|
Infect ag eia chlamydia trachomatis
|
$198.40 |
$198.40 |
$198.40 |
$74.88
|
|
Infect ag genotype na hiv-1 other region
|
$1,689.60 |
$1,689.60 |
$1,689.60 |
$326.20
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,532.80 |
$1,532.80 |
$1,532.80 |
$603.75
|
|
Infect ag ia optc obs influenza
|
$153.60 |
$153.60 |
$153.60 |
$72.93
|
|
Infect ag if legionella pneumophila
|
$286.40 |
$286.40 |
$286.40 |
$73.46
|
|
Infect ag na influenza r/amp 1st 2 types
|
$405.60 |
$405.60 |
$405.60 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$284.80 |
$284.80 |
$284.80 |
$99.36
|
|
Infect ag na resp virus 12-25 targets
|
$962.40 |
$962.40 |
$962.40 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$217.60 |
$217.60 |
$217.60 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$146.40 |
$146.40 |
$146.40 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$168.00 |
$168.00 |
$168.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$252.00 |
$252.00 |
$252.00 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$324.80 |
$324.80 |
$324.80 |
$81.06
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$334.40 |
$334.40 |
$334.40 |
$57.60
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$184.80 |
$184.80 |
$184.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$493.60 |
$493.60 |
$493.60 |
$127.80
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$198.40 |
$198.40 |
$198.40 |
$97.50
|
|
Infectious agent nucleic acid amplified probe
|
$1,200.00 |
$1,200.00 |
$1,200.00 |
$267.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$1,210.40 |
$1,210.40 |
$1,210.40 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$324.00 |
$324.00 |
$324.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,544.00 |
$1,544.00 |
$1,544.00 |
$861.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$379.20 |
$379.20 |
$379.20 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$301.60 |
$301.60 |
$301.60 |
$151.25
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$529.60 |
$529.60 |
$529.60 |
$201.60
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$308.80 |
$308.80 |
$308.80 |
$135.80
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$65.60 |
$65.60 |
$65.60 |
$100.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$350.40 |
$350.40 |
$350.40 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$79.20 |
$79.20 |
$79.20 |
$94.53
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$197.60 |
$197.60 |
$197.60 |
$105.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$96.80 |
$96.80 |
$96.80 |
$250.50
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$2,289.60 |
$2,289.60 |
$2,289.60 |
$1,325.35
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,576.80 |
$1,576.80 |
$1,576.80 |
$711.93
|
|
Infectious agent nucleic acid quantification bk virus
|
$1,197.60 |
$1,197.60 |
$1,197.60 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$532.00 |
$532.00 |
$532.00 |
$238.80
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$637.60 |
$637.60 |
$637.60 |
$252.60
|
|
Infectious agent nucleic acid quantification hiv-1
|
$524.80 |
$524.80 |
$524.80 |
$374.50
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$368.80 |
$368.80 |
$368.80 |
$303.59
|
|
Influenza dna amp prob addl
|
$101.60 |
$101.60 |
$101.60 |
$64.26
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$248.00 |
$248.00 |
$248.00 |
$293.04
|
|
Initiation & management bipap/cpap initial day
|
$574.40 |
$574.40 |
$574.40 |
$576.00
|
|
Inj cntr knee arthro incl ct/mri
|
$1,024.00 |
$1,024.00 |
$1,024.00 |
$436.80
|
|
Inj disk cerv-thor ea lev
|
$8,904.80 |
$8,904.80 |
$8,904.80 |
$945.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$3,499.20 |
$3,499.20 |
$3,499.20 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,109.60 |
$1,109.60 |
$1,109.60 |
$500.50
|
|
Injection carpal tunnel therapeutic (both sides)
|
$752.80 |
$752.80 |
$752.80 |
$504.90
|
|
Injection epidural blood patch or clot
|
$2,544.80 |
$2,544.80 |
$2,544.80 |
$1,156.80
|
|
Injection for arthrography wrist (both sides)
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$441.12
|
|
Injection for bladder x-ray
|
$1,324.00 |
$1,324.00 |
$1,324.00 |
$459.20
|
|
Injection for hip x-ray
|
$1,564.80 |
$1,564.80 |
$1,564.80 |
$669.24
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,420.00 |
$1,420.00 |
$1,420.00 |
$494.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,860.80 |
$1,860.80 |
$1,860.80 |
$683.28
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$2,137.60 |
$2,137.60 |
$2,137.60 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$4,568.00 |
$4,568.00 |
$4,568.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$4,568.00 |
$4,568.00 |
$4,568.00 |
$1,939.60
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$4,106.40 |
$4,106.40 |
$4,106.40 |
$1,029.45
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,568.00 |
$4,568.00 |
$4,568.00 |
$1,777.50
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$4,106.40 |
$4,106.40 |
$4,106.40 |
$1,064.70
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$4,568.00 |
$4,568.00 |
$4,568.00 |
$1,961.05
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$4,503.20 |
$4,503.20 |
$4,503.20 |
$1,842.00
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$2,573.60 |
$2,573.60 |
$2,573.60 |
$1,704.78
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,093.60 |
$1,093.60 |
$1,093.60 |
$460.94
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,093.60 |
$1,093.60 |
$1,093.60 |
$517.24
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,093.60 |
$1,093.60 |
$1,093.60 |
$625.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$324.80 |
$324.80 |
$324.80 |
$166.38
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$312.80 |
$312.80 |
$312.80 |
$145.60
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$364.00 |
$364.00 |
$364.00 |
$261.00
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$223.20 |
$223.20 |
$223.20 |
$135.20
|
|
Injection treatment of nerve
|
$7,538.40 |
$7,538.40 |
$7,538.40 |
$2,054.00
|
|
Inject sacroiliac joint
|
$3,216.00 |
$3,216.00 |
$3,216.00 |
$963.00
|
|
Inj epidural sgl cerv-thor without img
|
$3,051.20 |
$3,051.20 |
$3,051.20 |
$1,329.00
|
|
Inj epidural sgl lumb-sacral without img
|
$2,050.40 |
$2,050.40 |
$2,050.40 |
$1,415.50
|
|
Inj for mammo ductogram
|
$938.40 |
$938.40 |
$938.40 |
$433.50
|
|
Inj multihance
|
$10.40 |
$10.40 |
$10.40 |
$79.42
|
|
Inj multihance multipack
|
$10.40 |
$10.40 |
$10.40 |
$2.80
|
|
Inj non-compmd foam sclrsnt mlt trncl veins same leg
|
$1,651.20 |
$1,651.20 |
$1,651.20 |
$2,485.20
|
|
Inj non-compmd foam sclrsnt sgl trncl vein
|
$1,651.20 |
$1,651.20 |
$1,651.20 |
$2,431.74
|
|
Inj proc elbow arthro
|
$1,367.20 |
$1,367.20 |
$1,367.20 |
$432.00
|
|
Inj proc lumbr disk ea lvl
|
$8,780.00 |
$8,780.00 |
$8,780.00 |
$1,139.40
|
|
Inj proc myelogram lumbar
|
$2,524.80 |
$2,524.80 |
$2,524.80 |
$856.00
|
|
Inj prohance multipack
|
$10.40 |
$10.40 |
$10.40 |
$9.60
|
|
Inj retro urethrocysto
|
$1,522.40 |
$1,522.40 |
$1,522.40 |
$450.00
|
|
Inj(s) sclerosant spider veins limb/trunk
|
$961.60 |
$961.60 |
$961.60 |
$436.80
|
|
Inj w/fluor eval cv device
|
$916.80 |
$916.80 |
$916.80 |
$463.40
|
|
Insertion catheter bladder non indwelling
|
$227.20 |
$227.20 |
$227.20 |
$205.20
|
|
Insertion catheter bladder temporary simple
|
$227.20 |
$227.20 |
$227.20 |
$229.32
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$2,916.80 |
$2,916.80 |
$2,916.80 |
$2,511.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$9,098.40 |
$9,098.40 |
$9,098.40 |
$12,508.08
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$9,098.40 |
$9,098.40 |
$9,098.40 |
$12,384.25
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$6,220.80 |
$6,220.80 |
$6,220.80 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$6,297.60 |
$6,297.60 |
$6,297.60 |
$2,414.10
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$28,964.00 |
$28,964.00 |
$28,964.00 |
$29,146.96
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$16,051.20 |
$16,051.20 |
$16,051.20 |
$7,513.67
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$7,190.40 |
$7,190.40 |
$7,190.40 |
$7,342.20
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$4,511.20 |
$4,511.20 |
$4,511.20 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$7,190.40 |
$7,190.40 |
$7,190.40 |
$7,388.80
|
|
Ins icd gen exist sgl lead
|
$20,226.40 |
$20,226.40 |
$20,226.40 |
$23,742.75
|
|
Insitu hybridization auto
|
$1,156.00 |
$1,156.00 |
$1,156.00 |
$371.00
|
|
Insitu hybridization (fish)
|
$975.20 |
$975.20 |
$975.20 |
$481.60
|
|
Insitu hybridization manual
|
$928.80 |
$928.80 |
$928.80 |
$388.20
|
|
In situ hybridization per specimen each additional single probe stain
|
$886.40 |
$886.40 |
$886.40 |
$243.60
|