|
Ihc/icc per specimen initial single antibody stain
|
$454.32 |
$454.32 |
$454.32 |
$274.86
|
|
Immobilizer shldr cntor adlt
|
$21.60 |
$21.60 |
$21.60 |
$171.43
|
|
Immobilizer shldr dlx str 24-36in med
|
$54.00 |
$54.00 |
$54.00 |
$102.00
|
|
Immune complex assay
|
$47.52 |
$47.52 |
$47.52 |
$109.20
|
|
Immunoassay tumor antigen quantitative ca 125
|
$198.00 |
$198.00 |
$198.00 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$185.76 |
$185.76 |
$185.76 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$36.72 |
$36.72 |
$36.72 |
$48.50
|
|
Immunofixation electrophoresis serum
|
$266.40 |
$266.40 |
$266.40 |
$138.60
|
|
Immunoglobulin assay
|
$114.48 |
$114.48 |
$114.48 |
$74.15
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,276.00 |
$3,276.00 |
$3,276.00 |
$2,080.80
|
|
Infect ag eia influenza a or b ea
|
$131.76 |
$131.76 |
$131.76 |
$69.03
|
|
Infect ag ia optc obs influenza
|
$132.48 |
$132.48 |
$132.48 |
$72.93
|
|
Infect ag na herpes simplex quant
|
$277.92 |
$277.92 |
$277.92 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$256.32 |
$256.32 |
$256.32 |
$139.20
|
|
Infect ag na orthopoxvirus amp prb each
|
$99.36 |
$99.36 |
$99.36 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$1,321.20 |
$1,321.20 |
$1,321.20 |
$859.44
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$113.76 |
$113.76 |
$113.76 |
$51.31
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$137.52 |
$137.52 |
$137.52 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$180.00 |
$180.00 |
$180.00 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$88.56 |
$88.56 |
$88.56 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$619.20 |
$619.20 |
$619.20 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$272.16 |
$272.16 |
$272.16 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$254.16 |
$254.16 |
$254.16 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$33.12 |
$33.12 |
$33.12 |
$127.80
|
|
Infectious agent nucleic acid amplified probe
|
$458.64 |
$458.64 |
$458.64 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$231.12 |
$231.12 |
$231.12 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$158.40 |
$158.40 |
$158.40 |
$167.05
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$635.76 |
$635.76 |
$635.76 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$217.44 |
$217.44 |
$217.44 |
$151.25
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$226.80 |
$226.80 |
$226.80 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$342.00 |
$342.00 |
$342.00 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$346.32 |
$346.32 |
$346.32 |
$217.70
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$396.00 |
$396.00 |
$396.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$186.48 |
$186.48 |
$186.48 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$227.52 |
$227.52 |
$227.52 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$721.44 |
$721.44 |
$721.44 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$480.96 |
$480.96 |
$480.96 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,247.76 |
$1,247.76 |
$1,247.76 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$658.80 |
$658.80 |
$658.80 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$181.44 |
$181.44 |
$181.44 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$464.40 |
$464.40 |
$464.40 |
$303.59
|
|
Initiation & management bipap/cpap initial day
|
$507.60 |
$507.60 |
$507.60 |
$576.00
|
|
Inj cntr knee arthro incl ct/mri
|
$529.20 |
$529.20 |
$529.20 |
$436.80
|
|
Inj daptomycin (xellia)
|
$0.42 |
$0.42 |
$0.42 |
$56.04
|
|
Injection arthrography hip without anesthesia (both sides)
|
$289.44 |
$289.44 |
$289.44 |
$500.50
|
|
Injection epidural blood patch or clot
|
$1,348.56 |
$1,348.56 |
$1,348.56 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$289.44 |
$289.44 |
$289.44 |
$441.12
|
|
Injection for bladder x-ray
|
$955.44 |
$955.44 |
$955.44 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$332.64 |
$332.64 |
$332.64 |
$494.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$970.56 |
$970.56 |
$970.56 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,348.56 |
$1,348.56 |
$1,348.56 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,550.88 |
$1,550.88 |
$1,550.88 |
$1,045.65
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$134.64 |
$134.64 |
$134.64 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$134.64 |
$134.64 |
$134.64 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$216.72 |
$216.72 |
$216.72 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$103.68 |
$103.68 |
$103.68 |
$135.20
|
|
Inj, lidocaine w epinephrine
|
$0.26 |
$0.26 |
$0.26 |
$44.96
|
|
Inj multihance
|
$15.66 |
$15.66 |
$15.66 |
$79.42
|
|
Inj proc ankle arthr
|
$910.08 |
$910.08 |
$910.08 |
$405.31
|
|
Inj proc elbow arthro
|
$667.44 |
$667.44 |
$667.44 |
$432.00
|
|
Inj retro urethrocysto
|
$1,293.12 |
$1,293.12 |
$1,293.12 |
$450.00
|
|
Insertion catheter bladder non indwelling
|
$166.32 |
$166.32 |
$166.32 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$270.00 |
$270.00 |
$270.00 |
$229.32
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,399.12 |
$3,399.12 |
$3,399.12 |
$2,511.00
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$1,534.32 |
$1,534.32 |
$1,534.32 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$3,607.20 |
$3,607.20 |
$3,607.20 |
$2,414.10
|
|
Ins tun cv cath wo subq prt/pm
|
$6,410.88 |
$6,410.88 |
$6,410.88 |
$4,202.70
|
|
Insulin total
|
$126.00 |
$126.00 |
$126.00 |
$66.64
|
|
Intens cardiac rehab no exer
|
$246.24 |
$246.24 |
$246.24 |
$238.40
|
|
Intens cardiac rehab w/exerc
|
$262.08 |
$262.08 |
$262.08 |
$238.40
|
|
Intrinsic factor antibody
|
$87.84 |
$87.84 |
$87.84 |
$66.60
|
|
Intubation endotracheal emergency procedure
|
$668.88 |
$668.88 |
$668.88 |
$589.60
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$1.37 |
$1.37 |
$1.37 |
$279.10
|
|
Iron
|
$108.72 |
$108.72 |
$108.72 |
$74.40
|
|
Iron binding capacity
|
$122.40 |
$122.40 |
$122.40 |
$63.79
|
|
Irrigation implantable venous access device for drug delivery systems
|
$145.44 |
$145.44 |
$145.44 |
$142.20
|
|
IV infusion therapy/prophylaxis/diagnosis addl sequential infusion new drug/substance > 1 hour
|
$150.48 |
$150.48 |
$150.48 |
$191.75
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$150.48 |
$150.48 |
$150.48 |
$157.50
|
|
IV infusion therapy/prophylaxis/diagnosis each additional 1 hour
|
$126.00 |
$126.00 |
$126.00 |
$151.80
|
|
IV infusion therapy/prophylaxis/diagnosis initial up to 1 hour
|
$303.12 |
$303.12 |
$303.12 |
$439.56
|
|
Jak2 targeted sequence analysis
|
$501.84 |
$501.84 |
$501.84 |
$379.87
|
|
John cunningham antibody
|
$2,745.36 |
$2,745.36 |
$2,745.36 |
$72.60
|
|
Ketorolac 15 mg/ml injection (wrapper)
|
$12.96 |
$12.96 |
$12.96 |
$23.50
|
|
Kidney imag w/bld flow multi
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
$1,570.65
|
|
Kidney img w/bldflw sgl without rx
|
$1,694.16 |
$1,694.16 |
$1,694.16 |
$1,427.40
|
|
Kidney (Retroperitoneal) Ultrasound (complete)
|
$1,056.24 |
$1,056.24 |
$1,056.24 |
$666.00
|
|
Knee MRI (with and without contrast)
|
$3,722.40 |
$3,722.40 |
$3,722.40 |
$3,034.80
|
|
Knee MRI (with contrast)
|
$2,949.12 |
$2,949.12 |
$2,949.12 |
$2,394.58
|
|
Knee MRI (without contrast)
|
$2,943.36 |
$2,943.36 |
$2,943.36 |
$2,169.60
|
|
Knee X-ray
|
$541.44 |
$541.44 |
$541.44 |
$425.55
|
|
Labetalol 5 mg/ml IV (wrapper)
|
$3.24 |
$3.24 |
$3.24 |
$32.34
|
|
Lactate dehydrogenase (ldh)
|
$89.28 |
$89.28 |
$89.28 |
$55.50
|
|
Lactated ringers intravenous solution
|
$32.40 |
$32.40 |
$32.40 |
$45.56
|
|
Lactic acid
|
$136.80 |
$136.80 |
$136.80 |
$107.00
|
|
Lactoferrin fecal qualitative
|
$54.72 |
$54.72 |
$54.72 |
$80.40
|
|
Lactoferrin fecal quant
|
$133.20 |
$133.20 |
$133.20 |
$106.10
|
|
Laryngoscopy direct w/wo tracheoscopy dx exc newborn
|
$2,895.12 |
$2,895.12 |
$2,895.12 |
$2,480.71
|
|
Lead capillary
|
$105.84 |
$105.84 |
$105.84 |
$57.50
|
|
Leg Vein Ultrasound (DVT study, both legs)
|
$1,406.88 |
$1,406.88 |
$1,406.88 |
$1,088.26
|
|
Levetiracetam 500 mg/5 ml intravenous solution
|
$0.28 |
$0.28 |
$0.28 |
$95.68
|