|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$123.00 |
$123.00 |
$123.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$186.00 |
$186.00 |
$186.00 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$239.40 |
$239.40 |
$239.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$253.20 |
$253.20 |
$253.20 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$227.40 |
$227.40 |
$227.40 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$380.40 |
$380.40 |
$380.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$207.60 |
$207.60 |
$207.60 |
$98.02
|
|
Infectious agent nucleic acid amplified probe
|
$898.20 |
$898.20 |
$898.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$916.80 |
$916.80 |
$916.80 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$247.80 |
$247.80 |
$247.80 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,166.40 |
$1,166.40 |
$1,166.40 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$397.80 |
$397.80 |
$397.80 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$230.40 |
$230.40 |
$230.40 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$388.20 |
$388.20 |
$388.20 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$166.20 |
$166.20 |
$166.20 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$52.20 |
$52.20 |
$52.20 |
$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
|
$59.40 |
$59.40 |
$59.40 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$157.80 |
$157.80 |
$157.80 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$72.60 |
$72.60 |
$72.60 |
$211.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,717.20 |
$1,717.20 |
$1,717.20 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,194.00 |
$1,194.00 |
$1,194.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$906.00 |
$906.00 |
$906.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$395.40 |
$395.40 |
$395.40 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$519.00 |
$519.00 |
$519.00 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$492.60 |
$492.60 |
$492.60 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$295.80 |
$295.80 |
$295.80 |
$303.59
|
|
Influenza dna amp prob addl
|
$48.00 |
$48.00 |
$48.00 |
$64.26
|
|
Infuse radioactive materials
|
$946.20 |
$946.20 |
$946.20 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$222.60 |
$222.60 |
$222.60 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$571.20 |
$571.20 |
$571.20 |
$576.00
|
|
Inj dx for sinogram
|
$227.40 |
$227.40 |
$227.40 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,743.80 |
$2,743.80 |
$2,743.80 |
$1,214.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$364.80 |
$364.80 |
$364.80 |
$450.72
|
|
Injection epidural blood patch or clot
|
$2,303.40 |
$2,303.40 |
$2,303.40 |
$1,156.80
|
|
Injection for bladder x-ray
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,060.80 |
$1,060.80 |
$1,060.80 |
$494.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,476.60 |
$1,476.60 |
$1,476.60 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,868.40 |
$1,868.40 |
$1,868.40 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$2,157.60 |
$2,157.60 |
$2,157.60 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,197.20 |
$2,197.20 |
$2,197.20 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,894.20 |
$1,894.20 |
$1,894.20 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,527.80 |
$2,527.80 |
$2,527.80 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,647.60 |
$1,647.60 |
$1,647.60 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,197.20 |
$2,197.20 |
$2,197.20 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,108.60 |
$3,108.60 |
$3,108.60 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$4,044.00 |
$4,044.00 |
$4,044.00 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,688.40 |
$1,688.40 |
$1,688.40 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,501.20 |
$1,501.20 |
$1,501.20 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,688.40 |
$1,688.40 |
$1,688.40 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$217.20 |
$217.20 |
$217.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$210.00 |
$210.00 |
$210.00 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$244.20 |
$244.20 |
$244.20 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$150.00 |
$150.00 |
$150.00 |
$135.60
|
|
Inject sacroiliac joint
|
$2,662.80 |
$2,662.80 |
$2,662.80 |
$1,028.95
|
|
Inj for mammo ductogram
|
$622.80 |
$622.80 |
$622.80 |
$399.60
|
|
Inj multihance
|
$13.80 |
$13.80 |
$13.80 |
$73.49
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$894.00 |
$894.00 |
$894.00 |
$1,413.35
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,483.80 |
$1,483.80 |
$1,483.80 |
$2,837.09
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,483.80 |
$1,483.80 |
$1,483.80 |
$2,609.38
|
|
Inj proc myelogram lumbar
|
$897.60 |
$897.60 |
$897.60 |
$830.50
|
|
Inj prohance multipack
|
$13.80 |
$13.80 |
$13.80 |
$9.59
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$1,483.80 |
$1,483.80 |
$1,483.80 |
$436.80
|
|
Inj w/fluor eval cv device
|
$414.00 |
$414.00 |
$414.00 |
$503.92
|
|
Ins cath ren art 1st bi
|
$5,389.20 |
$5,389.20 |
$5,389.20 |
$5,753.10
|
|
Ins cath ren art 1st uni
|
$4,834.80 |
$4,834.80 |
$4,834.80 |
$4,660.00
|
|
Ins cath ren art 2nd+ bi
|
$6,107.40 |
$6,107.40 |
$6,107.40 |
$5,500.86
|
|
Ins cath ren art 2nd+ uni
|
$6,107.40 |
$6,107.40 |
$6,107.40 |
$5,395.20
|
|
Insert cath pleura with image
|
$1,804.20 |
$1,804.20 |
$1,804.20 |
$2,194.40
|
|
Insertion catheter bladder non indwelling
|
$346.20 |
$346.20 |
$346.20 |
$205.40
|
|
Insertion catheter bladder temporary simple
|
$195.60 |
$195.60 |
$195.60 |
$232.25
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$16,068.60 |
$16,068.60 |
$16,068.60 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,263.80 |
$2,263.80 |
$2,263.80 |
$2,505.60
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$7,347.00 |
$7,347.00 |
$7,347.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$7,347.00 |
$7,347.00 |
$7,347.00 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,853.40 |
$4,853.40 |
$4,853.40 |
$2,079.50
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$2,532.60 |
$2,532.60 |
$2,532.60 |
$2,419.65
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$23,388.60 |
$23,388.60 |
$23,388.60 |
$29,042.52
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$12,070.20 |
$12,070.20 |
$12,070.20 |
$7,200.05
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$5,806.20 |
$5,806.20 |
$5,806.20 |
$7,312.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$10,567.80 |
$10,567.80 |
$10,567.80 |
$9,332.50
|
|
Insert pm/icd lead dual
|
$5,806.20 |
$5,806.20 |
$5,806.20 |
$7,115.20
|
|
Insert swan-ganz cath
|
$3,792.60 |
$3,792.60 |
$3,792.60 |
$2,210.50
|
|
Ins icd gen exist sgl lead
|
$16,332.60 |
$16,332.60 |
$16,332.60 |
$23,230.50
|
|
Insitu hybridization auto
|
$564.00 |
$564.00 |
$564.00 |
$377.37
|
|
Insitu hybridization (fish)
|
$583.80 |
$583.80 |
$583.80 |
$481.60
|
|
Insitu hybridization manual
|
$552.00 |
$552.00 |
$552.00 |
$401.28
|
|
In situ hybridization per specimen each additional single probe stain
|
$553.80 |
$553.80 |
$553.80 |
$241.15
|
|
In situ hybridization per specimen initial single probe stain
|
$475.20 |
$475.20 |
$475.20 |
$331.69
|
|
Ins/rplc spi npg/rcvr pocket
|
$39,290.40 |
$39,290.40 |
$39,290.40 |
$24,061.80
|
|
Instillation anticarcinogenic agent bladder
|
$453.60 |
$453.60 |
$453.60 |
$621.40
|
|
Insulin total
|
$130.20 |
$130.20 |
$130.20 |
$66.64
|
|
Ins vag brachytx device
|
$609.00 |
$609.00 |
$609.00 |
$935.50
|
|
Interdental fixation
|
$1,930.80 |
$1,930.80 |
$1,930.80 |
$2,133.48
|
|
Intrinsic factor antibody
|
$136.80 |
$136.80 |
$136.80 |
$63.15
|
|
Intro catheter aorta
|
$1,216.20 |
$1,216.20 |
$1,216.20 |
$1,654.05
|
|
Intro cath svc/ivc
|
$1,002.60 |
$1,002.60 |
$1,002.60 |
$1,323.27
|
|
Intubation endotracheal emergency procedure
|
$598.80 |
$598.80 |
$598.80 |
$598.80
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$6.00 |
$6.00 |
$6.00 |
$170.06
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$8.40 |
$8.40 |
$8.40 |
$288.11
|