|
Infect ag if ea plyvlnt antsrm
|
$30.40 |
$30.40 |
$30.40 |
$65.10
|
|
Infect ag if hep delta agent
|
$46.40 |
$46.40 |
$46.40 |
$125.97
|
|
Infect ag if influenza a
|
$35.20 |
$35.20 |
$35.20 |
$41.22
|
|
Infect ag if influenza b
|
$31.20 |
$31.20 |
$31.20 |
$37.95
|
|
Infect ag if legionella pneumophila
|
$38.58 |
$38.58 |
$38.58 |
$73.45
|
|
Infect ag if nos ea
|
$38.58 |
$38.58 |
$38.58 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$30.40 |
$30.40 |
$30.40 |
$68.40
|
|
Infect ag if varicella zoster
|
$38.58 |
$38.58 |
$38.58 |
$72.00
|
|
Infect ag na chlamydia trachomatis qnt
|
$107.20 |
$107.20 |
$107.20 |
$100.70
|
|
Infect ag na hep b amp
|
$88.80 |
$88.80 |
$88.80 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$108.00 |
$108.00 |
$108.00 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$77.60 |
$77.60 |
$77.60 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$206.40 |
$206.40 |
$206.40 |
$221.39
|
|
Infect ag na influenza revr/amp ea type
|
$124.80 |
$124.80 |
$124.80 |
$156.60
|
|
Infect ag na resp virus 12-25 targets
|
$935.20 |
$935.20 |
$935.20 |
$871.20
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,225.60 |
$1,225.60 |
$1,225.60 |
$954.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$127.86 |
$127.86 |
$127.86 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$39.73 |
$39.73 |
$39.73 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$38.58 |
$38.58 |
$38.58 |
$82.50
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$38.58 |
$38.58 |
$38.58 |
$72.10
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$38.58 |
$38.58 |
$38.58 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$38.58 |
$38.58 |
$38.58 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$38.58 |
$38.58 |
$38.58 |
$100.80
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$38.58 |
$38.58 |
$38.58 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$38.58 |
$38.58 |
$38.58 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$48.80 |
$48.80 |
$48.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$38.58 |
$38.58 |
$38.58 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$38.58 |
$38.58 |
$38.58 |
$98.02
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$38.58 |
$38.58 |
$38.58 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$88.80 |
$88.80 |
$88.80 |
$275.06
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$88.80 |
$88.80 |
$88.80 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$89.60 |
$89.60 |
$89.60 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$909.60 |
$909.60 |
$909.60 |
$866.04
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$88.80 |
$88.80 |
$88.80 |
$182.63
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$87.20 |
$87.20 |
$87.20 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$101.60 |
$101.60 |
$101.60 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$88.80 |
$88.80 |
$88.80 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$103.20 |
$103.20 |
$103.20 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$285.60 |
$285.60 |
$285.60 |
$208.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$285.60 |
$285.60 |
$285.60 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$88.80 |
$88.80 |
$88.80 |
$97.50
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$79.20 |
$79.20 |
$79.20 |
$113.00
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$153.60 |
$153.60 |
$153.60 |
$191.95
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$919.20 |
$919.20 |
$919.20 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$283.20 |
$283.20 |
$283.20 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$526.40 |
$526.40 |
$526.40 |
$432.60
|
|
Infectious agent nucleic acid quantification bk virus
|
$108.00 |
$108.00 |
$108.00 |
$279.40
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$108.00 |
$108.00 |
$108.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$108.00 |
$108.00 |
$108.00 |
$255.50
|
|
Infectious agent nucleic acid quantification hiv-1
|
$213.60 |
$213.60 |
$213.60 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$288.00 |
$288.00 |
$288.00 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$188.52 |
$188.52 |
$188.52 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$81.17 |
$81.17 |
$81.17 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$152.68 |
$152.68 |
$152.68 |
$1,537.84
|
|
Influenza dna amp prob addl
|
$59.20 |
$59.20 |
$59.20 |
$64.26
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$76.00 |
$76.00 |
$76.00 |
$110.00
|
|
Influenza virus vaccine, live trivalent intranasal
|
$29.60 |
$29.60 |
$29.60 |
$36.50
|
|
Inf lwr xtr fscl pln blk uni w/wo image
|
$811.20 |
$811.20 |
$811.20 |
$762.00
|
|
Inf thrc fascial pln blk bi w/wo image
|
$624.00 |
$624.00 |
$624.00 |
$523.25
|
|
Inf thrc fascial pln blk uni w/wo image
|
$820.80 |
$820.80 |
$820.80 |
$780.00
|
|
Infuse radioactive materials
|
$744.00 |
$744.00 |
$744.00 |
$672.42
|
|
Ingest challenge ea addl 60 min
|
$264.80 |
$264.80 |
$264.80 |
$289.64
|
|
Ingest challenge ini 120 min
|
$367.20 |
$367.20 |
$367.20 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$118.40 |
$118.40 |
$118.40 |
$302.94
|
|
Initial foot exam pt lops
|
$117.60 |
$117.60 |
$117.60 |
$152.50
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$629.60 |
$629.60 |
$629.60 |
$540.80
|
|
Initial nursing facility care/day 35 minutes
|
$244.00 |
$244.00 |
$244.00 |
$184.80
|
|
Initial nursing facility care/day 45 minutes
|
$333.60 |
$333.60 |
$333.60 |
$231.84
|
|
Initial nursing facility care/day low severity 99304
|
$162.40 |
$162.40 |
$162.40 |
$127.63
|
|
Init nb em per day non-fac
|
$167.20 |
$167.20 |
$167.20 |
$97.68
|
|
Init pm e/m new pat 65+ yrs
|
$296.00 |
$296.00 |
$296.00 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$11.50 |
$11.50 |
$11.50 |
$5,355.30
|
|
Inj, acetaminophen (b braun)
|
$0.84 |
$0.84 |
$0.84 |
$32.79
|
|
Inj acetaminophen -fresenius
|
$2.57 |
$2.57 |
$2.57 |
$36.60
|
|
Inj., benralizumab, 1 mg
|
$199.20 |
$199.20 |
$199.20 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$61.88 |
$61.88 |
$61.88 |
$7,612.43
|
|
Inj, bupivacaine liposome
|
$3.44 |
$3.44 |
$3.44 |
$699.38
|
|
Inj cefazolin sodium, hikma
|
$12.77 |
$12.77 |
$12.77 |
$27.38
|
|
Inj, clindamycin (baxter)
|
$43.56 |
$43.56 |
$43.56 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$769.60 |
$769.60 |
$769.60 |
$441.88
|
|
Inj, daptomycin (hospira)
|
$0.40 |
$0.40 |
$0.40 |
$128.08
|
|
Inj daptomycin (xellia)
|
$0.30 |
$0.30 |
$0.30 |
$56.04
|
|
Inj disk cerv-thor ea lev
|
$828.00 |
$828.00 |
$828.00 |
$875.28
|
|
Inj dupuytren cord w/enzyme
|
$416.00 |
$416.00 |
$416.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$16.00 |
$16.00 |
$16.00 |
$1,950.93
|
|
Inj dx for sinogram
|
$336.80 |
$336.80 |
$336.80 |
$447.50
|
|
Inject for sacroiliac joint
|
$1,323.20 |
$1,323.20 |
$1,323.20 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,044.80 |
$1,044.80 |
$1,044.80 |
$1,231.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,072.00 |
$1,072.00 |
$1,072.00 |
$504.00
|
|
Injection carpal tunnel therapeutic (both sides)
|
$1,331.84 |
$1,331.84 |
$1,331.84 |
$463.20
|
|
Injection during cath supravalvular aortography
|
$265.60 |
$265.60 |
$265.60 |
$1,030.00
|
|
Injection epidural blood patch or clot
|
$1,290.64 |
$1,290.64 |
$1,290.64 |
$1,192.80
|
|
Injection estrone per 1 mg
|
$0.80 |
$0.80 |
$0.80 |
$0.80
|
|
Injection eye drug
|
$504.00 |
$504.00 |
$504.00 |
$654.00
|
|
Injection, famotidine, 20 mg
|
$71.44 |
$71.44 |
$71.44 |
$24.14
|
|
Injection for arthrography wrist (both sides)
|
$910.40 |
$910.40 |
$910.40 |
$439.50
|
|
Injection for bladder x-ray
|
$505.60 |
$505.60 |
$505.60 |
$462.90
|
|
Injection for hip x-ray
|
$1,432.00 |
$1,432.00 |
$1,432.00 |
$750.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$752.00 |
$752.00 |
$752.00 |
$503.30
|
|
Injection for spleen x-ray
|
$341.60 |
$341.60 |
$341.60 |
$595.50
|