|
Idecabtagene vicleucel car
|
$1,498,500.00 |
$1,498,500.00 |
$1,498,500.00 |
$1,129,895.40
|
|
Idet single level
|
$3,030.00 |
$3,030.00 |
$3,030.00 |
$3,347.50
|
|
Idh1 common variants
|
$417.50 |
$417.50 |
$417.50 |
$415.35
|
|
Idh2 common variants
|
$417.50 |
$417.50 |
$417.50 |
$486.00
|
|
I&d upper arm/elbow deep abscess/hematoma
|
$3,035.00 |
$3,035.00 |
$3,035.00 |
$3,371.02
|
|
Ifosfamide 1 gram intravenous solution
|
$122.47 |
$122.47 |
$122.47 |
$246.95
|
|
Igh gene rearrange amp meth
|
$1,035.00 |
$1,035.00 |
$1,035.00 |
$464.25
|
|
Igh@ var region somatic mutation analy
|
$960.00 |
$960.00 |
$960.00 |
$660.80
|
|
Ihc/icc per specimen each additional single antibody stain
|
$290.00 |
$290.00 |
$290.00 |
$191.52
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$380.00 |
$380.00 |
$380.00 |
$331.20
|
|
Ihc/icc per specimen initial single antibody stain
|
$290.00 |
$290.00 |
$290.00 |
$277.90
|
|
Ikbkap gene
|
$140.00 |
$140.00 |
$140.00 |
$173.49
|
|
Iliac/fem angio cath insert
|
$1,915.00 |
$1,915.00 |
$1,915.00 |
$1,856.01
|
|
Iliac revasc add-on 37222
|
$4,600.00 |
$4,600.00 |
$4,600.00 |
$6,082.65
|
|
Immob elbow child sm
|
$30.00 |
$30.00 |
$30.00 |
$85.39
|
|
Immune complex assay
|
$185.00 |
$185.00 |
$185.00 |
$101.60
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$154.99 |
$154.99 |
$154.99 |
$6,106.32
|
|
Immunoassay tumor antigen quantitative ca 125
|
$122.50 |
$122.50 |
$122.50 |
$132.00
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$105.00 |
$105.00 |
$105.00 |
$116.40
|
|
Immunodiff gel qual ea antigen/ab
|
$65.00 |
$65.00 |
$65.00 |
$48.57
|
|
Immunofixation electrophoresis serum
|
$120.00 |
$120.00 |
$120.00 |
$142.50
|
|
Immunofluorescence per specimen each additional single antibody stain
|
$185.00 |
$185.00 |
$185.00 |
$154.05
|
|
Immunofluorescence per specimen initial single antibody stain
|
$250.00 |
$250.00 |
$250.00 |
$234.27
|
|
Immunoglobulin assay
|
$97.50 |
$97.50 |
$97.50 |
$78.00
|
|
Implant cartilage 10mm synthetic
|
$5,802.50 |
$5,802.50 |
$5,802.50 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$8,531.56 |
$8,531.56 |
$8,531.56 |
$16,195.55
|
|
Implant ureth bulk agent
|
$2,787.75 |
$2,787.75 |
$2,787.75 |
$2,168.00
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,780.00 |
$1,780.00 |
$1,780.00 |
$2,086.70
|
|
Incision of tongue fold
|
$1,515.00 |
$1,515.00 |
$1,515.00 |
$1,792.50
|
|
Infect ag drug suscept pheno predict
|
$325.00 |
$325.00 |
$325.00 |
$325.00
|
|
Infect ag genotype na cytomegalovirus
|
$695.00 |
$695.00 |
$695.00 |
$665.40
|
|
Infect ag genotype na hiv-1 other region
|
$730.00 |
$730.00 |
$730.00 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$975.00 |
$975.00 |
$975.00 |
$603.83
|
|
Infect ag ia direct hiv-1 antgn
|
$132.50 |
$132.50 |
$132.50 |
$95.55
|
|
Infect ag ia optc obs influenza
|
$85.00 |
$85.00 |
$85.00 |
$72.93
|
|
Infect ag if pneumocystis carinii
|
$62.50 |
$62.50 |
$62.50 |
$66.06
|
|
Infect ag na hep b amp
|
$205.00 |
$205.00 |
$205.00 |
$120.50
|
|
Infect ag na hpv high-risk types
|
$177.50 |
$177.50 |
$177.50 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$227.50 |
$227.50 |
$227.50 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$147.50 |
$147.50 |
$147.50 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$405.00 |
$405.00 |
$405.00 |
$854.70
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,770.00 |
$1,770.00 |
$1,770.00 |
$954.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$140.00 |
$140.00 |
$140.00 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$47.50 |
$47.50 |
$47.50 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$57.50 |
$57.50 |
$57.50 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$67.50 |
$67.50 |
$67.50 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$72.50 |
$72.50 |
$72.50 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$67.50 |
$67.50 |
$67.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$112.50 |
$112.50 |
$112.50 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$105.00 |
$105.00 |
$105.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$97.50 |
$97.50 |
$97.50 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$60.00 |
$60.00 |
$60.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$267.50 |
$267.50 |
$267.50 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$180.00 |
$180.00 |
$180.00 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$187.50 |
$187.50 |
$187.50 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,370.00 |
$1,370.00 |
$1,370.00 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$190.00 |
$190.00 |
$190.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$177.50 |
$177.50 |
$177.50 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$210.00 |
$210.00 |
$210.00 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$180.00 |
$180.00 |
$180.00 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$87.50 |
$87.50 |
$87.50 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$150.00 |
$150.00 |
$150.00 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$165.00 |
$165.00 |
$165.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$75.00 |
$75.00 |
$75.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$135.00 |
$135.00 |
$135.00 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$185.00 |
$185.00 |
$185.00 |
$195.60
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$530.00 |
$530.00 |
$530.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$197.50 |
$197.50 |
$197.50 |
$289.91
|
|
Infectious agent nucleic acid quantification bk virus
|
$225.00 |
$225.00 |
$225.00 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$242.50 |
$242.50 |
$242.50 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$250.00 |
$250.00 |
$250.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$480.00 |
$480.00 |
$480.00 |
$375.00
|
|
Infliximab 100 mg intravenous solution
|
$112.47 |
$112.47 |
$112.47 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$117.59 |
$117.59 |
$117.59 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$113.46 |
$113.46 |
$113.46 |
$1,537.84
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$762.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$780.00 |
$780.00 |
$780.00 |
$770.00
|
|
Infuse radioactive materials
|
$1,085.00 |
$1,085.00 |
$1,085.00 |
$739.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$275.00 |
$275.00 |
$275.00 |
$296.00
|
|
Inj, abilify maintena, 1 mg
|
$15.77 |
$15.77 |
$15.77 |
$5,355.30
|
|
Inj, adzynma, 10 iu
|
$73.18 |
$73.18 |
$73.18 |
$34.60
|
|
Inj, aspara, rylaze, 0.1 mg
|
$125.69 |
$125.69 |
$125.69 |
$10,458.00
|
|
Inj, bupivacaine liposome
|
$4.08 |
$4.08 |
$4.08 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$25.53 |
$25.53 |
$25.53 |
$27.38
|
|
Inj, cefiderocol, 10 mg
|
$6.74 |
$6.74 |
$6.74 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$479.32 |
$479.32 |
$479.32 |
$364.86
|
|
Inj cntr knee arthro incl ct/mri
|
$332.50 |
$332.50 |
$332.50 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$690.00 |
$690.00 |
$690.00 |
$875.28
|
|
Inj dx for sinogram
|
$190.00 |
$190.00 |
$190.00 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,700.00 |
$1,700.00 |
$1,700.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$332.50 |
$332.50 |
$332.50 |
$503.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$670.00 |
$670.00 |
$670.00 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$184.02 |
$184.02 |
$184.02 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$570.00 |
$570.00 |
$570.00 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$995.00 |
$995.00 |
$995.00 |
$1,182.33
|
|
Injection eye drug
|
$450.00 |
$450.00 |
$450.00 |
$654.00
|
|
Injection for arthrography wrist (both sides)
|
$332.50 |
$332.50 |
$332.50 |
$436.00
|
|
Injection for bladder x-ray
|
$380.00 |
$380.00 |
$380.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$415.00 |
$415.00 |
$415.00 |
$497.76
|
