|
Immunoglobulin assay
|
$333.50 |
$333.50 |
$333.50 |
$74.15
|
|
Implant cochlear osia osi300
|
$35,580.73 |
$35,580.73 |
$35,580.73 |
$17,698.33
|
|
Implant pulse generator remede el
|
$68,750.00 |
$68,750.00 |
$68,750.00 |
$50,985.00
|
|
Implant ureth bulk agent
|
$3,680.00 |
$3,680.00 |
$3,680.00 |
$2,141.57
|
|
In-111 oxyquinolin per 0.5 mci
|
$29.84 |
$29.84 |
$29.84 |
$2,601.60
|
|
In-111 pentetate dtpa / 0.5 mci
|
$2,598.17 |
$2,598.17 |
$2,598.17 |
$2,598.17
|
|
In-111 pentetreotide
|
$4,394.56 |
$4,394.56 |
$4,394.56 |
$4,994.01
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$3,924.50 |
$3,924.50 |
$3,924.50 |
$2,080.80
|
|
Incision of breast lesion
|
$163.62 |
$163.62 |
$163.62 |
$2,577.85
|
|
Incobotulinumtoxin a
|
$2,578.00 |
$2,578.00 |
$2,578.00 |
$1,359.43
|
|
Infect ag drug suscept pheno predict
|
$308.00 |
$308.00 |
$308.00 |
$323.20
|
|
Infect ag genotype na hiv-1 other region
|
$357.00 |
$357.00 |
$357.00 |
$340.00
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$540.00 |
$540.00 |
$540.00 |
$603.75
|
|
Infect ag if ea plyvlnt antsrm
|
$81.00 |
$81.00 |
$81.00 |
$68.40
|
|
Infect ag if influenza a
|
$47.50 |
$47.50 |
$47.50 |
$42.35
|
|
Infect ag if influenza b
|
$51.00 |
$51.00 |
$51.00 |
$41.22
|
|
Infect ag if pneumocystis carinii
|
$85.50 |
$85.50 |
$85.50 |
$68.69
|
|
Infect ag na herpes simplex quant
|
$242.00 |
$242.00 |
$242.00 |
$168.50
|
|
Infect ag na influenza r/amp 1st 2 types
|
$227.00 |
$227.00 |
$227.00 |
$219.70
|
|
Infect ag na orthopoxvirus amp prb each
|
$148.00 |
$148.00 |
$148.00 |
$99.36
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$82.00 |
$82.00 |
$82.00 |
$82.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$83.00 |
$83.00 |
$83.00 |
$76.50
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$88.00 |
$88.00 |
$88.00 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$137.50 |
$137.50 |
$137.50 |
$99.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$63.00 |
$63.00 |
$63.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$98.50 |
$98.50 |
$98.50 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$77.00 |
$77.00 |
$77.00 |
$101.43
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$340.50 |
$340.50 |
$340.50 |
$129.68
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$132.00 |
$132.00 |
$132.00 |
$99.00
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$71.00 |
$71.00 |
$71.00 |
$56.70
|
|
Infectious agent nucleic acid amplified probe
|
$120.50 |
$120.50 |
$120.50 |
$268.50
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$82.50 |
$82.50 |
$82.50 |
$137.67
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$135.50 |
$135.50 |
$135.50 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$909.00 |
$909.00 |
$909.00 |
$860.00
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$164.50 |
$164.50 |
$164.50 |
$184.80
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$120.50 |
$120.50 |
$120.50 |
$153.00
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$207.50 |
$207.50 |
$207.50 |
$208.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$98.50 |
$98.50 |
$98.50 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$187.50 |
$187.50 |
$187.50 |
$102.57
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$188.50 |
$188.50 |
$188.50 |
$216.51
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$230.50 |
$230.50 |
$230.50 |
$233.40
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$92.00 |
$92.00 |
$92.00 |
$94.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$99.00 |
$99.00 |
$99.00 |
$108.21
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$263.00 |
$263.00 |
$263.00 |
$254.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$629.50 |
$629.50 |
$629.50 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$54.00 |
$54.00 |
$54.00 |
$283.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$429.50 |
$429.50 |
$429.50 |
$440.26
|
|
Infectious agent nucleic acid quantification bk virus
|
$288.50 |
$288.50 |
$288.50 |
$287.76
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$274.00 |
$274.00 |
$274.00 |
$239.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$252.00 |
$252.00 |
$252.00 |
$258.05
|
|
Infectious agent nucleic acid quantification hiv-1
|
$393.00 |
$393.00 |
$393.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$249.50 |
$249.50 |
$249.50 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$1,986.92 |
$1,986.92 |
$1,986.92 |
$2,069.44
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,226.50 |
$1,226.50 |
$1,226.50 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,128.50 |
$1,128.50 |
$1,128.50 |
$1,537.84
|
|
Ingest challenge ea addl 60 min
|
$97.00 |
$97.00 |
$97.00 |
$289.64
|
|
Ingest challenge ini 120 min
|
$129.00 |
$129.00 |
$129.00 |
$640.00
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$242.00 |
$242.00 |
$242.00 |
$302.94
|
|
Initial nursing facility care/day 35 minutes
|
$80.00 |
$80.00 |
$80.00 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$103.00 |
$103.00 |
$103.00 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$57.50 |
$57.50 |
$57.50 |
$128.00
|
|
Initiation & management bipap/cpap initial day
|
$430.50 |
$430.50 |
$430.50 |
$576.00
|
|
Inj, abilify asimtufii, 1 mg
|
$12,633.78 |
$12,633.78 |
$12,633.78 |
$9,426.91
|
|
Inj, abilify maintena, 1 mg
|
$4,761.56 |
$4,761.56 |
$4,761.56 |
$5,355.30
|
|
Inj, acetaminophen (hikma)
|
$81.30 |
$81.30 |
$81.30 |
$61.77
|
|
Inj. acthar gel to 40 units
|
$0.01 |
$0.01 |
$0.01 |
$7,918.32
|
|
Inj allopurinol sodium 1 mg
|
$3,419.02 |
$3,419.02 |
$3,419.02 |
$6,968.99
|
|
Inj alymsys 10 mg
|
$5,026.08 |
$5,026.08 |
$5,026.08 |
$1,280.74
|
|
Inj andexxa, 10 mg
|
$3,875.00 |
$3,875.00 |
$3,875.00 |
$4,370.80
|
|
Inj anifrolumab-fnia 1mg
|
$13,099.42 |
$13,099.42 |
$13,099.42 |
$10,052.58
|
|
Inj., aristada initio, 1 mg
|
$5,530.00 |
$5,530.00 |
$5,530.00 |
$4,052.45
|
|
Inj, aspara, rylaze, 0.1 mg
|
$12,851.00 |
$12,851.00 |
$12,851.00 |
$10,458.00
|
|
Inj., benralizumab, 1 mg
|
$14,217.88 |
$14,217.88 |
$14,217.88 |
$11,239.97
|
|
Inj beta interferon sq 1 mcg
|
$2,016.70 |
$2,016.70 |
$2,016.70 |
$2,856.95
|
|
Inj, bezlotoxumab, 10 mg
|
$9,526.00 |
$9,526.00 |
$9,526.00 |
$7,612.43
|
|
Inj, biorphen, 20 micrograms
|
$134.16 |
$134.16 |
$134.16 |
$17.12
|
|
Inj cefazolin sodium, baxter
|
$50.82 |
$50.82 |
$50.82 |
$27.38
|
|
Inj, cefiderocol, 10 mg
|
$953.96 |
$953.96 |
$953.96 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$698.14 |
$698.14 |
$698.14 |
$390.44
|
|
Inj, clevidipine butyrate
|
$437.20 |
$437.20 |
$437.20 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$52.42 |
$52.42 |
$52.42 |
$48.03
|
|
Inj cntr knee arthro incl ct/mri
|
$997.00 |
$997.00 |
$997.00 |
$436.80
|
|
Inj., copanlisib, 1 mg
|
$13,160.00 |
$13,160.00 |
$13,160.00 |
$9,204.29
|
|
Inj cyclophosphamd (ingenus)
|
$742.72 |
$742.72 |
$742.72 |
$741.63
|
|
Inj, durolane 1 mg
|
$2,526.95 |
$2,526.95 |
$2,526.95 |
$1,950.93
|
|
Inj dx for sinogram
|
$690.00 |
$690.00 |
$690.00 |
$420.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$593.50 |
$593.50 |
$593.50 |
$504.00
|
|
Injection, belinostat, 10mg
|
$6,030.58 |
$6,030.58 |
$6,030.58 |
$4,446.10
|
|
Injection, burosumab-twza 1m
|
$33,411.90 |
$33,411.90 |
$33,411.90 |
$20,002.09
|
|
Injection, caplacizumab-yhdp
|
$22,279.40 |
$22,279.40 |
$22,279.40 |
$16,642.50
|
|
Injection, daratumumab 10 mg
|
$6,251.15 |
$6,251.15 |
$6,251.15 |
$5,239.24
|
|
Injection during cath supravalvular aortography
|
$2,238.00 |
$2,238.00 |
$2,238.00 |
$990.03
|
|
Injection, edaravone, 1 mg
|
$1,588.37 |
$1,588.37 |
$1,588.37 |
$1,136.59
|
|
Injection epidural blood patch or clot
|
$2,435.00 |
$2,435.00 |
$2,435.00 |
$1,170.45
|
|
Injection for arthrography wrist (both sides)
|
$568.50 |
$568.50 |
$568.50 |
$448.20
|
|
Injection for bladder x-ray
|
$528.50 |
$528.50 |
$528.50 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$848.50 |
$848.50 |
$848.50 |
$494.65
|
|
Injection for ureter x-ray
|
$441.50 |
$441.50 |
$441.50 |
$527.70
|
|
Injection, fulvestrant
|
$202.44 |
$202.44 |
$202.44 |
$1,719.16
|
|
Injection glatiramer acetate
|
$190.63 |
$190.63 |
$190.63 |
$830.51
|