|
Infectious agent nucleic acid joint space pathogens multiplex amplified probe >= 26 targets
|
$2,039.00 |
$2,039.00 |
$2,039.00 |
$1,143.75
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$805.00 |
$805.00 |
$805.00 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$295.00 |
$295.00 |
$295.00 |
$289.91
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 6-11 targets
|
$559.00 |
$559.00 |
$559.00 |
$432.63
|
|
Infectious agent nucleic acid quantification bk virus
|
$483.00 |
$483.00 |
$483.00 |
$283.00
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$129.00 |
$129.00 |
$129.00 |
$242.50
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$549.00 |
$549.00 |
$549.00 |
$253.00
|
|
Infectious agent nucleic acid quantification hiv-1
|
$685.00 |
$685.00 |
$685.00 |
$375.00
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$392.00 |
$392.00 |
$392.00 |
$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
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$497.00 |
$497.00 |
$497.00 |
$296.00
|
|
Inj calcitriol per 0.1 mcg
|
$45.80 |
$45.80 |
$45.80 |
$22.69
|
|
Inj cntr knee arthro incl ct/mri
|
$591.00 |
$591.00 |
$591.00 |
$436.80
|
|
Inj dx for sinogram
|
$589.00 |
$589.00 |
$589.00 |
$436.00
|
|
Injection arthrography hip without anesthesia (both sides)
|
$1,171.00 |
$1,171.00 |
$1,171.00 |
$503.50
|
|
Injection epidural blood patch or clot
|
$8,073.00 |
$8,073.00 |
$8,073.00 |
$1,182.33
|
|
Injection for arthrography wrist (both sides)
|
$1,098.00 |
$1,098.00 |
$1,098.00 |
$436.00
|
|
Injection for bladder x-ray
|
$2,167.00 |
$2,167.00 |
$2,167.00 |
$459.20
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$1,095.00 |
$1,095.00 |
$1,095.00 |
$497.76
|
|
Injection for ureter x-ray
|
$1,280.00 |
$1,280.00 |
$1,280.00 |
$515.21
|
|
Injection, inclisiran, 1 mg
|
$18,656.20 |
$18,656.20 |
$18,656.20 |
$6,679.35
|
|
Injection,onabotulinumtoxina
|
$3,255.00 |
$3,255.00 |
$3,255.00 |
$2,277.65
|
|
Injection px peyronie ds
|
$678.00 |
$678.00 |
$678.00 |
$409.34
|
|
Injection radioactive tracer sentinel node (both sides)
|
$1,691.00 |
$1,691.00 |
$1,691.00 |
$685.44
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$40,880.10 |
$40,880.10 |
$40,880.10 |
$1,391.40
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$37,307.73 |
$37,307.73 |
$37,307.73 |
$145.60
|
|
Inj for ext venography
|
$2,958.00 |
$2,958.00 |
$2,958.00 |
$628.80
|
|
Inj, gadopiclenol, 1 ml
|
$161.55 |
$161.55 |
$161.55 |
$37.63
|
|
Inj hydroxocobalamin IV 25mg
|
$4,819.80 |
$4,819.80 |
$4,819.80 |
$2,452.32
|
|
Inj levocarnitine per 1 gm
|
$30.55 |
$30.55 |
$30.55 |
$136.62
|
|
Inj mepivacaine hcl/10 ml
|
$72.00 |
$72.00 |
$72.00 |
$34.34
|
|
Inj., meropenem, vaborbactam
|
$935.25 |
$935.25 |
$935.25 |
$556.87
|
|
Inj proc elbow arthro
|
$771.00 |
$771.00 |
$771.00 |
$432.00
|
|
Inj retro urethrocysto
|
$4,577.00 |
$4,577.00 |
$4,577.00 |
$447.74
|
|
Inj testosterone cypionate
|
$142.75 |
$142.75 |
$142.75 |
$64.96
|
|
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
|
|
Inpt/ed teleconsult30
|
$293.00 |
$293.00 |
$293.00 |
$164.40
|
|
Inpt/ed teleconsult50
|
$399.00 |
$399.00 |
$399.00 |
$223.80
|
|
Inpt/ed teleconsult70
|
$392.00 |
$392.00 |
$392.00 |
$330.60
|
|
Ins cath ren art 1st bi
|
$10,070.00 |
$10,070.00 |
$10,070.00 |
$5,974.80
|
|
Ins cath ren art 1st uni
|
$15,007.00 |
$15,007.00 |
$15,007.00 |
$4,667.63
|
|
Ins cath ren art 2nd+ uni
|
$10,070.00 |
$10,070.00 |
$10,070.00 |
$5,395.20
|
|
Ins cerv dilator (sep proc)
|
$883.00 |
$883.00 |
$883.00 |
$490.73
|
|
Insert cath pleura with image
|
$7,884.00 |
$7,884.00 |
$7,884.00 |
$2,194.40
|
|
Insert cath pleura without image
|
$795.00 |
$795.00 |
$795.00 |
$2,099.70
|
|
Insertion catheter bladder non indwelling
|
$405.00 |
$405.00 |
$405.00 |
$208.01
|
|
Insertion catheter pleural indwelling tunneled with cuff
|
$6,837.00 |
$6,837.00 |
$6,837.00 |
$4,897.20
|
|
Insertion intra aortic balloon assist device percutaneous
|
$11,164.00 |
$11,164.00 |
$11,164.00 |
$2,447.63
|
|
Insertion intravascular vena cava (ivc) access supervision & interpretation w/imaging guidance
|
$12,243.00 |
$12,243.00 |
$12,243.00 |
$7,210.78
|
|
Insertion nontunneled centrally inserted central venous catheter >= 5 years old
|
$3,882.00 |
$3,882.00 |
$3,882.00 |
$2,585.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$16,985.00 |
$16,985.00 |
$16,985.00 |
$12,384.25
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular
|
$12,819.00 |
$12,819.00 |
$12,819.00 |
$12,324.60
|
|
Insertion pacing electrode lv pacing w/insertion of ppm/implantable defibrillator
|
$9,144.00 |
$9,144.00 |
$9,144.00 |
$9,884.16
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$4,312.00 |
$4,312.00 |
$4,312.00 |
$2,103.75
|
|
Insertion picc without port or pump with imaging guidance=>5y
|
$5,217.00 |
$5,217.00 |
$5,217.00 |
$2,453.83
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$24,681.00 |
$24,681.00 |
$24,681.00 |
$29,180.00
|
|
Insertion/replacement temporary single chamber electrode/pacemaker catheter
|
$7,743.00 |
$7,743.00 |
$7,743.00 |
$7,183.68
|
|
Insertion single tranvenous electrode/ppm/implantable defibrillator
|
$12,164.00 |
$12,164.00 |
$12,164.00 |
$7,267.20
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$18,360.00 |
$18,360.00 |
$18,360.00 |
$9,332.50
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$24,219.00 |
$24,219.00 |
$24,219.00 |
$5,236.80
|
|
Insert pm/icd lead dual
|
$13,382.00 |
$13,382.00 |
$13,382.00 |
$7,115.90
|
|
Insert self-contd prosthesis
|
$45,962.19 |
$45,962.19 |
$45,962.19 |
$22,279.50
|
|
In situ hybridization per specimen each additional single probe stain
|
$190.00 |
$190.00 |
$190.00 |
$243.50
|
|
In situ hybridization per specimen initial single probe stain
|
$335.00 |
$335.00 |
$335.00 |
$338.40
|
|
Insole orthotic freedom sz6 6816
|
$68.15 |
$68.15 |
$68.15 |
$84.00
|
|
Ins/rpl ldless pm right vent w img & eval
|
$28,743.00 |
$28,743.00 |
$28,743.00 |
$24,135.54
|
|
Ins/rpl prph sac/gstr npg/r
|
$42,016.18 |
$42,016.18 |
$42,016.18 |
$18,129.80
|
|
Inst fibrinolysis agent ini day
|
$216.00 |
$216.00 |
$216.00 |
$1,043.35
|
|
Inst fibrinolysis agent sbsq d
|
$193.00 |
$193.00 |
$193.00 |
$997.05
|
|
Ins tun cv cath wo subq prt/pm
|
$10,238.00 |
$10,238.00 |
$10,238.00 |
$4,218.00
|
|
Insulin total
|
$147.00 |
$147.00 |
$147.00 |
$66.64
|
|
Integra matrix wnd inj flowable 3cc-q4114-cost per sq cm
|
$3,590.44 |
$3,590.44 |
$3,590.44 |
$8,617.32
|
|
Integra os putty 2.5cc - cost per 0.5cc
|
$225.79 |
$225.79 |
$225.79 |
$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
|
|
Intrapul surf admin endo tube
|
$492.00 |
$492.00 |
$492.00 |
$220.80
|
|
Intrinsic factor antibody
|
$142.00 |
$142.00 |
$142.00 |
$65.00
|
|
Intrvasc Ultrasound noncoronary 1st vessel
|
$2,435.00 |
$2,435.00 |
$2,435.00 |
$3,472.95
|
|
Intubation endotracheal emergency procedure
|
$21,265.00 |
$21,265.00 |
$21,265.00 |
$601.28
|
|
Iopamidol 250 mg iodine/ml (51 %) intravenous solution
|
$192.00 |
$192.00 |
$192.00 |
$165.67
|
|
Iopamidol 300 mg iodine/ml (61 %) intravenous solution
|
$117.25 |
$117.25 |
$117.25 |
$279.10
|
|
Ipilimumab 5 mg/ml intravenous solution (wrapper)
|
$110,829.85 |
$110,829.85 |
$110,829.85 |
$62,692.46
|
|
Irinotecan 20 mg/ml intravenous solution (wrapper)
|
$522.90 |
$522.90 |
$522.90 |
$173.98
|
|
Irinotecan liposomal 4.3 mg/ml intravenous
|
$9,268.95 |
$9,268.95 |
$9,268.95 |
$5,517.12
|
|
Iron
|
$91.00 |
$91.00 |
$91.00 |
$75.00
|
|
Iron binding capacity
|
$158.00 |
$158.00 |
$158.00 |
$63.91
|
|
Iron dextran 50 mg/ml injection solution
|
$185.90 |
$185.90 |
$185.90 |
$80.67
|
|
Iron sucrose 20 mg iron/ml intravenous solution (wrapper)
|
$158.45 |
$158.45 |
$158.45 |
$187.06
|
|
Irradiation of blood product each unit reference
|
$211.00 |
$211.00 |
$211.00 |
$115.20
|
|
Isatuximab-irfc 20 mg/ml intravenous solution
|
$2,779.35 |
$2,779.35 |
$2,779.35 |
$8,273.35
|
|
Ivc venogram s&i
|
$7,274.00 |
$7,274.00 |
$7,274.00 |
$3,332.55
|
|
IV Fluids (each additional hour)
|
$4,437.00 |
$4,437.00 |
$4,437.00 |
$133.90
|
|
IV Fluids (first hour)
|
$2,919.00 |
$2,919.00 |
$2,919.00 |
$390.00
|
|
IV infusion therapy/prophylaxis/diagnosis concurrent infusion
|
$221.00 |
$221.00 |
$221.00 |
$162.68
|
|
IV Medicine Infusion (additional drug)
|
$307.00 |
$307.00 |
$307.00 |
$191.75
|
|
IV Medicine Infusion (each additional hour)
|
$25,454.49 |
$25,454.49 |
$25,454.49 |
$154.00
|
|
IV Medicine Infusion (first hour)
|
$25,454.49 |
$25,454.49 |
$25,454.49 |
$439.56
|
|
IV Push Injection (each additional drug)
|
$8,246.00 |
$8,246.00 |
$8,246.00 |
$167.50
|
|
IV Push Injection (first drug)
|
$8,246.00 |
$8,246.00 |
$8,246.00 |
$252.76
|
