|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$101.60 |
$101.60 |
$282.75 |
$212.01
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$88.80 |
$88.80 |
$170.95 |
$137.67
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$103.20 |
$103.20 |
$152.75 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$285.60 |
$285.60 |
$361.40 |
$208.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$285.60 |
$285.60 |
$875.00 |
$236.08
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$67.60 |
$67.60 |
$88.80 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$79.20 |
$79.20 |
$3,339.00 |
$112.50
|
|
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 |
$153.60 |
$200.20
|
|
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
|
$919.20 |
$919.20 |
$1,118.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$191.75 |
$191.75 |
$283.20 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$357.50 |
$357.50 |
$526.40 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$108.00 |
$108.00 |
$356.20 |
$280.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$108.00 |
$108.00 |
$317.20 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$108.00 |
$108.00 |
$373.75 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$213.60 |
$213.60 |
$1,983.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$288.00 |
$288.00 |
$309.40 |
$304.20
|
|
Infliximab 100 mg intravenous solution
|
$188.60 |
$188.60 |
$1,310.75 |
$2,043.22
|
|
Infliximab-axxq 100 mg intravenous solution
|
$81.44 |
$81.44 |
$1,379.70 |
$1,062.00
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$152.75 |
$152.75 |
$2,739.55 |
$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 |
$111.51
|
|
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
|
$239.00 |
$239.00 |
$264.80 |
$289.64
|
|
Ingest challenge ini 120 min
|
$259.00 |
$259.00 |
$367.20 |
$764.78
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$118.40 |
$118.40 |
$184.60 |
$299.65
|
|
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 |
$878.00 |
$540.80
|
|
Initial nursing facility care/day 35 minutes
|
$244.00 |
$244.00 |
$310.00 |
$184.80
|
|
Initial nursing facility care/day 45 minutes
|
$333.60 |
$333.60 |
$399.00 |
$231.84
|
|
Initial nursing facility care/day low severity 99304
|
$162.40 |
$162.40 |
$216.00 |
$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 |
$309.00 |
$189.15
|
|
Inj, abilify maintena, 1 mg
|
$11.52 |
$11.52 |
$13,758.25 |
$5,355.30
|
|
Inj alymsys 10 mg
|
$112.55 |
$112.55 |
$112.55 |
$1,280.74
|
|
Inj., benralizumab, 1 mg
|
$307.37 |
$307.37 |
$18,067.45 |
$11,310.00
|
|
Inj cefazolin sodium, hikma
|
$36.11 |
$36.11 |
$36.11 |
$27.38
|
|
Inj, cefiderocol, 10 mg
|
$1,135.10 |
$1,135.10 |
$1,135.10 |
$544.85
|
|
Inj ceftolozane tazobactam
|
$881.35 |
$881.35 |
$881.35 |
$358.56
|
|
Inj, clevidipine butyrate
|
$8.44 |
$8.44 |
$8.44 |
$4.86
|
|
Inj, clindamycin (baxter)
|
$75.36 |
$75.36 |
$75.36 |
$48.30
|
|
Inj cntr knee arthro incl ct/mri
|
$769.60 |
$769.60 |
$769.60 |
$441.88
|
|
Inj cyclophosphamd (ingenus)
|
$7.09 |
$7.09 |
$7.09 |
$742.72
|
|
Inj daptomycin (xellia)
|
$0.39 |
$0.39 |
$0.39 |
$56.04
|
|
Inj. denosumab-bbdz, 1 mg
|
$7,377.40 |
$7,377.40 |
$7,377.40 |
$4,615.43
|
|
Inj disk cerv-thor ea lev
|
$828.00 |
$828.00 |
$828.00 |
$875.28
|
|
Inj, donanemab-azbt, 2 mg
|
$14,983.80 |
$14,983.80 |
$14,983.80 |
$1,233.44
|
|
Inj dupuytren cord w/enzyme
|
$416.00 |
$416.00 |
$416.00 |
$416.00
|
|
Inj, durolane 1 mg
|
$30.71 |
$30.71 |
$1,709.30 |
$1,950.93
|
|
Inj dx for sinogram
|
$474.50 |
$474.50 |
$476.55 |
$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)
|
$1,299.88 |
$1,299.88 |
$4,404.00 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$609.70 |
$609.70 |
$1,072.00 |
$504.00
|
|
Injection carpal tunnel therapeutic (both sides)
|
$541.96 |
$541.96 |
$17,393.20 |
$458.15
|
|
Injection, daratumumab 10 mg
|
$114.11 |
$114.11 |
$9,893.85 |
$5,324.34
|
|
Injection during cath supravalvular aortography
|
$410.79 |
$410.79 |
$19,372.76 |
$1,028.00
|
|
Injection epidural blood patch or clot
|
$1,661.40 |
$1,661.40 |
$1,730.78 |
$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 |
$648.96
|
|
Injection, famotidine, 20 mg
|
$71.44 |
$71.44 |
$71.44 |
$24.14
|
|
Injection for arthrography wrist (both sides)
|
$528.45 |
$528.45 |
$910.40 |
$438.00
|
|
Injection for bladder x-ray
|
$551.29 |
$551.29 |
$986.05 |
$460.00
|
|
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 |
$789.10 |
$503.30
|
|
Injection for spleen x-ray
|
$341.60 |
$341.60 |
$341.60 |
$595.50
|
|
Injection for tear sac x-ray
|
$392.00 |
$392.00 |
$392.00 |
$212.55
|
|
Injection for ureter x-ray
|
$576.00 |
$576.00 |
$576.00 |
$415.80
|
|
Injection for ureter x-ray
|
$268.80 |
$268.80 |
$268.80 |
$527.70
|
|
Injection, fulvestrant
|
$119.20 |
$119.20 |
$919.80 |
$1,719.16
|
|
Injection, inclisiran, 1 mg
|
$19.54 |
$19.54 |
$7,668.00 |
$6,679.35
|
|
Injection into brain canal
|
$261.60 |
$261.60 |
$261.60 |
$1,261.40
|
|
Injection into brain canal
|
$2,295.00 |
$2,295.00 |
$2,295.00 |
$844.50
|
|
Injection into hemorrhoid(s)
|
$731.20 |
$731.20 |
$731.20 |
$1,433.00
|
|
Injection into spinal artery
|
$2,231.20 |
$2,231.20 |
$2,231.20 |
$1,710.80
|
|
Injection into vocal cord
|
$323.20 |
$323.20 |
$323.20 |
$459.51
|
|
Injection jaw joint x-ray
|
$964.80 |
$964.80 |
$964.80 |
$340.00
|
|
Injection of HIV prep drug
|
$33.60 |
$33.60 |
$33.60 |
$78.84
|
|
Injection of sinus tract
|
$738.64 |
$738.64 |
$738.64 |
$1,640.99
|
|
Injection,onabotulinumtoxina
|
$11.04 |
$11.04 |
$3,255.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$275.20 |
$275.20 |
$275.20 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$408.00 |
$408.00 |
$2,244.45 |
$694.20
|
|
Injection, renflexis
|
$121.93 |
$121.93 |
$1,933.40 |
$1,341.52
|
|
Injection sacroiliac joint anesthesia/steroid without or w/arthrography (both sides)
|
$3,362.47 |
$3,362.47 |
$4,303.30 |
$1,582.12
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$1,815.62 |
$1,815.62 |
$62,408.95 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$1,060.78 |
$1,060.78 |
$5,128.00 |
$1,045.65
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$3,099.16 |
$3,099.16 |
$6,755.60 |
$2,071.80
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$3,445.32 |
$3,445.32 |
$8,635.00 |
$1,030.05
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$2,142.26 |
$2,142.26 |
$4,316.00 |
$1,888.80
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$3,127.80 |
$3,127.80 |
$19,622.80 |
$1,048.20
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$1,912.37 |
$1,912.37 |
$14,192.20 |
$2,006.79
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$1,681.24 |
$1,681.24 |
$2,325.70 |
$1,826.80
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$1,681.24 |
$1,681.24 |
$3,725.90 |
$1,685.00
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,191.35 |
$1,191.35 |
$2,391.00 |
$485.28
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$595.68 |
$595.68 |
$1,290.00 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$629.99 |
$629.99 |
$10,225.80 |
$638.95
|
