45 |
$11,035.45 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$762.72 |
$762.72 |
$762.72 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$6,376.75 |
$6,376.75 |
$6,376.75 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$5,026.42 |
$5,026.42 |
$5,026.42 |
$441.12
|
|
Injection for bladder x-ray
|
$7,627.23 |
$7,627.23 |
$7,627.23 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$5,593.29 |
$5,593.29 |
$5,593.29 |
$504.00
|
|
Injection for ureter x-ray
|
$2,477.22 |
$2,477.22 |
$2,477.22 |
$444.95
|
|
Injection for ureter x-ray
|
$626.95 |
$626.95 |
$626.95 |
$515.21
|
|
Injection, fulvestrant
|
$6,004.65 |
$6,004.65 |
$6,004.65 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$57,085.56 |
$57,085.56 |
$57,085.56 |
$10,366.61
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$6,376.75 |
$6,376.75 |
$6,376.75 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$6,376.75 |
$6,376.75 |
$6,376.75 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$6,376.75 |
$6,376.75 |
$6,376.75 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$9,504.85 |
$9,504.85 |
$9,504.85 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$11,393.78 |
$11,393.78 |
$11,393.78 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$4,036.29 |
$4,036.29 |
$4,036.29 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$11,384.35 |
$11,384.35 |
$11,384.35 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$7,702.56 |
$7,702.56 |
$7,702.56 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,601.45 |
$1,601.45 |
$1,601.45 |
$472.76
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$521.67 |
$521.67 |
$521.67 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$521.67 |
$521.67 |
$521.67 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$521.67 |
$521.67 |
$521.67 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$521.67 |
$521.67 |
$521.67 |
$141.60
|
|
Inject sacroiliac joint
|
$4,371.06 |
$4,371.06 |
$4,371.06 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$260,947.90 |
$260,947.90 |
$260,947.90 |
$66,229.74
|
|
Inj epidural sgl lumb-sacral without img
|
$6,376.75 |
$6,376.75 |
$6,376.75 |
$1,450.84
|
|
Inj for ext venography
|
$1,231.65 |
$1,231.65 |
$1,231.65 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$1,242.20 |
$1,242.20 |
$1,242.20 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$140.09 |
$140.09 |
$140.09 |
$96.70
|
|
Inj ivig privigen 500 mg
|
$62,657.81 |
$62,657.81 |
$62,657.81 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$20.76 |
$20.76 |
$20.76 |
$28.41
|
|
Inj multihance
|
$418.45 |
$418.45 |
$418.45 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$7,659.24 |
$7,659.24 |
$7,659.24 |
$1,522.56
|
|
Inj proc elbow arthro
|
$5,589.53 |
$5,589.53 |
$5,589.53 |
$453.60
|
|
Inj retro urethrocysto
|
$1,669.73 |
$1,669.73 |
$1,669.73 |
$551.29
|
|
Inj secukinumab intrav 1mg
|
$35,708.30 |
$35,708.30 |
$35,708.30 |
$9,077.39
|
|
Inj, spesolimab-sbzo, 1 mg
|
$862,822.72 |
$862,822.72 |
$862,822.72 |
$253,022.14
|
|
Inj testosterone cypionate
|
$323.42 |
$323.42 |
$323.42 |
$77.15
|
|
Inj, tislelizumab-jsgr
|
$38,980.88 |
$38,980.88 |
$38,980.88 |
$45,250.97
|
|
Inj, vancomycin hcl (mylan)
|
$99.75 |
$99.75 |
$99.75 |
$63.82
|
|
Inj, vegzelma, 10 mg
|
$9,267.61 |
$9,267.61 |
$9,267.61 |
$10,892.59
|
|
Inj w/fluor eval cv device
|
$9,218.60 |
$9,218.60 |
$9,218.60 |
$588.90
|
|
Ins cath ren art 1st bi
|
$24,307.34 |
$24,307.34 |
$24,307.34 |
$6,033.75
|
|
Insert cath pleura with image
|
$15,291.79 |
$15,291.79 |
$15,291.79 |
$2,239.02
|
|
Insert cath pleura without image
|
$20,348.51 |
$20,348.51 |
$20,348.51 |
$2,212.00
|
|
Insertion catheter bladder non indwelling
|
$1,475.52 |
$1,475.52 |
$1,475.52 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$1,475.52 |
$1,475.52 |
$1,475.52 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$37,788.55 |
$37,788.55 |
$37,788.55 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$14,574.61 |
$14,574.61 |
$14,574.61 |
$2,549.95
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$31,648.06 |
$31,648.06 |
$31,648.06 |
$2,618.40
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$40,620.20 |
$40,620.20 |
$40,620.20 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$40,620.20 |
$40,620.20 |
$40,620.20 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$29,546.58 |
$29,546.58 |
$29,546.58 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$15,291.79 |
$15,291.79 |
$15,291.79 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$8,877.72 |
$8,877.72 |
$8,877.72 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$168,935.96 |
$168,935.96 |
$168,935.96 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$19,585.99 |
$19,585.99 |
$19,585.99 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$18,665.06 |
$18,665.06 |
$18,665.06 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$36,518.45 |
$36,518.45 |
$36,518.45 |
$9,793.46
|
|
Insert pm/icd lead dual
|
$33,261.22 |
$33,261.22 |
$33,261.22 |
$7,562.63
|
|
Insert/repl sq defib w/eltrd
|
$117,851.41 |
$117,851.41 |
$117,851.41 |
$33,948.20
|
|
Insert vad art access left hrt arterial access
|
$2,296.50 |
$2,296.50 |
$2,296.50 |
$5,062.80
|