|
Immunofixation electrophoresis serum
|
$155.35 |
$155.35 |
$155.35 |
$142.50
|
|
Impl ahmed 6x25x9.6mm glaucoma vlv w/sil ped ster
|
$5,473.00 |
$5,473.00 |
$5,473.00 |
$2,946.00
|
|
Implant 11 volt lithium-ion backup battery for controller pocket
|
$913.25 |
$913.25 |
$913.25 |
$1,754.00
|
|
Implant cartilage 10mm synthetic
|
$4,241.57 |
$4,241.57 |
$4,241.57 |
$8,332.51
|
|
Implant cochlear osia osi300
|
$6,357.14 |
$6,357.14 |
$6,357.14 |
$16,195.55
|
|
Implant power module patient cable cable 14 volt
|
$2,283.12 |
$2,283.12 |
$2,283.12 |
$3,695.42
|
|
Implant pulse generator remede el
|
$12,314.25 |
$12,314.25 |
$12,314.25 |
$43,752.80
|
|
Implant spine infusion pump
|
$23,274.55 |
$23,274.55 |
$23,274.55 |
$17,270.40
|
|
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 neurostim electr perc
|
$56,786.95 |
$56,786.95 |
$56,786.95 |
$7,672.50
|
|
Implnt spinl canal catheter 62350
|
$13,092.95 |
$13,092.95 |
$13,092.95 |
$5,095.20
|
|
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 of eardrum
|
$11,382.01 |
$11,382.01 |
$11,382.01 |
$3,837.72
|
|
Incision of foot tendon 28234
|
$35,136.12 |
$35,136.12 |
$35,136.12 |
$2,211.05
|
|
Incision of metatarsal
|
$35,136.12 |
$35,136.12 |
$35,136.12 |
$3,786.00
|
|
Incision tendon sheath
|
$6,600.90 |
$6,600.90 |
$6,600.90 |
$3,073.20
|
|
Inf agt nucleic acid human papillomavirus separately reported high-risk types pooled result(s)
|
$137.15 |
$137.15 |
$137.15 |
$140.80
|
|
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
|
$997.00 |
$997.00 |
$997.00 |
$83.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$64.35 |
$64.35 |
$64.35 |
$72.80
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$103.35 |
$103.35 |
$103.35 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$100.10 |
$100.10 |
$100.10 |
$74.88
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$210.60 |
$210.60 |
$210.60 |
$103.40
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$94.25 |
$94.25 |
$94.25 |
$81.20
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$49.40 |
$49.40 |
$49.40 |
$60.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$123.50 |
$123.50 |
$123.50 |
$100.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$53.30 |
$53.30 |
$53.30 |
$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
|
$213.85 |
$213.85 |
$213.85 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$200.85 |
$200.85 |
$200.85 |
$141.95
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$126.10 |
$126.10 |
$126.10 |
$167.05
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,146.60 |
$1,146.60 |
$1,146.60 |
$864.67
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$193.70 |
$193.70 |
$193.70 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$181.35 |
$181.35 |
$181.35 |
$149.13
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$109.20 |
$109.20 |
$109.20 |
$212.16
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$193.05 |
$193.05 |
$193.05 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$187.20 |
$187.20 |
$187.20 |
$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
|
$459.00 |
$459.00 |
$459.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$483.00 |
$483.00 |
$483.00 |
$96.00
|
|
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
|
$209.95 |
$209.95 |
$209.95 |
$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
|
$987.00 |
$987.00 |
$987.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$313.95 |
$313.95 |
$313.95 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$831.00 |
$831.00 |
$831.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$231.40 |
$231.40 |
$231.40 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$310.70 |
$310.70 |
$310.70 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$308.10 |
$308.10 |
$308.10 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$219.05 |
$219.05 |
$219.05 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$287.30 |
$287.30 |
$287.30 |
$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
|
|
Inj alymsys 10 mg
|
$1,199.10 |
$1,199.10 |
$1,199.10 |
$1,280.74
|
|
Inj, cyclophosphamd, sandoz
|
$1,937.10 |
$1,937.10 |
$1,937.10 |
$735.20
|
|
Inj. denosumab-bbdz, 1 mg
|
$7,377.40 |
$7,377.40 |
$7,377.40 |
$4,615.43
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,686.75 |
$1,686.75 |
$1,686.75 |
$1,214.78
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$535.60 |
$535.60 |
$535.60 |
$497.76
|
|
Injection, fulvestrant
|
$817.50 |
$817.50 |
$817.50 |
$1,719.16
|
|
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)
|
$2,261.28 |
$2,261.28 |
$2,261.28 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$238.00 |
$238.00 |
$238.00 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$190.00 |
$190.00 |
$190.00 |
$1,043.72
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$6,399.90 |
$6,399.90 |
$6,399.90 |
$2,040.36
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,080.00 |
$2,080.00 |
$2,080.00 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,907.45 |
$2,907.45 |
$2,907.45 |
$1,855.36
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$9,481.93 |
$9,481.93 |
$9,481.93 |
$1,043.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$9,480.17 |
$9,480.17 |
$9,480.17 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,006.85 |
$1,006.85 |
$1,006.85 |
$1,817.24
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,006.85 |
$1,006.85 |
$1,006.85 |
$1,685.00
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,472.45 |
$1,472.45 |
$1,472.45 |
$548.80
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$742.30 |
$742.30 |
$742.30 |
$637.92
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$741.30 |
$741.30 |
$741.30 |
$145.60
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$49,230.70 |
$49,230.70 |
$49,230.70 |
$32,176.93
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$326.00 |
$326.00 |
$326.00 |
$794.70
|
|
Inj mepivacaine hcl/10 ml
|
$51.30 |
$51.30 |
$51.30 |
$34.34
|
|
Inj, nithiodote, 3mg / 125mg
|
$984.90 |
$984.90 |
$984.90 |
$468.10
|
|
Inj ocrelizumab 1mg hya-ocsq
|
$130,285.75 |
$130,285.75 |
$130,285.75 |
$66,582.27
|
|
Inj., tildrakizumab, 1 mg
|
$53,884.35 |
$53,884.35 |
$53,884.35 |
$26,635.60
|
|
Inj, vegzelma, 10 mg
|
$981.40 |
$981.40 |
$981.40 |
$1,186.35
|
|
Inotuzumab ozogamicin 0.9 mg(0.25 mg/ml initial concentration) IV soln
|
$73,182.85 |
$73,182.85 |
$73,182.85 |
$41,083.73
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$2,022.15 |
$2,022.15 |
$2,022.15 |
$2,103.75
|
|
In situ hybridization per specimen each additional single probe stain
|
$158.60 |
$158.60 |
$158.60 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$280.15 |
$280.15 |
$280.15 |
$338.40
|
|
Insole orthotic freedom sz6 6816
|
$44.30 |
$44.30 |
$44.30 |
$84.00
|
|
Ins/rplc spi npg/rcvr pocket
|
$56,786.95 |
$56,786.95 |
$56,786.95 |
$24,061.80
|
|
Insulin total
|
$85.80 |
$85.80 |
$85.80 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$2,333.79 |
$2,333.79 |
$2,333.79 |
$8,617.32
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$146.76 |
$146.76 |
$146.76 |
$3,803.11
|
|
Interferon beta-1a 30 mcg/0.5 ml im injection (wrapper)
|
$10,427.90 |
$10,427.90 |
$10,427.90 |
$10,427.90
|