|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$203.40 |
$203.40 |
$203.40 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$208.80 |
$208.80 |
$208.80 |
$75.27
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$129.60 |
$129.60 |
$129.60 |
$60.95
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$190.20 |
$190.20 |
$190.20 |
$107.90
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$238.20 |
$238.20 |
$238.20 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$250.80 |
$250.80 |
$250.80 |
$98.40
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$45.60 |
$45.60 |
$45.60 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$404.40 |
$404.40 |
$404.40 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$253.20 |
$253.20 |
$253.20 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$228.00 |
$228.00 |
$228.00 |
$174.06
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$198.00 |
$198.00 |
$198.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$375.60 |
$375.60 |
$375.60 |
$148.80
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$504.60 |
$504.60 |
$504.60 |
$217.10
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$253.20 |
$253.20 |
$253.20 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$406.20 |
$406.20 |
$406.20 |
$109.18
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$404.40 |
$404.40 |
$404.40 |
$135.00
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,041.00 |
$1,041.00 |
$1,041.00 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$608.40 |
$608.40 |
$608.40 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,143.00 |
$1,143.00 |
$1,143.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$907.20 |
$907.20 |
$907.20 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$655.20 |
$655.20 |
$655.20 |
$381.55
|
|
Infliximab 100 mg intravenous solution
|
$23.58 |
$23.58 |
$23.58 |
$178.95
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$20.66 |
$20.66 |
$20.66 |
$157.14
|
|
Influenza dna amp prob addl
|
$78.00 |
$78.00 |
$78.00 |
$75.80
|
|
Initiation & management bipap/cpap initial day
|
$685.20 |
$685.20 |
$685.20 |
$608.40
|
|
Inj allopurinol sodium 1 mg
|
$5,992.97 |
$5,992.97 |
$5,992.97 |
$5,937.23
|
|
Inj anifrolumab-fnia 1mg
|
$26.38 |
$26.38 |
$26.38 |
$1,038.87
|
|
Inj, aspara, rylaze, 0.1 mg
|
$790.20 |
$790.20 |
$790.20 |
$99.60
|
|
Inj., benralizumab, 1 mg
|
$8,674.10 |
$8,674.10 |
$8,674.10 |
$12,417.10
|
|
Inj, bupivacaine liposome
|
$842.91 |
$842.91 |
$842.91 |
$3.22
|
|
Inj calcitriol per 0.1 mcg
|
$40.17 |
$40.17 |
$40.17 |
$11.21
|
|
Inj cefazolin sodium, hikma
|
$104.18 |
$104.18 |
$104.18 |
$66.38
|
|
Inj, cefiderocol, 10 mg
|
$3.83 |
$3.83 |
$3.83 |
$79.20
|
|
Inj ceftolozane tazobactam
|
$248.93 |
$248.93 |
$248.93 |
$248.93
|
|
Inj cntr knee arthro incl ct/mri
|
$505.20 |
$505.20 |
$505.20 |
$505.20
|
|
Inj dx for sinogram
|
$734.40 |
$734.40 |
$734.40 |
$484.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$853.80 |
$853.80 |
$853.80 |
$609.20
|
|
Injection, burosumab-twza 1m
|
$590.52 |
$590.52 |
$590.52 |
$481.57
|
|
Injection, doxercalciferol
|
$45.89 |
$45.89 |
$45.89 |
$30.35
|
|
Injection, edaravone, 1 mg
|
$1,721.40 |
$1,721.40 |
$1,721.40 |
$1,721.40
|
|
Injection epidural blood patch or clot
|
$1,537.20 |
$1,537.20 |
$1,537.20 |
$1,470.60
|
|
Injection for arthrography wrist (both sides)
|
$618.00 |
$618.00 |
$618.00 |
$521.18
|
|
Injection for bladder x-ray
|
$560.40 |
$560.40 |
$560.40 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$684.60 |
$684.60 |
$684.60 |
$514.36
|
|
Injection for ureter x-ray
|
$2,074.20 |
$2,074.20 |
$2,074.20 |
$544.50
|
|
Injection, fulvestrant
|
$1,660.11 |
$1,660.11 |
$1,660.11 |
$166.25
|
|
Injection glatiramer acetate
|
$418.45 |
$418.45 |
$418.45 |
$458.43
|
|
Injection, inclisiran, 1 mg
|
$5,431.58 |
$5,431.58 |
$5,431.58 |
$12.72
|
|
Injection into brain canal
|
$836.40 |
$836.40 |
$836.40 |
$961.20
|
|
Injection, isavuconazonium
|
$634.28 |
$634.28 |
$634.28 |
$634.28
|
|
Injection, necitumumab, 1 mg
|
$8.12 |
$8.12 |
$8.12 |
$5.73
|
|
Injection,onabotulinumtoxina
|
$12.88 |
$12.88 |
$12.88 |
$12.88
|
|
Injection, peramivir
|
$857.20 |
$857.20 |
$857.20 |
$857.20
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,740.00 |
$1,740.00 |
$1,740.00 |
$787.50
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$216.00 |
$216.00 |
$216.00 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$155.40 |
$155.40 |
$155.40 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$306.60 |
$306.60 |
$306.60 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$157.20 |
$157.20 |
$157.20 |
$130.19
|
|
Injection torsemide 10 mg/ml
|
$40.94 |
$40.94 |
$40.94 |
$40.67
|
|
Inject sacroiliac joint
|
$4,227.00 |
$4,227.00 |
$4,227.00 |
$1,028.95
|
|
Inj fluphenazine hcl 1.25 mg
|
$266.49 |
$266.49 |
$266.49 |
$29.65
|
|
Inj for mammo ductogram
|
$606.60 |
$606.60 |
$606.60 |
$469.16
|
|
Inj human fibrinogen con nos
|
$3.16 |
$3.16 |
$3.16 |
$2.41
|
|
Inj hydroxocobalamin IV 25mg
|
$1,593.19 |
$1,593.19 |
$1,593.19 |
$1,593.19
|
|
Inj hydroxyprogst capoat nos
|
$1,293.56 |
$1,293.56 |
$1,293.56 |
$1,495.98
|
|
Inj ivig privigen 500 mg
|
$7,298.71 |
$7,298.71 |
$7,298.71 |
$6,144.00
|
|
Inj, lanreotide, (cipla) 1mg
|
$12,160.05 |
$12,160.05 |
$12,160.05 |
$12,160.05
|
|
Inj levocarnitine per 1 gm
|
$53.36 |
$53.36 |
$53.36 |
$87.51
|
|
Inj melpha hydroch nos 50 mg
|
$2,513.20 |
$2,513.20 |
$2,513.20 |
$1,713.99
|
|
Inj mepivacaine hcl/10 ml
|
$41.81 |
$41.81 |
$41.81 |
$28.41
|
|
Inj., meropenem, vaborbactam
|
$426.85 |
$426.85 |
$426.85 |
$426.85
|
|
Inj, moxifloxacin 100 mg
|
$262.28 |
$262.28 |
$262.28 |
$100.44
|
|
Inj. mycophenolate mofetil
|
$442.90 |
$442.90 |
$442.90 |
$387.27
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$2,632.80 |
$2,632.80 |
$2,632.80 |
$1,522.56
|
|
Inj., patisiran, 0.1 mg
|
$146.78 |
$146.78 |
$146.78 |
$36,180.04
|
|
Inj pegfilgrastim-bmez 0.5mg
|
$5,688.86 |
$5,688.86 |
$5,688.86 |
$1,695.87
|
|
Inj peritoneal venous shunt
|
$681.00 |
$681.00 |
$681.00 |
$329.49
|
|
Inj proc ankle arthr
|
$482.40 |
$482.40 |
$482.40 |
$405.60
|
|
Inj proc elbow arthro
|
$534.60 |
$534.60 |
$534.60 |
$483.15
|
|
Inj proc lumbr disk ea lvl
|
$4,177.80 |
$4,177.80 |
$4,177.80 |
$1,218.51
|
|
Inj proc myelogram lumbar
|
$1,544.40 |
$1,544.40 |
$1,544.40 |
$1,026.35
|
|
Inj progesterone per 50 mg
|
$120.00 |
$120.00 |
$120.00 |
$35.00
|
|
Inj retacrit esrd on dialysi
|
$1,074.20 |
$1,074.20 |
$1,074.20 |
$307.40
|
|
Inj retro urethrocysto
|
$640.80 |
$640.80 |
$640.80 |
$569.60
|
|
Inj secretin synthetic human
|
$1,234.65 |
$1,234.65 |
$1,234.65 |
$610.89
|
|
Inj testostero enanthate 1mg
|
$197.08 |
$197.08 |
$197.08 |
$55.89
|
|
Inj testosterone cypionate
|
$122.55 |
$122.55 |
$122.55 |
$78.79
|
|
Inj., tildrakizumab, 1 mg
|
$24,563.40 |
$24,563.40 |
$24,563.40 |
$126.24
|
|
Inj w/fluor eval cv device
|
$872.40 |
$872.40 |
$872.40 |
$573.00
|
|
Insert cath pleura with image
|
$3,266.40 |
$3,266.40 |
$3,266.40 |
$2,239.02
|
|
Insertion catheter bladder non indwelling
|
$343.80 |
$343.80 |
$343.80 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$315.00 |
$315.00 |
$315.00 |
$245.00
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,024.60 |
$3,024.60 |
$3,024.60 |
$2,457.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,831.80 |
$4,831.80 |
$4,831.80 |
$2,079.43
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,228.40 |
$5,228.40 |
$5,228.40 |
$2,367.00
|
|
Insert swan-ganz cath
|
$2,650.80 |
$2,650.80 |
$2,650.80 |
$2,269.00
|
|
Insitu hybridization auto
|
$726.00 |
$726.00 |
$726.00 |
$328.79
|
|
Insitu hybridization manual
|
$1,167.60 |
$1,167.60 |
$1,167.60 |
$407.11
|
|
In situ hybridization per specimen each additional single probe stain
|
$183.60 |
$183.60 |
$183.60 |
$291.00
|
|
In situ hybridization per specimen initial single probe stain
|
$1,285.80 |
$1,285.80 |
$1,285.80 |
$364.00
|