|
Infect ag if legionella pneumophila
|
$121.00 |
$121.00 |
$121.00 |
$75.79
|
|
Infect ag if nos ea
|
$42.35 |
$42.35 |
$42.35 |
$60.40
|
|
Infect ag if pneumocystis carinii
|
$42.35 |
$42.35 |
$42.35 |
$62.29
|
|
Infect ag if varicella zoster
|
$140.80 |
$140.80 |
$140.80 |
$66.00
|
|
Infect ag na hpv high-risk types
|
$42.35 |
$42.35 |
$42.35 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$73.70 |
$73.70 |
$73.70 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$704.55 |
$704.55 |
$704.55 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$69.30 |
$69.30 |
$69.30 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$53.90 |
$53.90 |
$53.90 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$84.15 |
$84.15 |
$84.15 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$57.20 |
$57.20 |
$57.20 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$106.70 |
$106.70 |
$106.70 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$117.15 |
$117.15 |
$117.15 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$112.20 |
$112.20 |
$112.20 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$69.85 |
$69.85 |
$69.85 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$176.55 |
$176.55 |
$176.55 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$257.40 |
$257.40 |
$257.40 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$112.20 |
$112.20 |
$112.20 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$386.10 |
$386.10 |
$386.10 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$132.00 |
$132.00 |
$132.00 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$177.65 |
$177.65 |
$177.65 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$520.85 |
$520.85 |
$520.85 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$380.60 |
$380.60 |
$380.60 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$83.60 |
$83.60 |
$83.60 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$343.75 |
$343.75 |
$343.75 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$115.50 |
$115.50 |
$115.50 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$91.30 |
$91.30 |
$91.30 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$217.80 |
$217.80 |
$217.80 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$270.60 |
$270.60 |
$270.60 |
$248.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$45.10 |
$45.10 |
$45.10 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$189.75 |
$189.75 |
$189.75 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$611.60 |
$611.60 |
$611.60 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$180.40 |
$180.40 |
$180.40 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$298.10 |
$298.10 |
$298.10 |
$489.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$366.30 |
$366.30 |
$366.30 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$377.30 |
$377.30 |
$377.30 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$351.45 |
$351.45 |
$351.45 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$287.10 |
$287.10 |
$287.10 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$306.90 |
$306.90 |
$306.90 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$143.55 |
$143.55 |
$143.55 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$288.20 |
$288.20 |
$288.20 |
$645.79
|
|
Inj cntr knee arthro incl ct/mri
|
$213.40 |
$213.40 |
$213.40 |
$464.28
|
|
Inj dx for sinogram
|
$194.70 |
$194.70 |
$194.70 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$475.20 |
$475.20 |
$475.20 |
$507.10
|
|
Injection during cath supravalvular aortography
|
$980.65 |
$980.65 |
$980.65 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$1,275.45 |
$1,275.45 |
$1,275.45 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$379.50 |
$379.50 |
$379.50 |
$441.12
|
|
Injection for bladder x-ray
|
$496.10 |
$496.10 |
$496.10 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$534.05 |
$534.05 |
$534.05 |
$504.00
|
|
Injection radioactive tracer sentinel node (both sides)
|
$717.20 |
$717.20 |
$717.20 |
$717.20
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$4,248.20 |
$4,248.20 |
$4,248.20 |
$1,160.25
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$706.75 |
$706.75 |
$706.75 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$963.05 |
$963.05 |
$963.05 |
$1,017.28
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$646.80 |
$646.80 |
$646.80 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$879.45 |
$879.45 |
$879.45 |
$2,154.68
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$418.55 |
$418.55 |
$418.55 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$463.65 |
$463.65 |
$463.65 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$513.70 |
$513.70 |
$513.70 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$204.05 |
$204.05 |
$204.05 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$180.95 |
$180.95 |
$180.95 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$390.50 |
$390.50 |
$390.50 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$158.40 |
$158.40 |
$158.40 |
$141.60
|
|
Inj for ext venography
|
$367.95 |
$367.95 |
$367.95 |
$737.55
|
|
Inj for mammo ductogram
|
$136.40 |
$136.40 |
$136.40 |
$433.50
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$1,034.55 |
$1,034.55 |
$1,034.55 |
$1,482.00
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,812.25 |
$1,812.25 |
$1,812.25 |
$1,522.56
|
|
Inj proc elbow arthro
|
$246.40 |
$246.40 |
$246.40 |
$453.60
|
|
Inj proc myelogram lumbar
|
$1,201.20 |
$1,201.20 |
$1,201.20 |
$922.80
|
|
Inj proc sialogram
|
$510.95 |
$510.95 |
$510.95 |
$380.80
|
|
Inj retro urethrocysto
|
$669.35 |
$669.35 |
$669.35 |
$551.29
|
|
Inj w/fluor eval cv device
|
$1,493.80 |
$1,493.80 |
$1,493.80 |
$588.90
|
|
Ins cath ren art 1st bi
|
$12,274.90 |
$12,274.90 |
$12,274.90 |
$6,033.75
|
|
Ins cath ren art 1st uni
|
$5,897.10 |
$5,897.10 |
$5,897.10 |
$4,667.63
|
|
Ins cerv dilator (sep proc)
|
$380.60 |
$380.60 |
$380.60 |
$544.00
|
|
Insert cath pleura with image
|
$1,135.75 |
$1,135.75 |
$1,135.75 |
$2,239.02
|
|
Insert cath pleura without image
|
$1,529.55 |
$1,529.55 |
$1,529.55 |
$2,212.00
|
|
Insertion catheter bladder non indwelling
|
$264.55 |
$264.55 |
$264.55 |
$237.13
|
|
Insertion catheter bladder temporary simple
|
$513.70 |
$513.70 |
$513.70 |
$273.60
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$3,835.70 |
$3,835.70 |
$3,835.70 |
$4,943.21
|
|
Insertion intra aortic balloon assist device percutaneous
|
$10,297.10 |
$10,297.10 |
$10,297.10 |
$2,549.95
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$6,088.50 |
$6,088.50 |
$6,088.50 |
$7,088.54
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$1,268.30 |
$1,268.30 |
$1,268.30 |
$2,618.40
|
|
Insertion of heart electrode 33211
|
$8,292.90 |
$8,292.90 |
$8,292.90 |
$9,090.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$19,374.30 |
$19,374.30 |
$19,374.30 |
$14,158.20
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$15,761.35 |
$15,761.35 |
$15,761.35 |
$12,813.28
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$22,627.00 |
$22,627.00 |
$22,627.00 |
$9,855.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,856.25 |
$1,856.25 |
$1,856.25 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$1,271.60 |
$1,271.60 |
$1,271.60 |
$2,527.91
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$41,764.80 |
$41,764.80 |
$41,764.80 |
$29,997.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$9,598.60 |
$9,598.60 |
$9,598.60 |
$7,572.47
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$11,188.10 |
$11,188.10 |
$11,188.10 |
$7,673.12
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$13,988.70 |
$13,988.70 |
$13,988.70 |
$9,793.46
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$3,686.65 |
$3,686.65 |
$3,686.65 |
$5,470.54
|
|
Insert pm/icd lead dual
|
$11,188.10 |
$11,188.10 |
$11,188.10 |
$7,562.63
|
|
Insert swan-ganz cath
|
$2,125.20 |
$2,125.20 |
$2,125.20 |
$2,164.52
|
|
Insert vad art access left hrt arterial access
|
$4,504.50 |
$4,504.50 |
$4,504.50 |
$5,062.80
|
|
Ins icd gen exist mlt leads
|
$35,956.25 |
$35,956.25 |
$35,956.25 |
$31,286.77
|
|
Ins icd gen exist sgl lead
|
$27,667.75 |
$27,667.75 |
$27,667.75 |
$24,159.72
|
|
Insitu hybridization auto
|
$513.15 |
$513.15 |
$513.15 |
$398.16
|
|
Insitu hybridization manual
|
$519.20 |
$519.20 |
$519.20 |
$407.11
|