|
Incision of breast lesion
|
$257.28 |
$257.28 |
$257.28 |
$2,560.80
|
|
Incision of eardrum
|
$132.16 |
$132.16 |
$132.16 |
$552.75
|
|
Incision of eardrum
|
$127.36 |
$127.36 |
$127.36 |
$3,827.50
|
|
Incision of rectal abscess
|
$400.00 |
$400.00 |
$400.00 |
$3,245.23
|
|
Incision of small bowel 44010
|
$665.28 |
$665.28 |
$665.28 |
$1,362.00
|
|
Incision of tendon sheath
|
$243.52 |
$243.52 |
$243.52 |
$2,211.05
|
|
Incision of tongue fold
|
$578.88 |
$578.88 |
$578.88 |
$1,792.50
|
|
Incisn windpipe
|
$234.56 |
$234.56 |
$234.56 |
$3,810.50
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$63.68 |
$63.68 |
$63.68 |
$137.15
|
|
Infect ag drug suscept pheno predict
|
$37.08 |
$37.08 |
$37.08 |
$323.20
|
|
Infect ag genotype na dna hepatitis b
|
$189.76 |
$189.76 |
$189.76 |
$405.30
|
|
Infect ag genotype na hiv-1 other region
|
$36.61 |
$36.61 |
$36.61 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$285.44 |
$285.44 |
$285.44 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$22.08 |
$22.08 |
$22.08 |
$72.93
|
|
Infect ag if hep delta agent
|
$19.20 |
$19.20 |
$19.20 |
$125.97
|
|
Infect ag if influenza a
|
$24.00 |
$24.00 |
$24.00 |
$41.30
|
|
Infect ag if influenza b
|
$24.00 |
$24.00 |
$24.00 |
$40.08
|
|
Infect ag if legionella pneumophila
|
$24.00 |
$24.00 |
$24.00 |
$72.58
|
|
Infect ag if nos ea
|
$14.72 |
$14.72 |
$14.72 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$14.72 |
$14.72 |
$14.72 |
$66.00
|
|
Infect ag if varicella zoster
|
$14.72 |
$14.72 |
$14.72 |
$70.70
|
|
Infect ag na hpv high-risk types
|
$63.68 |
$63.68 |
$63.68 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$149.76 |
$149.76 |
$149.76 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$27.20 |
$27.20 |
$27.20 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$566.96 |
$566.96 |
$566.96 |
$835.80
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$32.00 |
$32.00 |
$32.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$22.08 |
$22.08 |
$22.08 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$10.88 |
$10.88 |
$10.88 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$14.08 |
$14.08 |
$14.08 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$17.28 |
$17.28 |
$17.28 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$34.88 |
$34.88 |
$34.88 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$81.92 |
$81.92 |
$81.92 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$8.64 |
$8.64 |
$8.64 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$22.08 |
$22.08 |
$22.08 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$44.80 |
$44.80 |
$44.80 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$58.88 |
$58.88 |
$58.88 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$11.20 |
$11.20 |
$11.20 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$225.28 |
$225.28 |
$225.28 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$52.80 |
$52.80 |
$52.80 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$63.68 |
$63.68 |
$63.68 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$610.56 |
$610.56 |
$610.56 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$262.40 |
$262.40 |
$262.40 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$64.00 |
$64.00 |
$64.00 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$376.64 |
$376.64 |
$376.64 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$52.48 |
$52.48 |
$52.48 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$81.60 |
$81.60 |
$81.60 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$154.88 |
$154.88 |
$154.88 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$32.00 |
$32.00 |
$32.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$34.47 |
$34.47 |
$34.47 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$52.80 |
$52.80 |
$52.80 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$92.16 |
$92.16 |
$92.16 |
$185.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$380.80 |
$380.80 |
$380.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$271.04 |
$271.04 |
$271.04 |
$286.06
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$196.48 |
$196.48 |
$196.48 |
$423.53
|
|
Infectious agent nucleic acid quantification bk virus
|
$138.88 |
$138.88 |
$138.88 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$144.96 |
$144.96 |
$144.96 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$101.44 |
$101.44 |
$101.44 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$173.12 |
$173.12 |
$173.12 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$120.64 |
$120.64 |
$120.64 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$964.15 |
$964.15 |
$964.15 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$750.97 |
$750.97 |
$750.97 |
$1,537.84
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$192.96 |
$192.96 |
$192.96 |
$293.25
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$267.20 |
$267.20 |
$267.20 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$107.20 |
$107.20 |
$107.20 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$145.92 |
$145.92 |
$145.92 |
$236.80
|
|
Initiation & management bipap/cpap initial day
|
$402.24 |
$402.24 |
$402.24 |
$576.00
|
|
Init nb em per day non-fac
|
$48.32 |
$48.32 |
$48.32 |
$109.15
|
|
Init pm e/m new pat 65+ yrs
|
$43.20 |
$43.20 |
$43.20 |
$185.90
|
|
Inj alymsys 10 mg
|
$608.00 |
$608.00 |
$608.00 |
$1,280.74
|
|
Inj anifrolumab-fnia 1mg
|
$4,491.79 |
$4,491.79 |
$4,491.79 |
$9,878.82
|
|
Inj atezolizumb 5mg hya-tqjs
|
$6,720.00 |
$6,720.00 |
$6,720.00 |
$18,716.52
|
|
Inj., benralizumab, 1 mg
|
$4,686.73 |
$4,686.73 |
$4,686.73 |
$11,239.97
|
|
Inj cntr knee arthro incl ct/mri
|
$280.00 |
$280.00 |
$280.00 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$5.34 |
$5.34 |
$5.34 |
$742.72
|
|
Inj, daptomycin (baxter)
|
$55.41 |
$55.41 |
$55.41 |
$1.83
|
|
Inj disk cerv-thor ea lev
|
$407.04 |
$407.04 |
$407.04 |
$875.28
|
|
Inj dx for sinogram
|
$169.60 |
$169.60 |
$169.60 |
$422.59
|
|
Injection arthrography hip without anesthesia (both sides)
|
$280.00 |
$280.00 |
$280.00 |
$495.84
|
|
Injection during cath supravalvular aortography
|
$315.52 |
$315.52 |
$315.52 |
$952.66
|
|
Injection epidural blood patch or clot
|
$546.24 |
$546.24 |
$546.24 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$280.00 |
$280.00 |
$280.00 |
$428.40
|
|
Injection for bladder x-ray
|
$156.48 |
$156.48 |
$156.48 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$280.00 |
$280.00 |
$280.00 |
$494.65
|
|
Injection for spleen x-ray
|
$271.36 |
$271.36 |
$271.36 |
$529.57
|
|
Injection, fulvestrant
|
$72.96 |
$72.96 |
$72.96 |
$1,817.65
|
|
Injection, inclisiran, 1 mg
|
$3,303.24 |
$3,303.24 |
$3,303.24 |
$6,679.35
|
|
Injection into brain canal
|
$407.04 |
$407.04 |
$407.04 |
$836.40
|
|
Injection jugular
|
$278.08 |
$278.08 |
$278.08 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$618.71 |
$618.71 |
$618.71 |
$2,277.65
|
|
Injection px peyronie ds
|
$72.96 |
$72.96 |
$72.96 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$295.04 |
$295.04 |
$295.04 |
$670.64
|
|
Injection, renflexis
|
$622.00 |
$622.00 |
$622.00 |
$1,341.52
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$540.16 |
$540.16 |
$540.16 |
$1,681.24
|
|
Injection, siltuximab
|
$4,380.67 |
$4,380.67 |
$4,380.67 |
$10,680.75
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$168.00 |
$168.00 |
$168.00 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$168.00 |
$168.00 |
$168.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$168.00 |
$168.00 |
$168.00 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$78.08 |
$78.08 |
$78.08 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$77.12 |
$77.12 |
$77.12 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$156.48 |
$156.48 |
$156.48 |
$249.32
|