|
Incision of foot tendon 28234
|
$781.80 |
$781.80 |
$781.80 |
$2,211.05
|
|
Incision of gallbladder 47480
|
$1,650.00 |
$1,650.00 |
$1,650.00 |
$1,650.00
|
|
Incision of heel bone
|
$1,263.60 |
$1,263.60 |
$1,263.60 |
$6,004.47
|
|
Incision of metatarsal
|
$1,168.80 |
$1,168.80 |
$1,168.80 |
$4,881.00
|
|
Incision of metatarsal
|
$1,065.60 |
$1,065.60 |
$1,065.60 |
$3,786.00
|
|
Incision of midfoot bones
|
$1,158.60 |
$1,158.60 |
$1,158.60 |
$6,004.47
|
|
Incision of pyloric muscle 43520
|
$1,306.20 |
$1,306.20 |
$1,306.20 |
$1,685.60
|
|
Incision of rectal abscess
|
$891.60 |
$891.60 |
$891.60 |
$3,245.23
|
|
Incision of small bowel 44010
|
$1,430.40 |
$1,430.40 |
$1,430.40 |
$1,362.00
|
|
Incision of spinal nerve 64772
|
$1,095.60 |
$1,095.60 |
$1,095.60 |
$2,685.07
|
|
Incision of tendon sheath
|
$487.80 |
$487.80 |
$487.80 |
$2,263.68
|
|
Incision of toe tendons 28011
|
$525.60 |
$525.60 |
$525.60 |
$2,119.12
|
|
Incision of tongue fold
|
$401.40 |
$401.40 |
$401.40 |
$1,792.50
|
|
Incision tendon sheath
|
$1,060.20 |
$1,060.20 |
$1,060.20 |
$3,073.20
|
|
Incisn of toe tndn
|
$408.00 |
$408.00 |
$408.00 |
$2,667.00
|
|
Incisn windpipe
|
$771.00 |
$771.00 |
$771.00 |
$3,819.23
|
|
Incobotulinumtoxin a
|
$917.50 |
$917.50 |
$917.50 |
$1,339.57
|
|
Induced ab 1+vag supp d&c
|
$1,003.20 |
$1,003.20 |
$1,003.20 |
$1,194.40
|
|
Induced ab 1+ vag sup w/dlv fetus
|
$853.20 |
$853.20 |
$853.20 |
$1,997.99
|
|
Induced abortion d&c
|
$511.20 |
$511.20 |
$511.20 |
$3,762.53
|
|
Induced abortion dilat&evac
|
$784.20 |
$784.20 |
$784.20 |
$4,451.18
|
|
Infect ag drug suscept pheno predict
|
$447.60 |
$447.60 |
$447.60 |
$325.00
|
|
Infect ag genotype na hiv-1 other region
|
$454.80 |
$454.80 |
$454.80 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$937.20 |
$937.20 |
$937.20 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$50.40 |
$50.40 |
$50.40 |
$72.93
|
|
Infect ag if ea plyvlnt antsrm
|
$68.40 |
$68.40 |
$68.40 |
$68.40
|
|
Infect ag if influenza a
|
$43.20 |
$43.20 |
$43.20 |
$41.30
|
|
Infect ag if influenza b
|
$33.60 |
$33.60 |
$33.60 |
$37.95
|
|
Infect ag if legionella pneumophila
|
$44.40 |
$44.40 |
$44.40 |
$73.45
|
|
Infect ag if nos ea
|
$43.20 |
$43.20 |
$43.20 |
$74.88
|
|
Infect ag if pneumocystis carinii
|
$42.60 |
$42.60 |
$42.60 |
$66.06
|
|
Infect ag if varicella zoster
|
$72.00 |
$72.00 |
$72.00 |
$72.00
|
|
Infect ag na hep b amp
|
$295.20 |
$295.20 |
$295.20 |
$120.50
|
|
Infect ag na herpes simplex quant
|
$162.00 |
$162.00 |
$162.00 |
$178.86
|
|
Infect ag na hpv high-risk types
|
$124.20 |
$124.20 |
$124.20 |
$139.20
|
|
Infect ag na influenza r/amp 1st 2 types
|
$295.20 |
$295.20 |
$295.20 |
$219.70
|
|
Infect ag na influenza revr/amp ea type
|
$175.80 |
$175.80 |
$175.80 |
$156.60
|
|
Infect ag na orthopoxvirus amp prb each
|
$78.00 |
$78.00 |
$78.00 |
$100.00
|
|
Infect ag na resp virus 12-25 targets
|
$1,167.00 |
$1,167.00 |
$1,167.00 |
$854.70
|
|
Infect ag phenotype na hiv-1 1-10 drugs
|
$1,675.80 |
$1,675.80 |
$1,675.80 |
$954.00
|
|
Infect ag phenotype na hiv-1 ea addl drg
|
$99.00 |
$99.00 |
$99.00 |
$75.63
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$36.60 |
$36.60 |
$36.60 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$103.80 |
$103.80 |
$103.80 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$116.40 |
$116.40 |
$116.40 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$65.40 |
$65.40 |
$65.40 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$183.60 |
$183.60 |
$183.60 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$65.40 |
$65.40 |
$65.40 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$85.80 |
$85.80 |
$85.80 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$149.40 |
$149.40 |
$149.40 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$99.00 |
$99.00 |
$99.00 |
$98.58
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$42.00 |
$42.00 |
$42.00 |
$55.31
|
|
Infectious agent nucleic acid amplified probe
|
$373.80 |
$373.80 |
$373.80 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$151.20 |
$151.20 |
$151.20 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$132.60 |
$132.60 |
$132.60 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$224.40 |
$224.40 |
$224.40 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$141.00 |
$141.00 |
$141.00 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$199.80 |
$199.80 |
$199.80 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$133.20 |
$133.20 |
$133.20 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$136.80 |
$136.80 |
$136.80 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$196.80 |
$196.80 |
$196.80 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$267.00 |
$267.00 |
$267.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$96.00 |
$96.00 |
$96.00 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$129.00 |
$129.00 |
$129.00 |
$112.45
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,051.20 |
$1,051.20 |
$1,051.20 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$300.00 |
$300.00 |
$300.00 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$143.40 |
$143.40 |
$143.40 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$472.20 |
$472.20 |
$472.20 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$310.80 |
$310.80 |
$310.80 |
$375.00
|
|
Infliximab 100 mg intravenous solution
|
$2,080.86 |
$2,080.86 |
$2,080.86 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$898.02 |
$898.02 |
$898.02 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,688.48 |
$1,688.48 |
$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
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$705.00 |
$705.00 |
$705.00 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$253.20 |
$253.20 |
$253.20 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$322.20 |
$322.20 |
$322.20 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$178.80 |
$178.80 |
$178.80 |
$128.00
|
|
Initial observation care
|
$196.20 |
$196.20 |
$196.20 |
$156.00
|
|
Initial observation care
|
$268.20 |
$268.20 |
$268.20 |
$268.20
|
|
Initial observation care
|
$369.00 |
$369.00 |
$369.00 |
$369.00
|
|
Init pm e/m new pat 65+ yrs
|
$270.00 |
$270.00 |
$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
|
$9,648.88 |
$9,648.88 |
$9,648.88 |
$10,052.58
|
|
Inj., aristada initio, 1 mg
|
$4,325.66 |
$4,325.66 |
$4,325.66 |
$4,052.45
|
|
Inj aval alfa-nqpt 4mg
|
$3,478.84 |
$3,478.84 |
$3,478.84 |
$3,907.30
|
|
Inj., benralizumab, 1 mg
|
$10,067.08 |
$10,067.08 |
$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
|
$442.01 |
$442.01 |
$442.01 |
$544.85
|
|
Inj cntr knee arthro incl ct/mri
|
$166.80 |
$166.80 |
$166.80 |
$436.80
|
|
Inj cyclophosphamd (ingenus)
|
$1,338.80 |
$1,338.80 |
$1,338.80 |
$742.72
|
|
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, donanemab-azbt, 2 mg
|
$1,277.15 |
$1,277.15 |
$1,277.15 |
$1,233.44
|
|
Inj, durolane 1 mg
|
$1,987.31 |
$1,987.31 |
$1,987.31 |
$1,950.93
|
|
Inj dx for sinogram
|
$409.20 |
$409.20 |
$409.20 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$414.00 |
$414.00 |
$414.00 |
$1,214.78
|