|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$166.80 |
$166.80 |
$175.20 |
$82.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$111.60 |
$111.60 |
$117.60 |
$72.10
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$75.60 |
$75.60 |
$84.60 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$58.20 |
$58.20 |
$65.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$174.60 |
$174.60 |
$183.60 |
$102.82
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$79.80 |
$79.80 |
$89.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$45.00 |
$45.00 |
$50.40 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$79.20 |
$79.20 |
$85.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$134.40 |
$134.40 |
$149.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$88.80 |
$88.80 |
$99.00 |
$98.40
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$63.60 |
$63.60 |
$70.80 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$439.20 |
$439.20 |
$461.40 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$144.00 |
$144.00 |
$151.20 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$193.20 |
$193.20 |
$203.40 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$750.60 |
$750.60 |
$835.80 |
$865.50
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$394.20 |
$394.20 |
$414.00 |
$181.80
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$164.40 |
$164.40 |
$183.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$369.60 |
$369.60 |
$388.20 |
$212.01
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$119.40 |
$119.40 |
$133.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$123.00 |
$123.00 |
$136.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$176.40 |
$176.40 |
$196.80 |
$208.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$239.40 |
$239.40 |
$267.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$91.20 |
$91.20 |
$96.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$115.20 |
$115.20 |
$129.00 |
$112.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,000.20 |
$1,000.20 |
$1,050.60 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$285.60 |
$285.60 |
$300.00 |
$280.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$374.40 |
$374.40 |
$393.60 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$449.40 |
$449.40 |
$472.20 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$405.00 |
$405.00 |
$451.20 |
$375.00
|
|
Infliximab 100 mg intravenous solution
|
$2,080.85 |
$2,080.85 |
$2,080.86 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$898.02 |
$898.02 |
$898.02 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,688.47 |
$1,688.47 |
$1,688.48 |
$1,537.84
|
|
Influenza virus vaccine, inact hemagglutinin tiv pf inj
|
$73.99 |
$73.99 |
$73.99 |
$111.51
|
|
Influenza virus vaccine, live trivalent intranasal
|
$63.28 |
$63.28 |
$63.28 |
$36.50
|
|
Infuse radioactive materials
|
$334.80 |
$334.80 |
$365.40 |
$672.42
|
|
Initial foot exam pt lops
|
$114.00 |
$114.00 |
$127.20 |
$152.50
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$671.40 |
$671.40 |
$705.00 |
$540.80
|
|
Initial nursing facility care/day 35 minutes
|
$241.20 |
$241.20 |
$253.20 |
$184.80
|
|
Initial nursing facility care/day 45 minutes
|
$306.60 |
$306.60 |
$322.20 |
$231.84
|
|
Initial nursing facility care/day low severity 99304
|
$170.40 |
$170.40 |
$178.80 |
$127.63
|
|
Initial observation care
|
$186.60 |
$186.60 |
$196.20 |
$156.00
|
|
Initial observation care
|
$255.60 |
$255.60 |
$268.20 |
$268.20
|
|
Initial observation care
|
$351.60 |
$351.60 |
$369.00 |
$369.00
|
|
Init pm e/m new pat 65+ yrs
|
$236.40 |
$236.40 |
$270.00 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$5,156.77 |
$5,156.77 |
$5,156.77 |
$5,355.30
|
|
Inj, adalimumab, 1 mg
|
$6,143.09 |
$6,143.09 |
$6,143.09 |
$12,098.05
|
|
Inj anifrolumab-fnia 1mg
|
$8,872.01 |
$8,872.01 |
$9,648.88 |
$10,052.58
|
|
Inj., aristada initio, 1 mg
|
$4,078.06 |
$4,078.06 |
$4,325.66 |
$4,052.45
|
|
Inj aval alfa-nqpt 4mg
|
$3,218.92 |
$3,218.92 |
$3,478.84 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$9,774.23 |
$9,774.23 |
$10,067.08 |
$11,310.00
|
|
Inj, bezlotoxumab, 10 mg
|
$6,760.17 |
$6,760.17 |
$6,760.17 |
$7,612.43
|
|
Inj calcitriol per 0.1 mcg
|
$22.69 |
$22.69 |
$22.69 |
$22.69
|
|
Inj, cefepime hcl (b braun)
|
$64.46 |
$64.46 |
$64.46 |
$69.85
|
|
Inj, cefiderocol, 10 mg
|
$400.15 |
$400.15 |
$442.01 |
$544.85
|
|
Inj, clevidipine butyrate
|
$174.89 |
$174.89 |
$174.89 |
$4.86
|
|
Inj cntr knee arthro incl ct/mri
|
$144.00 |
$144.00 |
$166.80 |
$441.88
|
|
Inj cyclophosphamd (ingenus)
|
$1,338.80 |
$1,338.80 |
$1,338.80 |
$742.72
|
|
Inj, cyclophosphamd, sandoz
|
$649.55 |
$649.55 |
$649.55 |
$735.20
|
|
Inj, daptomycin (hospira)
|
$152.35 |
$152.35 |
$152.35 |
$128.08
|
|
Inj. denosumab-bbdz, 1 mg
|
$5,694.89 |
$5,694.89 |
$5,694.89 |
$4,615.43
|
|
Inj disk cerv-thor ea lev
|
$343.20 |
$343.20 |
$396.60 |
$875.28
|
|
Inj, donanemab-azbt, 2 mg
|
$1,277.15 |
$1,277.15 |
$1,277.15 |
$1,233.44
|
|
Inj, durolane 1 mg
|
$1,872.18 |
$1,872.18 |
$1,987.31 |
$1,950.93
|
|
Inj dx for sinogram
|
$354.00 |
$354.00 |
$409.20 |
$447.50
|
|
Inject for sacroiliac joint
|
$223.80 |
$223.80 |
$258.60 |
$1,025.77
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$394.20 |
$394.20 |
$414.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$216.00 |
$216.00 |
$249.60 |
$504.00
|
|
Injection, cangrelor
|
$1,356.24 |
$1,356.24 |
$1,356.24 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$600.00 |
$600.00 |
$693.00 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$4,769.32 |
$4,769.32 |
$5,239.24 |
$5,324.34
|
|
Injection, doxercalciferol
|
$58.44 |
$58.44 |
$58.44 |
$23.86
|
|
Injection during cath supravalvular aortography
|
$135.60 |
$135.60 |
$171.00 |
$1,028.00
|
|
Injection epidural blood patch or clot
|
$768.60 |
$768.60 |
$928.20 |
$1,192.80
|
|
Injection for arthrography wrist (both sides)
|
$234.00 |
$234.00 |
$270.60 |
$438.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$504.00 |
$504.00 |
$582.60 |
$503.30
|
|
Injection, fulvestrant
|
$3,446.87 |
$3,446.87 |
$3,446.87 |
$1,719.16
|
|
Injection glatiramer acetate
|
$3,493.72 |
$3,493.72 |
$3,493.72 |
$830.51
|
|
Injection, inclisiran, 1 mg
|
$5,768.82 |
$5,768.82 |
$5,987.41 |
$6,679.35
|
|
Injection, isavuconazonium
|
$674.71 |
$674.71 |
$674.71 |
$787.67
|
|
Injection,onabotulinumtoxina
|
$1,872.18 |
$1,872.18 |
$2,318.52 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$75.00 |
$75.00 |
$78.60 |
$694.20
|
|
Injection, renflexis
|
$1,346.83 |
$1,346.83 |
$1,346.83 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$673.80 |
$673.80 |
$778.20 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$712.20 |
$712.20 |
$823.20 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$398.40 |
$398.40 |
$481.80 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$1,599.60 |
$1,599.60 |
$1,848.00 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$988.20 |
$988.20 |
$1,076.40 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$1,413.00 |
$1,413.00 |
$1,632.60 |
$1,888.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$1,048.20 |
$1,048.20 |
$1,076.40 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,413.00 |
$1,413.00 |
$1,632.60 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$528.60 |
$528.60 |
$610.80 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$553.80 |
$553.80 |
$639.60 |
$1,685.00
|
|
Injection, siltuximab
|
$9,427.67 |
$9,427.67 |
$9,427.67 |
$11,502.35
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$301.20 |
$301.20 |
$348.00 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$301.20 |
$301.20 |
$363.60 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$377.40 |
$377.40 |
$436.20 |
$638.95
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$95.40 |
$95.40 |
$106.80 |
$145.60
|
|
Injection torsemide 10 mg/ml
|
$26.06 |
$26.06 |
$26.06 |
$16.02
|
|
Inject sacroiliac joint
|
$1,011.00 |
$1,011.00 |
$1,168.20 |
$1,029.04
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$28,508.30 |
$28,508.30 |
$28,508.30 |
$32,176.93
|
