|
Implant pulse generator remede el
|
$12,314.25 |
$12,314.25 |
$12,314.25 |
$43,752.80
|
|
Implant ureth bulk agent
|
$2,100.47 |
$2,100.47 |
$2,100.47 |
$2,168.00
|
|
Impl ear abutment ba300 9mm
|
$3,704.37 |
$3,704.37 |
$3,704.37 |
$3,974.88
|
|
Impl eye bio-eye 16mm
|
$1,657.55 |
$1,657.55 |
$1,657.55 |
$3,917.20
|
|
Impl oi implt skull perq esp
|
$76,267.30 |
$76,267.30 |
$76,267.30 |
$13,525.50
|
|
In-111 autologous plt stdy dx
|
$1,494.95 |
$1,494.95 |
$1,494.95 |
$6,139.64
|
|
In-111 autol wbc diag per dose
|
$10,776.60 |
$10,776.60 |
$10,776.60 |
$3,493.75
|
|
In-111 capromab pendet
|
$7,024.00 |
$7,024.00 |
$7,024.00 |
$3,141.45
|
|
In-111 ibritumomab tiux dx
|
$7,246.75 |
$7,246.75 |
$7,246.75 |
$4,748.02
|
|
In-111 oxyquinolin per 0.5 mci
|
$10,776.60 |
$10,776.60 |
$10,776.60 |
$2,753.23
|
|
In-111 pentetate dtpa / 0.5 mci
|
$11,163.95 |
$11,163.95 |
$11,163.95 |
$2,598.17
|
|
In-111 pentetreotide
|
$15,327.00 |
$15,327.00 |
$15,327.00 |
$5,294.90
|
|
In-111 satumomab pend
|
$3,524.25 |
$3,524.25 |
$3,524.25 |
$3,113.04
|
|
Incision & drainage hematoma/seroma/fluid collection
|
$21,287.30 |
$21,287.30 |
$21,287.30 |
$2,086.70
|
|
Incision & drainage open of deep abscess (subfascial) pos
|
$3,257.00 |
$3,257.00 |
$3,257.00 |
$2,312.00
|
|
Incision of eardrum
|
$241.15 |
$241.15 |
$241.15 |
$552.75
|
|
Incision of metatarsal
|
$47,045.18 |
$47,045.18 |
$47,045.18 |
$3,786.00
|
|
Incision of spinal nerve 64772
|
$49,792.00 |
$49,792.00 |
$49,792.00 |
$2,685.07
|
|
Incision of tendon sheath
|
$23,887.25 |
$23,887.25 |
$23,887.25 |
$2,263.68
|
|
Incision of tongue fold
|
$2,683.85 |
$2,683.85 |
$2,683.85 |
$1,792.50
|
|
Incision tendon sheath
|
$18,217.17 |
$18,217.17 |
$18,217.17 |
$3,073.20
|
|
Incisn windpipe
|
$1,201.00 |
$1,201.00 |
$1,201.00 |
$3,819.23
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$137.15 |
$137.15 |
$137.15 |
$140.80
|
|
Infect ag drug suscept pheno predict
|
$685.10 |
$685.10 |
$685.10 |
$325.00
|
|
Infect ag genotype na hiv-1 other region
|
$336.70 |
$336.70 |
$336.70 |
$361.65
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$249.60 |
$249.60 |
$249.60 |
$603.83
|
|
Infect ag ia optc obs influenza
|
$40.30 |
$40.30 |
$40.30 |
$72.93
|
|
Infect ag na influenza r/amp 1st 2 types
|
$553.00 |
$553.00 |
$553.00 |
$219.70
|
|
Infect ag na resp virus 12-25 targets
|
$321.75 |
$321.75 |
$321.75 |
$854.70
|
|
Infectious agent antigen immunoassay direct optical observation sars-cov-2
|
$65.00 |
$65.00 |
$65.00 |
$53.00
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$1,100.00 |
$1,100.00 |
$1,100.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$63.70 |
$63.70 |
$63.70 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$80.60 |
$80.60 |
$80.60 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$970.00 |
$970.00 |
$970.00 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$57.20 |
$57.20 |
$57.20 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$2,064.00 |
$2,064.00 |
$2,064.00 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$101.40 |
$101.40 |
$101.40 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$146.90 |
$146.90 |
$146.90 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$1,719.00 |
$1,719.00 |
$1,719.00 |
$129.00
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$118.30 |
$118.30 |
$118.30 |
$98.58
|
|
Infectious agent nucleic acid amplified probe
|
$1,763.00 |
$1,763.00 |
$1,763.00 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$170.95 |
$170.95 |
$170.95 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$973.00 |
$973.00 |
$973.00 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$587.60 |
$587.60 |
$587.60 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$771.00 |
$771.00 |
$771.00 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$171.60 |
$171.60 |
$171.60 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$181.35 |
$181.35 |
$181.35 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$54.60 |
$54.60 |
$54.60 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$273.65 |
$273.65 |
$273.65 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$361.40 |
$361.40 |
$361.40 |
$206.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$751.00 |
$751.00 |
$751.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$67.60 |
$67.60 |
$67.60 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$54.60 |
$54.60 |
$54.60 |
$112.45
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$137.15 |
$137.15 |
$137.15 |
$217.60
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$97.50 |
$97.50 |
$97.50 |
$195.60
|
|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$1,325.35 |
$1,325.35 |
$1,325.35 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$627.90 |
$627.90 |
$627.90 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$699.00 |
$699.00 |
$699.00 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$852.00 |
$852.00 |
$852.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$168.35 |
$168.35 |
$168.35 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$171.60 |
$171.60 |
$171.60 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$258.05 |
$258.05 |
$258.05 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$1,110.00 |
$1,110.00 |
$1,110.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$343.20 |
$343.20 |
$343.20 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$3,222.55 |
$3,222.55 |
$3,222.55 |
$2,047.13
|
|
Infliximab-axxq 100 mg intravenous solution
|
$1,379.70 |
$1,379.70 |
$1,379.70 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$2,739.55 |
$2,739.55 |
$2,739.55 |
$1,537.84
|
|
Ingest challenge ini 120 min
|
$380.25 |
$380.25 |
$380.25 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$258.05 |
$258.05 |
$258.05 |
$296.00
|
|
Initial hosp neonate 28 d/less than not critically ill 99477
|
$878.00 |
$878.00 |
$878.00 |
$629.60
|
|
Initial nursing facility care/day 35 minutes
|
$310.00 |
$310.00 |
$310.00 |
$188.50
|
|
Initial nursing facility care/day 45 minutes
|
$399.00 |
$399.00 |
$399.00 |
$236.80
|
|
Initial nursing facility care/day low severity 99304
|
$216.00 |
$216.00 |
$216.00 |
$128.00
|
|
Init pm e/m new pat 65+ yrs
|
$309.00 |
$309.00 |
$309.00 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$13,758.25 |
$13,758.25 |
$13,758.25 |
$5,355.30
|
|
Inj alymsys 10 mg
|
$1,199.10 |
$1,199.10 |
$1,199.10 |
$1,280.74
|
|
Inj cntr knee arthro incl ct/mri
|
$614.25 |
$614.25 |
$614.25 |
$436.80
|
|
Inj. denosumab-bbdz, 1 mg
|
$14,754.85 |
$14,754.85 |
$14,754.85 |
$4,615.43
|
|
Inj dx for sinogram
|
$475.80 |
$475.80 |
$475.80 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,077.70 |
$1,077.70 |
$1,077.70 |
$503.50
|
|
Injection, cangrelor
|
$4,830.15 |
$4,830.15 |
$4,830.15 |
$1,889.78
|
|
Injection carpal tunnel therapeutic (both sides)
|
$598.00 |
$598.00 |
$598.00 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$9,893.85 |
$9,893.85 |
$9,893.85 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$707.85 |
$707.85 |
$707.85 |
$1,027.26
|
|
Injection epidural blood patch or clot
|
$1,963.00 |
$1,963.00 |
$1,963.00 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$715.65 |
$715.65 |
$715.65 |
$436.00
|
|
Injection for bladder x-ray
|
$418.60 |
$418.60 |
$418.60 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,124.50 |
$1,124.50 |
$1,124.50 |
$497.76
|
|
Injection, fulvestrant
|
$328.60 |
$328.60 |
$328.60 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$18,656.20 |
$18,656.20 |
$18,656.20 |
$6,679.35
|
|
Injection, isavuconazonium
|
$1,868.20 |
$1,868.20 |
$1,868.20 |
$787.67
|
|
Injection of sinus tract
|
$2,778.10 |
$2,778.10 |
$2,778.10 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$6,021.75 |
$6,021.75 |
$6,021.75 |
$2,277.65
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,400.10 |
$1,400.10 |
$1,400.10 |
$685.44
|
|
Injection, renflexis
|
$1,933.40 |
$1,933.40 |
$1,933.40 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,238.30 |
$3,238.30 |
$3,238.30 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$78,555.38 |
$78,555.38 |
$78,555.38 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$711.75 |
$711.75 |
$711.75 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,916.90 |
$3,916.90 |
$3,916.90 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$8,451.50 |
$8,451.50 |
$8,451.50 |
$1,043.20
|
