|
Icatibant injection
|
$6,938.65 |
$6,938.65 |
$6,938.65 |
$2,196.00
|
|
Ifosfamide 1 gram intravenous solution
|
$200.03 |
$200.03 |
$200.03 |
$185.67
|
|
Ihc/icc per specimen each additional single antibody stain
|
$8,700.06 |
$8,700.06 |
$8,700.06 |
$187.20
|
|
Ihc/icc per specimen each multiplex antibody stain
|
$3,795.35 |
$3,795.35 |
$3,795.35 |
$339.73
|
|
Ihc/icc per specimen initial single antibody stain
|
$8,198.23 |
$8,198.23 |
$8,198.23 |
$274.86
|
|
Iliac/fem angio cath insert
|
$1,976.00 |
$1,976.00 |
$1,976.00 |
$2,070.72
|
|
Immune globulin, gamma (igg) (10 %)-gly-iga over 50 mcg/ml injection solution
|
$11,917.13 |
$11,917.13 |
$11,917.13 |
$2,621.62
|
|
Immune globulin, gamma (igg) (10 %)-malt-iga over 50 mcg/ml intravenous solution
|
$4,419.41 |
$4,419.41 |
$4,419.41 |
$3,132.49
|
|
Immunoassay tumor antigen quantitative ca 125
|
$152.75 |
$152.75 |
$152.75 |
$122.50
|
|
Immunoassay tumor antigen quantitative ca 19-9
|
$271.05 |
$271.05 |
$271.05 |
$117.00
|
|
Immunodiff gel qual ea antigen/ab
|
$78.65 |
$78.65 |
$78.65 |
$58.25
|
|
Immunofixation electrophoresis serum
|
$201.50 |
$201.50 |
$201.50 |
$133.38
|
|
Incision of anal sphincter
|
$11,592.39 |
$11,592.39 |
$11,592.39 |
$3,035.44
|
|
Infect ag eia influenza a or b ea
|
$99.45 |
$99.45 |
$99.45 |
$64.00
|
|
Infect ag ia direct hiv-1 antgn
|
$141.05 |
$141.05 |
$141.05 |
$95.55
|
|
Infect ag na hpv high-risk types
|
$175.50 |
$175.50 |
$175.50 |
$147.00
|
|
Infect ag na influenza r/amp 1st 2 types
|
$200.85 |
$200.85 |
$200.85 |
$248.80
|
|
Infectious agent antigen immunoassay ql/sq multi step clostridium difficile toxin
|
$53.95 |
$53.95 |
$53.95 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step cryptosporidium
|
$76.05 |
$76.05 |
$76.05 |
$76.00
|
|
Infectious agent antigen immunoassay ql/sq multi step giardia
|
$42.90 |
$42.90 |
$42.90 |
$73.45
|
|
Infectious agent antigen immunoassay ql/sq multi step helicobacter pylori stool
|
$131.95 |
$131.95 |
$131.95 |
$96.00
|
|
Infectious agent antigen immunoassay ql/sq multi step hepatitis b surface agn
|
$59.80 |
$59.80 |
$59.80 |
$75.27
|
|
Infectious agent antigen immunoassay ql/sq multi step hiv-1 antigen(s) hiv-1&2 antibodies
|
$44.20 |
$44.20 |
$44.20 |
$107.90
|
|
Infectious agent antigen immunoassay ql/sq multi step legionella urine
|
$151.45 |
$151.45 |
$151.45 |
$132.60
|
|
Infectious agent antigen immunoassay ql/sq multi step rotavirus
|
$113.75 |
$113.75 |
$113.75 |
$98.40
|
|
Infectious agent nucleic acid amplified probe
|
$241.15 |
$241.15 |
$241.15 |
$276.90
|
|
Infectious agent nucleic acid amplified probe chlamydia trachomatis
|
$143.00 |
$143.00 |
$143.00 |
$144.00
|
|
Infectious agent nucleic acid amplified probe clostridium difficile toxin gene(s)
|
$210.60 |
$210.60 |
$210.60 |
$174.06
|
|
Infectious agent nucleic acid amplified probe cns pathogen 12-25 targets
|
$1,251.25 |
$1,251.25 |
$1,251.25 |
$855.45
|
|
Infectious agent nucleic acid amplified probe hsv-1
|
$263.25 |
$263.25 |
$263.25 |
$181.35
|
|
Infectious agent nucleic acid amplified probe methicillin resistant staphylococcus aureus
|
$203.45 |
$203.45 |
$203.45 |
$148.80
|
|
Infectious agent nucleic acid amplified probe neisseria gonorrhoeae
|
$131.30 |
$131.30 |
$131.30 |
$134.55
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/covid-19
|
$80.60 |
$80.60 |
$80.60 |
$109.18
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b
|
$139.10 |
$139.10 |
$139.10 |
$194.40
|
|
Infectious agent nucleic acid amplified probe sars-cov-2/inf a&b/rsv
|
$377.00 |
$377.00 |
$377.00 |
$211.09
|
|
Infectious agent nucleic acid amplified probe streptococcus group a
|
$135.20 |
$135.20 |
$135.20 |
$96.00
|
|
Infectious agent nucleic acid amplified probe trichomonas vaginalis
|
$159.90 |
$159.90 |
$159.90 |
$135.00
|
|
Infectious agent nucleic acid amp probe multiplex chlamydia trachomatis neisseria gonorrhoeae
|
$207.35 |
$207.35 |
$207.35 |
$296.71
|
|
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets
|
$1,042.60 |
$1,042.60 |
$1,042.60 |
$727.50
|
|
Infectious agent nucleic acid quantification bk virus
|
$194.35 |
$194.35 |
$194.35 |
$300.00
|
|
Infectious agent nucleic acid quantification hepatitis c
|
$559.00 |
$559.00 |
$559.00 |
$280.20
|
|
Infectious agent nucleic acid quantification hiv-1
|
$457.60 |
$457.60 |
$457.60 |
$381.55
|
|
Infectious agent nucleic acid respiratory virus multiplex amplified probe 3-5 targets
|
$200.85 |
$200.85 |
$200.85 |
$303.59
|
|
Infliximab 100 mg intravenous solution
|
$856.86 |
$856.86 |
$856.86 |
$178.95
|
|
Infliximab-axxq 100 mg intravenous solution
|
$901.55 |
$901.55 |
$901.55 |
$89.49
|
|
Infliximab-dyyb 100 mg intravenous solution
|
$1,699.28 |
$1,699.28 |
$1,699.28 |
$157.14
|
|
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis
|
$158.60 |
$158.60 |
$158.60 |
$344.50
|
|
Initiation & management bipap/cpap initial day
|
$460.85 |
$460.85 |
$460.85 |
$608.40
|
|
Inj anifrolumab-fnia 1mg
|
$9,878.82 |
$9,878.82 |
$9,878.82 |
$1,038.87
|
|
Inj., benralizumab, 1 mg
|
$10,772.97 |
$10,772.97 |
$10,772.97 |
$12,417.10
|
|
Inj cefazolin sodium, hikma
|
$24.93 |
$24.93 |
$24.93 |
$66.38
|
|
Inj ceftolozane tazobactam
|
$809.64 |
$809.64 |
$809.64 |
$248.93
|
|
Inj crotalidae im f(ab')2 eq
|
$3,003.00 |
$3,003.00 |
$3,003.00 |
$2,388.06
|
|
Inj cyclophosphamd (ingenus)
|
$1,317.15 |
$1,317.15 |
$1,317.15 |
$1.16
|
|
Inj. denosumab-bbdz, 1 mg
|
$5,742.57 |
$5,742.57 |
$5,742.57 |
$6,618.42
|
|
Injection anesthetic agent(s) and/or steroid genicular nerve branches w/guidance (both sides)
|
$24,195.07 |
$24,195.07 |
$24,195.07 |
$1,165.32
|
|
Injection during cath supravalvular aortography
|
$1,079.65 |
$1,079.65 |
$1,079.65 |
$1,604.20
|
|
Injection for bladder x-ray
|
$1,520.61 |
$1,520.61 |
$1,520.61 |
$585.00
|
|
Injection, inclisiran, 1 mg
|
$8,488.57 |
$8,488.57 |
$8,488.57 |
$12.72
|
|
Injection, renflexis
|
$1,354.49 |
$1,354.49 |
$1,354.49 |
$632.98
|
|
Injection(s) anesthetic agent(s) and/or steroid femoral nerve left
|
$27,627.47 |
$27,627.47 |
$27,627.47 |
$1,391.40
|
|
Injection(s) anesthetic agent(s) and/or steroid other peripheral nerve/branch (both sides)
|
$19,992.17 |
$19,992.17 |
$19,992.17 |
$1,017.28
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug
|
$135.85 |
$135.85 |
$135.85 |
$153.60
|
|
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push same substance/drug
|
$124.15 |
$124.15 |
$124.15 |
$150.00
|
|
Injection therapeutic/prophylactic/diagnostic IV push single/initial substance/drug
|
$182.65 |
$182.65 |
$182.65 |
$303.60
|
|
Injection therapeutic/prophylactic/diagnostic subcutaneous/im
|
$99.45 |
$99.45 |
$99.45 |
$130.19
|
|
Inject sacroiliac joint
|
$1,028.95 |
$1,028.95 |
$1,028.95 |
$1,028.95
|
|
Inj, fulvestrant (fresenius)
|
$1,795.30 |
$1,795.30 |
$1,795.30 |
$1,713.99
|
|
Inj heparin, pfizer, 1000u
|
$25.30 |
$25.30 |
$25.30 |
$18.49
|
|
Inj herzuma 10 mg
|
$5,467.01 |
$5,467.01 |
$5,467.01 |
$77.49
|
|
Inj hrt cath w/s&i nonsel p-art angrp
|
$2,738.45 |
$2,738.45 |
$2,738.45 |
$1,646.97
|
|
Inj hydroxocobalamin IV 25mg
|
$4,427.80 |
$4,427.80 |
$4,427.80 |
$1,593.19
|
|
Inj intralesional > 7 lsns
|
$156.65 |
$156.65 |
$156.65 |
$222.75
|
|
Inj ivig privigen 500 mg
|
$8,991.71 |
$8,991.71 |
$8,991.71 |
$6,144.00
|
|
Inj, kovaltry, 1 i.u
|
$17,130.75 |
$17,130.75 |
$17,130.75 |
$1.58
|
|
Inj, lanreotide, (cipla) 1mg
|
$15,903.43 |
$15,903.43 |
$15,903.43 |
$12,160.05
|
|
Inj lwr xtr fscl pln blk uni w/wo image
|
$31,664.74 |
$31,664.74 |
$31,664.74 |
$625.00
|
|
Inj mepivacaine hcl/10 ml
|
$59.57 |
$59.57 |
$59.57 |
$28.41
|
|
Inj mogamulizumab-kpkc, 1 mg
|
$8,727.30 |
$8,727.30 |
$8,727.30 |
$540.60
|
|
Inj, moxifloxacin 100 mg
|
$181.67 |
$181.67 |
$181.67 |
$100.44
|
|
Inj ogivri 10 mg
|
$4,700.08 |
$4,700.08 |
$4,700.08 |
$91.01
|
|
Inj ontruzant 10 mg
|
$2,375.63 |
$2,375.63 |
$2,375.63 |
$34.96
|
|
Inj, releuko 1 mcg
|
$1,074.84 |
$1,074.84 |
$1,074.84 |
$775.12
|
|
Inj retro urethrocysto
|
$2,503.05 |
$2,503.05 |
$2,503.05 |
$569.60
|
|
Inj, tofidence, 1 mg
|
$801.45 |
$801.45 |
$801.45 |
$1,167.32
|
|
Inj triamcinolone ace X-ray 1mg
|
$1,595.32 |
$1,595.32 |
$1,595.32 |
$18.21
|
|
Inj, tyenne, 1 mg
|
$707.93 |
$707.93 |
$707.93 |
$12.60
|
|
Inj, vegzelma, 10 mg
|
$4,851.21 |
$4,851.21 |
$4,851.21 |
$43.62
|
|
Inj w/fluor eval cv device
|
$598.65 |
$598.65 |
$598.65 |
$573.00
|
|
Ins cath ren art 1st bi
|
$22,802.43 |
$22,802.43 |
$22,802.43 |
$6,012.50
|
|
Ins cerv dilator (sep proc)
|
$1,248.65 |
$1,248.65 |
$1,248.65 |
$557.60
|
|
Insert intrauterine device iud
|
$15,121.47 |
$15,121.47 |
$15,121.47 |
$366.65
|
|
Insertion catheter bladder non indwelling
|
$108.55 |
$108.55 |
$108.55 |
$230.40
|
|
Insertion catheter bladder temporary simple
|
$17,044.86 |
$17,044.86 |
$17,044.86 |
$245.00
|
|
Insertion of new/replacement ppm w/transvenous electrode(s) atrial & ventricular
|
$22,197.16 |
$22,197.16 |
$22,197.16 |
$14,777.24
|
|
Insertion peripherally inserted central venous catheter (picc) without port/pump/img gud >= 5 years
|
$3,701.48 |
$3,701.48 |
$3,701.48 |
$2,079.43
|
|
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber
|
$15,939.95 |
$15,939.95 |
$15,939.95 |
$32,608.80
|
|
Insertion subcutaneous cardiac rhythm monitor
|
$12,971.19 |
$12,971.19 |
$12,971.19 |
$9,824.59
|
|
Insertion tunneled centrally inserted central venous access device with port >= 5 years old (both sides)
|
$9,995.64 |
$9,995.64 |
$9,995.64 |
$5,423.04
|
|
Insertion ureth cath
|
$10,564.08 |
$10,564.08 |
$10,564.08 |
$1,780.46
|
