|
Incision & drainage hematoma/seroma/fluid collection
|
$5,166.16 |
$5,166.16 |
$5,166.16 |
$2,261.20
|
|
Incision of breast lesion
|
$4,294.74 |
$4,294.74 |
$4,294.74 |
$3,029.60
|
|
Incision of tongue fold
|
$10,568.12 |
$10,568.12 |
$10,568.12 |
$1,865.58
|
|
Infect ag drug suscept pheno predict
|
$587.94 |
$587.94 |
$587.94 |
$325.00
|
|
Infect ag genotype na dna hepatitis b
|
$1,195.23 |
$1,195.23 |
$1,195.23 |
$500.40
|
|
Infect ag genotype na hiv-1 other region
|
$1,380.31 |
$1,380.31 |
$1,380.31 |
$301.50
|
|
Infect ag genotype na hiv-1 revr trn/prt
|
$1,793.79 |
$1,793.79 |
$1,793.79 |
$574.60
|
|
Infect ag ia direct hiv-1 antgn
|
$348.86 |
$348.86 |
$348.86 |
$95.55
|
|
Infect ag if pneumocystis carinii
|
$176.07 |
$176.07 |
$176.07 |
$62.29
|
|
Infect ag if varicella zoster
|
$331.79 |
$331.79 |
$331.79 |
$66.00
|
|
Infect ag na hpv high-risk types
|
$431.01 |
$431.01 |
$431.01 |
$139.75
|
|
Infect ag na orthopoxvirus amp prb each
|
$301.58 |
$301.58 |
$301.58 |
$102.00
|
|
Infect ag na resp virus 12-25 targets
|
$961.23 |
$961.23 |
$961.23 |
$859.44
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$178.99 |
$178.99 |
$178.99 |
$81.44
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptococcus neoformans
|
$308.53 |
$308.53 |
$308.53 |
$63.60
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$220.18 |
$220.18 |
$220.18 |
$80.05
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$386.06 |
$386.06 |
$386.06 |
$77.28
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$460.46 |
$460.46 |
$460.46 |
$83.50
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$254.99 |
$254.99 |
$254.99 |
$77.72
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn neutralization
|
$303.86 |
$303.86 |
$303.86 |
$55.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$319.39 |
$319.39 |
$319.39 |
$101.00
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$579.27 |
$579.27 |
$579.27 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$399.98 |
$399.98 |
$399.98 |
$97.50
|
|
Infectious agent antigen immunoassay ql/sq multi step shiga-like toxin
|
$369.00 |
$369.00 |
$369.00 |
$60.00
|
|
Infectious agent nucleic acid amplified probe
|
$1,462.01 |
$1,462.01 |
$1,462.01 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$666.64 |
$666.64 |
$666.64 |
$141.48
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$390.70 |
$390.70 |
$390.70 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,851.16 |
$1,851.16 |
$1,851.16 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$603.18 |
$603.18 |
$603.18 |
$178.00
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$413.96 |
$413.96 |
$413.96 |
$150.15
|
|
Infectious agent nucleic acid amplified probe mycobacteria tuberculosis
|
$384.18 |
$384.18 |
$384.18 |
$210.00
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$606.05 |
$606.05 |
$606.05 |
$136.00
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$548.91 |
$548.91 |
$548.91 |
$103.20
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$857.28 |
$857.28 |
$857.28 |
$222.60
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$816.44 |
$816.44 |
$816.44 |
$248.15
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$362.07 |
$362.07 |
$362.07 |
$98.15
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$410.31 |
$410.31 |
$410.31 |
$112.45
|
|
Infectious agent nucleic acid amp probe mycobacterium tuberculosis rifampin resistance
|
$230.31 |
$230.31 |
$230.31 |
$200.20
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,602.74 |
$1,602.74 |
$1,602.74 |
$727.50
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 3-5 targets
|
$395.94 |
$395.94 |
$395.94 |
$283.20
|
|
Infectious agent nucleic acid quantification bk virus
|
$1,751.92 |
$1,751.92 |
$1,751.92 |
$285.66
|
|
Infectious agent nucleic acid quantification hepatitis b
|
$1,368.98 |
$1,368.98 |
$1,368.98 |
$226.35
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$655.82 |
$655.82 |
$655.82 |
$278.78
|
|
Infectious agent nucleic acid quantification hiv-1
|
$615.50 |
$615.50 |
$615.50 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$691.47 |
$691.47 |
$691.47 |
$298.35
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$1,554.28 |
$1,554.28 |
$1,554.28 |
$359.64
|
|
Initiation & management bipap/cpap initial day
|
$3,422.85 |
$3,422.85 |
$3,422.85 |
$645.79
|
|
Inj., benralizumab, 1 mg
|
$68,150.90 |
$68,150.90 |
$68,150.90 |
$16,865.48
|
|
Inj, bezlotoxumab, 10 mg
|
$15,277.13 |
$15,277.13 |
$15,277.13 |
$9,702.65
|
|
Inj cefazolin sodium, hikma
|
$152.33 |
$152.33 |
$152.33 |
$56.70
|
|
Inj cntr knee arthro incl ct/mri
|
$616.03 |
$616.03 |
$616.03 |
$464.28
|
|
Inj, durolane 1 mg
|
$7,206.77 |
$7,206.77 |
$7,206.77 |
$3,382.31
|
|
Inj dx for sinogram
|
$353.52 |
$353.52 |
$353.52 |
$436.00
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$1,915.96 |
$1,915.96 |
$1,915.96 |
$1,214.78
|
|
Injection arthrography hip without anesthesia (both sides)
|
$456.17 |
$456.17 |
$456.17 |
$507.10
|
|
Injection carpal tunnel therapeutic (both sides)
|
$2,252.41 |
$2,252.41 |
$2,252.41 |
$536.00
|
|
Injection, daratumumab 10 mg
|
$28,637.29 |
$28,637.29 |
$28,637.29 |
$7,107.73
|
|
Injection during cath supravalvular aortography
|
$4,029.16 |
$4,029.16 |
$4,029.16 |
$1,148.80
|
|
Injection epidural blood patch or clot
|
$3,282.54 |
$3,282.54 |
$3,282.54 |
$1,473.12
|
|
Injection for arthrography wrist (both sides)
|
$360.53 |
$360.53 |
$360.53 |
$441.12
|
|
Injection for bladder x-ray
|
$1,119.22 |
$1,119.22 |
$1,119.22 |
$585.00
|
|
Injection for shoulder arthrogram or enhanced ct/mri shoulder arthography (both sides)
|
$360.53 |
$360.53 |
$360.53 |
$504.00
|
|
Injection for tear sac x-ray
|
$702.25 |
$702.25 |
$702.25 |
$386.00
|
|
Injection for ureter x-ray
|
$5,250.99 |
$5,250.99 |
$5,250.99 |
$444.95
|
|
Injection for ureter x-ray
|
$275.89 |
$275.89 |
$275.89 |
$515.21
|
|
Injection, fulvestrant
|
$17,063.41 |
$17,063.41 |
$17,063.41 |
$2,756.47
|
|
Injection, inclisiran, 1 mg
|
$48,205.28 |
$48,205.28 |
$48,205.28 |
$10,366.61
|
|
Injection radioactive tracer sentinel node (both sides)
|
$5,505.76 |
$5,505.76 |
$5,505.76 |
$717.20
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$3,821.48 |
$3,821.48 |
$3,821.48 |
$1,471.50
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$885.98 |
$885.98 |
$885.98 |
$1,017.28
|
|
Injection(s) anesthetic agent(s)/steroid lumb/s transforaminal epidural w/img single (both sides)
|
$2,656.25 |
$2,656.25 |
$2,656.25 |
$2,251.00
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic 2nd level
|
$2,531.72 |
$2,531.72 |
$2,531.72 |
$1,131.41
|
|
Injection(s) diagnostic/therapeutic agent facet cervical/thoracic single level
|
$4,163.56 |
$4,163.56 |
$4,163.56 |
$1,961.05
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral 2nd level w/image guidance
|
$2,847.41 |
$2,847.41 |
$2,847.41 |
$1,119.88
|
|
Injection(s) diagnostic/therapeutic agent facet lumbar/sacral single level
|
$5,628.60 |
$5,628.60 |
$5,628.60 |
$2,154.68
|
|
Injection(s) epidural/subarachnoid cervical/thoracic needle placement w/guidance
|
$3,056.14 |
$3,056.14 |
$3,056.14 |
$1,829.28
|
|
Injection(s) epidural/subarachnoid lumbar/sacral needle placement w/guidance
|
$3,056.14 |
$3,056.14 |
$3,056.14 |
$1,758.12
|
|
Injection(s) tendon sheath/ligament aponeurosis single (both sides)
|
$1,502.75 |
$1,502.75 |
$1,502.75 |
$472.76
|
|
Injection(s) trigger point(s) single/multiple 1 or 2 muscle(s)
|
$1,652.80 |
$1,652.80 |
$1,652.80 |
$552.60
|
|
Injection(s) trigger point(s) single/multiple >= 3 muscle(s)
|
$1,909.04 |
$1,909.04 |
$1,909.04 |
$670.00
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$267.99 |
$267.99 |
$267.99 |
$168.05
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$261.94 |
$261.94 |
$261.94 |
$154.05
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$497.23 |
$497.23 |
$497.23 |
$271.65
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$307.81 |
$307.81 |
$307.81 |
$141.60
|
|
Inject sacroiliac joint
|
$3,459.10 |
$3,459.10 |
$3,459.10 |
$1,090.00
|
|
Inj efgart-alfa 2mg hya-qvfc
|
$220,347.56 |
$220,347.56 |
$220,347.56 |
$66,229.74
|
|
Inj epidural sgl cerv-thor without img
|
$3,361.74 |
$3,361.74 |
$3,361.74 |
$1,366.20
|
|
Inj epidural sgl lumb-sacral without img
|
$3,056.14 |
$3,056.14 |
$3,056.14 |
$1,450.84
|
|
Inj for ext venography
|
$185.98 |
$185.98 |
$185.98 |
$737.55
|
|
Inj, fulvestrant (fresenius)
|
$3,509.82 |
$3,509.82 |
$3,509.82 |
$1,713.99
|
|
Inj glycopyrrolate fres kabi
|
$105.30 |
$105.30 |
$105.30 |
$96.70
|
|
Inj hrt cath w/s&i sel right vent
|
$1,546.25 |
$1,546.25 |
$1,546.25 |
$947.65
|
|
Inj intralesional <= 7 lsn(s)
|
$2,262.23 |
$2,262.23 |
$2,262.23 |
$241.74
|
|
Inj ivig privigen 500 mg
|
$26,860.47 |
$26,860.47 |
$26,860.47 |
$7,298.71
|
|
Inj mepivacaine hcl/10 ml
|
$19.04 |
$19.04 |
$19.04 |
$28.41
|
|
Inj multihance
|
$406.88 |
$406.88 |
$406.88 |
$119.25
|
|
Inj nephrosto/ureterogram w/img exstng access
|
$4,119.46 |
$4,119.46 |
$4,119.46 |
$1,522.56
|
|
Inj proc elbow arthro
|
$456.17 |
$456.17 |
$456.17 |
$453.60
|
|
Inj proc lumbr disk ea lvl
|
$331.98 |
$331.98 |
$331.98 |
$1,224.30
|
|
Inj retro urethrocysto
|
$2,357.60 |
$2,357.60 |
$2,357.60 |
$551.29
|