|
Infect ag na hep b amp
|
$173.60 |
$173.60 |
$173.60 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$528.50 |
$528.50 |
$528.50 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$295.40 |
$295.40 |
$295.40 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$283.50 |
$283.50 |
$283.50 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$179.90 |
$179.90 |
$179.90 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$1,284.50 |
$1,284.50 |
$1,284.50 |
$835.80
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$2,718.10 |
$2,718.10 |
$2,718.10 |
$943.80
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$263.20 |
$263.20 |
$263.20 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$42.00 |
$42.00 |
$42.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$126.00 |
$126.00 |
$126.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$72.80 |
$72.80 |
$72.80 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$122.50 |
$122.50 |
$122.50 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$72.80 |
$72.80 |
$72.80 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$117.60 |
$117.60 |
$117.60 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$255.50 |
$255.50 |
$255.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$77.70 |
$77.70 |
$77.70 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$210.00 |
$210.00 |
$210.00 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$145.60 |
$145.60 |
$145.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$136.50 |
$136.50 |
$136.50 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$85.40 |
$85.40 |
$85.40 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$660.10 |
$660.10 |
$660.10 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$225.40 |
$225.40 |
$225.40 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$260.40 |
$260.40 |
$260.40 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,138.90 |
$1,138.90 |
$1,138.90 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$380.80 |
$380.80 |
$380.80 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$282.80 |
$282.80 |
$282.80 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$716.80 |
$716.80 |
$716.80 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$231.00 |
$231.00 |
$231.00 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$125.30 |
$125.30 |
$125.30 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$140.00 |
$140.00 |
$140.00 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$290.50 |
$290.50 |
$290.50 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$152.60 |
$152.60 |
$152.60 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$226.10 |
$226.10 |
$226.10 |
$108.75
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$456.40 |
$456.40 |
$456.40 |
$211.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$239.40 |
$239.40 |
$239.40 |
$185.00
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$490.70 |
$490.70 |
$490.70 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$933.80 |
$933.80 |
$933.80 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$310.80 |
$310.80 |
$310.80 |
$286.06
|
|
Infectious agent nucleic acid quantification bk virus
|
$781.90 |
$781.90 |
$781.90 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,099.70 |
$1,099.70 |
$1,099.70 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$764.40 |
$764.40 |
$764.40 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$737.80 |
$737.80 |
$737.80 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$716.80 |
$716.80 |
$716.80 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$3,958.67 |
$3,958.67 |
$3,958.67 |
$2,080.86
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,570.92 |
$2,570.92 |
$2,570.92 |
$1,537.84
|
|
Infuse radioactive materials
|
$544.60 |
$544.60 |
$544.60 |
$640.50
|
|
Ingest challenge ea addl 60 min
|
$313.60 |
$313.60 |
$313.60 |
$289.64
|
|
Ingest challenge ini 120 min
|
$822.50 |
$822.50 |
$822.50 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$438.20 |
$438.20 |
$438.20 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$819.00 |
$819.00 |
$819.00 |
$576.00
|
|
Inj, abilify maintena, 1 mg
|
$6,735.22 |
$6,735.22 |
$6,735.22 |
$5,355.30
|
|
Inj acetaminophen -fresenius
|
$44.10 |
$44.10 |
$44.10 |
$36.60
|
|
Inj, acetaminophen (hikma)
|
$82.42 |
$82.42 |
$82.42 |
$58.50
|
|
Inj allopurinol sodium 1 mg
|
$4,395.47 |
$4,395.47 |
$4,395.47 |
$6,968.99
|
|
Inj atezolizumb 5mg hya-tqjs
|
$64,773.27 |
$64,773.27 |
$64,773.27 |
$18,716.52
|
|
Inj., benralizumab, 1 mg
|
$20,323.27 |
$20,323.27 |
$20,323.27 |
$11,239.97
|
|
Inj beta interferon sq 1 mcg
|
$4,956.17 |
$4,956.17 |
$4,956.17 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$63,921.37 |
$63,921.37 |
$63,921.37 |
$7,612.43
|
|
Inj cefazolin sodium, baxter
|
$161.52 |
$161.52 |
$161.52 |
$27.38
|
|
Inj ceftolozane tazobactam
|
$1,449.17 |
$1,449.17 |
$1,449.17 |
$380.80
|
|
Inj cntr knee arthro incl ct/mri
|
$158.90 |
$158.90 |
$158.90 |
$436.80
|
|
Inj cyclophosphamd auromedic
|
$4,316.37 |
$4,316.37 |
$4,316.37 |
$249.68
|
|
Inj cyclophosphamd (ingenus)
|
$8,486.80 |
$8,486.80 |
$8,486.80 |
$742.72
|
|
Inj, decitabine (sun pharma)
|
$1,546.30 |
$1,546.30 |
$1,546.30 |
$310.09
|
|
Inj. denosumab-bbdz, 1 mg
|
$10,663.10 |
$10,663.10 |
$10,663.10 |
$4,615.43
|
|
Inj, donanemab-azbt, 2 mg
|
$11,718.17 |
$11,718.17 |
$11,718.17 |
$1,233.44
|
|
Inj dx for sinogram
|
$975.10 |
$975.10 |
$975.10 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$4,981.02 |
$4,981.02 |
$4,981.02 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$945.00 |
$945.00 |
$945.00 |
$495.84
|
|
Injection, belinostat, 10mg
|
$6,972.00 |
$6,972.00 |
$6,972.00 |
$4,446.10
|
|
Injection, cangrelor
|
$5,135.72 |
$5,135.72 |
$5,135.72 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$423.50 |
$423.50 |
$423.50 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$330.40 |
$330.40 |
$330.40 |
$952.66
|
|
Injection, edaravone, 1 mg
|
$7,058.10 |
$7,058.10 |
$7,058.10 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$8,372.52 |
$8,372.52 |
$8,372.52 |
$1,156.80
|
|
Injection eye drug
|
$3,068.80 |
$3,068.80 |
$3,068.80 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$343.70 |
$343.70 |
$343.70 |
$428.40
|
|
Injection for bladder x-ray
|
$1,544.20 |
$1,544.20 |
$1,544.20 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$627.90 |
$627.90 |
$627.90 |
$494.65
|
|
Injection for spleen x-ray
|
$2,619.40 |
$2,619.40 |
$2,619.40 |
$529.57
|
|
Injection for ureter x-ray
|
$1,450.40 |
$1,450.40 |
$1,450.40 |
$427.70
|
|
Injection for ureter x-ray
|
$2,568.30 |
$2,568.30 |
$2,568.30 |
$515.21
|
|
Injection, fulvestrant
|
$10,494.92 |
$10,494.92 |
$10,494.92 |
$1,817.65
|
|
Injection, glucarpidase
|
$119,124.07 |
$119,124.07 |
$119,124.07 |
$74,113.20
|
|
Injection into brain canal
|
$1,261.40 |
$1,261.40 |
$1,261.40 |
$1,289.60
|
|
Injection jugular
|
$4,524.10 |
$4,524.10 |
$4,524.10 |
$790.00
|
|
Injection,onabotulinumtoxina
|
$3,670.10 |
$3,670.10 |
$3,670.10 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$45,746.69 |
$45,746.69 |
$45,746.69 |
$670.64
|
|
Injection, renflexis
|
$3,792.25 |
$3,792.25 |
$3,792.25 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,506.30 |
$3,506.30 |
$3,506.30 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$68,909.63 |
$68,909.63 |
$68,909.63 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$60,149.52 |
$60,149.52 |
$60,149.52 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,561.42 |
$3,561.42 |
$3,561.42 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$8,887.20 |
$8,887.20 |
$8,887.20 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$8,881.77 |
$8,881.77 |
$8,881.77 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$8,959.82 |
$8,959.82 |
$8,959.82 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$8,948.80 |
$8,948.80 |
$8,948.80 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,930.60 |
$1,930.60 |
$1,930.60 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,781.62 |
$2,781.62 |
$2,781.62 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,052.80 |
$1,052.80 |
$1,052.80 |
$472.76
|
