|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,203.60 |
$1,203.60 |
$1,203.60 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$276.00 |
$276.00 |
$276.00 |
$184.50
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$187.20 |
$187.20 |
$187.20 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$628.80 |
$628.80 |
$628.80 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$223.80 |
$223.80 |
$223.80 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$51.00 |
$51.00 |
$51.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$262.80 |
$262.80 |
$262.80 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$61.20 |
$61.20 |
$61.20 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$155.40 |
$155.40 |
$155.40 |
$110.50
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$72.60 |
$72.60 |
$72.60 |
$220.35
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,717.20 |
$1,717.20 |
$1,717.20 |
$1,240.55
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,223.40 |
$1,223.40 |
$1,223.40 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$928.20 |
$928.20 |
$928.20 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$348.00 |
$348.00 |
$348.00 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$408.00 |
$408.00 |
$408.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$377.40 |
$377.40 |
$377.40 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$290.40 |
$290.40 |
$290.40 |
$303.59
|
|
Influenza dna amp prob addl
|
$74.40 |
$74.40 |
$74.40 |
$64.26
|
|
Infuse radioactive materials
|
$1,593.00 |
$1,593.00 |
$1,593.00 |
$744.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$90.00 |
$90.00 |
$90.00 |
$293.25
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$358.80 |
$358.80 |
$358.80 |
$629.60
|
|
Initiation & management bipap/cpap initial day
|
$598.80 |
$598.80 |
$598.80 |
$571.20
|
|
Init pm e/m new pat 65+ yrs
|
$155.40 |
$155.40 |
$155.40 |
$180.77
|
|
Inj cntr knee arthro incl ct/mri
|
$540.60 |
$540.60 |
$540.60 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$591.00 |
$591.00 |
$591.00 |
$945.31
|
|
Inj dx for sinogram
|
$286.80 |
$286.80 |
$286.80 |
$416.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,167.60 |
$1,167.60 |
$1,167.60 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$606.60 |
$606.60 |
$606.60 |
$504.00
|
|
Injection carpal tunnel therapeutic (both sides)
|
$937.20 |
$937.20 |
$937.20 |
$504.90
|
|
Injection during cath supravalvular aortography
|
$267.00 |
$267.00 |
$267.00 |
$1,028.88
|
|
Injection epidural blood patch or clot
|
$1,482.60 |
$1,482.60 |
$1,482.60 |
$1,153.03
|
|
Injection eye drug
|
$1,278.60 |
$1,278.60 |
$1,278.60 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$513.60 |
$513.60 |
$513.60 |
$441.12
|
|
Injection for bladder x-ray
|
$499.20 |
$499.20 |
$499.20 |
$459.20
|
|
Injection for hip x-ray
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$709.15
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$477.00 |
$477.00 |
$477.00 |
$494.65
|
|
Injection for ureter x-ray
|
$841.80 |
$841.80 |
$841.80 |
$415.80
|
|
Injection for ureter x-ray
|
$272.40 |
$272.40 |
$272.40 |
$515.21
|
|
Injection into brain canal
|
$1,038.00 |
$1,038.00 |
$1,038.00 |
$844.50
|
|
Injection jugular
|
$585.00 |
$585.00 |
$585.00 |
$790.00
|
|
Injection of sinus tract
|
$1,809.60 |
$1,809.60 |
$1,809.60 |
$1,627.60
|
|
Injection radioactive tracer sentinel node (both sides)
|
$408.60 |
$408.60 |
$408.60 |
$699.68
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,451.00 |
$2,451.00 |
$2,451.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,361.40 |
$1,361.40 |
$1,361.40 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,710.80 |
$2,710.80 |
$2,710.80 |
$1,939.97
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,033.40 |
$2,033.40 |
$2,033.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,033.40 |
$2,033.40 |
$2,033.40 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,033.40 |
$2,033.40 |
$2,033.40 |
$1,011.89
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,033.40 |
$2,033.40 |
$2,033.40 |
$1,951.80
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$4,233.00 |
$4,233.00 |
$4,233.00 |
$1,808.64
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$4,233.00 |
$4,233.00 |
$4,233.00 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$596.40 |
$596.40 |
$596.40 |
$475.80
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$703.20 |
$703.20 |
$703.20 |
$541.00
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$875.40 |
$875.40 |
$875.40 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$183.00 |
$183.00 |
$183.00 |
$166.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$177.60 |
$177.60 |
$177.60 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$192.60 |
$192.60 |
$192.60 |
$257.24
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$148.20 |
$148.20 |
$148.20 |
$136.00
|
|
Injection treatment of nerve
|
$1,870.20 |
$1,870.20 |
$1,870.20 |
$2,054.00
|
|
Inject sacroiliac joint
|
$2,244.60 |
$2,244.60 |
$2,244.60 |
$990.00
|
|
Inj epidural sgl cerv-thor without img
|
$2,803.20 |
$2,803.20 |
$2,803.20 |
$1,311.74
|
|
Inj epidural sgl lumb-sacral without img
|
$2,803.20 |
$2,803.20 |
$2,803.20 |
$1,415.50
|
|
Inj for ext venography
|
$733.80 |
$733.80 |
$733.80 |
$654.00
|
|
Inj for mammo ductogram
|
$388.80 |
$388.80 |
$388.80 |
$397.80
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
$1,323.50
|
|
Inj hrt cath w/s&i sel left vent
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
$1,083.20
|
|
Inj hrt cath w/s&i sel right vent
|
$2,047.20 |
$2,047.20 |
$2,047.20 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$294.00 |
$294.00 |
$294.00 |
$235.13
|
|
Inj intralesional > 7 lsns
|
$314.40 |
$314.40 |
$314.40 |
$234.00
|
|
Inj multihance
|
$6.60 |
$6.60 |
$6.60 |
$72.00
|
|
Inj multihance multipack
|
$5.40 |
$5.40 |
$5.40 |
$2.80
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$1,381.80 |
$1,381.80 |
$1,381.80 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,419.00 |
$1,419.00 |
$1,419.00 |
$2,484.00
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,419.00 |
$1,419.00 |
$1,419.00 |
$2,373.55
|
|
Inj peritoneal venous shunt
|
$1,875.60 |
$1,875.60 |
$1,875.60 |
$413.70
|
|
Inj proc ankle arthr
|
$363.60 |
$363.60 |
$363.60 |
$405.60
|
|
Inj proc elbow arthro
|
$403.80 |
$403.80 |
$403.80 |
$438.00
|
|
Inj proc for lymphang
|
$172.20 |
$172.20 |
$172.20 |
$777.60
|
|
Inj proc lumbr disk ea lvl
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$1,136.00
|
|
Inj proc myelogram lumbar
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$859.98
|
|
Inj proc sialogram
|
$1,139.40 |
$1,139.40 |
$1,139.40 |
$380.80
|
|
Inj prohance multipack
|
$6.60 |
$6.60 |
$6.60 |
$9.60
|
|
Inj retro urethrocysto
|
$624.00 |
$624.00 |
$624.00 |
$450.00
|
|
Inj scleros sol mult veins
|
$563.40 |
$563.40 |
$563.40 |
$643.65
|
|
Inj scleros sol sgl vein
|
$1,004.40 |
$1,004.40 |
$1,004.40 |
$558.97
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$1,419.00 |
$1,419.00 |
$1,419.00 |
$436.80
|
|
Inj w/fluor eval cv device
|
$605.40 |
$605.40 |
$605.40 |
$504.40
|
|
Ins cath ren art 1st bi
|
$4,772.40 |
$4,772.40 |
$4,772.40 |
$5,820.00
|
|
Ins cath ren art 1st uni
|
$4,772.40 |
$4,772.40 |
$4,772.40 |
$4,667.63
|
|
Ins cath ren art 2nd+ bi
|
$6,379.80 |
$6,379.80 |
$6,379.80 |
$5,475.60
|
|
Ins cath ren art 2nd+ uni
|
$6,771.00 |
$6,771.00 |
$6,771.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$190.20 |
$190.20 |
$190.20 |
$473.90
|
|
Insert abdomen-venous drain
|
$9,661.80 |
$9,661.80 |
$9,661.80 |
$3,199.20
|
|
Insert and remove bone pin
|
$3,111.00 |
$3,111.00 |
$3,111.00 |
$4,421.00
|
|
Insert cath pleura with image
|
$5,657.40 |
$5,657.40 |
$5,657.40 |
$2,164.52
|
|
Insert cath pleura without image
|
$3,423.00 |
$3,423.00 |
$3,423.00 |
$2,026.58
|
|
Insert drug delivery implant
|
$172.20 |
$172.20 |
$172.20 |
$280.00
|
|
Insert electrodes for eeg
|
$486.00 |
$486.00 |
$486.00 |
$564.20
|
|
Insert hepatic shunt (tips)
|
$4,315.20 |
$4,315.20 |
$4,315.20 |
$7,606.50
|
|
Insert heyman uteri capsule
|
$5,191.20 |
$5,191.20 |
$5,191.20 |
$5,841.60
|
