|
Hyperbaric oxygen therapy
|
$1,692.00 |
$1,692.00 |
$1,692.00 |
$802.00
|
|
Hysterosalpingography s&i
|
$1,221.84 |
$1,221.84 |
$1,221.84 |
$651.85
|
|
Iadna legionella pneumophila amplified probe tq
|
$157.68 |
$157.68 |
$157.68 |
$109.80
|
|
Ibandronate 3 mg/3 ml intravenous syringe
|
$1,470.01 |
$1,470.01 |
$1,470.01 |
$635.44
|
|
Icd cobalt xt dr MRI is1 df1
|
$34,020.00 |
$34,020.00 |
$34,020.00 |
$34,234.20
|
|
Icd crtp serena MRI
|
$11,880.00 |
$11,880.00 |
$11,880.00 |
$14,346.00
|
|
Icd reliance df4 ib 64cm
|
$7,128.00 |
$7,128.00 |
$7,128.00 |
$9,259.80
|
|
I&d abscss rtrphryngl/paraphryngl intraorl apprch
|
$5,697.36 |
$5,697.36 |
$5,697.36 |
$3,771.20
|
|
Igh gene rearrange amp meth
|
$809.28 |
$809.28 |
$809.28 |
$456.54
|
|
Igh@ var region somatic mutation analy
|
$893.52 |
$893.52 |
$893.52 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$889.20 |
$889.20 |
$889.20 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$672.48 |
$672.48 |
$672.48 |
$328.79
|
|
Ihc/icc per specimen initial single antibody stain
|
$808.56 |
$808.56 |
$808.56 |
$274.86
|
|
Iliac/fem angio cath insert
|
$5,924.88 |
$5,924.88 |
$5,924.88 |
$1,827.35
|
|
Iliac revasc add-on 37222
|
$8,458.56 |
$8,458.56 |
$8,458.56 |
$6,082.65
|
|
Immobilizer shldr dlx str 24-36in med
|
$159.12 |
$159.12 |
$159.12 |
$102.00
|
|
Immune complex assay
|
$462.24 |
$462.24 |
$462.24 |
$109.20
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$301.72 |
$301.72 |
$301.72 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$172.80 |
$172.80 |
$172.80 |
$130.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$140.40 |
$140.40 |
$140.40 |
$116.40
|
|
Immunodiffusion nes
|
$94.32 |
$94.32 |
$94.32 |
$53.76
|
|
Immunofixation electrophoresis serum
|
$202.32 |
$202.32 |
$202.32 |
$138.60
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$229.68 |
$229.68 |
$229.68 |
$156.00
|
|
Immunofluorescence per specimen initial single antibody stain
|
$259.92 |
$259.92 |
$259.92 |
$232.05
|
|
Impedence cardiogram
|
$253.44 |
$253.44 |
$253.44 |
$152.54
|
|
Implant ureth bulk agent
|
$1,944.00 |
$1,944.00 |
$1,944.00 |
$2,139.62
|
|
Impl neurostim electr perc
|
$9,050.40 |
$9,050.40 |
$9,050.40 |
$7,546.20
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,117.60 |
$3,117.60 |
$3,117.60 |
$2,080.80
|
|
Incision of breast lesion
|
$5,955.12 |
$5,955.12 |
$5,955.12 |
$2,577.85
|
|
Incision of tongue fold
|
$2,848.32 |
$2,848.32 |
$2,848.32 |
$1,792.50
|
|
Infect ag drug suscept pheno predict
|
$342.72 |
$342.72 |
$342.72 |
$320.00
|
|
Infect ag eia influenza a or b ea
|
$39.60 |
$39.60 |
$39.60 |
$69.03
|
|
Infect ag genotype na hiv-1 other region
|
$1,177.20 |
$1,177.20 |
$1,177.20 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$677.52 |
$677.52 |
$677.52 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$54.72 |
$54.72 |
$54.72 |
$72.93
|
|
Infect ag na herpes simplex quant
|
$158.40 |
$158.40 |
$158.40 |
$169.65
|
|
Infect ag na hpv high-risk types
|
$122.40 |
$122.40 |
$122.40 |
$139.20
|
|
Infect ag na orthopoxvirus amp prb each
|
$86.40 |
$86.40 |
$86.40 |
$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
|
$114.48 |
$114.48 |
$114.48 |
$51.31
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$107.28 |
$107.28 |
$107.28 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$90.00 |
$90.00 |
$90.00 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$92.88 |
$92.88 |
$92.88 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$97.20 |
$97.20 |
$97.20 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$108.00 |
$108.00 |
$108.00 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$113.04 |
$113.04 |
$113.04 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$64.80 |
$64.80 |
$64.80 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$97.92 |
$97.92 |
$97.92 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$262.80 |
$262.80 |
$262.80 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$123.12 |
$123.12 |
$123.12 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$182.16 |
$182.16 |
$182.16 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$690.48 |
$690.48 |
$690.48 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$254.88 |
$254.88 |
$254.88 |
$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 mycobacteria tuberculosis
|
$95.04 |
$95.04 |
$95.04 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$119.52 |
$119.52 |
$119.52 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$442.08 |
$442.08 |
$442.08 |
$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
|
$98.64 |
$98.64 |
$98.64 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$61.92 |
$61.92 |
$61.92 |
$105.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$655.92 |
$655.92 |
$655.92 |
$711.93
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$660.96 |
$660.96 |
$660.96 |
$429.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$203.04 |
$203.04 |
$203.04 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$141.12 |
$141.12 |
$141.12 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$176.40 |
$176.40 |
$176.40 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$113.76 |
$113.76 |
$113.76 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$464.40 |
$464.40 |
$464.40 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$403.60 |
$403.60 |
$403.60 |
$2,080.86
|
|
Initiation & management bipap/cpap initial day
|
$206.64 |
$206.64 |
$206.64 |
$576.00
|
|
Inj, biorphen, 20 micrograms
|
$2.12 |
$2.12 |
$2.12 |
$17.12
|
|
Inj cefazolin sodium, hikma
|
$15.48 |
$15.48 |
$15.48 |
$29.10
|
|
Inj cefazolin (wg crit care)
|
$12.92 |
$12.92 |
$12.92 |
$18.30
|
|
Inj ceftolozane tazobactam
|
$92.28 |
$92.28 |
$92.28 |
$408.00
|
|
Inj cntr knee arthro incl ct/mri
|
$304.56 |
$304.56 |
$304.56 |
$436.80
|
|
Inj daptomycin (xellia)
|
$1.21 |
$1.21 |
$1.21 |
$56.04
|
|
Inj dx for sinogram
|
$573.84 |
$573.84 |
$573.84 |
$413.82
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,298.88 |
$1,298.88 |
$1,298.88 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$478.80 |
$478.80 |
$478.80 |
$500.50
|
|
Injection during cath supravalvular aortography
|
$558.00 |
$558.00 |
$558.00 |
$904.17
|
|
Injection epidural blood patch or clot
|
$2,823.12 |
$2,823.12 |
$2,823.12 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$493.92 |
$493.92 |
$493.92 |
$441.12
|
|
Injection for bladder x-ray
|
$622.08 |
$622.08 |
$622.08 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$342.00 |
$342.00 |
$342.00 |
$494.65
|
|
Injection for ureter x-ray
|
$214.56 |
$214.56 |
$214.56 |
$515.21
|
|
Injection, fulvestrant
|
$30.24 |
$30.24 |
$30.24 |
$1,719.16
|
|
Injection,onabotulinumtoxina
|
$68.37 |
$68.37 |
$68.37 |
$2,241.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$910.80 |
$910.80 |
$910.80 |
$683.28
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,629.52 |
$3,629.52 |
$3,629.52 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,846.80 |
$1,846.80 |
$1,846.80 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,846.80 |
$1,846.80 |
$1,846.80 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$4,835.52 |
$4,835.52 |
$4,835.52 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$1,062.00 |
$1,062.00 |
$1,062.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,968.72 |
$4,968.72 |
$4,968.72 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,176.48 |
$1,176.48 |
$1,176.48 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,968.72 |
$4,968.72 |
$4,968.72 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$2,823.12 |
$2,823.12 |
$2,823.12 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,747.52 |
$2,747.52 |
$2,747.52 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$485.28 |
$485.28 |
$485.28 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$767.52 |
$767.52 |
$767.52 |
$517.24
|
