|
Implant power module patient cable cable 14 volt
|
$12,897.00 |
$12,897.00 |
$12,897.00 |
$3,380.00
|
|
Implant single ventricular device 33975
|
$10,821.60 |
$10,821.60 |
$10,821.60 |
$5,053.23
|
|
Implant tcat pulm vlv perq
|
$33,267.60 |
$33,267.60 |
$33,267.60 |
$9,812.40
|
|
Impl neurostim electr perc
|
$11,764.80 |
$11,764.80 |
$11,764.80 |
$7,672.50
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$1,672.80 |
$1,672.80 |
$1,672.80 |
$2,056.93
|
|
Incision of achilles tendon
|
$14,482.20 |
$14,482.20 |
$14,482.20 |
$3,172.80
|
|
Incision of burn scab initi
|
$399.60 |
$399.60 |
$399.60 |
$494.40
|
|
Incision of tongue fold
|
$2,636.40 |
$2,636.40 |
$2,636.40 |
$1,792.50
|
|
Incisn windpipe
|
$4,479.60 |
$4,479.60 |
$4,479.60 |
$3,810.50
|
|
Incobotulinumtoxin a
|
$13.80 |
$13.80 |
$13.80 |
$1,339.57
|
|
Infect ag drug suscept pheno predict
|
$377.40 |
$377.40 |
$709.80 |
$323.20
|
|
Infect ag eia chlamydia trachomatis
|
$159.60 |
$159.60 |
$159.60 |
$67.20
|
|
Infect ag genotype na hiv-1 other region
|
$326.40 |
$326.40 |
$1,397.40 |
$386.40
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$326.40 |
$326.40 |
$1,264.20 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$146.40 |
$146.40 |
$146.40 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$229.80 |
$229.80 |
$229.80 |
$72.58
|
|
Infect ag na hpv high-risk types
|
$173.40 |
$173.40 |
$173.40 |
$139.75
|
|
Infect ag na influenza r/amp 1st 2 types
|
$324.60 |
$324.60 |
$324.60 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$228.60 |
$228.60 |
$228.60 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$798.60 |
$798.60 |
$798.60 |
$835.80
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$2,211.60 |
$2,211.60 |
$2,211.60 |
$943.80
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$169.80 |
$169.80 |
$169.80 |
$75.63
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$115.20 |
$115.20 |
$222.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$130.20 |
$130.20 |
$130.20 |
$76.32
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$149.40 |
$149.40 |
$149.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$45.00 |
$45.00 |
$199.80 |
$100.02
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$58.20 |
$58.20 |
$257.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$297.00 |
$297.00 |
$297.00 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$129.00 |
$129.00 |
$129.60 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$163.20 |
$163.20 |
$444.60 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$286.20 |
$286.20 |
$286.20 |
$98.02
|
|
Infectious agent nucleic acid amplified probe
|
$1,015.20 |
$1,015.20 |
$1,015.20 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$40.20 |
$40.20 |
$961.20 |
$139.68
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$39.00 |
$39.00 |
$291.60 |
$167.00
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,183.20 |
$1,183.20 |
$1,183.20 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$336.00 |
$336.00 |
$336.00 |
$179.92
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$81.00 |
$81.00 |
$227.40 |
$147.55
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$492.60 |
$492.60 |
$492.60 |
$217.85
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$273.60 |
$273.60 |
$273.60 |
$136.03
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$45.00 |
$45.00 |
$54.00 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$255.00 |
$255.00 |
$267.60 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$108.00 |
$108.00 |
$108.00 |
$92.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$163.80 |
$163.80 |
$163.80 |
$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 amp probe mycobacterium tuberculosis rifampin resistance
|
$164.40 |
$164.40 |
$164.40 |
$185.00
|
|
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
|
$1,251.60 |
$1,251.60 |
$1,251.60 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$261.00 |
$261.00 |
$951.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$321.00 |
$321.00 |
$423.60 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$385.80 |
$385.80 |
$481.80 |
$252.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$62.40 |
$62.40 |
$434.40 |
$374.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$202.80 |
$202.80 |
$306.00 |
$303.59
|
|
Influenza dna amp prob addl
|
$90.00 |
$90.00 |
$90.00 |
$64.26
|
|
Infuse radioactive materials
|
$1,878.60 |
$1,878.60 |
$1,878.60 |
$640.50
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$127.80 |
$127.80 |
$127.80 |
$293.25
|
|
Initiation & management bipap/cpap initial day
|
$261.60 |
$261.60 |
$265.80 |
$576.00
|
|
Init pm e/m new pat 65+ yrs
|
$135.60 |
$135.60 |
$135.60 |
$185.90
|
|
Inj cntr knee arthro incl ct/mri
|
$1,708.20 |
$1,708.20 |
$1,708.20 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$875.28
|
|
Inj dx for sinogram
|
$2,065.20 |
$2,065.20 |
$2,065.20 |
$422.59
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$2,744.40 |
$2,744.40 |
$2,744.40 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,343.40 |
$1,343.40 |
$1,343.40 |
$495.84
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,250.40 |
$1,250.40 |
$1,250.40 |
$450.72
|
|
Injection during cath supravalvular aortography
|
$1,369.80 |
$1,369.80 |
$1,369.80 |
$952.66
|
|
Injection epidural blood patch or clot
|
$1,665.00 |
$1,665.00 |
$1,665.00 |
$1,156.80
|
|
Injection eye drug
|
$2,188.80 |
$2,188.80 |
$2,188.80 |
$644.50
|
|
Injection for arthrography wrist (both sides)
|
$1,372.20 |
$1,372.20 |
$1,372.20 |
$428.40
|
|
Injection for bladder x-ray
|
$512.40 |
$512.40 |
$512.40 |
$459.20
|
|
Injection for hip x-ray
|
$1,372.20 |
$1,372.20 |
$1,372.20 |
$710.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,372.20 |
$1,372.20 |
$1,372.20 |
$494.65
|
|
Injection for ureter x-ray
|
$2,058.60 |
$2,058.60 |
$2,058.60 |
$427.70
|
|
Injection for ureter x-ray
|
$1,372.20 |
$1,372.20 |
$1,372.20 |
$515.21
|
|
Injection into brain canal
|
$1,470.00 |
$1,470.00 |
$1,470.00 |
$836.40
|
|
Injection jugular
|
$1,019.40 |
$1,019.40 |
$1,019.40 |
$790.00
|
|
Injection of sinus tract
|
$2,595.00 |
$2,595.00 |
$2,595.00 |
$1,627.60
|
|
Injection,onabotulinumtoxina
|
$14.40 |
$14.40 |
$14.40 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$2,722.20 |
$2,722.20 |
$2,722.20 |
$670.64
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,126.60 |
$3,126.60 |
$3,126.60 |
$1,348.56
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,570.80 |
$1,570.80 |
$1,570.80 |
$1,023.50
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,126.60 |
$3,126.60 |
$3,126.60 |
$1,952.40
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$3,000.00 |
$3,000.00 |
$3,000.00 |
$1,814.40
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,592.60 |
$2,592.60 |
$2,592.60 |
$1,017.90
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$2,592.60 |
$2,592.60 |
$2,592.60 |
$1,995.00
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$5,398.80 |
$5,398.80 |
$5,398.80 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$5,398.80 |
$5,398.80 |
$5,398.80 |
$1,681.24
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$613.80 |
$613.80 |
$613.80 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$897.00 |
$897.00 |
$897.00 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$780.00 |
$780.00 |
$1,153.20 |
$632.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$265.20 |
$265.20 |
$265.20 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$256.20 |
$256.20 |
$256.20 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$298.80 |
$298.80 |
$298.80 |
$249.32
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$183.00 |
$183.00 |
$183.00 |
$135.60
|
|
Injection treatment of nerve
|
$2,760.60 |
$2,760.60 |
$2,760.60 |
$2,025.45
|
|
Inject sacroiliac joint
|
$1,902.60 |
$1,902.60 |
$1,902.60 |
$1,028.95
|
|
Inj epidural sgl cerv-thor without img
|
$4,135.20 |
$4,135.20 |
$4,135.20 |
$1,318.80
|
|
Inj epidural sgl lumb-sacral without img
|
$3,575.40 |
$3,575.40 |
$3,575.40 |
$1,415.50
|
|
Inj for ext venography
|
$1,583.40 |
$1,583.40 |
$1,583.40 |
$649.95
|
|
Inj for mammo ductogram
|
$769.20 |
$769.20 |
$769.20 |
$399.60
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,555.40 |
$2,555.40 |
$2,555.40 |
$1,439.90
|